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Mental Wellness during COVID-19

        A “new normal” has been introduced into the lives of many during the COVID-19 pandemic. The majority of people have had their lives uprooted because of factors such as a loved one catching the virus, the loss of a job, and other forms of emotional and financial stress. In this chaotic time, it is easy to feel overworked and overwhelmed. However, it is very important that you set time aside to look after your mental wellbeing. This blog post will cover the immediate and long-term impacts of COVID-19 on people’s mental health, how you can protect your mental wellbeing while social distancing, and how families have been affected. It will also provide resources for COVID-19-related volunteer opportunities and mental health resources.


Immediate Impact on Mental Health


Some effects of COVID-19 on our mental health are ones that we will start to feel right away, or ones that we might have already gone through. One such effect is increased loneliness. Loneliness could be the biggest threat to survival and living a long life, and The World Health Organization (WHO) states that loneliness is a major health concern worldwide (Bzdok & Dunbar, 2020). This is because loneliness can easily spread across a social network in situations where people are asked to isolate and are unable to get the social support that they are accustomed to. Increased loneliness causes people to view the world in a more negative way. Social distancing and orders to stay at home could increase the number of those experiencing loneliness, especially in vulnerable groups (Luchetti et al., 2020). However, sufficient social support decreases one’s loneliness and makes it less likely that you will become sick, and a tight social network has been shown to help you recover faster if you fall ill or undergo surgery (Bzdok & Dunbar, 2020).


This pandemic has also caused exacerbated symptoms of mental health disorders. For example, people with contamination OCD are more vulnerable to the psychological outcomes of this COVID-19 pandemic since they might not get the psychiatric care they need due to their perception of increased contamination in healthcare places (French & Lyne, 2020). In past disease outbreaks, there were also a larger number of patients suffering from a relapse of OCD symptoms. Thus, Canadians today need to be focused on making sure that people with OCD have proper psychological support when they need it (French & Lyne, 2020). Additional support could be provided to OCD patients through telehealth, which will be discussed later.


Anxiety and depression are two mental health conditions that should be given extra consideration during this pandemic. According to Yao et al. (2020), people living with a mental health disorder have a greater chance of being influenced by emotional reactions caused by the COVID-19 pandemic, and this could cause relapses or worsening of a preexisting mental health disorder due to their high vulnerability to stress compared to the overall population. This emotional chain reaction is especially applicable to anxiety and depression given that they are both categorized as mood disorders. The fear caused by the pandemic raises the anxiety and stress levels of people with preexisting mental health conditions (Ornell et al., 2020). While there are no well-established universal psychological support practices for emergencies such as this pandemic, it is essential that psychological first aid is established worldwide. Mental health strategies for this pandemic should involve three things: a multifaceted mental health team with doctors from a variety of disciplines, clear communication with regular and reliable updates on the COVID-19 pandemic, and psychological counseling services with safe access (e.g., online) (Ornell et al., 2020). Treating anxiety and depression with a combination of these three factors should be beneficial to the individual involved.


Another area of concern is the growing number of people developing Pre-Loss Grief (PLG). This is a grief reaction that happens when someone is unable to process the possibility of losing a loved one (Singer et al., 2020). Put in a different way, PLG is the grief that occurs before a family member passes away, or when they are terminally ill and there is a high chance of them passing away. Mandatory isolation due to COVID-19 could decrease one’s social support, which also makes people more vulnerable to PLG. One way to decrease the severity of this condition is to help the family of COVID-19 patients become more prepared for the potential death of their loved one (Singer et al., 2020). Using telemedicine is a way to help family members be more prepared for a loss, which in turn lowers the risk of developing PLG. Additionally, psychologists working in a hospital can help patients and family members communicate with healthcare providers so that these professionals can correct anxiety-inducing misinformation and provide psychoeducation for the family (Singer et al., 2020).


The COVID-19 health crisis has also become a crisis for feminism. Women, girls, and gender-diverse people have been more greatly affected by the COVID-19 pandemic, due to being stuck in abusive relationships or living situations with limited opportunities to leave the house (Mukhtar, 2020). If someone is living with an abusive partner, two coping mechanisms they could use to help their situation are giving themselves unconditional positive regard and developing healthy boundaries with other people; these mechanisms will help the individual deal with the psychological effects of abuse until they are able to seek out help from a mental health professional (Mukhtar, 2020).


Long-Term Consequences on Mental Health


The social and economic impacts of this pandemic are likely to last for a very long time, which means that long-term impacts on people’s mental health are likely to occur (Prime et al., 2020). These long lasting impacts could take a toll on people’s mental health long after the pandemic starts to subside. For example, in past natural disasters and large chaotic events, a large concern was Post Traumatic Stress Disorder (PTSD) resulting from exposure to such trauma. Thus, an increased rate of people presenting with PTSD symptoms will most likely happen during and after the COVID-19 pandemic. Even if one is not diagnosable with PTSD, there is still a concern that depression and anxiety problems could arise (Pfefferbaum & North, 2020). People who are self-isolating or in quarantine are more likely to develop anxiety, depression, or a panic disorder (Aluh & Onu, 2020). The mental health concerns stemming from the COVID-19 pandemic could become long-term health complications and could also lead to extended isolation and stigma (Torales et al., 2020). In order to ameliorate the occurrences of depression and anxiety brought on by the pandemic, support for mental health should be given to individuals with a previous mental health condition for at least 6 months after discontinuing social isolation (Torales et al., 2020).


In a study done by Gao et al. (2020), participants were asked to rate their mood and level of social media use before and during the COVID-19 outbreak in Wuhan, China. The study observed that the prevalence of depression and anxiety rose significantly during the outbreak compared to before the outbreak occurred. Also, there was a positive correlation between this high prevalence of mental health issues and the frequent use of social media (Gao et al., 2020). Social media is one of the main ways that people are obtaining news about COVID-19, however, incorrect information and untruthful reports are spread across social media, which has been increasing people’s fear about the pandemic. This false information also causes confusion and can endanger people’s mental health (Gao et al., 2020).


The COVID-19 pandemic will undoubtedly increase peoples’ emotional distress as well as their risk for mental illness (Pfefferbaum & North, 2020). However, not everyone will have a severe long-term emotional reaction to the stressors of COVID-19; the appropriate response to stressors can be normalized by dispensing correct information about healthy stress reactions and managing stress even in extreme situations.


How to Protect your Mental Wellbeing During Isolation/Social Distancing


It is challenging to offer mental health support while individuals are in isolation (Zhou et al., 2020). Some people might feel uncomfortable going into a medical setting to seek help because of a perceived increased risk of exposure to the virus. One way that people can access mental health services from the safety of their own home is telehealth. In the past, telehealth has been shown to help with depression, anxiety, and PTSD (Zhou et al., 2020). The following platforms have been an effective way of delivering telehealth services for mental health needs: video calling, online forums, phone apps, texting, and e-mailing.


During this time, it is more common for an individual to experience negative emotions. As the amount of negative emotions that one experiences increases, one’s anxiety will also increase, which can lead to feeling more negative emotions (Mukhtar, 2020). One’s feeling of helplessness can also increase. This progression may make someone want to attend therapy for their mental health, which is a perfectly normal reaction. When seeking therapy services for your mental health concerns, it is important to find a therapist who is empathetic towards you and who is committed to your wellbeing (Mukhtar, 2020). Your therapy needs to be tailored to meet your unique needs and goals because therapy is about accepting a person as they are. In order for counseling to be the most beneficial and for psychological growth and self-actualization to occur, you need to have meaningful, close interactions with other people (Mukhtar, 2020). 


A study conducted by Colgan et al. (2020) attempted to use a Mindfulness-Based Wellness and Resilience (MBWR) intervention to address burnout in those working in healthcare. Participants in this study reported high satisfaction for the intervention, and believed it would be acceptable in a workplace setting. Thus, the MBWR intervention could be a good way to benefit the individual healthcare worker, increase collaboration in a healthcare team, and strengthen patient care (Colgan et al., 2020). It could also increase the resilience of healthcare workers, which would be very beneficial during the COVID-19 pandemic.


Once more people feel comfortable visiting healthcare providers in person for mental health support, there are some steps that should be taken to ensure mental health support is easily accessible. First of all, mental health care should be integrated into primary health care facilities to make mental health services more accessible and to reduce the stigma associated with reaching out for help for a mental health problem (Aluh & Onu, 2020). Second of all, more primary care providers could be trained to integrate and administer psychological counseling into their established practice.


The World Health Organization (WHO) has given ways that an individual can look after the mental health of themselves and others (2020). They are outlined in the list below.


  1. Be empathetic towards all those who have been impacted by COVID-19.

  2. Limit how often you watch, read, or listen to news about COVID-19 that may increase your anxiety or distress levels. 

  3. Try to only get information from trusted sources, and do not digest too much information at once as this is likely to make you feel more worried.

  4. Work together with those in your community, as this will help create an environment of solidarity in addressing COVID-19 together.


The following links are resources for telehealth, telemental health, and online support for your overall well being:


Impact on Families


The closure of schools and workplaces combined with stay-at-home orders means that children and their parents are spending much more time at home together than before. This impacts the way the family interacts with one another. Prime et al. (2020) published an article outlining the ways in which the wellbeing of children and families could be at risk during the COVID-19 pandemic. First of all, school closures could negatively impact the mental health of children. Secondly, one-third of families have said they feel increasingly anxious about family stress caused by stay-at-home orders enacted because of COVID-19 (Prime et al., 2020). Ineffective coping strategies during this time could lead to more posttraumatic stress symptoms in family members. According to Family Systems Theory, stressors that impact how one family member functions could cause changes in the functioning of the other family members. 


There are ways that families can fight the strain of the COVID-19 pandemic and be there for each other. Strong family leadership is essential for keeping the family structure intact in this time of uncertainty (Prime et al., 2020). Positive family relationships are also very important for ameliorating child and adolescent depression and PTSD symptoms. The resilience of family members can be upheld through shared family beliefs and close relationships (Prime et al., 2020).


Places to Volunteer for COVID-19 Relief

You may be asking yourself what you can do to help those affected by COVID-19. Luckily, there are resources you can turn to for supporting those that need help in your community. Alberta Health Services (2020) has given the following information for volunteers and relaunching volunteer programs to help keep everyone safe and healthy: people are only allowed to volunteer if they have not travelled outside of Canada in the past 14 days, if they have not had contact with a suspected or confirmed case of COVID-19, if they have not had laboratory exposure to material containing COVID-19, and if they are not currently experiencing any of the COVID-19 symptoms. Volunteers must also attend a province-wide mandatory COVID-19 orientation before beginning or resuming volunteer activities (Alberta Health Services, 2020). Interviews and orientation for volunteers will be online to reduce on-site presence. Additionally, the Volunteer Resources Department will be responsible for informing volunteers of the safety and health risks associated with COVID-19. Below is a list of volunteering resources and a brief description of them.

Volunteering Resources:


Conclusion


In summary, taking the time to care for your mental health is essential both during the COVID-19 pandemic and after. There will be short-term and long-term consequences of the stress caused by this novel virus and the social distancing/stay-at-home order rules in place. Additionally, people with preexisting mental health conditions such as OCD, depression, and anxiety need to take extra precautions to care for their mental health. There are many reasons why you should protect your mental wellbeing, especially during this novel time, and fortunately there are many ways that you can do so. Furthermore, the stress caused by the COVID-19 pandemic will undoubtedly have an impact on family structure and functioning. If you feel inclined to help others in need, there are precautions you should take before volunteering. In addition to using this as a resource for mental health during COVID-19, the links and articles used in this blog post can be sources of additional support. 



















References


Aluh, D. O., & Onu, J. U. (2020). The need for psychosocial support amid COVID-19 crises in Nigeria. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. http://dx.doi.org/10.1037/tra0000704


Alberta Health Services. (2020, June 18). Information for Volunteers. https://www.albertahealthservices.ca/topics/Page17004.aspx


Bzdok, D., & Dunbar, R. (2020). The Neurobiology of Social Distance. Trends in cognitive sciences, S1364-6613(20)30140-6. Advance online publication. https://doi.org/10.1016/j.tics.2020.05.016


Colgan, D. D., Christopher, M., Bowen, S., Brems, C., Hunsinger, M., Tucker, B., & Dapolonia, E. (2019). Mindfulness-based Wellness and Resilience intervention among interdisciplinary primary care teams: a mixed-methods feasibility and acceptability trial. Primary Health Care Research & Development, 20, E91.  doi:10.1017/S1463423619000173


Department of Communications, & WHO Global. (2020). Mental health and psychosocial considerations during the COVID-19 outbreak. World Health Organization. Advance online publication. https://www.who.int/publications/i/item/WHO -2019-nCoV-MentalHealth-2020.1


Digital Health Canada. (2020, March 18). Webinar Wednesday: Virtual Care Strategies across Canada in Response to COVID-19. https://digitalhealthcanada.com/past-webinars/ webinar-wednesday-virtual-care-strategies-for-primary-care-across-canada-in- response-to-covid-19/


French, I., & Lyne, J. Acute exacerbation of OCD symptoms precipitated by media reports of COVID-19. Irish journal of psychological medicine, 1-4. Advance online publication. https://doi.org/10.1017/ipm.2020.61


Gao J., Zheng P., Jia Y., Chen H., Mao Y., & Chen S. (2020). Mental health problems and social media exposure during COVID-19 outbreak. PLoS ONE, 15(4). https://doi.org/10.1371/journal.pone.0231924


Government of Canada. (2020). I Want to Help. https://www.jobbank.gc.ca/volunteer


Luchetti, M., Lee, J. H., Aschwanden, D., Sesker, A., Strickhouser, J. E., Terracciano, A., & Sutin, A. R. (2020). The trajectory of loneliness in response to COVID-19. American Psychologist. Advance online publication. http://dx.doi.org/10.1037/amp0000690


Mental Health Commission of Canada. (2020). Resource hub: Mental health and wellness during the COVID-19 pandemic. https://www.mentalhealthcommission.ca/English/covid19


Mukhtar, S. (2020). Feminism and gendered impact of COVID-19: Perspective of a counselling psychologist. Gender Work Organ, 2020; 1-6.   https://doi-org.ezproxy.lib.ucalgary.ca/10.1111/gwao.12482


Ornell, F., Schuch, J. B., Sordi, A. O., & Paim Kessler, F. H. (2020). “Pandemic fear” and COVID-19: mental health burden and strategies. Brazilian Journal of Psychiatry, 42(3). http://dx.doi.org/10.1590/1516-4446-2020-0008


Pfefferbaum, B. & North, C. S. (2020). Mental Health and the Covid-19 Pandemic. The New England Journal of Medicine. Advance online publication. https://www.nejm.org/doi/full/10.1056/NEJMp2008017


Prime, H., Wade, M., & Browne, D. T. (2020). Risk and resilience in family well-being during the COVID-19 pandemic. American psychologist. Advance online publication. http://dx.doi.org/10.1037/amp0000660


Singer, J., Spiegel, J. A., & Papa, A. (2020). Preloss grief in family members of COVID-19 patients: Recommendations for clinicians and researchers. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. http://dx.doi.org/10.1037/tra0000876


Tejada, J. (2020). 9 Telehealth Services Available to Canadians During the Pandemic. Reader’s Digest Magazines. https://www.besthealthmag.ca/best-you/covid-19/telehealth-services/


Torales, J., O’Higgins, M., Castaldelli-Maia, J. M. & Ventriglio, A. (2020). The outbreak of COVID-19 coronavirus and its impact on global mental health. International Journal of Social Psychiatry, 66(4), 317-320. https://doi.org/10.1177/0020764020915212


Wellness Together Canada. (n.d.). Mental Health and Substance Use Support. https://ca.portal.gs/


Yao, H., Chen, J.H., & Xu, Y. F. (2020). Patients with mental health disorders in the COVID-19 epidemic. The Lancet Psychiatry, 7(4), e21. https://doi.org/10.1016/S2215-0366(20)30090-0


Zhou, X., Snoswell, C. L., Harding, L. E., Bambling, M., Edirippulige, S., Bai, X., & Smith, A. C. (2020). The Role of Telehealth in Reducing the Mental Health Burden from COVID-19. Telemedicine and e-Health, 26(4), 377-379. http://doi.org/10.1089/tmj.2020.0068
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