Increased irritability with people around you. Fear of stepping outside. A fragmented, disrupted sleep pattern punctuated by particularly vivid and unusual dreams.
All of these are early signs that isolation may be getting under your skin, says Dr Michael Musker, a senior research fellow in mental health and wellbeing at the South Australian Health and Medical Research Institute. For many, this period will bring heightened incidents of anxiety. Others might see their mental health deteriorate, and become diagnosed with clinical depression.
Musker says this anxiety will manifest itself differently for different people.
“People become a little agitated. In the shops, some people are looking at each other with fear, almost like a competitor.”
All of that unease is exacerbated by the sense of uncertainty that comes when people’s routines are upended by the realities of working from home and the loss of social contact.
“People’s days are going to be completely thrown out. You’re going to sleep in, you’re going to stay up later,” Musker says.
“And that also affects your mood. People’s sleep pattern will change, they’ll become irritable. We’re not going to eat well. For some people the first thing for comfort is to overeat.
“Some people will maybe burst into tears, some may even become more quiet. Others will stay home and drink, and possibly drink themselves into oblivion.”
A catch-22
The current pandemic poses another unique problem. Poor sleep, irritability and anxiety are, in some ways, the natural impact of a once-in-a generation crisis. But at what point do those responses cross the line into clinical depression?
Pat McGorry, executive director of youth mental health organisation Orygen, and one of Australia’s leading experts in the field, warns that we should be careful not to “over-pathologise” the whole population.
“The interesting thing about this disaster is that it’s affecting the whole population — no one’s immune,” McGorry says.
“When you have a major stressor or trauma, it is a risk factor. All disasters increase the percentage of people who need treatment. But most reactions aren’t pathological, and don’t cause them to become ill.”
McGorry says that while inability to sleep, increased irritability, and bouts of anger may be normal in this climate, they could be signs someone is developing depression, if they continue and get deeper.
A bigger, badder health crisis
Over the past week and a half, Australia’s epidemic curve has been trending down from its peak in March. Across the Easter weekend, there were less than 50 new cases recorded each day nationwide. But McGorry warns that mental ill-health could become the other major peak.
“The government is so preoccupied with the main game at the moment that they might not get in a position to deal with it in time.”
Like the virus, the mental health impact will be felt hardest among particular groups of people. Those with pre-existing mental health issues, around 20% of the Australian population, could see their conditions worsen.
That might mean more hypomanic episodes for people with bipolar disorder, or a relapse for people rebounding from depression.
According to McGorry, young people, already more vulnerable to mental health issues and now forced to sacrifice economic security and a social life to protect their elders from the virus, will be particularly at risk. So too will older Australians, already living more isolated lives, now robbed of crucial contact with their children and grandchildren. People living in rural and regional areas, with far less access to mental health services, are also at great risk.
The long term impacts
What might this all mean in the long term? Long before we went into lockdown, governments and health experts were talking about a loneliness crisis. Loneliness can shorten life spans, and increase vulnerability to physical and mental illness — one study found it has the same impact on heart disease as smoking 15 cigarettes a day. This period of indefinite social isolation could expose more Australians to the health effects of loneliness.
And all this will likely be exacerbated by a prolonged period of economic uncertainty. During the Great Depression, the suicide rate rose along with unemployment. More extreme health conditions like schizophrenia worsened. As the economy sputters, even with government assistance, there could be a snowball effect on people’s mental health.
And for many, habits will be forever changed. Like our ancestors who lived through the Depression and World Wars, some of us might never stop stockpiling, even in times of abundance. Musker suggests germophobia might be cemented into our psyche for the rest of our lives. This weekend Anthony Fauci, one of the doctors leading America’s response to the pandemic, suggested we might never shake hands again.
Most Australians won’t get COVID-19. But we could still emerge from the crisis an altogether sicker nation.
Prof McGorry’s point about not pathologising a normal response to abnormal conditions seems important. There is good evidence, for example, that rushing to provide individual counselling and therapy during crises can cause more harm than good. However, I’d have thought the unequal impact of the crisis would be far more socio-economic than aged-based i.e. more likely to fall on those in deprived neighbourhoods, insecure jobs and/or low-income jobs, insecure housing, single-parent households, and abusive relationships–regardless of age. If true, the best responses would be social and economic: aiming to mitigate uncertainties around employment/education, create safety nets for income lost, and harness community resources to support those already experiencing social deprivation, poor mental health, isolation and loneliness.
As a person in one of these associated professions I am seeing this problem manifesting already. I feel we must
strongly move towards opening our shut downs
THE BEST FORM OF CENSORSHIP IS SELF CENSORSHIP. To enact a LOCK DOWN, or Marshal law remains the social nightmare of a Police State, reminiscent of Kafka’s ‘The Trial’ where ‘your crimes are carved into the middle your back’. To enact a “Medical Marshal Law” of self quarantine clamours for the communities responsible self preservation as they see it. The MSM wall paper of FEAR masks the beneficent Government’s Police State Mandate from the invisible enemy, encouraging your responsible STAY AT HOME choice. “We are All In This together” – and Disney gets a royalty every time the TV sings the ditty.
Medical Marshal Law has created Public adherence, and the ‘DOB in the breacher’ is the publics enforcement of a police states commitment to Self Imprisonment. What is this public self supportive acceptance of Marshal law? Enough people will get used to it, but will you protest against this once it is all over? The militarisation of the streets is already in place. Do not normalise this quarantine emergency because it will become the “New Normal” which has already brain washed your Sub Conscious along with the Disney tune.
Yes, there is a lot of truth there. In the early days, the police were restrained and civil. Having established our subservience to power, they are wielding it with increasing arrogance.
Who is Marshal – Matt Dillon? Or did you mean martial?
I did. Thank you. Spelling etc for me is always a discovery, and spell check sure doesn’t make it easier. If that’s all you have to say about the ideas, did you miss something?
“Do not normalise this quarantine emergency”
Fair points veeski, but this police state is only a slight variation on the economic police state we were all already living under.
“You have complete freedom, provided you devote most of your waking hours to work, doing marginally useful and often outright stupid things because the boss told you to, you must follow social norms and work until you drop or are no longer physically able, then we’ll put you in a nursing home where freedom is seriously curtailed.”
You’re afraid we’ll accept this as the new normal. In fact we already did, long ago.
Too true!
Self Censorship is this very comatose behaviour the Fruity-Gooogle Meme, “Don’t be Evil Just Obey” recommends. Safely entrained with our own ‘Personal Propaganda Device,’ a self imposed pacification allows the Police State to supervise your obedience. Are we headed this way? Governments fear public dissent, and brain wash the public with some patriotic compliance rewards.
Poor spelling, fractured syntax and RaNdOm caps. are the digital equivalent of green ink.
I believe that many shops now sell a heavier grade of tinfoil – surely an essential product?
Feel better now do we?
What would a psychopathic bully care for our mental health?
Health care that truly effectively cares for the ill is not likely to come from those who ignore, deny, or refuse to validate, the cause of health problems.
Some 14.6% don’t believe depression is a mental illness at all, 21.6% would not hire someone who had been depressed, and 24.7% think a person with depression could “snap out of it” if they wanted to. Yet addictions are now known to be a compound result of genetic predisposition and high levels of stress, anxiety and depression. Which is why addictions typically last an average of 27 years. Nevertheless, where 45% of us prefer to believe “weakness of character” to be the cause of social anxiety.
Yet the absurdity and hypocrisy of such views will be indicated by the sympathy those same believers will show towards James Packer. “The Australian”, in its Morning Hates normally a promoter of aggressive workplace rules against the “sickie” and the “fake sick note”, thus took care to couch its front-page story “Inside the private pain haunting Packer” in sympathetic terms. Thus “James Packer chose to make the gutsiest call of his life at one of the places he feels safest, his polo ranch in Argentina”.
Not an option for most of us. In Australia in 2014, 87% of young men with mental illness received no care. “The Australian” doesn’t. Nor morrison. Not then, not now.
All fair comment and justified concern but it’s family violence that worries me most.
There’s also the possibility that this restricted time might be good for some people’s health. No airport noise and less road traffic will be great for many. Others will like not having to make excuses for their preference to stay at home. Then there’s those people you don’t have to put up with and places you don’t have to go to for now. A good walk each day for a change, more home cooking, saying hi to the locals albeit at a distance for the first time in ages.
Is it possible these sorts of things could help some mental illnesses ?