Dan O'Heirity

The Mental Health Dimension of Covid-19

I will have written 79 posts on Covid-19 by the end of today and yet I have not once mentioned the impact of the pandemic on people’s mental health. The oddity of this omission lies in the fact that I have two somewhat challenging mental health conditions. First, I am I am bipolar and, secondly, I have some sort of dissociative relation to my emotions which is likely best characterized as alexithymia. So far, at least as far as I can see, Covid-19 has not impacted negatively on my mental health. The reason for this fact, if indeed it is one, is that I led a reclusive, self-managed life before the pandemic and so lockdown measures have not impacted me in any real way. However, the same is not true for others. The Centre for Disease Control and Prevention website has comprehensive information on the extent of mental health challenges people are facing under Covid-19. Academic research is pointing to the causes of increased rates of depression, anxiety and stress during Covid-19.

There is no doubt that people have become depressed and that domestic violence has increased under Covid-19. A story from ABC News puts a human face on Covid-19 mental health challenges through weaving personal accounts of mental health issues with facts and figures for the demands placed on mental health services. For example, in March 2020 “Lifeline” received 25 per cent more than the same time last year and half of the callers wanted to discuss coronavirus. The mental health service “Beyond Blue” has seen a 30 per cent increase in calls since before the pandemic started. In terms of reasons for the surge in demand for mental health services, Dr Patrick Clarke, of Curtin University’s School of Psychology says that, “There’s high levels of uncertainty about what the future holds, there’s low levels of perceived ability to control the situation and there’s an elevated risk of physical health to people and their loved ones.”

Conditions For Remaining Mentally Well

Following on from analysing the factors contributing to mental health conditions, Dr Clarke provides some advice on how to keep well. He points to the importance of regular exercise, having regular contact with people, finding things that one enjoys, sleeping well, and eating well. These are all eminently sensible suggestions for staying well and they can be thought of, to some degree at least, in terms of Maslow’s hierarchy of human needs. Maslow’s hierarchy posits that humans are intrinsically motivated to meet different levels of need. At the “lower levels” of the hierarchy we have basic physiological needs such as having food, water, shelter and feeling secure through being employed. Next comes psychological needs such as having a sense of belonging, feeling loved and experiencing a sense of self worth. At the “top level” humans are motivated to achieve self-actualization.

Dr Clarke’s advice on staying well during Covid-19 will help to promote well-being by focussing us on meeting our basic needs such as eating well and having a regular sleep pattern. Here we might refer to maintaining a homeostasis or a stable physical state. The recommendations will also help to ensure that we meet our psychological needs for a sense of belonging and for experiencing a sense of self worth. His advice may even help us in actualizing ourselves. However, under Covid-19, the fact of “loss” at one level of hierarchy is impacting on other levels of the hierarchy. For example, if people are faced with a lack of security through becoming unemployed, then this will very likely impact negatively on being fulfilled in other areas of their lives such as having a sense of belonging, feeling loved, and having a sense of self-esteem.

Let’s take Dr Clarke’s points about causes of mental health problems one by one to see how these losses might be managed. First, there is uncertainty about what the future holds. Well, make a plan premised on the simple and fail safe principle of, “hope for the best and plan for the worst”. Secondly, people are experiencing low levels of “perceived control”. The word “perceived” is key here. Basically, identify every area in your life where you do have control and then work outwards until you hit the areas where you have no control. Stop at that point and work on the things that you can control. Finally, there is the elevated risk to the physical health of people and their of loved ones. Well, looking at matters objectively it would be fair to say that there has never been a pandemic in Australia. Furthermore, those most at risk from Covid-19 are the elderly, not the general populace. The rest of us should just focus on staying physically well.

What Place for Reason in Coping With Mental Health Challenges?

I would say that there are strategies people can use to stay mentally well and these same strategies can help, to some degree, when people are experiencing mental health challenges. In this context, I would venture that rationality has a significant part to play in staying well and in addressing mental health challenges should they arise. I mean by this that distancing oneself from irrational thoughts and from unhelpful emotions will likely be incredibly helpful in managing mental health under Covid-19 conditions. Here is an example of why this might be the case. Irrational thoughts cause anxiety and anxiety perpetuates irrational thoughts. Thus, there is a vicious cycle of irrational thinking which leads to anxiety which in turn leads to irrational thinking. One way to break this cycle is to apply reason to one’s thoughts to see that they are irrational.

So far I’ve been thinking in terms of mental health issues such as depression and anxiety and I’ve made the general point that engaging in reasoning processes can go some way to managing these conditions. However, to leave matters there would be to trivialize the struggles that people have with severe mental health conditions such as schizophrenia. In these cases, “reasoning” is not going to win the day because there are underlying physiological conditions that impact on a person’s ability to make the sorts of decisions that are “in their best interests”. For example, the brain of a schizophrenic person may not function in the same way as the brain of a healthy person. The same holds true for a substance abuser taking, for example, cocaine. In cases such as these a therapeutic technique known as Cognitive Remediation Therapy might be used.

A Personal Reflection On Staying Well During Covid-19

I am of course aware that my line of argumentation has, to some degree at least, been an articulation of the way in which I manage my own mental health conditions. However, this does not mean that the my perspective is necessarily idiosyncratic. I have seen dozens of health professionals – GPs, therapists, psychologists and psychiatrists – over the years and I have read dozens, if not hundreds, of books on managing my mental health. Thus, I would say that I am fairly well informed on the topic of dealing with a mental health condition. You may agree or disagree with me in this respect but at time when the Australian Government has allocated $74 million to mental health services, one can only hope that the help provided extends beyond telling people to look after themselves through a self-care regimen.

The final point I would make is that here I stand, a fact that should be counted as worthy of note considering that I was not diagnosed with bipolar until I was well into my thirties. It then took over three years for a variety of health professionals to find a drug combination that would manage my symptoms without dulling my mind to an unacceptable degree. The point I am making here is that I spent an awful lot of bipolar years managing myself with only the resources that I had available to me, my mind and my will, both of which served me well and both of which continue to serve me well. Of course, there are some who would argue that I am missing out on life, that I am nothing more than a simulacrum, an empty shell if you will. Perhaps, but I am at peace, satisfied and sated by my inner life.

First Published June 1st, 2020

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