Will Mental Illness be the Second Pandemic?

Saturday morning and it’s always nice to get a day off, and sit and read the papers with a good coffee. It’s less nice to see so many headlines proclaiming doom about the mental health of the nation.

And there have not been many positive reads recently in the media if you are interested in mental health. The title of this article comes from a comment piece from Alistair Campbell in The Independent claiming that mental illness will indeed be 'the second pandemic'. Earlier that week Bruce Adamson, the children and young people’s commissioner for Scotland said lockdown had been ‘catastrophic’ for children in Scotland, and that every child in Scotland would need additional mental health support as a result. This generation of teenagers have variously been described as 'lost' and defined by what has happened as the 'coronavirus generation'.

And it cannot be denied that the impact on mental health has been significant, with some early reports and plenty of anecdotal evidence recognising the increase in issues like anxiety, depression and associated problems like insomnia. 

The question is - are these predictions inevitable? And will it really be as bad as so many are darkly predicting? It is inevitable that this unique season will have taken a toll on many people. We lost, in a moment, not only the basic structure and routine to our lives, but so many of the things we know are vital to human wellbeing: contact with other people, the chance to be productive, freedom, control and choice and - for some - even access to the outside world. Even now as lockdown is eased, challenges continue, with the confusion over what exactly is safe or wise, or recommended to do and massive debate over what is coming next. The media seems to present two opposite futures: one where life will be back to normal by Christmas and another with second waves of virus, localised lockdowns and an NHS preparing for the worst: choose which future you prefer.… 

In the midst of this, an increase in challenging emotions is inevitable - but is this what we might call illness? Or is it an ordinary, expected, human reaction to extraordinary circumstances? When so many are experiencing the same distress or difficulty, what we need to to do is to recognise a shared experience we need to process, and help people to manage their inevitable need to react to what just happened. This is not the same as labelling it illness - there's a need to recognise some truths about what it means to be people. Human beings are not machines. We will react to extreme events with unusual and difficult emotions, and we will need help to manage them - from each other, and sometimes from experts and clinicians too. But if we treat all those normal, explicable reactions as something else, we risk adding guilt and fear to the emotional mix as we shape people’s understanding of what has just happened to them. WE all have emotional health - and it is to be expected in difficult times that we will all find ourselves needing to take care of our emotional wellbeing and focus on this more than normal. Emotional health is not the absence of negative emotions: it is managing and responding well to them when life’s difficult phases church them up; responding without being afraid of our emotional selves or feeling guilty for what we are feeling. 

In this season, it isn’t just ‘pure’ emotions we are managing. This unprecedented time also requires a lot of our minds as we work out what on earth just happened - and what that MEANS. We all carry in our minds basic rules and beliefs - about ourselves, how the world works, what we can rely on, etc - and many of those have been utterly obliterated by lockdown. Who would EVER have thought that schools could be closed for over a term?! In a world where your GCSEs can be canceled, what CAN you rely on? If you can suddenly be cut off from the friend and relatives you depend upon just because they do not live in your household, are any relationships secure? This requires real cognitive work from our minds - and for many people the emotions they are experiencing are a signal of their very real need to find time and space to process all they have been through. 

Processing all of these things requires a literal restructuring of your mind - never mind the implications on how you live your life. So here are three things we can focus on if we want to do that well - or help other people with if we’re supporting them:

SPACE

Most of all to figure out the meaning of what we have all been through and to get that elusive ‘closure’ as we move on, we need headspace to think about it, and time in our busy lives when other demands on our minds can turn down so we can concentrate on this.

Even now there are sufficient additional demands on us that this feels difficult if not impossible: constant changes to keep up with, adjustments to make, etc. What we need is a calmer spell: a time when things settle, where advice is consistent, and as much as possible life can tick over in something like a normal pattern. 

Many people also need distance - no not that kind! - distance from their situation, from the 4 walls they have been in for the last 3 months, literal distance to withdraw and ponder before returning. Whether that is frequent long walks, rides or getting out and about, or actual holiday time, the clarity offered by a clear boundary really helps this process, so its good to be creative and grab whatever chances you can get, whilst creating them for other people you are supporting - including kids and teens. 

STRUCTURE

Sometimes our minds benefit from actually having a clear structure or road map to help us to think things through. Especially when thoughts are so numerous that they can feel overwhelming, or for teens and young adults whose brains are still maturing, having a process and guided path to follow can really help. 

Structure could be many things: it could be time for prayer to change your perspective and ponder the bigger picture, mindfulness to intentionally reconnect with yourself (who on earth has ANY idea what they are actually feeling after the rollercoaster of the recent weeks and months?!) or a much more task-focused structure around specific questions you need to ponder (this resource from the team at Youthscape is designed for youth workers to help them do this - but actually a lot of the questions and structure would be helpful whatever your context - https://www.youthscape.co.uk/store/product/now-what).

SUPPORT

If there’s one thing this season has made us all realise it is the difference it makes having people around. We’ve all taken that for granted (even that sounds weird to say!) - being able to catch up with friends and family when we wanted to - but recent restrictions have made it so much harder.

In this season accessing that support may remain tricky for some - if you or friends or family are shielding or highly vulnerable - but it is getting easier. And for many people, the old social world is returning almost to its normal form. But do you need to take some action to reconnect with people who you lost contact with during lockdown? Are there some changes or challenges to friendships you need to admit to and make part of the list of things you need to ponder? Whether it is people who didn’t stay in touch with you, efforts people didn’t make - or friendships that struggled under the unusual strain of lockdown - we've all probably got some which need a bit of TLC. 

Support can be about conversation - which helps us to have the headspace to think about the things we need to. Think of that mental work as a bit like hitting a tennis ball around - its difficult to do that on your own. Chatting with someone else is a bit like someone hitting the ball back to you so you can hit it again - and conversation helps us to keep that mental ‘rally’ going. It doesn’t always need any particular direction - just bashing the ball back and forth a bit can help a lot. But sometimes we can benefit from someone with additional expertise - like a tennis coach who deliberately hits us the same shot again and again so we can practice different ways of returning it, or who looks at how we’re hitting the ball and can suggest tweaks and changes that will help us do it better. That is the role of many talking therapies - and these can be hugely helpful in times like these when so much needs to be reassessed. 

Of course, for some people, the changes and trauma of the last three months may be triggering extreme and powerful emotions - or reactions that were not able to be processed in the normal way, such as grief - without the normal rituals of funerals, etc. In this case, the support required might be clinical help - someone who understands these more complex areas and can help you to work through them. If you’re really struggling don’t be reticent to ask for help. We all have mental health just like we all have physical health - and times like these can push us into a place where we do need to see a clinician. In general, the sooner you get that support the better - so don’t delay if you think you or someone you are supporting might need it.

In this season sometimes the support we most need is reassurance. So often our difficulties with emotions are not the emotions themselves but our reaction to them: the fear, guilt or frustration they trigger in us as we see ourselves responding in ways we do not want to, the challenges to our self-concept as we see ourselves unable to manage or reacting with powerful emotions and the changes that strong emotions can trigger in relationship dynamics.

Go easy on yourself ... 

You may find yourself reacting in ways that surprise you right now: doing or saying things that are uncharacteristic for you, needing support in ways you have not before, or finding yourself at the end of your limits in a way you haven’t ever before. But this is an unprecedented time and it is one where we may encounter unprecedented reactions. Go easy on yourself, give yourself time, and don’t panic. Maybe the best way for us to respond to the emotional pressure of this time is the same we responded to the time itself: together. WIth good compassion, empathy, and genuine support for one another, we can weather this storm - and whatever the next season brings.