The pandemic has erased entire categories of friendship

 There’s a reason you miss the people you didn’t even know that well.

A few months ago, when millions of Americans were watching the Netflix series Emily in Paris because it was what we had been given that week, I cued up the first episode and was beset almost immediately by an intense longing. Not for travel, or for opportunities to wear beautiful clothes—two commonly cited high points in an otherwise charmless show—but for sports. Specifically, watching sports in a packed bar, which is what the titular character’s boyfriend is doing when the viewer meets him.

The scene is fleeting, and it’s also pretty bad. It doesn’t come close to capturing the sweaty intensity of a horde of nervous fans, poised to embrace each other in collective joy or drink through despair. I know this because I am, sometimes unfortunately, a person who has spent a good chunk of her adult social life watching sports in bars, both with my actual close friends and with 500 or so fellow travelers at the New York City bar that hosts expatriated University of Georgia alumni during college-football season.

During the pandemic, I’ve been able to maintain, on an outdoor TV, the ability to watch a game with a couple of my closest buddies, which is a balm. But the other experience—the one Emily in Paris was trying to portray—has been lost entirely. In noticing all the ways the show misunderstood its joys, I realized how much I missed it, and especially how much I missed all of those people I only sort of know. Of the dozens of fellow fans and bar employees I’d greet with a hug on a normal fall Saturday, I follow only a handful of them on social media; for most of the others, I know only their first name, if that. But many comforted me through mutual, bone-deep disappointment, or sprayed champagne at me in exhilaration.

In the weeks following, I thought frequently of other people I had missed without fully realizing it. Pretty good friends with whom I had mostly done things that were no longer possible, such as trying new restaurants together. Co-workers I didn’t know well but chatted with in the communal kitchen. Workers at the local coffee or sandwich shops who could no longer dawdle to chat. The depth and intensity of these relationships varied greatly, but these people were all, in some capacity, my friends, and there was also no substitute for them during the pandemic. Tools like Zoom and FaceTime, useful for maintaining closer relationships, couldn’t re-create the ease of social serendipity, or bring back the activities that bound us together.

Understandably, much of the energy directed toward the problems of pandemic social life has been spent on keeping people tied to their families and closest friends. These other relationships have withered largely unremarked on after the places that hosted them closed. The pandemic has evaporated entire categories of friendship, and by doing so, depleted the joys that make up a human life—and buoy human health. But that does present an opportunity. In the coming months, as we begin to add people back into our lives, we’ll now know what it’s like to be without them.

American culture does not have many words to describe different levels or types of friendship, but for our purposes, sociology does provide a useful concept: weak ties. The term was coined in 1973 by the Stanford sociologist Mark Granovetter, and it comprises acquaintances, people you see infrequently, and near strangers with whom you share some familiarity. They’re the people on the periphery of your life—the guy who’s always at the gym at the same time as you, the barista who starts making your usual order while you’re still at the back of the line, the co-worker from another department with whom you make small talk on the elevator. They’re also people you might have never directly met, but you share something important in common—you go to the same concerts, or live in the same neighborhood and frequent the same local businesses. You might not consider all of your weak ties friends, at least in the common use of the word, but they’re often people with whom you’re friendly. Most people are familiar with the idea of an inner circle; Granovetter posited that we also have an outer circle, vital to our social health in its own ways.

During the past year, it’s often felt like the pandemic has come for all but the closest of my close ties. There are people on the outer periphery of my life for whom the concept of “keeping up” makes little sense, but there are also lots of friends and acquaintances—people I could theoretically hang out with outdoors or see on videochat, but with whom those tools just don’t feel right. In my life, this perception seems to be largely mutual—I am not turning down invites from these folks for Zoom catch-ups and walks in the park. Instead, our affection for each other is in a period of suspended animation, alongside indoor dining and international travel. Sometimes we respond to each other’s Instagram Stories.

None of the experts I spoke with had a good term for this kind of middle ground—the weaker points of Granovetter’s proposed inner circle and the strongest of the weak ties—except for the general one. “Friend is a very promiscuous word,” William Rawlins, a communications professor at Ohio University who studies friendship, told me. “Do we have a word for this array of friends that aren’t our close friends? I’m not sure we do, and I’m not sure we should.”

The extent to which individuals are separated from their moderate and weak ties during the pandemic varies by their location, employment, and willingness to put themselves and others at risk. 

But even in places where it’s possible to work out in gyms and eat inside restaurants, far fewer people are taking part in these activities, changing the social experience for both patrons and employees. And even if your job requires you to come in to work, you and your colleagues are likely adhering to some kind of protocol intended to reduce interaction. Masks, though necessary, mean you can’t tell when people smile at you.

Friends are sometimes delineated by the ways we met or the things we do together—work friends, old college buddies, beer-league-softball teammates—but they’re all friends, and Rawlins thinks that’s for the best. “Living well isn’t some cloistered retreat with just a few folks,” he told me. “The way worlds are created is by people sharing with and recognizing each other.” Many different kinds of relationships are important, he says, and man does not thrive on close friendships alone.

This realization, new to me, is also somewhat new in the general understanding of human behavior. Close relationships were long thought to be the essential component of humans’ social well-being, but Granovetter’s research led him to a conclusion that was at the time groundbreaking and is still, to many people, counterintuitive: Casual friends and acquaintances can be as important to well-being as family, romantic partners, and your closest friends. In his initial study, for example, he found that the majority of people who got new jobs through social connections did so through people on the periphery of their lives, not close relations.

Some of the most obvious consequences of our extended social pause could indeed play out in the professional realm. I started hearing these concerns months ago, while writing a story on how working from home affects people’s careers. According to the experts I spoke with, losing the incidental, repeated social interactions that physical workplaces foster can make it especially difficult for young people and new hires to establish themselves within the complex social hierarchy of a workplace. Losing them can make it harder to progress in work as a whole, access development opportunities, and be recognized for your contributions. (After all, no one can see you or what you’re doing.) These kinds of setbacks early in professional life can be especially devastating, because the losses tend to compound—fall behind right out of the gate, and you’re more likely to stay there.

The loss of these interactions can make the day-to-day realities of work more frustrating, too, and can fray previously pleasant relationships. In a recent study, Andrew Guydish, a doctoral candidate in psychology at UC Santa Cruz, looked at the effects of what he calls conversational reciprocity—how much each participant in a conversation talks while one is directing the other to complete a task. He found that in these situations—which often crop up between managers and employees at work—pairs of people tended to use unstructured time, if it were available, to balance the interaction. When that happened, both people reported feeling happier and more satisfied afterward.

Now Guydish worries that reciprocity has been largely lost. “Zoom calls usually have a very defined goal, and with that goal comes defined expectations in terms of who’s going to talk,” he told me. “Other people sit by, and they don’t get their opportunity to give their two cents. That kind of just leaves everybody with this overwhelming sense of almost isolation, in a way.”

This loss of reciprocity has extended to nondigital life. For example, friendly chats between customers and delivery guys, bartenders, or other service workers are rarer in a world of contactless delivery and curbside pickup. In normal times, those brief encounters tend to be good for tips and Yelp reviews, and they give otherwise rote interactions a more pleasant, human texture for both parties. Strip out the humanity, and there’s nothing but the transaction left.

The psychological effects of losing all but our closest ties can be profound. Peripheral connections tether us to the world at large; without them, people sink into the compounding sameness of closed networks. Regular interaction with people outside our inner circle “just makes us feel more like part of a community, or part of something bigger,” Gillian Sandstrom, a social psychologist at the University of Essex, told me. People on the peripheries of our lives introduce us to new ideas, new information, new opportunities, and other new people. If variety is the spice of life, these relationships are the conduit for it.

The loss of these interactions may be one reason for the growth in internet conspiracy theories in the past year, and especially for the surge in groups like QAnon. But while online communities of all kinds can deliver some of the psychological benefits of meeting new people and making friends in the real world, the echo chamber of conspiracism is a further source of isolation. “There’s a lot of research showing that when you talk only to people who are like you, it actually makes your opinions shift even further away from other groups,” Sandstrom explained. “That’s how cults work. That’s how terrorist groups work.”

Most Americans were especially ill-prepared for the sudden loss of their weak ties. The importance of friendship overall, and especially friendships of weak or moderate strength, is generally downplayed in the country’s culture, while family and romantic partners are supposed to be the be-all and end-all.

The physical ramifications of isolation are also well documented. Julianne Holt-Lunstad, a psychologist and neuroscientist at Brigham Young University, has found that social isolation increases the risk of premature death from any cause by almost 30 percent. “The scientific evidence suggests that we need a variety of kinds of relationships in our lives, and that different kinds of relationships or social roles can fulfill different kinds of needs,” she told me. People maintain hygiene, take their medication, and try to hold themselves together at least in part because those behaviors are socially necessary, and their repetition is rewarded. Remove those incentives, and some people fall into despair, unable to perform some of the crucial tasks of being alive. In people at risk for illness, lack of interaction can mean that symptoms go unnoticed and arrangements for medical care aren’t made. Humans are meant to be with one another, and when we aren’t, the decay shows in our bodies.

The small joys of running into an old co-worker or chatting with the bartender at your local bar might not be the first thing you think of when imagining the value of friendship—images of more intentional celebrations and comforts, such as birthday parties and movie nights, might come to mind more easily. But Rawlins says that both kinds of interactions meet our fundamental desire to be known and perceived, to have our own humanity reflected back at us. “A culture is only human to the extent that its members confirm each other,” he said, paraphrasing the philosopher Martin Buber. “The people that we see in any number of everyday activities that we say, Hey, how you doing? That’s an affirmation of each other, and this is a comprehensive part of our world that I think has been stopped, to a great extent, in its tracks.”

Rawlins describes the state of American social life as a barometer for all that is going on in the country. “Our capacity for—and the possibilities of—friendship are really a kind of measure of the actual freedom we have in our lives at any moment in time,” he told me. Friendship, he says, is all about choice and mutual agreement, and the broad ability to pursue and navigate those relationships as you see fit is an indicator of your ability to self-determine overall. Widespread loneliness and social isolation, on the other hand, are usually indicative of some kind of larger rot within a society. In America, isolation had set in for many people long before the pandemic, making it one of the country’s many problems both exacerbated and illuminated by extended disaster.

In some senses, that means there’s cause for optimism. As more Americans are vaccinated in the coming months, more people will be able to return confidently to more types of interactions. If the best historical analogue for the coronavirus outbreak is the 1918 flu pandemic, the Roaring ’20s suggest we’ll indulge in some wild parties. In any case, Rawlins doubts that many of the moderate and weak ties people lost touch with in the past year will be hurt that they didn’t get many check-in texts. Mostly, he predicts, people will just be so happy to see one another again.

All of the researchers I spoke with were hopeful that this extended pause would give people a deeper understanding of just how vital friendships of all types are to our well-being, and how all the people around us contribute to our lives—even if they occupy positions that the country’s culture doesn’t respect very much, such as service workers or store clerks. “My hope is that people will realize that there’s more people in their social networks that matter and provide some kind of value than just those few people that you spend time with, and have probably managed to keep up with during the break,” Sandstrom said. America, even before the pandemic, was a lonely country. It doesn’t have to be. The end of our isolation could be the beginning of some beautiful friendships.

(Source: The Atlantic)

Covid linked to risk of mental illness and brain disorder, study suggests

 One in eight people who get coronavirus also have first psychiatric or neurological illness within six months, research finds

One in eight people who have had Covid-19 are diagnosed with their first psychiatric or neurological illness within six months of testing positive for the virus, a new analysis suggests, adding heft to an emerging body of evidence that stresses the toll of the virus on mental health and brain disorders cannot be ignored.

The analysis – which is still to be peer-reviewed – also found that those figures rose to one in three when patients with a previous history of psychiatric or neurological illnesses were included.

It found that one in nine patients were also diagnosed with things such as depression or stroke despite not having gone to hospital when they had Covid-19, which was surprising, said the lead author, Dr Max Taquet of the department of psychiatry at the University of Oxford.

Research that suggests the virus can have an impact on the brain and the central nervous system is emerging. Photograph: MachineHeadz/Getty Images/iStockphoto

The researchers used electronic health records to evaluate 236,379 hospitalised and non-hospitalised US patients with a confirmed diagnosis of Covid-19 who survived the disease, comparing them with a group diagnosed with influenza, and a cohort diagnosed with respiratory tract infections between 20 January and 13 December 2020.

The analysis, which accounted for known risk factors such as age, sex, race, underlying physical and mental conditions and socio-economic deprivation, found that the incidence of neurological or psychiatric conditions post-Covid within six months was 33.6%. Nearly 13% received their first such diagnosis.

The data adds to prior research by Taquet and others that showed nearly one in five people who have had Covid-19 are diagnosed with a psychiatric disorder within three months of testing positive for the virus.

In the latest analysis, the researchers found that most diagnoses were more common after Covid-19, than after influenza or other respiratory infections – including stroke, acute bleeding inside the skull or brain, dementia, and psychotic disorders.

Overall, Covid-19 was associated with increased risk of these diagnoses, but the incidence was greater in patients who required hospital treatment, and markedly so in those who developed brain disease.

The question was how long these conditions might persist after diagnosis, said Taquet. “I don’t think we have an answer to that question yet.”

He added: “For diagnoses like a stroke or an intracranial bleed, the risk does tend to decrease quite dramatically within six months … but for a few neurological and psychiatric diagnoses we don’t have the answer about when it’s going to stop.”

The likelihood that a proportion of patients who were given psychiatric or neurological diagnosis after Covid-19 had underlying illness that just hadn’t been diagnosed previously, could not be entirely ruled out – but the analysis indicated that this was not the case, he suggested.

Patients with influenza and other respiratory infections saw their doctor more often than patients with Covid-19, he said, adding that diagnoses such as an intracranial bleed or stroke could not be hidden for long and were usually diagnosed in emergency rooms.

Although the study does not prove that Covid-19 is directly behind these psychiatric and neurological conditions, research that suggests the virus can have an impact on the brain and the central nervous system is emerging.

The analysis should also be also interpreted with caution, given it is possible that the first entry of a diagnosis into the electronic database might not represent the first occurrence of the condition. Such records are also typically lacking in other relevant information such as housing density, family size, employment and immigration status.

Dr Tim Nicholson, a psychiatrist and clinical lecturer at King’s College hospital who was not involved in the analysis, said the findings would help steer researchers in the direction of which neurological and psychiatric complications required further careful study.

“I think particularly this raises a few disorders up the list of interests, particularly dementia and psychosis … and pushes a few a bit further down the list of potential importance, including Guillain-Barré syndrome.”

(Source: The Guardian)

Survivors of Covid-19 show increased rate of psychiatric disorders, study finds

Research suggests more than half experience PTSD, anxiety, insomnia, depression or compulsive symptoms

More than half of people who received hospital treatment for Covid-19 were found to be suffering from a psychiatric disorder a month later, a study has found.

Out of 402 patients monitored after being treated for the virus, 55% were found to have at least one psychiatric disorder, experts from San Raffaele hospital in Milan found. The results, based on clinical interviews and self-assessment questionnaires, showed post-traumatic stress disorder (PTSD) in 28% of cases, depression in 31% and anxiety in 42%.

Additionally, 40% of patients had insomnia and 20% had obsessive-compulsive (OC) symptoms.

The findings will increase concerns about the psychological effects of the virus. The paper, published on Monday in the journal Brain, Behavior and Immunity, says: “PTSD, major depression, and anxiety are all high-burden non-communicable conditions associated with years of life lived with disability.

Covid-19 patients at San Raffaele hospital, Milan, in March. The hospital’s study found outpatients showed more severe psychiatric effects. Photograph: Flavio Lo Scalzo/Reuters

“Considering the alarming impact of Covid-19 infection on mental health, the current insights on inflammation in psychiatry, and the present observation of worse inflammation leading to worse depression, we recommend to assess psychopathology of Covid-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.”

The study of 265 men and 137 women found that women – who are less likely to die from Covid than men – suffered more than men psychologically. Patients with positive previous psychiatric diagnoses suffered more than those without a history of psychiatric disorder. The researchers, led by Dr Mario Gennaro Mazza, said these results were consistent with previous epidemiological studies.

They said psychiatric effects could be caused “by the immune response to the virus itself, or by psychological stressors such as social isolation, psychological impact of a novel severe and potentially fatal illness, concerns about infecting others, and stigma.”

Outpatients showed increased anxiety and sleep disturbances, while – perhaps surprisingly – the duration of hospitalisation inversely correlated with symptoms of PTSD, depression, anxiety and OC.

The researchers said: “Considering the worse severity of Covid-19 in hospitalised patients, this observation suggests that less healthcare support could have increased the social isolation and loneliness typical of Covid-19 pandemics.”

They said their findings mirrored those from previous studies in outbreaks of coronaviruses, including Sars, where the psychiatric morbidities ranged from 10% to 35% in the post-illness stage.

There have been warnings from UK experts about brain disorders in Covid-19 patients. Problems including brain inflammation, stroke and psychosis have been linked to the virus.

(Source: The Guardian)

Life with a stoma: Is there enough mental health support for those facing surgery?

Earlier this month, a man who did not want to live with a stoma died after a judge ruled life-support treatment could end. His story caused an outpouring of shock amongst the stoma community and prompted the question - is there enough mental health support for those facing surgery?

Having lived with a stoma for four years as a teenager, the complex emotions this patient must have felt weighed heavy on my heart.

The man, referred to as MSP, from South Yorkshire, was in his 30s and had given judge Mr Justice Hayden an "advanced decision" to indicate he did not want to live with a permanent stoma, after a decade of "painful and complex abdominal problems".

A stoma is an opening on the abdomen which connects to your digestive or urinary system and allows waste to be diverted out of your body and into an ostomy bag.

YVONNE

MSP had previously lived with a temporary stoma and had been advised it needed to be made permanent. The judge noted he had "utterly loathed life with a stoma."

He said: "His confidence and self-esteem has been adversely impacted. His capacity to forge and maintain interpersonal relationships has been significantly eroded."

I too experienced a decade of excruciating ill health at the hands of Crohn's Disease, a bowel disease which causes severe inflammation of the digestive system. Symptoms include pain, loss of blood, weight loss, diarrhoea and fatigue.

Aged 12 I was told I must have 90% of my large intestine removed and a temporary ileostomy formed.

I felt a crushing sense of anxiety but I also hoped that however hard it would be, it would give me my life back.

And it did. Once I had my ileostomy, I was able to go back to school, go on trips and see friends. These had been impossible whilst Crohn's obliterated my colon. My ileostomy made my life mine again.

Adjusting to it took time and extra support for my mental health was absolutely essential to my recovery.

MSP's decision has prompted many people to share their own ostomy stories and query whether there is enough support for people facing this life-changing procedure.

"Stomas save a lot of our lives"

Moeed Majeed, 29, from London, was diagnosed with Crohn's while at university and describes the period as a "really, really bad time".

But when the prospect of surgery arose he thought, "no way". He was given a year to decide.

He says at the time he wasn't enjoying life, felt terrible and didn't look the way he wanted so concluded: "I may as well try it and see what happens."

In some cases, stomas are formed on a temporary basis, to let the bowel heal or to help resolve an intestinal narrowing.

Some patients may have their stoma reversed, or it might have to be made permanent further down the line, like MSP's.

Moeed had his temporary stoma formed in 2015 and says adapting to it was challenging.

"It took me four to five months to get back on my feet and to a point where I felt confident and healthy enough to go back to work and go to the gym. Things I actually hadn't been able to do for a long, long time.

"I am really comfortable and happy with my stoma. I don't care what anyone thinks. Stomas save a lot of our lives."

Moeed says mental health support and talking to others throughout the procedure was crucial.

He was offered support, first through his university then later by his hospital, but acknowledges this is not always available.

MOEED MAJEED

"Having an outlet to talk about what's on your mind and what you're going through is beneficial.

"It empowers you," he says. "It's a bit upsetting it's difficult to get mental health support, because [I think] 65% of this whole thing is about your mental state."

"I wouldn't have been able to have children"

Mr Phil Tozer, a colorectal surgeon at St Mark's Hospital in London, performs stoma surgery for patients with inflammatory bowel disease and other conditions including bowel cancer.

He agrees mental health support for those facing stoma surgery is "relatively poorly dealt with, in the sense that there isn't enough resource for it".

He says: "Stomas are sometimes seen by patients as the price they pay to stay alive.

"For others, it isn't a price but a gift, which restores to them a quality of life which had been taken away from them by their disease".

Yvonne, 30, from Somerset was diagnosed with Crohn's aged 11. 

After years of battling a severe abscess she had stoma surgery aged 20.

"When I was told I needed a stoma I was very, very poorly and weighed about five stone. I had just had enough. I was just like 'please give me a stoma'."

A year after Yvonne had her stoma formed, she got married and says it was a "blessing" compared to the discomfort she faced before.

When she became pregnant, despite a few fears she says "as my belly grew, my stoma grew with it".

Her baby girl was born with no complications, and a couple of years later Yvonne had a second child.

"My stoma, my bowels and my body adapted to a new way of life," she says.

Yvonne's stoma was made permanent after her second child and says she's never encountered any issues with her mental health.

"If it wasn't for my bag, I wouldn't have been able to have children. If it wasn't for my bag, I never would have got married and had a family. If it wasn't for my bag, I would not be here today."

An NHS England spokesperson said funding was "growing" for mental health services "so more people than ever before are able to access high quality services whether that is following stoma surgery or in any other circumstance".

It said those "concerned" about their mental wellbeing should seek "early advice" from friends and family or self-help websites such as Every Mind Matters "and if your symptoms worsen then NHS is here for you".

Lisa Younge, the Crohn's and Colitis UK Nursing Programme Manager says more mental health support is needed.

She speaks to patients living with a stoma, or facing the decision about surgery, every day and says taboos around talking about bowels make people worry others won't accept their ostomy.

"So many people say to me at the beginning, 'there is no way I'm having that stoma' and I think allowing those feelings to come out and recognising why they feel like that is so important."

She says it's essential people gather as much information prior to surgery as possible and talk to others who have a stoma.

Often she speaks with these patients after surgery and finds the stoma has "changed their lives for the better".

(Source: BBC)

Post-natal depression has almost tripled during coronavirus pandemic, study finds

‘The social and physical isolation measures are taking a toll on the mental health of many of us,’ says researcher

Depression among expectant and new mothers has almost tripled during the coronavirus pandemic, new research has found.

The study, which was conducted by the University of Alberta in Canada, showed that the number of women reporting symptoms of maternal depression has increased to 41 per cent compared to 15 per cent before the outbreak began.

In addition, the number of women expediting moderate to high anxiety symptoms has risen from 29 per cent to 72 per cent.

The survey included 900 women, 520 of whom were pregnant and 380 of whom had given birth in the past 12 months, and each participant was asked about their depression and anxiety symptoms before and during the pandemic.

Pregnant women and those who have recently given birth are already at a greater risk of depression and anxiety, with around one in seven struggling with symptoms just after having a baby.

However, the researchers found that the global health crisis has exacerbated those struggles, with the likelihood of maternal depression and anxiety having “substantially increased”.

“The social and physical isolation measures that are critically needed to reduce the spread of the virus are taking a toll on the physical and mental health of many of us,” explains Dr Margie Davenport, co-author of the study.

“We know that experiencing depression and anxiety during pregnancy and the postpartum period can have detrimental effects on the mental and physical health of both mother and baby that can persist for years.”

Dr Davenport added that effects of maternal depression can include premature delivery, reduced mother-baby bonding, and developmental delays in infants.

Annie Belasco, head of charity at the PANDAS Foundation – an organisation that gives support to people coping with pre and postnatal mental illnesses – added that while Covid-19 and lockdown do not “cause” postnatal depression, the circumstances and additional stress resulting from them could certainly contribute.

“We know that parents who have a diagnosis are particularly vulnerable during this time as their 'normal coping mechanisms' day to day are not able to take place,” she told Yahoo.

“Disturbance of routine, anxiety around the political and economical state have also contributed to parents with or without a diagnosis of perinatal mental illness that can create heightened anxiety and stress which can also magnify depression and low mood.”

According to the NHS, postnatal depression can affect women in different ways. It can start at any point in the first year after giving birth and may develop suddenly or gradually.

Some common symptoms include a persistent feeling of sadness and low mood, loss of interest in the world around you, lack of energy, trouble sleeping and feeling that you're unable to look after your baby.

(Source: Independent)

‘My anxiety skyrocketed’: How lockdown has impacted mental health

Sabrina Barr hears how lack of face-to-face contact with friends, family and mental health professionals has been fuelling anxiety in these uncertain times

When Nicola Cooper, 34, from Nantwich, Cheshire, found out she would have to stay confined to her household during lockdown, the thought immediately caused her anxiety to spike. In addition to being immunocompromised due to having Crohn’s disease and diabetes, she has bipolar disorder, borderline personality disorder, OCD and PTSD, having struggled with her mental health since she was a teenager.

“When I found out I’d have to stay at home for a long time, my anxiety skyrocketed because it was such a new thing and no one knew what was happening or how long it would last,” Cooper tells The Independent. “It was out of my control, and the routines I worked so hard at were thrown into disarray.”

Ever since lockdown was established across the UK on Monday 23 March, people’s everyday routines have changed drastically. While Boris Johnson announced a gradual easing of certain restrictions in England on Sunday 10 May, the lockdown and social distancing measures remain in place, and they’re having an enormous impact on people’s mental health.

Getty Images/iStockphoto

According to a recent study of 2,000 adults conducted by wellbeing brand Healthspan, the average adult’s anxiety and stress levels has increased by almost 50 per cent in recent weeks. Research published by global children’s charity Plan International UK found that around 40 per cent of girls in the UK feel their mental health has worsened since lockdown was established, while a survey carried out by the Mental Health Foundation concluded that almost a quarter of adults in the UK feel lonely amid the lockdown.

Dr Nicola Scott, clinical psychologist and CEO of Brain Brolly, explains to The Independent that worries concerning the coronavirus pandemic may trigger people’s “fight or flight” response. However, because “we can’t physically fight or physically run from it”, the reaction leaves us feeling anxious without the usual coping mechanisms available to us.

Cooper is currently isolating with her partner and seven-year-old son. Before lockdown, she would regularly see a counsellor at Motherwell Cheshire to support her mental health, an organisation for which she also volunteers. Recently, her counselling sessions have had to take place over the phone, something that she prefers as she feels she can “be more open from the confines of my safe haven of home”.

However, not everyone feels the same way about not being able to participate in counselling sessions in person. Darren Birch, an ex-police officer in his mid-thirties, medically retired from the police force when he was 33 years old after being diagnosed with PTSD.

Birch tells The Independent that he feels well-supported by his psychiatrist, family and clinical team. However, he has struggled with lack of face-to-face contact with people during lockdown, from his psychiatrist and also through his more recent work as a barbershop owner. Two weeks ago, the father-of-two had a session with his psychiatrist over the phone.

Having a telephone conversation with my psychiatrist felt impersonal

“That was quite difficult talking to her over the telephone about how I’ve worsened. Because I’m not doing what saved my life,” he says, emphasising how much his work at his barbershop The Den in Warwick and as an ambassador for the Lion Barber Collective has benefited his mental health. “For me, barbering allows me to be me. I get a sense of community. I talk to my clients, they know about my history and they open up to me. So having a telephone conversation with my psychiatrist felt impersonal.”

Hilda Burke, psychotherapist, couples counsellor and author of The Phone Addiction Workbook, explains that people who may use activities such as going to the gym or socialising with friends to take a “break” from issues in their life may be feeling “trapped” during lockdown. Therefore, if people’s usual “distractions” are “no longer accessible” to them, they may be finding lockdown particularly tough.

Lewis Alexander Baxter, a 21-year-old law student from Blackburn, Lancashire, felt “very disillusioned” when lockdown began, he tells The Independent. This was due to several factors, including the sudden inability to socialise and also the fact that he and his father were taking care of his mother, who has incurable cancer.

In late 2015 and early 2016, Baxter suffered from depression, which he says “controlled every part” of his life. In March 2016, the student attempted to take his own life after the depression “got too much” for him. Since then, he has become a mental health advocate, encouraging people “to speak before they get to that crisis point”.

On 26 March, Baxter had the idea to create a phone line called chit-chat. “We are not an advice line or a help line,” he explains. “There are fantastic mental health charities out there who do that. What we are there for is a chat. If you want a conversation about anything.” In just under two months, the organisation has gained more than 25 volunteers across the country, has conducted 250 calls and acquired funding from the National Lottery.

I didn’t know what to do because I’ve never dealt with anxiety before.

Baxter admits that without chit-chat, he would likely “have struggled with my mental health in this time”. “With my Mum’s health, with not being able to see people. Not being able to connect with the outside world,” he says. “That’s been really tough, so this has kept me grounded and filled what is a big void in my life at the moment.”

For women who are pregnant or experience pregnancy loss during lockdown, lack of contact with friends, family and support workers can take a particularly significant emotional toll. In March, maternity care charity Birthrights reported a 464 per cent increase in enquiries to its advice line in comparison to the same month the previous year.

Women's health technology brand Elvie is currently fundraising for pregnancy support charity Tommy’s to ensure its support service can remain open. In a recent survey of 1,000 British mothers conducted by the company, more than half said their mental health was worsening in lockdown. However, 67 per cent said they are not seeking professional help.

Rachel, a social media worker from Rille, North Wales who lives in London, is currently 17 weeks pregnant. During the early stages of her pregnancy, she experienced a subchorionic hematoma, a blood clot in the womb that can cause bleeding. She tells The Independent that this experience was extremely “anxiety-inducing”, especially as it occurred close to the prime minister’s announcement in March that pregnant women were to be deemed “moderate risk” during the pandemic.

Having never experienced any mental health issues before, developing high levels of anxiety made Rachel feel too scared to attend routine appointments at hospital. After emailing Tommy’s Midwives, the charity reassured her that it was safe for her to attend her hospital appointments. Rachel recalls that she had been worried she would “be a burden on the NHS” if she reached out to someone for help. “I didn’t know what to do because I’ve never had to deal with that before,” she says.

There is absolutely no-one who is untouched by the changes we are all having to make.

Sophie, who has been a midwife for nine years and has worked for Tommy’s for five years, explains that the charity’s midwife email service has seen a 71 per cent increase in activity since the beginning of lockdown. Of the mental health concerns, the most common are with regards to women who are going through or have experienced a miscarriage, women being unable to be joined by their birth partners in hospital and people feeling anxious about not being able to see loved ones when they bring their newborn home.

“What we’re trying to encourage women to do when they are feeling like they’re struggling is to speak out, to not be afraid to do so and to not feel like they’re taking up people’s time, because they’re really important,” Sophie says. “The whole population of the UK, whatever their medical concern is, needs to know that the NHS is open for them.”

While lockdown measures have started to become more relaxed, with businesses such as garden centres being reopened in England for economic and mental wellbeing purposes, the state of uncertainty surrounding the Covid-19 pandemic continues to fuel anxiety and worry. Dr Jane McNeill, a chartered psychologist at Clinical Partners who specialises in anxiety disorders and trauma, explains that for many people, “mental health problems have become much more pronounced during this period because much of what is happening to us is entirely outside of our control”.

“There is absolutely no-one who is untouched by the changes we are all having to make, but there are going to be some people for whom lockdown is going to be extremely difficult,” Dr McNeill tells The Independent. “But, building some certainty into our day can help us feel a bit more in control of the situation. Developing a sense of routine can be hugely helpful, and connecting with others as much as possible can provide a source of comfort.”

(Source: Independent)

Psychiatrists fear 'tsunami' of mental illness after lockdown

Psychiatrists are warning of a "tsunami" of mental illness from problems stored up during lockdown.

They are particularly concerned that children and older adults are not getting the support they need because of school closures, self-isolation and fear of hospitals.

In a survey, psychiatrists reported rises in emergency cases and a drop in routine appointments.

They emphasised that mental-health services were still open for business.

'Patients have evaporated'

"We are already seeing the devastating impact of Covid-19 on mental health, with more people in crisis," said Prof Wendy Burn, president of the Royal College of Psychiatrists.

"But we are just as worried about the people who need help now but aren't getting it. Our fear is that the lockdown is storing up problems which could then lead to a tsunami of referrals."

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A survey of 1,300 mental-health doctors from across the UK found that 43% had seen a rise in urgent cases while 45% reported a reduction in routine appointments.

One psychiatrist said: "In old-age psychiatry our patients appear to have evaporated, I think people are too fearful to seek help."

Another wrote: "Many of our patients have developed mental disorders as a direct result of the coronavirus disruption - eg social isolation, increased stress, running out of meds."

Dr Bernadka Dubicka, who chairs the faculty of child and adolescent psychiatry at the RCP, said: "We are worried that children and young people with mental illness who may be struggling are not getting the support that they need.

"We need to get the message out that services are still open for business."

Dr Amanda Thompsell, an expert in old-age psychiatry, said using technology to call a doctor during lockdown was difficult for some older people.

They were often "reluctant" to seek help, and their need for mental-health support was likely to be greater than ever, she added.

'Clear priority'

Mental-health charity Rethink Mental Illness said the concerns raised were supported by evidence from people living with mental illness.

In a survey of 1,000 people, many said their mental health had got worse since the pandemic had started, due to the disruption to routines that keep them safe and well.

"The NHS is doing an incredible job in the most difficult of circumstances, but mental health must be a clear priority, with investment to ensure services can cope with this anticipated surge in demand," said the charity's Danielle Hamm.

She said it could take years for some people to recover from the setbacks.

(Source: BBC)