Mental health can't be forgotten during the coronavirus pandemic

Ontario Premier Doug Ford finally acknowledged the extent to which the fight against COVID-19 is having on mental health.  

"Avoiding the tragedy that we've seen in Italy and Spain will be entirely up to all of us," Ford said. "We know the sacrifices many of you have made to stay home. We know all of this is taking a toll on the mental health of Ontarians. Daily routines have been broken, and the feeling of being isolated is real. We know this is very very stressful, and we want to help."

COVID-19 is causing unprecedented disruption in the present and uncertainty about our future. We are having to rethink how the habits of our daily life, even with something as simple as buying groceries. Our collective anxiety is high, and when anxiety is allowed to run amok it can be difficult to separate fear from reality. It's easy for us to feel that the future to appears bleak. Anger is rising. Calls to distress helplines are up. One of those who took her own life was a nurse who was afraid she would spread the virus to others.

In the Harvard Business Review, David Kessler described what we are feeling as grief: “The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively.”

But as these feelings emerge throughout the general population, some of us have been painfully aware of the effects of isolation for years. While it is widely accepted that people with underlying physical health conditions are more susceptible to complications from the novel coronavirus, there has been less acknowledgement that those of us with pre-existing mental health challenges are struggling a little bit extra under quarantine. I have experience with anxiety and major depression, and can attest to this.

Acknowledging mental health as an underlying condition helps us take better care of one another in the present, and creates an opportunity to learn first-hand how to be better mental-health allies and brighten peoples’ lives in a post-pandemic world.

Before COVID-19 those of us with mental health diagnoses were already predisposed to a pervasive feeling of having little to no control over our lives. Our social circles — if fortunate enough to have one — are often small, and it is common to feel less included within them. Chronic feelings of loneliness and hopelessness cast a shadow over everything we do, leaving us empty and devoid of purpose. Planning for the future in pre-pandemic times could be all but impossible due to the immense challenge of simply making it through another day. Anxiety leads us to not merely prepare for the worst “just in case,” but feel certain only the worst is possible.

Social distancing and staying home to “flatten the curve” in order to save lives are essential measures, yet the closures, job losses, and cancellations are exacerbating our symptoms by causing a widespread breakdown of the strategies we employ to manage our own illnesses. A medical professional who wished to remain anonymous saw a normally stable patient admitted through Emergency precisely because their coping mechanisms were no longer viable.

In his speech, Doug Ford said “We know staying home and practicing physical distancing is the right thing to do. But it can’t mean disconnecting from friends, neighbours, or loved ones,” adding “If you’re struggling, please reach out. Talk to someone. If you know someone who may be struggling, talk to them. Pick up the phone. During these difficult days, we need to stick together.”

Therapy and medication alone are not cures. No pill can replace the companionship we all need. An article in Psychology Today references how people with addictions isolate in order to hide their affliction, stating “overcoming a habit of distancing and isolating is an ongoing achievement that depends on connections, relationships, and routines.” Those routines help create a feeling of control. A regular visit to the local coffee shop — now closed — can be an integral part of feeling one belongs to the world. But now all of that is cancelled.

An article by the British Psychological Society emphasizes the importance of collectivizing our experience in order to protect the most vulnerable. “It is precisely when people stop thinking in terms of ‘I’ and start thinking in terms of ‘we’ – more technically, when they develop a sense of shared social identity – that they start to coordinate, support each other and ensure that the neediest get the greatest help.” This should not pertain only to those with underlying physical conditions. Dismissing someone with chronic depression for needing extra help not succumbing to the corona-coloured darkness is no different than denying an asthmatic a ventilator if they contract COVID-19.

An article in Psychology Today states “If you can sustain a positive mood, you’ll be more likely to do what’s needed to help yourself and others remain virus-free,”  and that “if you see your individual efforts as contributing to a better social outcome, you’ll be able to take inspiration from the small sacrifices you make in your own daily life.”

People with mental health diagnoses are no strangers to looking out for others in this regard. Robin Williams famously said "I think the saddest people always try their hardest to make people happy because they know what it’s like to feel absolutely worthless and they don't want anyone else to feel like that.”

Those of us who know what hell feels like don’t want to see it in others, so reach out to us as well—helping others benefits the greater good and creates a sense of purpose.

Even before the pandemic there was an attitude that merely sharing suicide hotlines and tweeting a trending hashtag made someone an ally for mental health and absolved them of further responsibility to those they claim are their friends. Now, a dismissive “We are all struggling!” has become the new “Others have it worse than you” when it is precisely because we are all struggling that we need to stop belittling those who need extra support. It could happen to anyone.

To beat COVID-19 — and we will — we need to look after one another. Full stop. We are inherently social creatures, and to maintain our humanity in an age of isolation we need to connect with others more than ever. We are seeing some amazing stories of people pulling together to keep collective spirits high, but we need to do more. While many are managing to hold themselves together, others have withdrawn or are afraid to appear weak or selfish at a time we are repeatedly told to be strong. This is when the darkness sets in.

Don’t be afraid to ask for help, but be proactive in helping others as well. Reach out. Listen to your friends. Forwarding a meme or trite inspirational quote can go a long way towards letting someone know you want them in the world. We need to go beyond splashing the words “we are all in this together!” across social media, shuttered store windows, and sidewalks, and dedicate ourselves to acting like it. And when we do, we will all emerge into a brighter world.