Melbourne in August 2020 has been tough for many people. So far, we’ve experienced lock downs for nearly 5 months, wearing masks is now mandatory, and people have lost their freedom, livelihoods and physical connection with those they love. We’re seeing and hearing that more people are struggling to cope with the impact of these changes and the unpredictability of the future.
In this article, we share insights into mental wellness, why and how the pandemic impacts mental wellness, and some techniques and strategies to help you through.
This article will cover:
- How mental wellness exists on a scale
- Why mental illness is just like any other health condition
- What mental illness looks like
- How crises impact the mind
- How humans crave connection - and research on Depression and Anxiety
- Strategies for shifting your mood during lockdown
- How food, movement and sleep can improve your mental wellness
- How to have mental health conversations with others
- Navigating thoughts of suicide - and how to recognise suicide risk in others
- Helpful resources
Mental wellness exists on a scale
Let’s begin with the question, what is mental wellbeing? Mental wellbeing is the wellbeing of your mind, the health of which is determined by a range of characteristics, signs or symptoms. Just like recognising that physical wellbeing means you have energy, feel fit and strong and have healthy digestion, for example, mental wellbeing is influenced by clarity of thought, stable emotions, regulated moods. It encompasses our social, emotional and psychological wellbeing.
Any deviation from these healthy states can mean that mental wellbeing is compromised. Just like with physical health, a sliding scale exists between health and disease. While some people have clinically diagnosable conditions, others may experience mild, infrequent or circumstantial periods of mental illness, which we’re seeing a rise in at the moment.
Mental illness is just like any other health condition
Unfortunately, a stigma around mental health has long existed in society, even in the medical industry. Often those suffering don't feel like they can talk about their mental health, or don't get the support they need. This can make them feel more alienated, often pushing them into deeper realms of poorer health.
Mental illness is an illness just like any other health complaint or injury. You wouldn’t feel uncomfortable having a conversation about someone’s broken leg, we imagine. And much like for someone with a broken leg, anxiety, depression or other mood disorder, patients need professional support to heal as well as the love and support of friends and family. They did not choose to feel this way. The person suffering deserves the same degree of care and support that any other patient would get (including flowers!).
What do mental health issues look like? Understanding anxiety and depression
The most common mental health issues around at present are depression and anxiety. Given that both health issues are rarely spoken about or understood among people, knowing what both look and feel like is important to determine whether you or loved ones are experiencing either, or both.
What does anxiety look and feel like? Some of the emotional symptoms of anxiety are:
- decreased concentration
- OCD behaviours
- sleep disturbance
Physical expressions can include:
- a pounding heart
- chest pain
- tension in the muscles around the neck, shoulders and back
Symptoms of depression are quite different and are known to impact more on a person’s mood wellbeing. They might display as:
- withdrawal from social activities
- sleeping too much (or too little)
- displaying feelings of helplessness or irritability or worry
- displaying anger or mood swings
- being pessimistic
- losing interest in their appearance, and other similar symptoms of withdrawal and sadness
How crises impact the mind
Before we dive into mental wellness strategies and how to have supportive conversations with loved ones, let’s take a moment to explore the human mind, and why an event like the 2020 pandemic can have such a great (and perhaps unexpected) impact.
Maslow's hierarchy of needs is a motivational theory in psychology that represents a hierarchy of motivations of humans based on their status in life. Conceptually, a human must first meet the needs at the base of the pyramid before moving up to the next tier.
The first two tiers identify basic human safety and survival - food, water, warmth, rest, security and safety. The next two tiers identify belonging; first to friendships and community, then to feelings of self accomplishment and self esteem. Finally, at the top of the pyramid we see self actualisation.
Understanding that one cannot attempt to fulfil self actualisation if food or income is limited makes sense. With that in mind, for many who have previously been entrepreneurial, studious, adventurous or otherwise, a sudden and distinct separation from that former version of self has led us back to those foundational tiers of the hierarchy.
This alone can create a lot of internal conflict - ‘who am I now?’ will be challenging many, as will the very primary need to provide the basics for survival. To understand this can help us allow space, and even give ourselves permission to sit in the space of basic survival. In doing so, we can disentangle our egos from our ideal reality versus our actual reality.
Humans are tribal, connected creatures. We crave connection. We aren't designed to be isolated.
Social isolation has often been used as a form of torture or punishment, and is well recognised as having an impact on a person’s mental health. Studies have found that numerous adults who have no history of mental health problems develop psychological symptoms in solitary confinement.
Author, speaker and researcher of depression and anxiety, Johann Hari, has presented his findings into the real causes of anxiety and depression. He has travelled the world, studied many varied social structures and communities, and conducted clinical testing to arrive at his findings of what really drives depression.
In his work he identified 9 factors causing depression. Seven are psychosocial, and two are biological. He describes them as:
- Disconnection from work that gives meaning and purpose (little control or autonomy in your work).
- Disconnection from people (feeling profoundly lonely). Not sharing any meaningful experience with any other people.
- Disconnection from meaningful values. Focusing on materialism, and doing things purely for extrinsic rewards instead of intrinsic reward.
- Disconnection caused by childhood trauma. Every traumatic experience you go through as a child significantly increases the likelihood of a later diagnosis of depression.
- Disconnection from respect. Modern life cultivates the view that status, celebrity and wealth are what denote success. Anxiety over the loss of financial security and status often cause constant stress in people.
- Disconnection from the natural world. Faced with the vista of the natural world we feel ‘small’ not ‘big’, and we feel like we are part of something much bigger than ourselves. Animals in captivity rock back and forth, lose interest in sex (which is why they are so hard to breed in captivity) and show other compulsive and depressive behaviors they don’t exhibit in the wild. We are animals. We need to be outdoors. Rates of depression when exercising in the natural world, and spending time outdoors all reduce in comparison to time spent inside. We often feel ‘more alive’ and grounded when outdoors in nature.
- Disconnection from loss of hope for a better future.
- The role of genes and biology in depression. Neuroplasticity means the brain is continually growing and changing and does not stay the same. Therefore, the concept of a ‘broken’ brain that cannot be fixed is not supported by current scientific evidence. However, distress from the external world and brain changes occur together which lead to depression. Johann Hari in his book “Lost Connections” on page 146, says that these changes in the brain can then “acquire a momentum of their own that deepens the effects from the outside world.”
If you review the list of findings of Hari, the word or theme you'll see that most occurs is ‘disconnection’. We're experiencing disconnection in a multitude of ways right now, from currently physically disconnected - from family, friends, workmates and even with masks from those we pass on our daily walk, to experiencing a loss of connection to purpose if your job has been lost. You may also have a disconnection from nature with the instructions to stay mostly indoors.
We only need to look at those factors to realise it’s quite reasonable to be having psychological responses to our conditions, thoughts and environment.
Strategies for mental health during a pandemic
The field of positive psychology aligns with many of Johann Hari’s findings and offers support to those who have had socially restrictive conditions imposed upon them.
It’s said that where your focus goes, your thoughts follow. Focusing on gratitude is a big contributor to a sense of happiness in life. While times can be tough, we can still be grateful for the little things in life that are often the most important.
Spending time each day writing down what you’re grateful for, or in those moments when you’re down, thinking of things you’re grateful for, can make a big difference in your mood and perspective. Your gratitude list could include things like being grateful for your favourite cup of tea, the beautiful secluded park down the road, having fresh clean linen, or appreciating the humour of a loved one.
Keeping a book or journal of all the things you’re grateful for can be a great source of comfort, reminding you of all the things you have in your life to be thankful for. Add to your book when you think of something new, and read over your list when you’re feeling low.
Chasing happiness can lead to distress
Happiness is part of a process, not an outcome. We all experience a range of emotions ranging from joy to anger and all the colours in between. It’s widely thought that positive thinking is the antidote to suffering negative emotions, and that we must always try to stay in a state of happiness. This suggests that we just have to think positively to get there. Trying to think positively often leads to more frustration, as we compare our state of discontent with what we believe is the ideal.
Such a thing exists as ‘positive toxicity’ - being positive at all costs. The reality is that our emotions are reflective of our thoughts, that are typically dictated by our environment. The answer isn’t to ignore those feelings and just think good thoughts. Often, it’s about recognising those thoughts and feelings as being valid (even if many of those thoughts may not be true), then seeking to understand, or discuss with someone to transform them to let them go.
Our negative thoughts are simply feedback, just like our positive thoughts. Both are valid, and valuable, as they tell us where we need to draw our focus to get more, or less, of what we’re experiencing. Sometimes we need to process our thoughts and emotions in order to move on from them.
This doesn’t mean we can’t use strategies to shift our mood to a more positive state at times. Perhaps you might not be in the right frame of mind to process these thoughts, and so the following strategies can cause a helpful circuit break to allow us space and emotional respite.
Minding your mind
As your thoughts are influenced by your environment and what you’re exposed to, it pays to set some boundaries around what you will and won’t do for the wellness of your mind.
For example, limiting exposure to the news, social media, and other stress-inducing things is worth exploring. Choosing to disengage from conversations that are stressful for you may be necessary.
Sharing these boundaries with those around you will help them understand and support you in protecting your mental wellbeing. A simple statement like ‘So I can maintain my mental wellbeing right now, I’m choosing not to engage in discussions about, or consume negative media around the pandemic. Thanks for supporting me and understanding’ or something along those lines.
Focus instead on consuming positive or nourishing content instead - this could be an adventurous fiction book, or perhaps expanding your knowledge around health and wellbeing or another topic of interest.
Other proven ways to improve mental health during a pandemic
Overall wellbeing can be boosted by simply giving hugs which releases stress-busting, mood enhancing oxytocin. Intentionally cultivating a positive mood by practicing gratitude, and performing acts of kindness can also elicit the same physiological response. These are all ways that you can modify your behaviour and outlook to nurture a deeper and more profound sense of wellbeing.
Reconnecting in as many ways as possible is also vital. If we look back at those identified disconnection points above, where can we pivot or adjust to find ways to access them?
A daily walk is allowed, so if you can access grass, try going barefoot to get more in touch with nature. Practice 'shinrin-yoku' - AKA forest bathing, which is the Japanese practice of taking in nature through all your senses - a mindful practice that calms your nervous system and mind.
Staying in regular contact with friends, workmates or family is also important. Scheduling regular chats or zooms with those who make you feel connected and supported not only makes you feel connected, it gives you something to look forward to .
Having a solid self care routine is also helpful for maintaining good mental health. Perhaps set yourself a goal - nothing overwhelming - that you can work towards. That could be doing 10 minutes of meditation daily, writing one letter a week, or moving your body a certain way each day.
Recognise that each of us will experience this situation differently
Health coach Bee had two conversations with patients recently that really spoke to perception and how personal values can play such a critical role in your experience.
In one situation, a patient spent their early childhood in a war-torn country. It was described as a horrific and terrifying environment where at any moment, your house could be under threat. The parents bravely found a way to bring the family to safety, and the scars of those early years have had a significant impact on this person. They were saying that their parents are completely unphased by what is going on right now - there are no bombs, our house is not under attack, it is just isolation.
Under the very same roof, the patient explained that whilst there were no bombs, one of the things that made them feel most safe in the war-torn country was that the family, including cousins and probably neighbours, could huddle together and physically and emotionally support each other. That real sense of being in this together was what mattered more, and so this person is most struggling with the isolation of the current climate.
Another patient has a spouse who is currently interstate. They haven’t seen each other in person for months. They have a successful business, plenty of wealth to share (and they do), food, cars, etc. The Melbourne-based spouse was saying that they felt alone and lonely as they are removed from their partner, even though the partner who is away working on the business feels confident and fine because for them, material wealth, therefore safety, is most important to feel OK.
For one person, physical and emotional connection supercedes material wealth in this context. We could reasonably assess that the spouse in lockdown is in one of the foundational tiers of Maslow’s hierarchy of needs, therefore valuing basic safety and connection above expansion and business success.
How food, movement and sleep can improve your mental wellness
As Johann Hari discovered, biology and genetics also influence mental wellbeing. How we live and what we eat directly impacts both our biology and genetics. Therefore, you can boost your emotional wellbeing through lifestyle factors - what we in the clinic call the pillars of health.
Focusing on the fundamentals of health doesn’t only improve your physical resilience - it improves your mental resilience as well. This means you have more capacity to cope with stressors and handle the challenges of life. If we only discuss your mind and don’t consider the impact of lifestyle, we’re missing a critical and valuable piece of the puzzle.
One of the most profound ways we can assist the body in a stressful situation is to pay attention to the body’s ultimate stress relief strategy - sleep. Good sleep will allow your body to reset, resulting in more emotional resilience.
You’re more likely to make better food choices (your hunger and satiety hormones are both reset during sleep), your glymphatic system, the brain’s garbage disposal system, is able to clear out neurological toxic waste that can impair mood and brain function, and your mood will improve if you can get both good sleep quality and quantity.
Things that can impact the quality of your sleep are:
Stress and worry
Circling or worrying thoughts that keep you up at night are signs that those thoughts need addressing. Journaling to express and release those thoughts can be helpful, or counselling may be necessary to move on from them. Having a gratitude practice before you go to bed can also help, as can meditation to calm the mind.
Eating too close to bedtime
Digestion takes a lot of energy that can get in the way of restorative sleep. Aim to be done with food 3 hours before bed.
At least an hour or two before bed, start winding down to get your body ready for sleep. This includes turning off all tech at least an hour out from bed, having a nice shower, reading a book or doing something else restorative. Your sleeping environment should also be conducive for sound sleep. This means keeping a slightly cooler room (which is best at around 17-19C), blocking out all artificial light, wearing comfortable clothing, and keeping disruptions like pets out of your room.
Sleep hygiene also includes the time you go to bed and wake up. A disrupted circadian rhythm (the natural rhythm of your body that’s linked to the rise and fall of the sun) has been linked to mood disorders like depression. Sticking to a consistent sleep/wake cycle helps your body stick to regulate your circadian rhythm and improve your mental wellbeing.
Alcohol may not impact on your ability to go to sleep, but can interrupt your sleep by depleting the relaxing neurotransmitter GABA, which is why you’ll typically wake up a few hours after falling asleep. Alcohol also compromises sleep quality as your body is focused on processing the alcohol rather than focusing on other restorative actions.
Nutrition is vital to a healthy functioning body. Instead of thinking of food as ‘breakfast, lunch and dinner’, think of it as messages. What your body is after is nutrition and calories. When choosing food, think of the instructions it will be giving to your body. Will your body recognise it, or is it a construct made by scientists to fulfil the ‘cravings’? Some checkpoints for food:
- Did it grow in nature?
- Does it look close to how it did when it was in its original state?
- Do I know that my body digests it well? (if you notice symptoms like bloating, altered bowels, lots of burping, tummy pain, fatigue - they can all be signs that your body is not a fan of what you consumed)
- Did I take my time and chew it well?
As your body’s demand for nutrients increases under stress, the below nutrient dense foods may help you feel calmer, stronger and more energised.
- Eat a rainbow assortment of fruit and veg for nutrients and antioxidants: green leafy veg (broccoli, kale, spinach, chard, cabbage, cauliflower), berries, tomatoes, apples, citrus fruits, pineapple, carrots, sweet potato, peas, mushrooms, asparagus, zucchini, pumpkin, onions, leeks, radishes
- Eat clean proteins: if possible, organic and pasture-raised animal products (lamb, chicken, turkey, plus organ meats like liver and kidneys), sustainably wild-caught oily fish (e.g. sardines, wild atlantic salmon), beans, lentils, chickpeas, quinoa, buckwheat
- Healthy fats: Oily fish: Salmon, mackerel, anchovy, sardines, herring; avocado, nuts (esp. walnuts) + seeds (hemp, chia, flax, sunflower, pumpkin), butter from grass-fed cows (Kerrygold), organic free-range eggs
Movement is a known strategy for releasing ‘happy hormones’ like the well known endorphins, or post exercise buzz. You don’t have to pump iron or sweat for an hour in a class to accomplish some positive outcomes from movement.
In fact, if stress is really high, it can be as beneficial to do a restorative type of movement like yoga, tai chi or qi gong. Also, gardening, vacuuming and dancing are all great ways to move your body and can elicit the same positive effects.
If you can pay attention to your mindset, and create an environment for your body that will naturally support the health of your mind, those elements can really make a difference in times of increased or ongoing stress.
Having mental health conversations with others
Another way the global pandemic may be impacting you is that someone in your life has begun to display some of the symptoms of stress or mental health challenges. Firstly, understand that while you may be able to support them, you do not have to fix them or find the solution. That pressure is unjust.
So how can you help? There are some communication strategies you might be able to use in order to be able to support or assist this person. This is known as Mental Health First Aid (if you're interested in learning more about this than what we share below, go here).
Here are the strategies for communication:
Firstly, ask them if they would like to talk. They always have the right to refuse, and the most important thing is they know someone is there to talk to. If their answer today is no, it might be yes tomorrow, so let them know you’ll be there if they’d ever like to talk.
If they agree to talk, find an appropriate setting. Generally privacy is appreciated, so holding the conversation away from others and away from distractions is good. Having this sort of conversation with kids running around or the TV blaring will likely not be as successful.
When they're sharing with you, it is important to listen and most certainly not to judge. If someone feels judged, they will likely shut down, become defensive or close that communication with you.
Some phrases to use could be “Hey I heard you say you’ve been quite stressed lately… I wondered if you’d like to talk about it?” or
“This year has been a really tough one and I know that losing your job has been really difficult, is there anything I can do to help you?”
As they share, simply hold space. That means keeping your opinions and judgements to yourself. Avoid responding by sharing your own experience, as this takes the conversation away from them, and on to you, making the other people not feel truly heard.
If you're concerned that the person needs to see a professional, you can offer that (some helpful resources are below).
“I saw on TV that a GP can help get you support when you’re feeling really anxious - and it’s super common and nothing to be ashamed of.”
“Feeling so low right now totally makes sense, and I’m really sorry that things are so tough for you. I wonder if you think talking with someone like a counsellor or psychologist might be a good move?”
Again, we aren’t trying to take control over the situation, but rather offer avenues for support that they get to opt into.
Please remember to respect a person’s privacy and not to tell other people about any private, vulnerable conversations someone has shared with you.
Navigating thoughts of suicide - and how to recognise suicide risk in others
There are predictions that as an outcome of the pandemic, we can expect an increase in suicide, especially amongst youth. To talk about suicide can feel very scary. Many people believe that if you ask someone directly if their intention is to commit suicide that you might convince them to do it, or give them the idea.
The official advice if you are concerned someone may take their life is to ask them directly - “are you going to commit suicide?” Whilst we hope to never be in this position, understanding the importance of asking that question is critical. Asking this question will not make someone do it but it may create an opportunity to support them.
Should the person say yes, it's recommended that you contact authorities who are able to support the suicidal person (suicide help line, ambulance or police, and other resources listed below) and if it is safe for you, stay with or near the person until help arrives.
Having these kinds of discussions as soon as someone’s mood and behaviour starts to shift is important. We want to have early discussions. We want to have our eyes, ears and hearts open as people move through a highly stressful environment. Noticing some of the following behaviours and then being willing to step in to support can make all the difference.
Human moods change from minute to minute - that is the very nature of humanity. But if someone is displaying the following symptoms, it's important to both offer and seek support:
- a consistent low mood
- has lost motivation and drive
- sleeps a lot more than usual
- loses contact with friends and family
- is more tearful, more reactive and short tempered or,
- openly talks about anxiety, depression or suicide
If you don’t feel safe or you don’t think that you're the right person to be having those conversations, you might instead contact other friends or family and ask them to support or if things are outside of your comfort zone you can contact an authority.
If you're experiencing an increase in mood disturbance like feeling low and unmotivated, noticing you’re worrying a lot more, feeling like you can’t cope, you’re scared for the future or any other behaviour that you're perhaps unfamiliar with, please know that you are not alone. You do not choose these thoughts and feelings, and if they are new to you, they can feel big and very scary.
In these situations, we urge you to talk to people and share your feelings and experiences. If there is no one in your immediate circle that you feel confident or safe to talk with, there are many highly skilled services ready to support you.
Lifeline 13 11 14
Kids Help Line 1800 55 1800
Mensline Australia 1300 789 978
Beyond Blue 1300 224 636
Mental Health Crisis Numbers
ACT 1800 629 354
NSW 1800 011 511
NT 1800 682 288
QLD 1300 642 255
SA 13 14 65
TAS 1800 332 388
VIC 1300 651 251 (Suicide Line)
WA 1300 555 788
The Australian Government has also announced 10 additional Medicare subsidised therapy sessions for those who need it. Find out more here.
Mental health is a community concern. It involves all of us.
The extreme nature of this situation is new for us all, and it's the time to unite with compassion and understanding. Mental health illness is not weakness, it is not contagious and it can be overcome with the right strategies from friends, family and health professionals.
As we move through these unusual times, we do so together. Let's do so with kindness, compassion, looking out for our neighbours and being willing to ask for help if you need it.
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