COVID-19 and how to manage your mental health

As a result of the global outbreak of COVID-19, many are struggling to adjust to what will be our “new normal” for the foreseeable future: social distancing (or social solidarity), self-isolation, quarantine and, following President Cyril Ramaphosa’s recent address, a 21-day nationwide lockdown.

If all of this is making you worry, feel anxious or down – you are not alone. You are certainly not without advice from experts from the University of Cape Town (UCT) on how to manage these experiences, particularly anxiety and depression.

“Broadly speaking, everyone needs to protect their mental health during this time,” said Associate Professor Kevin GF Thomas, the head of UCT’s Department of Psychology.

Thomas’s training is in clinical psychology and his specialisation is in neuropsychology. His research is focused primarily on modifiable causes of cognitive impairment and dysfunction, such as stress, anxiety and trauma, as well as disrupted sleep.

According to Thomas, those already experiencing mental health struggles – of whatever kind – may find that these struggles are exacerbated by the inability to attend face-to-face psychotherapy sessions, exercise regularly and engage in needed social contact, among other things.

“I will give three specific examples of some common mental health issues people in lockdown, quarantine and/or isolation have been reporting across the world,” Thomas said.

The first is depression.

Those prone to depressive episodes may be deprived of needed protections against low mood, protections such as exercise and social contact. Being isolated might feed their tendencies toward rumination, and reading about the effects of COVID-19 across the world may increase their sense of negativity about their present circumstances and prospects.

The second example is generalised anxiety disorder.

“Those diagnosed with this disorder tend to worry excessively about world affairs, their health, the health of family members, and so on,” explained Thomas.

While in the current circumstances these worries may appear to be appropriate at first, if they are not checked by some positive reframing of the situation – such as the lockdown may be inconvenient in the short term, but in the long term it is proven effective at slowing infection rates – then there can be a spiralling of negativity and increased anxiety.

The third example is post-traumatic stress disorder.

“Some people might find themselves confined in spaces with individuals who have inflicted violence, abuse or neglect upon them,” said Thomas. “This confinement can trigger memories of those prior negative episodes and can reawaken previously dormant traumatic episodes.”

Expert advice

To help manage the mental health struggles people might be facing during this time, Thomas shares some advice.

Lockdown, social distancing, isolation and quarantine does not mean that all social contact must cease. We are fortunate to live in an age where social media allows us to remain in touch with friends and family members who are physically distant from us.

“I would therefore advise judicious use of social media as a means to protect mental health.”

The keyword in the previous sentence is “judicious”. It’s not wise to furiously scroll through social media in search of COVID-19 information – an endless loop of bad news over which you have no control is a recipe for increasing stress and anxiety. Thomas therefore recommends limiting news intake to discrete, and brief, periods such as 30 minutes in the morning and/or 30 minutes in the evening.

Structure your days. People who are used to externally imposed structures on their daily activities, for example students and corporate workers, might find themselves wondering how best to spend their time. That sort of uncertainty can lead to increased levels of stress and anxiety. Have a period you dedicate to work tasks, make mealtimes as special as you can, take time to exercise, and celebrate mini-anniversaries (“One week into lockdown! Only two more weeks to go!”).

Be aware of how your relationships with others are being affected by the lockdown. Family ties, even the strongest ones, can fray when people are forced to spend whole days and weeks around one another with no breaks. Schedule some time when you can be alone, with a book or a podcast or something else that makes you happy and takes you out of your immediate family orbit. Parents of young children might want to schedule times when one of them is with the kids while the other works, and to then switch after a few hours.

Sleep regularly. Healthy sleep is important for emotion regulation, so it’s important to maintain your normal sleep habits. Do not use your bed for work or daytime reading – try to limit it to your regular night-time activities.

Finally, maintain contact with your mental health professional as much as possible. Some therapists are fine with Skype, Zoom or WhatsApp sessions. Others are okay with email check-ins and some might be okay with phone sessions.

“It is best to ask about this as far ahead of time as possible to make sure that your therapist is available to you in some form,” said Thomas.

If you cannot have contact with your regular therapist, there are some free online and telephone counselling services he suggests, such as the South African Depression and Anxiety Group, the Centre for Interactive Mental Health Solutions and 7 Cups of Tea.

Please note that there are paid offerings for the latter two, but there are free sessions as well. 7 Cups of Tea offers free peer-to-peer “emotional support”.

Thomas has no professional or personal interests in any of these organisations.