There’s no universal response to the lockdown but certainly we are understanding that a surge in referrals to are centre over and above what is a busy time of year for us in normal times, suggests a significant psychological impact for many people.
We have a term of reference for this lockdown that we didn’t have back in March and that’s not necessarily helpful as knowing what to expect can set people up to feel more despondent. There is now more of an understanding of the danger related to covid-19. The threat system that was all fired up last March has naturally dampened down (because we’re not programmed to maintain high levels of arousal over time) and this has allowed other emotions to come through such as sadness.
This lockdown coincides with the Christmas comedown and January can be a difficult month anyway with typically low levels of social contacts. This year’s January blues is operating on another level. We find ourselves adjusting to profound changes again without the usual supports. We’re dealing with many more worries than normal and on a much larger scale. For those who weren’t able to spend time with their family at Christmas, there’s a genuine sense of missing out and perhaps guilt. Not to mention shock surrounding the post Christmas daily figures of positive cases, hospitalisations and deaths.
The understandable desensitisation to the fear associated with the pandemic allows for a range emotion to be experienced. Sadness can be a more difficult emotion for people to deal with than anxiety. We are confronted with loss of our old lives daily. The theme of sadness and loss is everywhere.
We are particularly mindful of the impact on adolescents at the centre. The experience of time for adolescents is different to adults and they are less able to access the bigger perspective for this pandemic. Two weeks for an adolescent is simply ‘ages.’ Waiting for summer to come is ‘forever.’ Adolescents are less able to access months ahead because for them it is too far into the future. The impact of the lockdown for adolescents is therefore more profound and their lives will be disproportionately influenced by this lockdown experience as compared with adults. The Covid-19 pandemic is their formative experience.
Mental health is influenced by many factors and a national lockdown scenario reduces protective factors while risk factors are increased. Mood is influenced by a balance of opportunities for a sense of achievement, a sense of enjoyment and connection to others in the course of a day or week. All of these are compromised during lockdown. The novelty factor of zoom, memes shared via social media platforms, the sharing of lockdown survival tips and the visible appreciation of frontline worker has diminished. We don’t know how long this will go on for.
It can typically take many years for mental health disorders to emerge and what we are seeing in the centre currently is an exacerbation of existing difficulties. Part of a cognitive behavioural therapy assessment with clients involves a mapping out of factors that have made a person vulnerable to developing mental health difficulties in the first place. We suspect that for years to come, lockdown and covid-19 related experiences will feature heavily in these formulations.
CBT interventions help to change our responses to negative and catastrophic thoughts, to develop a healthy relationship with our emotions, and to engage in in behaviours that work for us in line with what matters most. It’s an extensively researched form of brief psychotherapy and recommended as the first line of psychological treatment for common mental health difficulties. CBT Randomised Controlled Trials completed in 2020 tell us there needs to be focused interventions for people suffering from covid -19 related clinical anxiety and depression. Current research is focusing on dysfunctional worry, sleep disturbance, stress and depression for the general population, for healthcare workers and for those who have been hospitalised for cov-19. The results so far highlights the effectiveness of short terms CBT in improving psychological health.