Confronting the shadow pandemic
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Confronting the shadow pandemic

COVID outbreaks and lockdowns are taking their toll in Sydney and Melbourne as we mark R U OK? Day on September 9. The AJN looks into the issue of pandemic mental health and how we can help the ones we love.

EIGHTEEN months on from the start of the COVID-19 pandemic, Sydney and Melbourne are in lockdown as the Delta strain runs rampant. Disconnected from our friends, loved ones and communities, we spend our days juggling working from home with home schooling, the monotony only broken by essential shopping trips and outdoor exercise.

Some people have lost jobs and livelihoods. Others are feeling the effects of prolonged isolation. All while we tune into the daily coronavirus media conferences with a dedicated regularity as we pine for a time when life might again look like some semblance of normal.

Lockdown might be reducing the load on our hospitals and saving lives – from COVID, that is – but what effect is it having on our mental health?

“Lockdown has impacted most aspects of people’s lives – daily routines, stability, and connection with supports. The ways that people can participate in things that provide meaning and purpose to them has also changed,” observed Cassandra Hastie, a caseworker in Mental Health and Wellbeing at JewishCare (NSW).

“A lot of people I know are experiencing prolonged periods of stress, are more socially isolated, and feel a sense of hopelessness towards the future. It impacts mood, connection with others and overall wellbeing.”

Marilyn Kraner, manager Individual and Family Services at Jewish Care (Victoria), described it as a “rollercoaster ride” in terms of mental health.

“Many of us will be finding the isolation and loss of routine/activities difficult to manage; it can feel like there is little to look forward to, or that each day blends in to the next,” she said.

“Some may be struggling with pragmatics like basic needs, worrying about their job security or how to make ends meet, or anxious at the prospect of contracting COVID.

“Then there is the struggle of sporadic home schooling alongside working from home. For those living alone or with small children, or who need to isolate for health reasons, it can be a particularly challenging time.”

Sydney-based clinical psychologist Eva Lowy said telephone help services such as Lifeline and Beyond Blue have reported “a dramatic rise in calls from people across all age groups” experiencing anxiety, social isolation and loneliness.

“We have all been affected by the restrictions, social distancing and extended lockdowns since the start of the pandemic. Some of us have been inconsolable because we were unable to farewell loved ones before they passed away; others felt the desperation and suicidal thoughts at the almost overnight loss of their livelihoods and businesses,” she said.

“Reduced opportunity to leave our homes has resulted in alteration to our sleep, exercise, nutritional and social routines.

“Not only have we lost connections with our peers and professional networks, but there is also additional strain within households as families grapple with spending an unusually large amount of time together in confined spaces. Interpersonal conflict and in some cases, domestic violence, has been the result.”

Lowy added, “If we ever doubted it we now know that human beings are not ‘designed’ to manage segregation or the absence of interaction with others for extended periods of time.

“Our resilience is closely related to the depth and strength of our interpersonal connections, including our involvement in groups and communities.”

Lowy said lockdown has been “particularly difficult” for people with pre-existing mental illness as they are dependent on their face-to-face contact with health professionals and support groups.

Children are also particularly vulnerable.

“Children and adolescents are experiencing a prolonged state of physical isolation from their peers, teachers, extended families, sporting and community networks. Social distancing, school closures and enforced isolation have led to an increase in mental health problems such as depression and anxiety,” said Lowy.

“Worrying statistics about teenagers who have been exposed to extended lockdowns in some parts of the country have shown increased rates of suicide compared to previous years.”

Rabbi Gabi Kaltmann of the ARK Centre in Melbourne – who is also a qualified social worker – said he typically receives three to four calls per day from distressed members of the community.

“They are stressed and overwhelmed and feel that this last lockdown has really stretched them to breaking point,” he said.

“Many have remarked that they are feeling very despondent that their children are missing out on critical life and social experiences.”

Rabbi Kaltmann said parents have reported a spike in anxious behaviours in their children including depression, anxiety, self-harm and eating disorders.

“There is no doubt that school closures and the restrictions on childcare are really pushing people over the edge,” he said.

“The ramifications of these lockdowns will be felt for many years to come.”

The other group that is feeling the effect of the pandemic and lockdown is seniors.

“Being isolated and homebound impacts seniors uniquely because they are not digital natives and find it harder to connect with friends and family via new technologies,” said COA Sydney CEO Rachel Tanny.

“They also don’t have the same kind of mobility, so they can’t go for long walks with a friend outside the way that younger people are.

“Many seniors are also neglecting essential self-care by skipping meals or not getting dressed in the morning. Unfortunately, when seniors decline it is much harder for them to get back to where they started.”

Tanny said the situation has been “especially hard” on Holocaust survivors.

“I have had Holocaust survivors say to me, ‘I hid in my house from the Nazis and the bombs and now I’m expected to hide in my house again.’ This triggers PTSD and flashbacks for trauma survivors in ways it doesn’t for others,” she said.

Tanny said all seniors are prone to anxiety, panic and paranoia stemming from a sense of loss and hopelessness.

“Seniors have worked hard their whole lives to be able to enjoy themselves in their ‘golden years’ but rather than enjoying the time with friends and playing with grandkids, they are suffering grief and trauma,” she said.

“Younger people have the hope that this will someday end and they will be able to live the rest of their lives in freedom, but seniors have the sense that their time left is short and they grieve that it is being spent in isolation.”

It is important to look out for signs that indicate if the ones we love are struggling.

Hastie explained, “This could look like a change in behaviour, withdrawal from others or from things that bring them joy. Another sign is a general reduction in being able to look after themselves.”

Kraner said ups and downs are to be expected, “But if there is a major change that persists over time, that can be an important sign that a person is having difficulties.

“Finding it difficult to feel any happiness or hope at all, general loss of interest in activities that are normally enjoyable, not looking forward to anything, can all be signs that someone is in need of some extra support,” she said.

If you are concerned about a loved one, it is important to start a conversation.

“Empathising with and validating the person’s experience can make a big difference,” said Kraner. “Allow the person to have the space to talk or to vent without pressuring them to ‘cheer up’ or ‘look on the bright side’; instead, you might try a simple ‘I’m sorry things are so hard at the moment’ or ‘What can I do that would be most helpful right now?’.

“Send a regular check-in text or schedule a weekly phone call or walk. Encourage the person to prioritise their self-care and be kind to themselves – and most importantly, to connect to support if they need it.”

Tanny said it is important to pay attention to the demeanour of older loved ones.

“We have many seniors break down and cry when speaking to us. But the signs they are struggling may be much more subtle. They may call more frequently than before or they may even deny offers of help because ‘someone less fortunate needs it more’,” she said.

Tanny said the best way to help is to provide additional support and contact.

“If you don’t have time to call more frequently or chat for longer, help them get in touch with a service like COA’s Shalom Connect phone support program,” she said.

“If you’re fully vaccinated and in the same LGA or 5km zone, go for a walk with them. If you’re not able to do that, help them access services where volunteers can legally visit them.”

While it is undoubtedly important to look out for indicators that others are struggling with their mental health, it can often be more difficult to notice changes within ourselves, Kraner said, “Especially when they creep up over time. Finding it hard to get up in the mornings; feeling much more irritable or angry than usual; feeling hopeless or panicked about the future; feeling that there’s nothing at all to look forward to – these are all signs that we might be in need of some extra support.”

Hastie noted that a way to tell is “by mentally checking in with yourself”.

“Are you avoiding thinking about how you’re coping at the moment? Are you dismissing others when they ask you how you’re doing? If this is happening, it’s probably all the more reason to reach out,” she said.

Self-care is very important, Hastie added.

“For some that may be ensuring you are eating regular meals and showering each day. For others that may be taking time to relax and recharge,” she said.

“Human beings are very resilient. We shouldn’t underestimate the strength in ourselves and our communities.”

Kraner said it is important to try to keep some degree of routine as much as possible, get outdoors for a walk “even if you don’t feel like it” and even try to give back in some way to help with feelings of purpose and connection.

Lowy emphasised the importance of maintaining social networks, even if not in person.

“Remain connected to friends, family and community members via telephone, email, social media or video conference,” she said.

“Pay attention to your own needs and feelings, and find a healthy activity to do each day that grounds you or gives you pleasure, such as going for a walk, phoning a friend, or taking a bath.”

Lowy urged people to limit their exposure to the news.

“Rather than constantly listening to a stream of news reports, which can cause us to feel anxious or distressed, seek information updates and practical guidance at specific times during the day from health professionals,” she said.

Lowy added, “Try to adopt a flexible attitude to the changes that are taking place. Mental flexibility reduces the onset of psychological stress.

“Accept the idea that ‘things may not return to the old normal’ and ‘change’ may become the ‘new normal’.”

IF YOU NEED TO TALK TO SOMEONE

JewishCare (NSW): 1300 133 660
Jewish House (NSW): 1300 544 357
Jewish Care (Victoria): (03) 8517 5999
Mental Health Line: 1800 011 511
Lifeline: 13 11 14
beyondblue: 1300 224 636
Mensline Australia: 1300 789 978
Kids Help Line: 1800 551 800
Domestic Violence Line: 1800 656 463
Suicide Call Back Service: 1300 659 467

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