COVID-19’s IMPACT ON MENTAL HEALTH—A SECONDARY PANDEMIC
By Elise-Marie Steenkamp
“We are all in the same storm, but not in the same boat. And we have to be aware that everyone’s boat is different and changing all the time.”
This was the message from Dr Colinda Linde, a clinical psychologist during a panel discussion about the impact of the Covid-19 pandemic on mental health. The session was hosted by the SA Depression and Anxiety Group (SADAG) with Linde, Dr Noluthando Nematswerani from Discovery, and executive coach, Niel Bierbaum on the panel.
Linde said that in a pandemic the context in which people operate shifts all the time and that mental health workers across the globe agree that we are facing a secondary pandemic parallel to the Covid pandemic, namely a mental health pandemic.
This has even lead to a psychological concept known as functional depression or languishing, which encapsulates the mood of 2021. Languishing is not quite being depressed, but you are certainly not flourishing either. You are just surviving. Everything is slightly grey and you just go through motions. Nothing excites or has any purpose.
According to Linde languishing is a coping mechanism when the processing of what is happening around you becomes too much. Although it describes low mental well-being, it could be a risk factor for major mental health conditions later.
She said that mental health workers are confronted with three psychological constructs that are relevant in the current situation: burnout, compassion fatigue, and depression, and although they look similar, they are different.
Burnout: Presents mostly during the week, but when Friday arrives there is a definitive mood shift, and someone will feel great and energized. By Sunday, the blues will set in. And on Monday you dread the rest of the week. The cycle repeats.
Compassion fatigue: Is something that caregivers and people in health services generally struggle with. Now, due to Covid, everyone is exposed to it. It can look a lot like depression and burnout but has a definitive phase where everything is being questioned to the point of someone becoming cynical. People are apathetic (don’t care about anything) and numb (don’t feel anything).
Depression: Is a cluster of symptoms. In the pandemic, people will start with either burnout or compassion fatigue, and if those are left untreated, will end up with depression. The first indicators of depression will present around mood. When someone presents with mood disturbances for two continuous weeks such as feeling numb, weepy, miserable—those are the first signs. When mood disturbances are combined with sleep problems (disrupted sleep, sleeping too much or too little) it should be a red flag. This will be followed by other symptoms such as disturbances with eating (too little/too much) libido problems, work problems, inability to focus, etc. (Learn more about clinical depression.)
SO HOW TO COPE?
Linde said that mental health care workers believe nourishing the mental state of flow will help. A flow state (from the school of positive psychology), also known colloquially as being in the zone, is the mental state in which a person performing some activity is fully immersed in a feeling of energized focus, full involvement, and enjoyment in the process of the activity. To achieve this, it is necessary to focus on what you are doing now and remove other distractions. (Learn more about flow state.)
Linde also says that work is good for you. “Ditto routine and structure to a day. Nature is helpful and definitely makes a difference. Have nature breaks. Find something you enjoy and do it regularly. Examples are watching a series/baking/anything that will give you that little bit of juice to pull you out of the grey.”
It is crucial that companies acknowledge mental health issues and understand what employees are dealing with, Linde said. “If you leave depression untreated in 50% of cases the person will feel better after about six months. But in 50% of cases, the situation can worsen. In both scenario’s employers lose out as depressed workers are not productive or engaged, they are often sick and projects and productivity will suffer. The better option is to take action.”
WHAT ABOUT THE WORKPLACE?
Dr. Noluthando Nematswerani, Centre Head for Clinical Excellence at Discovery said that companies should take lessons from the HIV pandemic—a disease that was highly stigmatized. “Companies need to integrate mental health as part of the general health of employees and normalize it. According to her companies will benefit by using screening tools for mental health, and implementing Employee Assistance Programmes (EAP). All employee general wellbeing programmes should have a mental health component.
“Employers should also identify mental health champions in the workplace. They should be vocal about mental health and share their own experiences. That way the company will authenticate mental health and built trust for open discussions. Employees should trust employers not to misuse the information in a punitive manner.”
She encouraged companies to tap into experts to assist with creating safe spaces and to implement mental health screening tools. “You need to be ready so that when people come forward, you have EAP’s and other resources in place.”
HOW DO WE MAINTAIN HOPE?
Executive coach, Neil Bierbaum, said that we need to distinguish hope from wishful thinking. “Hope has a vision, a goal and should be realistic.”
By creating micro levels of hope, we can confront apathy, Bierbaum said. “Something small to look forward to every day/week/month and so on. As soon as you have something to look forward to, your energy will shift.”
Bierbaum said that from an organisation’s standpoint employers need to encourage teams/colleagues to break down their goals into micro-events/achievements (daily, weekly, monthly) that are realistic and manageable. “You still have the long-term corporate vision, but by breaking goals down you improve feelings of control, and thereby it is easier to create small doses of hope. It can improve creativity and confidence, and help motivate a team.”
The hybrid work environment has changed the work/home paradigm. Managers and team leaders should set an example by creating boundaries and self-management. This way, you prevent burnout and the team will be able to perform at optimal levels, he said.
According to Bierbaum companies are held hostage by the busyness culture. “Being busy and sending emails after hours and on holidays, are seen as badges of honour, but what it really does is set bad example for self-management and will inevitably lead to burnout.”
Companies will increase their productivity by declaring certain days of the week as meeting-free days. Or ring-fence the length of meetings. In some countries and some companies, it is frowned upon to send emails after hours and when someone is on holiday – examples of healthy company culture.
According to Bierbaum technology is a big driver for anxiety disorders and even more so in the Covid pandemic. “We have to recognize that social media was designed to hook you in from one negative drama to the next. Misinformation is rife and feeds anxiety and fear. We have to create distance when using technology, and not focus too much on individual events. Create boundaries for technology use focus your energy on actions to restore balance such as exercise and spiritual practices. Issues tend to resolve themselves and we have no control over most dreadful events.”
“We have become slaves to technology and the challenge for companies is to recognize that busyness does not equal effectiveness/productivity.”
He said Covid is giving companies a chance to change unhealthy cultures and teach employees healthy work practices. Employees will be happier, work harder, and stay at companies longer. That is an investment for the company. He warned that in order for employees to feel that companies are taking mental health in the workplace seriously, top management needs to buy in and commit to healthy practices. Lead by example.
HOW TO DEAL WITH COLLEAGUES THAT ARE GRIEVING?
- Most people in the workplace have lost someone close to them to Covid, or maybe to something else.
- It is important to take this into consideration when talking to each other. Or handing out tasks to people.
- Never ignore the loss.
- Rather say, “I can’t imagine how you feel. I am thinking of you.”
- Allow taking breaks often.
- Understand the different stages of grief: Denial. Anger. Bargaining. Depression. Acceptance. (Learn more here.)
- Team leaders and HR should be on the lookout for employees that get stuck in one of the stages of grief and offer help if need be.
- The first six months of the grieving process will be difficult with people grieving differently and moving through the stages of grief at different tempos.
RESOURCES:
- https://thoughtsfirst.com/
- https://www.verywellmind.com/five-stages-of-grief-4175361
- South African Depression and Anxiety Group.
- Book recommendation: Anti-Social Media by Siva Vaidhyanthan