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COVID-19: An overview of mental health challenges when in isolation from professional perspective.

In the early weeks of March, Europe plundered into the depths of COVID-19. This forced a chaotic domino effect of countries shutting down. People’s freedoms were stripped in the name of preserving the health care system. 

Here we are now, almost two months later. European countries are beginning to loosen their lockdown policies. This gives people a taste of their former life. Seven weeks of crisis forced those indoors to face the harsh reality. What will happen? How long will it be like this? Will it ever go back to normal? These consuming questions circled the minds of every citizen, consequently taking some kind of toll on the majority’s mental health and well-being. 

Although still relatively taboo, mental health is detrimental when in a period of constant uncertainty. Dysfunctional thoughts can grow in those worried about the present and coming future. 

This article will give the perspectives of two clinical psychologists from Spain and Sweden. Although with polarized agendas on COVID-19, the view on mental health in isolation is relatively similar. Their synthesized testimonies will detail the challenges individuals and the mental health care system face during this time. 

What challenges are individuals facing?

It appears as though mental health challenges are consistent across regions, regardless of the country’s lockdown policy. Being forced to remain indoors or still being able to go outside both lead to a range of issues. This is mainly due to facing a crisis that changed people’s lifestyles somewhat overnight. It is a normal reaction to a very abnormal time.

Of course, it is challenging and difficult, but at the same time it is normal to have the feelings we are experiencing.”

Loneliness is one common theme felt. Having to self-isolate can mean living alone, living in a different country from your family, or not being able to visit friends. There is a disconnect from an individual’s close support system. This is where one should take advantage of social media, but it seems as though at times this is not as rewarding as face-to-face contact.

A consistent challenge found was a lack of internal motivation – motivators from our own feelings, thoughts, values and goals. Constantly being in an environment where pleasure is promoted, productivity can lose its momentum. External motivation is not questioned because there are many ways to validate productivity with external rewards (e.g. to earn money, my boss will think I am a hard worker). But all of those motivators would not be enough when there is no balance with internal drive (e.g. I need to do this to finish my degree, I enjoy doing this).

When taken together, loneliness, difficulties in motivation, and internal and external pressure can lead to someone feeling more depressed and anxious. For those already facing these issues, isolation loneliness can deepen their distress. Depending on the severity, those with pre-existing psychopathologies lack the active support needed to overcome their problems. In the long-term, this can is harmful as it prolongs their dysfunctional patterns and recovery time. This can also be applicable to those first developing these dysfunctions.

To make an overall comparison between European countries is difficult. Although policies are different, the same general issues are arising. One must also factor in that each form of mental health issues/disorder is unique. The severity of the lockdown can be moderate how severe the mental issues can progress to. However, it these claims are not generalizable because the severity of the problem varies between people.

The disorders are so different from each other, but one could say the harder the isolation, the harder the situation”.

People are grieving the loss of normalcy in their lives, constantly ruminating over questions like, “what happened to my life?” and “will I ever get that back?”. It is mourning the disruption and possibly the loss of a life they had control over, and now individuals are unsure of what they can do. This fuels behavioral distractions like increased alcohol consumption and reliance on digital media to escape.

What challenges does the mental health care system face? 

Given a rise in mental health issues during the COVID-19 period, it would be safe to assume this also means a rise in mental health care. Frankly, it appears to be the opposite. Even from pre-COVID-19, the industry is underfinanced, understaffed, and has an overall lack of resources. This already makes seeking mental health care laborious and waiting lines seemingly endless. The vulnerable population is growing, and the demands are not being met.

With added lockdown measures, many treatment centers have to cancel existing appointments or find alternative methods to avoid patients being admitted for hospitalization. This means, adapting the structure of the current mental health care system towards targeting more pressing issues. Consequently, neglecting other aspects beneficial for welfare. But this is typical not only to the psychological sector, but to all health care facilities.

We need to use shorter crisis interventions to help people stay at home since long-term psychological care is no longer there.

The online method of counselling is not attractive to patients. Again, it lacks the face-to-face intimacy that is not replicable. Given that it already takes large amounts of courage to physically seek help, the same or even more is needed do it over the internet. Some do not feel safe speaking about confidential information online. It does not feel as genuine or comforting as human interaction.

It is also difficult to find ways to combine physical and mental techniques. People are constantly in front of their own devices, disrupting a balance in lifestyle. The information overload we get from the government and news outlets on COVID-19 makes it even more difficult to remind patients to focus on their coping strategies. Individuals need to be able to move, exercise, and take advantage of the outdoors to balance with staying indoors.

This can make people enter a vicious cycle that pulls us down.”

It is also dependent on how accessible the health care system is. Some countries do not offer public mental health care, leaving more individuals without access to help. Administrative duties (e.g. paperwork, journals) are increasing. This is also a prolonging factor since it is unproportionate to the time you spend with the patient. The industry needs to evaluate how it is delegating the appropriate energy and resources, and rather focus on what is most important.

Patients have to want treatment, but many seem to slip through the cracks. Some are not responsive, or it becomes increasingly hard to contact them. What we see now is that individuals are only seeking help during COVID-19 if the problem has become drastic. People are not recognizing there might even be a problem. When in reality, they should seek help when it begins manifesting.

This is only the tip of the iceberg.”

A reminder

The COVID-19 period has created challenges we never saw coming. What many forget to internalize is that the issues we face is affecting everyone. Although in varying degrees, it is safe to say, you are not alone. The lifestyle challenges we face now are only temporary and eventually life will return to some form of normalcy. But in the meantime, addressing your own mental health by seeking help can improve your situation for the better.

*Our current project investigates student’s mental health and well-being across Europe. The next publication will address the recommendations these psychologists offer to improve your own well-being when in isolation.

This article was based on the compiled interviews from two clinical psychologists.

Caroline Nordeman, Sweden.

Anneleen Franssens, Spain.

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