The other second wave: ‘We need to be prepared for what’s coming down the line’

The current pandemic isn’t just a medical and social emergency. Now looms the potential for significant negative mental health impacts, writes Amanda Cassidy

“The only way through this is through,” admits Fiona Staunton. The mother of two runs a successful cookery demonstration business, and she has had to face more than most during this pandemic. But her outlook has been overwhelmingly, and refreshingly, positive.

Fiona’s father sadly passed away after a heart attack during the early days of lockdown. Just a few weeks later, she was diagnosed with breast cancer.

“Because of all the restrictions, you are on your own in that room when the doctors are about to deliver the news, when they ask that question: ‘Do you have anyone here with you today?’ And you know that’s not good. You have nobody to hold your hand in that moment. But you have to just get through it.”

When it comes to our mental health, we’ve all had a lot to contend with over the last several months – job losses, financial uncertainty, reduced medical services, funerals without mourners, weddings without guests, pregnancy scans without partners, isolation, anxiety…

For some, lockdown brought with it the silver-lining of lifestyle change, a freedom to work from home and the chance to re-evaluate what we really want from life. This has been a collective experience, but also a solitary one. For many others, the disruption has been unsurmountable, spirit-eroding, devastating.

The only way Fiona says she is coping is by trying to focus on what she does have, instead of what she doesn’t.

One of the things this Covid journey has taught me is the importance of resilience. We have to dig deep, figure it out – there is no other way.

“No matter the situation I was faced with, I tried to see what I could be thankful for. My dad died, yes, but at least he wasn’t in pain. I have breast cancer, but at least it is in the early stages. I have a great family, proximity to the hospital, a roof over my head, fabulous support.

“Of course, I do also feel very unlucky at the randomness of it all – the why-me part, but one of the things this Covid journey has taught me is the importance of resilience. We have to dig deep, figure it out – there is no other way.”

Professor Paul Fearon agrees that resilience is key. As medical director of St Patrick’s Mental Health Services, he believes the country needs to brace itself for the increased need for better resourced mental health services coming down the line.

“All the evidence nationally and internationally suggests that outbreaks like this increase the number of those who struggle with their mental health. Pieta House, for example, which helps those in suicidal stress, have seen an increased number of referrals. But I don’t think we will get a clear picture overall for a while yet. The severe restrictions make it hard to access services.”

It is the story without an ending. And without an ending, we cannot begin to heal.

A recent survey carried out by St Patrick’s during the pandemic found that 45 per cent of respondents have concerns about their or a family member’s mental health due to the Covid-19 pandemic. Twenty-seven per cent of those surveyed also admitted it is the first time they or a family member have experienced such mental health difficulties.

Professor Fearon says that normally in a psychiatric setting, he’d ask patients about any big life events. “One or two such events would be significant. Now, because of Covid, for the last several months everyone has been affected by stresses and have experienced multiple adverse life problems; financial problems, childcare changes, health fears. And there is no clear endpoint. This uncertainty feeds our anxieties.”

It is the story without an ending. And without an ending, we cannot begin to heal.

Psychiatrics and therapists note universally that surges in anxiety during emergencies like earthquakes or terrorist attacks are natural reactions that seldom become chronic.

However, the longer people experience these high levels of psychological distress, the more likely they are to present with a diagnosis that would benefit from mental health treatment.

And then there are those who believe that we are learning to live with the stress.

Tracey Jane Cassidy, who owns and runs Junior Einsteins Science Club, says that lockdown was initially a huge mental jolt to her, both professionally and personally: “Within 12 hours of schools closing, we were online, but it was a huge challenge to come up with creative ways to keep my business going, and to support all my franchisees as well as home-schooling my three children. We found a routine and stuck to it, and that definitely helped. But I had the 4am terrors many times, when I’d wake in the night and feel that burden of responsibility as a mother and as an employer. I tried to turn it into something positive and productive.

“Now there is part of me that feels very refreshed because I managed to steer the business in a direction I never had time to do before. Those long conversations with franchisees both here and internationally brought us closer, and we ended up creating our own support network.”

But she admits that she is now fatigued: “I’m deeply tired now. Adapting is all-consuming, and I think all business owners in Ireland feel the same. It has been a long, tough road. I think we’ll look back and see our country did best to keep us all positive as well as safe. But I think an awful lot of business owners felt crushed over and over during this pandemic. They honestly can’t take much more.”

It’s because of the knock-on effects of pressures such as these that Professor Fearon is keen that the government tries to remain one step ahead. “To buffer the fallout from the pandemic, it is really important that more mental health services are planned for, as well as properly resourced. Thankfully, we are beginning to talk about that now. But we need a national response to this – we need to be prepared for what’s coming down the line.”

We’ve been really honest with our nine- and 14-year-old about my cancer treatment. I don’t want them thinking things are worse than they are

Fiona is also planning ahead. Despite the tighter Dublin restrictions that came in, she is now grateful that her surgery can go ahead. “We’ve been really honest with our nine- and 14-year-old about my cancer treatment. I don’t want them thinking things are worse than they are – they’ve had a lot to deal with emotionally too, and I’m mindful of that.

“Something the doctor said to me recently really stuck with me. He said that in a few months’ time, this will just be something in the distant past.”

When it comes to Covid, we all dare to hope the same.

Professor Paul Fearon’s tips for building resilience during Covid-19…

1. Try not to be obsessed with news. Consciously limit the time you spend looking at your news feed. I’d suggest 15 minutes in the morning and again in the evening. Be disciplined, read reputable sources, and don’t get your information from social media, which can often be anxiety provoking and unreliable.

2. Lack of control of a situation can cause anxiety. In an pandemic, it is hard to find a plan to follow. But let’s flip it and focus on the things we can control, rather than those we can’t. Social distancing, reducing social contacts, mask wearing, hand and respiratory hygiene – these are the biggest weapons against this virus. This is something we can do positively for ourselves and our fellow citizens.

3. Try to find ways to deflect anxiety. We tend to be caught up in how we feel, but it is useful to think about how others around us might feel – our parents, our children, our friends. If we concentrate on them and ask how they are feeling, it has two benefits – it helps others, and it distracts from our own anxiety.

4. To those who have experienced mental health problems in the past, use the knowledge you gained then to help you in this situation. Revisit the coping techniques you found useful in the past.

5. Try to stop in your tracks and do a reality check once a day. Think about things logically. If everything seems vast and troublesome, stop and ask yourself, “Have I been in close contact with others, have I washed my hands, is it likely I’ve picked the virus up?” If the answer is no, then you have done all you can do. This checklist can help decrease anxiety and allow you to feel more in control.

6. Given how disrupted our lives have become, try to work towards a routine. Sleep and wake up at regular times, have a routine for exercise, and work on sticking to a healthy diet. This will help with overall mental health.

7. Finally, bring meditation or yoga into your routine. There are very good apps available that offer guided meditation too. This mindfulness helps us recreate that all-important sense of control over our own lives.

Related: A list of Irish mental health resources to bookmark during lockdown

Related: ‘It’s associated with shame’: How can we stop feeling so lonely?

Related: ‘That end-of-the-world feeling has passed, but 9 weeks of lockdown has taken a toll on my mental health’