Mental Health Impacts of the COVID-19 Pandemic

Voice Over

0:00:01 – 0:00:19

Ben Cooper

0:00:20 – 0:00:45

Charlotte

0:00:46 – 0:00:50

Ben Cooper

0:00:51 – 0:00:56

Charlotte

0:00:57 – 0:05:57

What is mental health? What are we really talking about here? Because mental health is often put out there as a strap line, as if it’s this specific, tangible thing that either you have or you do not have. And actually that isn’t, that isn’t true.

In fact, there’s a great model that came from Canada known as the Mental Health continuum and I really like their model, and I also think within that – and I’ll explain a little bit about that – but if we if we change the words mental health, to well-being okay? And you could add psychological well-being if you want to. But the reality is our physical health impacts our psychological health and our psychological health impacts our physical health.

So you could just say, look our well-being is, that model really says, “Look, all of us are fluctuating on how we’re doing on our, in our wellbeing day to day. Okay”? None of us are consistent because we’re not robots. We’re organic. We’re human beings and we live in a world that’s ever changing, and we have to respond to that ever changing world as well as the fact that internally as organic human beings, we are ever changing. We are not identical one day to the next. You know, we have cells that die and cells that renew. And so, in this dynamic, ever changing situation, we can’t expect something like our well-being to be static as if it’s a thing and it’s never about it being a thing.

It’s really about understanding, where am I in terms of do I feel quite healthy? Do I start to notice that I’m maybe reacting to the things that are happening around me a lot more? Do I suddenly start to feel like I’m reacting in quite an excessive way? Which in the, this mental health continuum from Canada, they would class this as sort of ‘injured’ category. Or do we get to the point where we’re really impacted in our well-being consistently and actually we could say that we’re ill at that point.

So if we start to look at it as this continuum, we’re in constant flux, and some days we have extra pressures, extra deadlines, additional – additional demands from family or from friends or, you know that come in. And the pressure that we feel means that we feel a lot more stressed. So we have a higher stress reaction that’s happening in our bodies. And we suddenly notice that we’re a lot more irritable. We’re a lot more impatient. We can reach overwhelm much more quickly. We are not sleeping as well. We can feel our muscles are a lot tighter. We feel less inclined to call our friends and speak to them on Zoom.

We start to say I am sick of Zoom. I’m sick of my calls, or we maybe start to reach for things to help us cope. So maybe the donut. Or maybe the extra G and T at night. Like whatever it is, these start to be signs, actually, the things that are happening for me in and around my life are putting me under pressure to the point where I’m feeling it and I can spot that because of my behaviours and what I mean by that our behaviours are, um that the things that you don’t consciously think about, the things that you automatically do day to day.

And then we also notice it by the activities, where an activity is a conscious choice. So what do I choose to do and within that we’ll then notice a shift in mood. So mood is like an emotional state, it’s a, it’s an emotional state we stay in for at least usually at least an hour, so we feel low maybe, we feel it all morning. So that was a kind of, we are in that state, that mood state for that morning and as we start to look at this, you know, we see our thoughts change. Maybe we become a bit more pessimistic, a bit more negative. And we become more of the glass half empty person rather than the glass half full.

We see less potential around us, so our thoughts and our attitudes are changing. So the more that we start to see these changes, the more we’re starting to move along that mental health continuum, where its case of, wow the things are happening for me in my life are starting to get to me a little bit more, and that’s where it’s all about making choices to say, I can do something about this and I can start to bring myself back to a more of a healthier, balanced place for me. And I should also reiterate that what healthy looks like specifically, that will be slightly different for each individual. Because we are human beings.

Ben Cooper

0:05:57 – 0:07:25

You sort of picture that person that you know, this pandemic and the process of lockdowns has changed everything. So before you may have been someone that was smashing life out of the park, your job was easy. The way you did everything before was just a doddle. You know, your marriage was great. You were both achieving, your home life was easy. Your job was easy the way that it used to be done. You used to have your gym routine worked out and you drank on a Friday night and that was it. And everything was hunky dory, all a doddle.

You can see how maybe there’s an awful lot of people out there right now, but all that’s changed maybe after the months that had passed by home life is difficult because everybody’s in each other’s pockets. You have put on a bit of weight because you can’t get to the gym because it’s closed and you reach for your extra donut? As you just said, maybe you also have a beer to at night because, you know, everyone stressed and miserable, so that doesn’t matter so much anymore.

On all of a sudden, maybe we get to February-March and the vaccine’s out there and people are returning to offices and maybe for the vast majority of people, life just bounces back to normal, and it’s fine. But maybe for a lot of people, it doesn’t. And they’re going to struggle to return life to either what it was or, as you say, an equilibrium of a new normal. But reintroduce all of those things. Is it about vigilance? Is it about communication and having other people say, “Look, you know, you’re doing these things that you never really used to do”? How do we spot that before it moves too far?

Charlotte

0:07:26 – 0:11:12

Well, the reality is, first of all, you have to know what are the things that tend to impact us as people, as human beings more. So, there are certain factors, so one is for instance, loneliness is a significant factor, and loneliness isn’t about having people around you. You’ve just described there that you know, somebody has say quite a sociable life, so they have their other half and family at home. But normally they’d have been, they’re a social person. They interact with colleagues at work in the day and then they would have friends that they would meet for say the drink after work.

Well for that individual, first of all, suddenly being contained a lot of the time within one location with one’s other half for many people. I mean, we do know there’s a lot of reports I’ve been reading about the increased tensions that are happening within relationships and marriages because it’s hard for people to get the space that they would normally have and so what happens is we begin to create space by creating a way to emotionally distance.

But what happens with that is that because we can’t physically distance, we would emotionally withdraw a little bit, which is protective. But then that accentuates a sense of loneliness. If you combine that with then not seeing the people that would normally bring a lot into your life, so colleagues and friends, that amplifies a sense of loneliness. Now the reason I emphasise loneliness is that it’s one of the biggest risk factors that there is in terms of our psychological wellbeing, and it’s also when we feel connected to the right people in our lives, it’s our most significant protective factor we have. It’s the thing that keeps us well and when we struggle, it’s a thing that can bring us back from the edge. Um, now, this isn’t about how many Facebook friends somebody has. It’s rather about identifying, “Gosh, who are the people I genuinely trust and I value and who I feel trusted and valued by. And I can really, I can hear what they have to say to me because I trust and value them and so if they tell, me look, I seem to be struggling” because, they’re often the people we can take that from. But sharing that in connecting with them and talking to them about that also adds as the sort of resolution, you know the balm to the injury and helps us heal. So I would say loneliness is a key factor for people to consider.

So to summarise that, you know, one of the things is yes your own self-awareness. Yes, input from people you trust and value. Ensuring you ask yourself about “Do I feel connected? And if not, how do I achieve some of that?” Even if it is via Zoom, even if it is by the telephone, how do I find a way to connect with the key people who really make a difference to me in my life?

And then am I doing the things to take care of myself, where I can? and that helps to give people a sense of control back, which reduces a sense of hopelessness. It reduces helplessness, and that helps our overall well-being increase. Whereas actually, if we don’t have that, one of the difficulties is it, it can lead often to a very negative and sometimes quite dangerous place.

Ben Cooper

0:11:13 – 0:12:02

Charlotte, some of those observations are really, really interesting because some of those examples you give there are things that we do think about, we are conscious of. Reaching for an extra drink at night. You know, it’s the first thing we sort of catch ourselves doing, and we think that I probably don’t need to do that. Some of those other things creep up on people, and I just wonder if there’s a few more that you could that you could talk to there.

So, for example, shying away from social activity, I don’t want to do the Zoom call because, you know, I’ve been on Zoom all day. Where really what you’re saying is, I don’t want to do the zoom call because, you know, I just want to be on my own. I’m turning away from social behaviour, but I’m sort of denying that, really. You’re not sleeping so well at night. Your habits are changing. Your mood is changing. You know, the other things that you think people could be more vigilant about, could spot earlier, but but they tend to just turn a blind eye to it.

Charlotte

0:12:02 – 0:21:13

So in answering that question, Ben, I think first of all there’s a little bit, a little bit of science. I want to explain that I think could be really helpful for people. So, well, what we’re talking about here when we’re talking about well-being, is we’re talking about going through a situation where we’re experiencing more stress than we did prior to the pandemic and when we say a different kind of stress, what we mean is we are having a stress response to the fact that we’re having to deal with situations that require us to make changes in our life that previously we hadn’t anticipated and where there may be greater levels of uncertainty about our future and really additional things to have to deal with day today, so those are stressors that we’re having to deal with.

Now when we have stressors in our life. So that’s the things that can make us stressed, we have a choice as human beings. So we look at that situation and then depending upon how we perceive the situation. And I would say the big question is always “am I looking at this situation and am I seeing it as a challenge? Or am I seeing it as a threat”?

So a simple example could be you’ve learned a new routine for your work. You know you’re working from home, all is well and then you get a phone call from your boss and he asks you to completely turn your day that you’ve got planned ahead upside down. And I need you to do this first and then I need you to do that and then I need you to do this. And you had your day all mapped out and having your day mapped out and having the routine to that is part of what keeps you well.

When you’re asked to, faced with that situation, does that feel like a threat like, but I have my routine. And I know that’s how I like to work. And now this is, I’ve got to face this. So we react in a, we react as if the situation is a threat. And it is a threat in some ways, if we see it that way, coz it’s a threat to your established norm, the established routine of your day and you’re being asked to change it.

Now, when we see that as a threat, we will have a stress response so the body responds to threat with a stress response, which is physiological. Okay, we’ve got different levels of adrenaline and cortisol fundamentally in our system, that create changes to the body and brain. Which is what I’m gonna come to. But if we see that situation as a challenge, “ Haha! Look at this. I have my, I have my routine, all planned out and look at this. I now have to turn my day on its head. Rather not. But you know what? Bring it on. Let’s see how I can deal with this.”

Now, the moment we start to look at a situation as a challenge rather than a threat, we don’t feel threatened by it because what’s happening is there is this underlying, well, our word would be in psychology would be self-efficacy. But you can think of that as like mastery, like I feel confident that I can handle this situation and I could do this. So we have almost a ‘bring it on’ attitude. We still have a stress response, but it’s lower and it’s actually something known as you stress, which is positive stress.

So all stress is not bad. It’s simply about the level of the stress response we have. So there’s an optimum sort of window where if we have a certain amount of adrenaline and cortisol, we function well. We feel on our game, we feel quite enthusiastic. Like yes, I can deal with the day. Come on, bring it on.

But once the stress starts to tick up too high, that’s where we start to feel fatigued. We start to struggle with our attention, our concentration and it can get gradually worse and worse as the stress levels build. So the first key question is always “How am I perceiving the situation I’m in”? and am I perceiving all these things I have to deal with those challenges or threats and depending on the balance of that, think of it as weighing these challenges as a see saw, one side I see these and reacting as if they’re threats to me, my life, my way of life. And on this other side I balance out the things I sort of more see as challenge and that will depend overall the level of stress that we’re experiencing.

Now this is important because when we have higher levels of stress okay, first of all, we respond with adrenaline. The second thing that kicks in is cortisol and cortisol maintains the stress response okay. Cortisol is interesting because it creates changes in the brain and it’s really important to understand that once were in a higher stressed state, – what does this mean?

Well, first of all, the more stressed we are, the more the brain becomes threat focused. So the more likely we are to see situations that we might once have seen as a challenge, as a threat. So we start to see threat everywhere, and you know if you’re in this place because you’ll feel yourself react like somebody can just ask you, “You want me to make you a cup of tea?” and you’ll snap, and you’ll start to experience that, like you respond as if there’s threat all around you. Everything seems like a problem. Another email drops into the inbox, and it’s like “I can’t believe it. I’ve got that to deal with this as well.” Spot that. It’s telling you your stress levels are higher.

So your brain is becoming threat focused and biased in a threat focused way. What that then means is that everybody talks about neuroplasticity. So this is the idea that the brain is, you know, basically like constantly rewiring itself. And it is, as long as we’re living and breathing, the brain is constantly adapting to what we’re doing most, what we are doing most often, the way we think, the way behave, our emotional responses.

Except when we’re in a sustained, stressed state and the changes in the brain are interesting. So first of all, and the science behind this is really quite fascinating. But first of all, what we go for, that the brain goes for is short term wins. So think about this. When the brain’s in a threat focus situation. it’s not interested in the long term. It needs to deal with the threat that’s in front of it now, which might well be just the emails in your inbox. But if you’re in a threat focused brain like okay and that’s keeping you in a stressed state.

So it becomes very focused on short term wins. Let’s just get replies to these emails out. Then they’re out of my inbox, rather than let me think about how I word these emails because there could be consequences if I phrase something one way versus phrase it another and what will happen is we become, we, the brain is not concerned about long term consequences. So this is one of the reasons why habits first of all become quite unhelpful. So the brain says have the extra G and T to bring you down because it’s been a stressful day, short term win. The brain then doesn’t think about the long-term consequences of this.

Now what also happens is the way that cortisol impacts the brain is that, Neuroplasticity reduces, so think of it like the, the brain becomes a bit sticky, like its, little habits form so much easier, and then once they’re formed, is much harder for the habits to break whilst were in a stressed state. So it becomes, we form the habits of just batting back the emails without thought or just reaching for the extra glass of wine or G and T, and we will form that habit much easier, but then find that habit much more difficult to break for as long as we’re in the stressed state.

So this is important to know, because I think often people really beat themselves up about “oh look what I’m doing. This isn’t good for me and that isn’t good for me” And it feels such a fight to change. And the answer is, it is a fight to change because your brain is sticky, think of it that way, you know, and it’s making it harder to change those habits.

The easy way to change the habits is say, what’s happening around me that’s really adding a lot of stress to my life. Can I change how I look at that to then being a challenge rather than a threat? Because it will change my stress response and you know what, habits become easier to change again. You’ll reach for less of the wine, less of the chocolate. You’ll want to be more sociable and more active.

And so, in understanding a little bit of the science of what’s going on, I think it also helps people be a little bit more compassionate towards themselves. Understanding towards themselves, and others, and also potentially be a bit more constructive in how they think of and respond to anything that acts as sort of a stressor for them in their life. Does that make sense, Ben?

Ben Cooper

0:21:13 – 0:22:54

Yeah, an awful lot of that makes an awful lot of sense, and I think it will to the people listening to this as well.

Just thinking back to what we said before. And this is a very granular comment to make. But, you know, there will be people who, for who the pandemic did change everything. You know those people that were kind of sort of cruising along and everything was fine. And maybe it was uhh you know, maybe it was a lost job or a career impact or, you know, a marriage that didn’t survive. But all of that came about purely because of the change that the pandemic brought.

There’s a grief there isn’t, you know, the pandemic did change this cruising down the highway life that they had and if it hadn’t been for the pandemic, it wouldn’t have happened. Everything would have carried on as it was and that there is a grief there. There was a thing to deal with there and that, that, that will certainly last the course over the months, months and years to come maybe for some, so very interesting.

Look, I want to talk about Christmas. We have Christmas on the horizon. We have lots of reasons to be really optimistic about 2021. Even as we’re recording this now, my phone is pinging about vaccines and all the rest of it. We all need, I think, to see the light at the end of the tunnel, we all need to feel good. We all need to think, right 2021 is gonna be much brighter. Maybe we all need to still keep our heads on a little bit as well and keep some of this resilience that we’re talking about. And for those people that maybe have had a really tough year. They are, let’s say, depending on some bad habits that they may be really, wanna, wanna kick.

There’s a certain mind-set they could be in now and do, do you think that as we sit here facing Christmas, we should all be really optimistic about the future? Do you think we should keep our heads on a little bit? What are your thoughts?

Charlotte

0:22:56 – 0:24:30

Oh, you’re asking if I’ve got a crystal ball, Ben? Fundamentally, you know, I’m thinking of almost a Buddhist perspective here. But you know that concept of love and compassion, it’s the one thing that can sustain us and keep us well and keep us healthy. And it’s the one thing that no body and no circumstance can take from us as human beings. Nobody can take away our ability to love and feel compassion for either ourselves or another human being and something that we can always give however little we ever find ourselves with at any point in time.

It’s something that we can always give, and sometimes coming back to that very human element as people and reminding ourselves is that creates links, bonds, it brings us together in our humanness, that I think is incredibly protective. And is the one thing that can sustain us in times of uncertainty. And perhaps more than any other year, perhaps this year we will all become more aware of that and perhaps if a little sprinkle of that continues more into next year because of it, I think it will be a wonderful thing and I also think it’s something that will, everybody will find help sustain them through whatever the challenges are in the coming months ahead.

Ben Cooper

0:24:31 – 0:24:46

Charlotte

0:24:47 – 0:24:49

Voice Over

0:24:50 – 0:25:21

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Understanding how your body responds to stress | Psychotherapist Charlotte Copeland – Part 1