Date published: 28th March 2020
At the beginning of this week (Monday 23rd March), Prime Minister Boris Johnson announce a near-complete lock down of the whole United Kingdom, as Coronavirus mortalities continue to rise exponentially and the NHS braces for the approaching avalanche of unwell patients. On the same day as Johnson’s announcement I was chatting to a journalist friend who asked me “what is your biggest fear in this pandemic?”. After a long pause, I answered: “I am fearful for my mental health”. Yes, I am fearful for my own safety and the risk to my health and life, working as an A&E doctor. Yes, I am fearful for the lives and health of my friends and family. Yes, I am fearful for all my friends who face redundancy or financial peril. But my greatest fear as the Coronavirus pandemic progresses is the danger it poses to my and others’ mental well-being.
As I have written about previously, I suffer from mixed anxiety and depression. And those who know me well will know that I have had a bad bout of depressive symptoms in recent months (prior to Coronavirus escalating in the UK).
In the first half of this article, I am going to unpick the ways in which the Coronavirus pandemic can potentially harm our mental health. And in the second half, I will explore how we can look after our mental health during this tough and trying time.
The Effect of Coronavirus on Mental Health
Sickness and Death
Firstly and most obviously, many of us have a very legitimately fear for our health and lives, and for the health and lives of our loved ones. As the infection spreads round the world, and as the mortalities climb, the virus increasingly threatens the safety of us all. And as time goes on, more and more will experience the devastation of losing loved ones. Sickness and death shake us to the very core of our humanity.
Uncertainty and Insecurity
Uncertainty about the future is also a major source of anxiety during this pandemic. Numerous industries and businesses have closed, with fears that some will never reopen. Schools and universities have abruptly shut, leave the educational futures of many students in limbo. And the NHS waits in fearful anticipation to see if our services can bear the burden of what is to come. Uncertainty on this scale is justifiably frightening.
Poverty and Scarcity
As most of the UK economy closes down, thousands of people have already been made redundant, and many more have been thrown into financial peril. And because of stock-piling and panic-buying, it is now challenging to find even basic supplies like bread and toilet paper in the supermarkets. Coronavirus has made simply maintaining the necessities of our lives turn into a stressful and burdensome experience, with the poorest hit hardest.
Loneliness and Isolation
As the country goes into lockdown, and as individuals self-isolate due to symptoms, contact with symptomatic people, or health risks, the effects of loneliness on mental health are becoming increasingly concerning. People are losing their social support networks, relationships are being broken off, and community services are becoming less accessible. And among the greatest at risk are individuals who do not have access or ability to use social media and those who live alone.
The effect of social media makes this pandemic unique in world history. We are being constantly bombarded and often overwhelmed by masses of information and opinions from sources of varying degrees of credibility. And social distancing is exacerbating the problem, as people spend more and more time on their devices. Of all these risks to mental health, I think information overload is the most prevalent one among millennials.
The Health of Health Workers
The possible effects of the pandemic on the mental health of health professionals really frightens me. An already over-stretched workforce is going to be pushed to its absolute limit. Clinicians are going to have to face many of our patients dying. And of course, we are all acutely aware of the risk to our own health, working on the front-line. I already know of one suicide among the London workforce, and I have the horrible certitude that it will not be the last.
For all these reasons and more, the Coronavirus pandemic poses a real and significant threat to our mental health. So how can be looking after our mental health during this time?
Looking After Our Mental Health: Mental Hygiene
If you were to ask me “who has been your greatest life influence?”, I would not hesitate to say Prof John Wyatt. Prof Wyatt is a friend and mentor of mine, and Professor Emeritus of Medical Ethics at UCL. He has also suffered from an acute psychiatric illness, and has personally helped me out from some really dark periods of my life.
In an article titled “How To Be a Recovering Perfectionist”, Wyatt advocates for the discipline of “mental hygiene”- an idea that he roots in his Christian faith:
We all know that if we wish to remain healthy we need to practise physical hygiene. Hands need washing every day. Just because I washed my hands yesterday does not mean that they don’t need a wash today. In fact my hands will need washing every single day of my life until I go to glory. It’s part of being human.
Just in the same way it is helpful to practise the discipline of mental hygiene. That means monitoring the content of my thought life and choosing to fill my mind with positive and healthy thoughts rather than negative, damaging and unhealthy thoughts. And just because I did this yesterday, does not mean that my thought life isn’t important today and every day to come. There is a daily discipline of keeping my thought life healthy.
The apostle Paul gives a wonderful illustration of mental hygiene in Philippians 4:8. “Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.”
It’s an interesting list. It starts with truth. Mental hygiene starts with focusing on truth and realism, rather than lies and fantasy. Of course, this includes the truth of God’s unconditional love and care for us, his acceptance of us in Christ and the limitless forgiveness he offers. Second, Paul refers to the noble, the right and the pure. These are all aspects of goodness. We are called to focus our thoughts on everything that is good and morally pure. Third comes everything that is lovely, excellent and attractive. These are all aspects of beauty.
During this pandemic, the importance of hand hygiene cannot be overstated. “Hands need washing every day” could probably be updated to say “hands need washing as many times as possible each day, for a minimum of 20 seconds each time”. And similarly, the importance of mental hygiene cannot be overstated.
So how can we fill our heads with truth, goodness and beauty during Coronavirus?
Meditating on truth necessarily involves filtering out all the junk and noise that jams our minds. It is clearly vital to keep to date with the latest government and NHS guidance. But it is also wise to be careful with how much time we are spending scrolling through our social media feeds and reading opinion pieces about what the future holds (and yes, I do see the irony of this saying this in a blog article). I for one, need to better cultivate the discipline of turning my screens off, for the sake of my mental health.
My social media feeds are saturated with sad statistics and anxious forecasting. But amongst the pain of the pandemic, there are positive stories to be grateful for and celebrate. Communities have come together to look after the vulnerable and the unwell in a way I have never seen before. The nation has united across political and social divides to support the NHS; I have been greatly appreciative of the kind gifts given to us by various companies, and was deeply moved by the national applause on 26th March. People are finding more time to talk to friends, independent of geographical proximity; last week was the first time my entire immediate family did a video call since us all leaving home. And the environment has had a sudden cleanse; Venice’s canals are clearer and London’s skies are cleaner than they have been in a long time. Whilst we have to be real about the pain and suffering of the pandemic, we can still meditate on these good and encouraging events.
We may not be able to go on exotic holidays or visit art galleries. But we still can fill our minds with beauty. Most young professionals I know rarely have time to regularly playing music, paint pictures or watch films. But clearly times are different now. In the hectic business of modern life, stillness and quietness are craved by so many and experienced by so few. It would be a shame to go through this pandemic and miss the opportunities to utilise the stillness and quietness of lock-down, through enjoying music or art or literature or cookery at home. We probably won’t get another opportunity like this again.
As Wyatt mentions in his article, Christians believe that truth, goodness and beauty find their richest fulfilment in the Christian gospel message of Jesus, who, out of love for us, descended from Heaven to Earth to bear our pain and grief even unto death, and who then defeated death by rising from the dead. How the message of Jesus addresses our fears of death, insecurity, poverty and loneliness is the topic of an upcoming article.
But for now, let me close by saying that whether we work in health or not, and whether we have underlying mental health issues or not, all of us need to maintain mental hygiene during this trying time. As this pandemic unfolds, I am fearful of the effect it may have on my mental health and that of my friends and colleagues. But I do also believe one of our best weapons against Coronavirus is regular and disciplined hygiene- both physical and mental.