Alongside the sometimes severe or fatal physical consequences of the Coronavirus there is a threat far less often discussed, the mental health implications of Covid-19. The true breadth and depth of this silent pandemic is only now becoming clear, writes Professor Sir Graham Thornicroft.
Health Anxiety & Mental Distress
What are the mental health effects of the pandemic for all of us, for the whole population? The early features of what is called ‘health anxiety’ were manifest from the first few days: panic buying, stockpiling and hoarding. Research in recent months has painted a picture of more prolonged and more generalised damage to public mental health. One study in the UK compared rates of mental distress in the general population between the spring of 2018 and spring 2020, which increased from 18.8% to 27.3%.
But these large increases did not occur equally across the population. Mental ill health grew more among young adults, women and people living with young children. A separate survey, also early during the pandemic, found that anxiety and depression were higher among young adults, women and people with risk factors for Covid-19.
A sobering discovery is that this increase in mental health problems during the pandemic may be a global phenomenon. Data from the United Nations have shown that in April 2020, levels of depressive symptoms were three times higher than the year before. A little later, in June, mental health and substance use problems were found in 40% of people in a survey in the USA, about twice the premorbid rates, at the same time as overall use of alcohol increased by 14%, with heavy drinking jumping by 41% for women.
- Understanding difficult feelings
- Tips for taking care of your mental wellbeing
- Looking after your practical needs
- Further advice and support
- UK Government coronavirus guidance, in English. This includes guidance on shielding and protecting vulnerable people in England, and on coronavirus restrictions across England.
- Welsh Government coronavirus guidance, in English and Welsh. This includes guidance on shielding and protecting vulnerable people in Wales, and on coronavirus restrictions across Wales.
Mental Illness – the destructive power of the mind.
Many of us may have unwittingly experienced achievement addiction at work. During our careers we have likely received positive rewards, not just monetary but emotional too – respect, camaraderie etc. Over time we may have reached a point where we need this positive feedback as it has become an essential aspect of our existence, essentially a large part of ‘who we are’. At retirement much of this can disappear and we may well miss that ‘warm glow’ that we never realised we had but become aware that it’s absence has left a gaping empty hole, maybe even Goosebumps and sweating – “Cold turkey” refers to the abrupt cessation of a dependence and the resulting unpleasant experience, as opposed to gradually easing the process through reduction over time or by using some form of replacement. So, knowing this we might want to reduce the ‘drug’ slowly or at least know what to expect and have a plan so as to mitigate the ‘clucking’ withdrawal symptoms.
Psychiatric illness has been linked to 20% of early retirements and there is evidence that involuntary retirement overall increases the possibility of mental disorders especially in men below 65 who are more likely to have mental health problems than their working peers and retirees above this age. Interestingly the poor mental health appears to be linked to being retired under the age of 65 rather than poor mental health being a reason for early retirement. So, the FIRE types (Financial Independence Retire Early) may well not enjoy their TOYL as much as those waiting and retiring later. Why would this be?
Depression is the single most significant risk factor for suicide among the elderly. Sadly, many of those who commit suicide did, in fact, reach out for help – 20% see a doctor on the day they die, 40% the same week and 70% the same month. Suicide rates are highest among people over the age of 65. According to the Substance Abuse and Mental Health Services Administration, the proportion of older people treated for a combination of cocaine and alcohol abuse tripled between 1992 and 2008. For this group, in 2008, cocaine abuse was the leading cause of admissions involving drugs with abuse of prescription drugs a close second making up over half the total. Too often people enter retirement with plenty of money but lose their sense of purpose, feel alone, less relevant, and either become depressed or turn to drugs and alcohol to try and fend off the dark side of retirement. New and existing retirees are advised to make specific plans to help them avoid these pitfalls. A successful transition from the workplace to TOYL requires people to embrace the fact that investment in traditional retirement planning requires an equal amount of time spent on tasks such as:-
- Replace your work identity – what is it that makes/made you answer the question “…and what do you do?” with “…I’m a doctor, lawyer, truck driver, XXX” or worse still “…I’m retired”. This to you and me may well sum up concisely the later part of our life story but to those out there can come across as somewhat negative. (“…and then you die?!”) Why not try and describe who you are now and who you are going to be even if it’s “…I’m a SKIer!” (Spending Kids Inheritance!) Gardener, golfer, child minder, husband/wife, homemaker, avid reader, musician, student, traveller etc.
- Establish a healthy active lifestyle – I think I might leave this for another blog or six! Save to say that if you have had a physically demanding or pressured job you might have expelled a great deal of energy or missed meals. Isaac Newton said in his first law of thermodynamics, also known as the Law of Conservation of Energy that ‘Energy can neither be created nor destroyed; energy can only be transferred or changed from one form to another.’ To you and me that means if you do less physical activity (using energy) and eat the same or more (adding energy) you’ll become FAT (Stored energy). That’s when to lose weight you’ll need to eat less and exercise more – why wait – prevention is better than cure!
To cope with the stresses of work life you like many others may have used drugs to get you through – the most popular are nicotine and alcohol – Your intake of these may have been modulated by the overt strict rules around smoking in the work place as well as the often unwritten rules of drinking in the office or turning up drunk or hung over. Some things to think about modifying or at least avoiding escalating!
- Stay involved and socially connected. – An unknown but wise person once said, “Retirement is wonderful if you have two essentials-Much to live on and much to live for.” If like many, a large proportion of your social connections are through work you may well miss even those connections and relationships you previously thought were far from ideal! Even if you decide to make the effort some of these ‘friendships’ may well have been built on the common purpose of work and might not survive the break. It’s likely YOU will need to make the effort to keep up. If retiring earlier than others or your cohort are much younger you may well find they are too busy working to join you in your TOYL whilst they can only dream of theirs! So, you may well have to take the advice of A. West, who said “Don’t act your age in retirement. Act like the inner young person you have always been.” (…and maybe don’t rub their faces in it that you are in fact retired!)
- Plan – resolve wants and needs in your significant relationships BEFORE you TOYL, always remembering that yours may be VERY different from your partners. I’m reminded of a seminar given on the “3rd Act” – for this is what the organisers called it. One exercise we had to do involved taking a few minutes and visualising what retirement looked like for each of us. Many attendees had come on their own like me (My better half was working!) but there were several couples. We were then all asked to briefly state our intentions one by one. The conclusions were interesting, many and various and eminently personal – that is your TOYL isn’t my TOYL! The most interesting future stories were not because of their individual personal visions but that they were told by a happily married couple sitting next to each other and attending to plan their future life TOGETHER.
Her : I’d like to get involved more in the community and do volunteer work for the needy.
Him: I’d like to climb Kilimanjaro and Kayak the Amazon.
Now who is to say these are not mutually exclusive and they may well have talked about their desires with their ‘future’ hats on. “Oh yes that would be great, but for now we have to work, bring up the kids, save……” and parked their plans so far as the other was concerned. In week one when he’s off with his backpack and she off to the homeless shelter, the life may not have that blissful hue they expected!
Making the transition into retirement is not always easy or automatic. Therefore, people must acknowledge the challenges they may face and seek out tools, resources, and professionals to help them address aspects of their mental health.
CONCLUSIONS Psychiatric morbidity is an important issue for all retirees. It appears that slightly younger people who retire are at greater risk of psychiatric morbidity than older age groups. Among psychiatric conditions, depression, anxiety and ‘stress’ have been implicated as the most common problems faced by the people retiring early from their jobs.
I’ve been ‘reading’ a book recently – ‘Clarity – by Jamie Smart’ – in truth the lazy way with Audible! For me it takes an altogether new approach to viewing the workings of our minds, one that needs NO fixing and thus NO work, exercises, mantras etc. It suggests in essence that we are born fine with ‘Inate thinking’ skills of wisdom, resilience etc. but in childhood are ‘encouraged’ by parents, education and society to think differently. This ‘Suspicious thinking’ encourages the Outside-In thinking of ‘…when you graduate/get married/own a Ferrari/xxx only then will you be happy’!!! – Ridiculous when you think about it, isn’t it??
Jamie Smart the Author, ‘state of mind specialist’ and Coach says, “Clarity = Capacity minus Contamination”. 100% of how you feel comes 100% from what you think. Unhappiness comes from Outside-In thinking – that external factors will make us happy….’when I get X, then I’ll be happy’ – He suggests that Inside-Out thinking, that is what we think (De-cluttered of all our ‘Suspicious thinking’) is the essence of being more content. Of course its not as simple as that but as I ‘get it’ more, I’ll write more – but for now I suggest you have a listen! It’s totally free and you won’t need a credit card if it is your first time accepting an Audible book from a friend.
Get it here: http://a.co/eulrAi4
After you accept the book, you will be prompted to download the Audible app to start listening. Enjoy!
What would you add to this?