Are we on the brink of a mental health crisis in the capital?
Just when you thought January couldn’t get any bleaker, along comes a third lockdown — the worst sequel yet. If you’re feeling lower than ever, you’re definitely not alone. Experts are calling it ‘pandemic fatigue’ — after so long living with the stress of the coronavirus hanging over us, we’re exhausted and demotivated. According to the Londoners I spoke to for this piece, Covid-19 has been ‘disastrous’, a ‘hellscape’, a ‘sledgehammer’ and ‘a complete and utter shitshow’ for mental health.
Whether you are battling the virus or its aftermath, attempting to home-school while simultaneously doing your actual job, dealing with the loss of a loved one, panicking about your work or financial situation, barely able to get dressed or simply bored out of your brain, you’ll be hard pushed to find someone whose sanity hasn’t been tested — and continues to be challenged. Although January is always a big month for self-help books, this year it’s dominated by a slew of titles addressing mental illness, from Oliver Kamm’s investigation into depression, Mending The Mind, to Bryony Gordon’s memoir, No Such Thing As Normal, to the no-nonsense Get A Grip, Love, by Kate Lucey. Although the vaccine means there is light at the end of the tunnel, experts predict a psychological pandemic that will far outlast the physical one.
‘I’m seeing a real despondency and bleakness among my clients now,’ says Chiswick-based psychotherapist Hilda Burke. ‘There was a brief bit of hope with the vaccine and then a plummet into helplessness again with the Tier 4 news and now a third national lockdown has sent people even lower. Also the winter weather has exacerbated things. Many of us have just been in survival mode for so long, using all our effort just to function and stay afloat, so now we’re seeing a crash.’
The capital was hit first and hardest in the UK by Covid-19, with the highest mortality rates (deprived boroughs such as Newham, Tower Hamlets and Hackney were the worst affected) and the biggest fall in business activity. A survey from the Greater London Authority in May found that about one third of Londoners had either lost their job, been furloughed or had their working hours greatly reduced by the Covid-19 crisis. Along with rising cases of addiction issues and eating disorders, record numbers of us experienced a mental health problem in 2020, with women and young people worst affected.
With counselling services stretched to breaking point, antidepressant use has soared, with more than six million people in England popping pills from July to September, the highest figure on record. There are also indications that having the virus impacts on mental health. Obviously research is in its infancy but a recent study from the United States found that one in five people who have had Covid-19 was diagnosed with a psychiatric disorder such as anxiety, depression or insomnia within three months of testing positive.
‘I’m seeing a lot of burnout,’ says Zoë Aston, a psychotherapist and author of Your Mental Health Workout: A Five Week Programme To A Happier, Healthier Mind. ‘Back in March a lot of my clients were actually coping well as lockdown removed a lot of their stresses and triggers. But as the year went on and the novelty wore off, people became increasingly isolated and things unravelled. Many of us are working from home for even longer hours, with no colleagues, camaraderie or support. Emotionally, people are at the end of their tether.’
For Freddie Cocker, 26, a communications manager who lives with his parents in Wanstead, the pandemic triggered his pre-existing mental health issues. ‘I’ve had anxiety attacks since I was seven but this year has been a real roller coaster for me in terms of feeling worried about my health,’ he says. ‘I lost all my self-care tools, from going to the gym to watching football matches with my dad. Working from home, I also lost any sense of structure or routine. I felt like I was just staring at a screen for eight hours a day for work, then logging off and staring at another screen, then going to bed.
‘Things came to a head and I had the worst panic attack I’ve ever had. It started with feeling like I had a temperature and then had visions of my own death, in hospital, alone. That sense of fear hasn’t really left me. Even now, I’ll get a bit out of breath or think that I’m losing my sense of smell and I’ll panic and think, have I got Covid? When the most recent lockdown happened, I felt constant dread and lost all my energy.’
The Centre for Mental Health charity predicts that about 1.3 million people who have not had mental health problems before are expected to need treatment for moderate to severe anxiety, and 1.8 million will need treatment for moderate to severe depression. Psychotherapist Brett Kahr, senior fellow at the Tavistock Institute of Medical Psychology, says: ‘I have witnessed a considerable upsurge of suicidal thoughts among patients, many of whom had never offered evidence of self-hatred or self-harm previously.’
Stephanie Cox, 37, is a management consultant who lives alone in New Cross and has been working from home since March. She was diagnosed with depression after the first lockdown. ‘I felt anxious when it all kicked off in March, but things got really bad for me in the summer,’ she says. ‘By then I’d digested what had happened and, once the fear subsided I was left numb to everything. Days went by like a grey blur with nothing to differentiate them. In September I went to see my GP and have been taking antidepressants, but I’m still on a waiting list for counselling. I feel anger about all the things I’ve missed out on.’
‘It might be helpful to think in terms of the five stages of grief,’ says Aston. ‘So you might have experienced denial, anger, bargaining, depression and acceptance, not necessarily in that order, and you may have moved around them depending on your personality type and your history. I think the turn of the new year was the hardest for a lot of people. It’s a time to get nostalgic and think about the things you have or haven’t done, and this year so much was lost. This feeling can then activate historic losses — all the other times in your life that you’ve been let down or disappointed.’
Aston believes we’ll see the impact of Covid-19 on our mental health for years to come. ‘There’ll be repercussions for everyone, from the development of babies who haven’t been able to see many faces, to teenagers who are spending even more time online, to older people who have experienced extreme loneliness,’ she says. ‘Even when we go back to relative normality, we can expect an increase in incidences of PTSD. There will be separation anxiety over being away from home and exaggerated levels of fear about being in large groups or not wearing a mask.’
Conversely, for some Londoners the past year has had a positive impact on their mindset. Hannah Schaapkens, 29, an electrical engineer based in Croydon, was diagnosed with depression after having suicidal thoughts at 23. ‘It might sound strange but 2020 has been awesome for my mental health,’ she says. ‘I’ve loved working from home because I find commuting really stressful. I have time to cook a nice meal and walk my dog and exercise. The only downside is that it’s been much harder to get my regular doctors’ appointments.’
And for some who have adjusted well to (groan) ‘the new normal’, the thought of lockdown ending is triggering anxiety. Krishna Thadani, 27, from Marylebone, works in sports hospitality and fears going back to his old life. ‘I’ve always been an overthinker, and in 2019 I saw a therapist to deal with my anxiety,’ he says. ‘When news of the lockdown came last March I thought, oh God, here we go, and I struggled. But after a few months I adapted to it and it felt like a brilliant opportunity to press pause and focus on my mental health. Now I feel so much calmer and I can’t believe how my life used to be — getting on packed trains, rushing down busy streets, going to restaurants and bars. I worry about those work and social pressures returning.’
So what can we do to feel hopeful about 2021? Aston says don’t bother thinking positively. ‘You don’t have to desperately try to find something to feel grateful for right now,’ she says. ‘When the world isn’t giving you much, that will only make you feel worse.’ Instead it’s time to actively cultivate a bit of hope. ‘You’ll know what type of hopefulness works best for you — it might be hope from being part of a community and surrounding yourself with people who are more optimistic than you,’ she says. ‘Or it might be that you feel more hopeful after a good night’s sleep, so put mechanisms in place to ensure that.’
And if your 2021 diary is looking a little blank, that’s okay. ‘Many people don’t feel they can make plans at the moment, which is understandable,’ says Aston. ‘Instead you could set smaller, more internal goals that don’t rely on external forces. So instead of “I want that promotion this year” or “I want to go on my dream holiday”, it might be “I want to use my voice a bit better” or “I want to create some boundaries and stick to them”. Before 2020 we were all so focused on short-term gains like making money, and this year has really turned the focus inward and towards things that, in the long-term, might serve us better, like spending more time with family or learning to like ourselves.’
Hilda Burke says she has been encouraging her clients to explore why they feel held back. ‘For some people it’s been tempting to use Covid-19 as an excuse for why they’re not progressing,’ she says. ‘So I try to get them to dismantle blanket statements like “I can’t get a new job” or “I can’t go on dates”. Okay, you can’t do it in the way you thought you would, but what’s another way of going about it? Yes, there is some powerlessness right now but there’s still an awful lot we can control. By recognising the tools we do have — whether it’s online courses or virtual dating — we can still feel like we’re progressing.’
And if all else fails, give yourself a pat on the back for making it thus far. ‘People have been pushed to their limits by this virus, but it has forced them to find new ways to be resilient,’ says Burke. ‘For anyone who’s been trundling along with a low level of anxiety, the past 10 months have been so extreme and all-encompassing that we’ve had to find better ways of managing. I think we know ourselves better as a result.’
In short: if we can survive this, we can survive anything. Come on, 2021! It’s not been the best start, but there are 11 months left to redeem yourself.
For information on mental health issues, including coping with lockdown, visit mind.org.uk or call 0300 123 3393 (9am-6pm, Mon-Fri)
