How are you, really? - Mental health in an era impacted by Covid

Have you been exercising? Sleeping 8 hours a day? Are you eating right? separating home life from work? Are you resting? I sincerely hope your answer was yes to at least one of these marginally intrusive questions. Thanks for being honest, especially considering we are probably strangers.

These questions are not mine by the way. They belong to (your mom and) the Center for Disease Control (CDC), and other entities in the medical field, such as Pfizer and Fiocruz, which have asserted that concern for mental care should accompany pandemic-related governmental strategies. Maintaining a support network or feeling a sense of belonging to a group should be seen and defended as essential steps for a healthy life as we move further into a world reshaped by the pandemic. 

The aggravation of problems such as depression, anxiety and post-traumatic stress, are already associated with long periods of social isolation according to The Lancet magazine. These elements need to be seriously analyzed and given due attention, the consequences of a parallel pandemic of declining mental health in the general population may well outlast problems caused by the coronavirus itself. From children who now need to be resocialized to retirees who fear contact with the outside world to all those  who feel like two years of their lives were stripped away from them, the impacts are many and differently from vaccinations there is no strict timeline on how to withstand the feelings of loss and grief given by this period.

Some of the main negative conditions that create this scenario of mental decline are: Fear of the pandemic, social isolation, fear of contaminating close relatives, feelings of detachment, boredom, distress, financial and social helplessness, and lack of adequate information. All are points that have been maximized in the present context. Personally, I spend more hours in boredom thinking about what to watch on Netflix than actually seeing something - a perfect anecdote to describe times in which so many of us spend thinking about how it would feel to be with people rather than actually living with others. 

As a good part of the world is already going out onto the streets and rediscovering life outside the home, reconnecting with the reality of friends, parties, bars and travel, it might feel like a simple thing to go back to “normal”, as if we could just press the “restart” button. The reality is: pressuring ourselves to return to things “exactly as they were before” might cause deeply frustrated expectations. The return to life in public spaces should not come with the responsibility to suddenly solve the psychosocial trauma imposed on well… humanity.

Isolated from their loved ones, and with their freedom restricted, people have created and continue to create new routines for work, school, leisure and household chores. This, of course, presents new challenges for mental healthcare, impacting work-life balance to academic performance. In the new trend of remote working, where the lines between rest and office time are blurred, increasing working hours and often leading to an overload and, simultaneously, the frequent sensation that no work is being done. That of course, not even counting the new isolation and extra costs that can come with working remotely.

Americans' own life expectancy fell in 2020 according to the New York Times, data show it was the biggest drop since World War II, an effect that was worse as a whole for the Black Americans population, 2.9 years, and for Hispanic 3 years old. All these factors point to a worsening of mental problems. Brazil, for example, was already the country with the most anxious people in the world, according to the World Health Organization (WHO), and one of the most popular drugs is the drug Rivotril, indicated for the treatment of depression and anxiety. That only in 2020 had a jump in sales of more than 22%, going from the alarming 4.6 million to 5.6 million boxes sold in Brazilian land. This increase follows the escalation of cases of anxiety, depression and stress reported in 23 states, according to studies carried out by the State University of Rio de Janeiro (Uerj).

In general, the quality of mental health has decreased, but it was among the most vulnerable that this impact is felt the most, as these demographics are more exposed to diseases, violence, and traumas. Those with the least access to physical and mental health care, therefore, are more likely to develop a psychological disorder, continuing a cyclical process of poverty, anxiety and depression. Public health policies to fight the consequences of the pandemic should then take into account those disparities.

We went through this pandemic already expecting to have some degree of feelings of confusion, stress, and lack of control in moments of uncertainty. But how long people, especially the most vulnerable, will continue to suffer the mental consequences of this pandemic period needs to be studied and treated as seriously as the physical ones.

We are still in the midst of the global mourning process for all the lives lost, and this process becomes even more difficult without human contact. So as much as you can, talk to your friends, create support networks, acknowledge your fears and talk to someone, take breaks from your work, make video calls with relatives, exercise, eat well, and sleep 8 hours a day, or at least, pick one of the above. Little by little, life returns to “normal”, and in the process, it's okay to take time out and recognize that you might not be and that is absolutely ok.