Covid 19 Delta outbreak: Psychology of a pandemic – mental health experts on how we’re feeling and why

Anxious? Over it? Ahead of Monday’s review of lockdown alert levels. Kim Knight spoke to mental health experts about how we’re coping – and why it all feels so hard.

In the first great lockdown, two-thirds of New Zealanders found a silver living.

This time? Not so much.

Results from a new psychological wellbeing survey show our ability to accentuate the positive has waned. If your optimism has died with your sourdough starter, you are not alone.

Susanna Every-Palmer, the Otago University associate professor who leads the team that has repeated the wellbeing survey four times since Covid-19 hit, says the latest findings are consistent with international evidence. Although there is often a honeymoon period of greater social connection and optimism just after a crisis, “it tends to fade over time”.

“It follows that in this Delta outbreak, the population is no longer counting their blessings, making sourdough, or deep-cleaning the spare room with quite the same optimism as occurred in the first lockdown,” Every-Palmer says.

On Monday, Cabinet meets to consider whether to move Auckland to alert level 2, ending a lockdown that is now in its 46th consecutive day. It is the region’s fifth stint at life under alert level 3 or 4. While the rest of the country has spent a total of 73 days in lockdown, Auckland has clocked up 127 days – and counting – since last March.

“This time around, social cohesion is more fragmented, and the disproportionate impact on Auckland has been very tough for some people,” says Every-Palmer.

How tough?

Full analysis of the survey, conducted last month when Auckland was still in full lockdown and the rest of the country was at alert level 2, is not complete. Early findings show that one-quarter of all participants reported their mental health was worse than usual due to the Covid situation. For Aucklanders, that figure rose to 32 per cent – and for Aucklanders with a past diagnosis of mental illness, it soared to 55 per cent.

Remember when we thought we were done with all of this? Months of zero community cases, a vaccine on the way, a transtasman bubble was open and the economy still intact?We were tanned, smiling and happy to sit cheek to howl at restaurants or queue with 50,000 strangers to see Six60 at Western Springs and the rugby at Eden Park. To outsiders, we were living the dream. But on the inside? How many of us were always wondering, deep down, what would happen when Covid came back?

An August survey of Royal Australian and New Zealand College of Psychiatrists members found 90 per cent of respondents working on acute on-call rosters had experienced an increased demand in after-hours work in the past two years. Crisis helpline Lifeline Aotearoa has also reported an increase in complex calls. Overall, calls and texts are up almost 40 per cent compared to level 4 lockdown in 2020, and more than 80 per cent compared to 2019. In the second week of the current lockdown, it was contacted 10,900 times. Meanwhile, ongoing Wellbeing@Work surveys show that between May last year, and April this year, there was a 56 per cent increase in the number of people reporting “high” anxiety – and a 29 per cent decrease in the number who felt no anxiety at all.

Covid is a mental health roller coaster. In the United States, two experts have coined the phrase “Pandemic Flux Syndrome” to reflect the spikes in depression and anxiety that people are reporting – the “two steps forward and one step back” nature of life in the shadow of a mutating virus that has now killed 4.55 million people worldwide.

“People are awash with conflicting feelings as they grapple with the swings and mixed signals of threats, shifting public health policies and uncertain social behavior,” write Amy Cuddy and JillEllyn Riley in the Washington Post.

They report that our brains and bodies are tired and recalibrating to new circumstances, (like the Delta variant that Prime Minister Jacinda Ardern has described as a “game changer”) is too much to bear.

According to Cuddy and Riley, for some people in America, the highly anticipated and vaccinated “return to normal” failed to deliver. People wanted to see friends and eat in restaurants, but the reality was weirdly disappointing; people felt sad about losing the work-from-home and slower-paced pandemic routines they had developed – and then they felt guilt about that sadness. And then Delta arrived.

New Zealand may have been more fortunate than most countries, but we are not mentally unscathed by our own ride on this roller coaster. On the eve of a new decision about the country’s alert level settings, 19 months since the pandemic hit here, the Weekend Herald asked four psychologists how New Zealanders were feeling right now – and why.

JACQUI MAGUIRE: Clinical psychologist and keynote speaker, Wellington
“In layman’s terms, people are over it,” says Jacqui Maguire. “Plain and simply over it.”

The novelty of the pandemic has worn off: “People’s moods are flat, they’re lacking motivation, lacking energy and it’s just this overwhelming sense of ‘meh’. The technical term is ‘languishing’ and I think that will be the overwhelming state of being for the bulk of the population at the moment.”

Maguire believes the “peak anxiety” experienced at the start of the pandemic has lessened, but the ongoing uncertainty is damaging because we can no longer look forward to good things – a practice psychologists call “anticipatory savouring”. Our “new normal” is not our old normal – and we’re still coming to terms with that.

“All we can do is be radically accepting of what’s going on for us right now. Acceptance of the now is actually all we really have control over.

“That baseline is gone . . . part of that radical acceptance is letting go of the world we knew, and that’s hard. That’s a huge grief. I’ve got grief over things like whether my child is going to grow up in a world where masks are always the way, for example.

“What strikes home for many of us, is that there has just been huge loss this year. Potentially, more loss this year than last. The loss of connection. Who thought we would not be able to be in touch with overseas family members for coming up to two years?”

Maguire, who mostly works with employees in large organisations, says for many Groundhog Day has hit hard.

“They’re struggling with a lack of variety and an endless sense of ‘how long is this going to go for?’ We don’t have any end point and if you’re a goal setter, or someone who works well with future vision, it’s really difficult.”

Compassion – for yourself, and others – is key, says Maguire.

“It’s unrealistic to say to people ‘go and thrive and flourish and live your best life’ during this period of time. Let’s just call it for what it is – but also, let’s try and not languish through the whole process.”

Her best advice: Focus on the day-to-day. Find tasks that absorb you, provide small wins and a sense of mastery and “the time will go by – and that’s better than looking at this unknown future and freaking out”.

KIRSTY ROSS: Senior clinical psychologist and lecturer, Massey University, Palmerston North

“If I look back to February last year, there was this real sense of ‘we are all in this major collective crisis’ and there was no hesitation,” says Dr Kirsty Ross. “I wasn’t aware of anybody who had any doubts about locking down being the right thing to do.”

And now?

“People’s experiences of the pandemic have been very, very different, depending on their working situation, their housing situation, their access to devices and Wi-Fi, their geography. The variations and the individual experience have become more pronounced as time goes on.”

And so has the impact on their mental health. Ross says people have begun to separate their lives into “BC/AC” – Before Covid and After Covid.

“There is this real sense of enormity. It’s a natural disaster but not a natural disaster that anyone alive has ever navigated before. Even things like the Spanish Flu . . . that is comparing apples with oranges. The world is very different now, so the impacts are different in terms of international trade and economies.

“Our brains are not super happy with a lot of uncertainty and vagueness. Being able to sit with uncertainty is not something we are actually programmed to do particularly well . . . it is emotionally and psychologically draining to constantly react rather than proactively plan.”

According to Ross, we plan and prepare based on prior experience. So, at the beginning of the current outbreak, when alert level decisions were reviewed every few days, anxiety rose. Were we supposed to be in first gear or fifth gear? Was it a sprint or a marathon?

“Our prior experience was to get ready for two weeks – and what we got [outsideAuckland] was, initially, three days. I think that threw people.”

Now, she says, we’re trying to process Covid and vaccination modelling scenarios and they are creating more questions.

“What does opening up look like? What does freedom look like? What is our life going to look like if we don’t get to these vaccination levels or we’re not looking for elimination? The scientists are figuring it out as they go along because we’ve never done this before – and people are looking for answers that don’t necessarily exist right now, because we are programmed to look ahead and plan and prepare.”

Although some people really did spend the first lockdown feeding their sourdough starters and learning a new language, Ross says anyone who simply “got through” can claim success and that knowledge should be helping us at this point in the pandemic.

“Going through that stuff builds resilience. We managed that, we navigated that and that’s resilience. It doesn’t mean it was pretty at the time, but we know if we were in that situation, we could do it again.”

And Ross says the concept of “pandemic flux”- especially as we consider alert level changes – makes sense, because “multiple feelings can be true at the same time”.

“You can have really missed seeing your colleagues and being face-to-face and going out shopping, and also crave being at home where it’s become familiar as you’ve adapted.

“People get to a point where they think ‘I should be happy the levels are going down’. Well, why should you? You feel how you feel and that’s okay. Emotions are never wrong, they are pieces of information for you to think about.”

SARAH COWIE: Senior lecturer, school of psychology, University of Auckland

Uncertainty keeps life interesting and exciting – but only in small doses, says Dr Sarah Cowie.

“Sudden lockdowns create a lot of uncertainty. Having potential choices taken away from you, not being able to go to shops or out to a restaurant. Small things, but having those options gives you a sense that you’re able to control what’s happening in your world.”

And when we lose a sense of control?

“Anxiety.”

One reason anxiety increases around alert level announcements, says Cowie, is that we know we are likely to experience change – but we don’t know exactly what that change will be.

“We are reasonably forward thinking in the way that we function and typically, even on a very subconscious level, we are orienting ourselves towards the future. We’re detecting patterns in our environment and using those to decide what to do next.

“When you are facing a situation where there is definite uncertainty, and you’re getting closer and closer in time to that time when that uncertainty will occur . . . that makes us anxious.”

At those times, “it would be a really good strategy just to focus on the very short-term moment. Focus on the small things, the small achievements and the things we enjoy . . . but that’s easier said than done. Because we are so geared towards the future”.

DOUGAL SUTHERLAND: Registered clinical psychologist and clinical practice manager, Victoria University of Wellington
New Zealanders are good at paying attention to the data, says Dr Dougal Sutherland. On the eve of possible alert level changes, that’s a habit that helps our mental health.

“You hear the way people respond. ‘Oh, I didn’t really expect we would get out of this level, because the numbers were still so high’. The key thing is expectations. If you expect to get out, and you don’t, then it becomes much harder to deal with.”

As a nation we don’t usually like to be behind the rest of the world, but Sutherland says when it comes to Covid, it has been an advantage.

“We’ve been able to watch and go, ‘that’s happening here’. We saw it hit Australia, and we’ve been able to prepare ourselves, rather than just getting suddenly plunged into something.”

In his experience, he says most people are coping with the current Covid situation. But he also admits that’s easier to say from Wellington, where citizens are at work and school under alert level 2 restrictions.

“I was an avid watcher of the 1pm briefing, and now it’s just ‘oh, I wonder what they said today’ . . . there is the potential of a rift, the potential that people in Auckland, in stricter levels of lockdown, become resentful. And with that, there is the potential for people to start breaking the rules . . . It seems most people have been okay about continuing – but I’m using the term ‘okay’ rather than happy.”

According to Sutherland, experiencing increased anxiety at alert levels 3 and 4 is normal and perhaps even helpful.

“Anxiety is useful for triggering safety behaviours. Things like wearing a mask, staying inside, not going out of your bubble. We often talk about anxiety as a negative thing but, in fact, this is exactly what anxiety was designed for. To keep us safe.”

And, he says, once lockdown ends, most of us will find some sort of “normal” again.

“Remember the very first lockdown and all those discussions about whether we would ever shake hands again? And, yes, we did. We very quickly went back to doing that. There might be some changes in our behaviour, wearing masks might become a bit more commonplace, but all the signs are we will largely go back to doing what we’ve always done.”

In the meantime? “Proactively look after your mental health being,” says Sutherland. “Do something in the morning and something in the evening. Diary it. There is a concept called ‘scheduled recovery’ which means not just letting good things happen – it’s being absolutely proactive.”

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