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Coronavirus

What is a Coronavirus?

A coronavirus is part of a family of viruses that usually only infect animals. Some of these however, can cross over to infect humans as well. The new coronavirus, known as COVID-19, is currently having an impact on people worldwide. Originating in China in late 2019, it rapidly spread to other countries throughout early 2020. For the latest information on COVID-19, please visit the following website: UK government – Coronavirus.

The potential impact on mental health in general

Mental health may be impacted in a variety of different ways as a direct and indirect result of COVID-19. Some people may experience a rise in their stress or anxiety levels. This may be in part due to worrying about catching the virus, financial worries, the constant updates in the news and not knowing when the pandemic will end, amongst other things.

As a consequence of COVID-19, the vast majority of people have had to adjust to dramatic changes in circumstances and daily life routines. Whilst many people can continue a certain amount of online socialising or communicating with neighbours, it is still a major change to the normal levels of interaction. This can lead to people feeling lonely or isolated, which can affect their mood and have a negative impact on their mental health.

As an indirect result, employment has been affected across the country, in a variety of different ways. Some people have lost jobs, events have been cancelled and most shops have experienced closures. The government has advised on ways of helping businesses (including people who are self-employed) and supporting people who are out of work financially during this time. Please see ‘The potential impact on mental health from psychosocial factors’ section below, for more information on the support available. For those that are able to work remotely, routines have changed, with some people juggling home schooling and childcare.

Key workers may face slightly different challenges, including a possible increase in workload and worrying about the increased risk of being infected or infecting others. The change of lifestyle may affect some people’s mental health more than others. If you are used to being very sociable and going out regularly, changing your routine to being mainly indoors may feel very strange. Even for those that are less sociable, it can be quite an adjustment. Understandably, some people can fall into unhealthy coping mechanisms to deal with increased stress, anxiety or boredom, including drinking or eating more than usual, spending longer periods of time scrolling through the news or social media or over or under-exercising.

If you are trying to access mental health support services, there may be a few changes. Some may have closed temporarily, be providing a reduced service, changed their referral process or there may be a longer wait time than usual. Some now provide online support groups and telephone services. ‘Every Mind Matters’ is an NHS run website which offers advice and practical tips to look after your mental health: Every Mind Matters.

The potential impact on existing mental health conditions

It is well known that stress can aggravate existing mental health conditions. Below are some conditions that may be affected in more specific ways due to the direct or indirect impact of COVID-19:

Generalised anxiety disorder: For some people, when things feel out of control or their routine changes, their anxiety levels can increase.

Social anxiety disorder: This condition can be affected by the switch to online communication. For example, some people find virtual meetings challenging as they can trigger social anxiety symptoms.

Obsessive compulsive disorder (OCD): Certain symptoms of OCD may be aggravated during this time, especially hand washing/sanitising, cleaning, a preoccupation with germs and obsessively checking for new information on the pandemic.

Low mood and depression: Some people may experience a worsening in mood during this time, in particular, feelings of hopelessness, loss of interest or a lack of motivation.

Insomnia: Stress and anxiety are known to directly impact the quality of sleep, coupled with the possibility of disrupted routines.

Alcohol or substance use: For some people, drinking or substance use is a way of ‘coping’ with life. These coping mechanisms may be used more during periods of increased stress, anxiety or boredom.

Disordered eating: Symptoms of disordered eating may be aggravated due to increased stress and anxiety, changes to routines, as well as the increased attention on food (stockpiling) and exercise during this period.

If you are already receiving psychological therapy or support for your mental health condition, you may have experienced a change in how the service is run. Unfortunately, some support groups and services have had to temporarily shut down or move to an online platform. This may cause additional temporary stress. There are some helpful tips (please see below) to look after your mental health during this time.

The potential impact on mental health from psychosocial factors

As a result of COVID-19, there has been a reported rise in psychosocial factors impacting mental health. ‘Psychosocial factors’ are social circumstances or stressors that have an impact on someone’s mental health. These social circumstances or stressors can include family or relationship problems, divorce, abuse, debt, homelessness and unemployment.

Below is a list of services who offer further information, advice and support about various psychosocial factors:

UK government – Coronavirus
This website contains the latest news, updates and information about COVID-19. It includes helpful advice about employment and financial support, school closures, education and childcare, businesses and other organisations and information for healthcare workers and carers.

National Debtline
An independent charity dedicated to providing free debt advice by phone and online to people across the UK.

Carers UK
Carers UK provides advice, information and support to carers across the UK.

Citizens advice
A network of charities offering free, confidential advice on a variety of topics including benefits, work, debt, money, housing, family, law and courts and health

Crisis

Crisis is a national charity who helps if you are homeless or at risk of becoming homeless.

Relate
Relationship support for everyone. The UK's largest provider of relationship support, helping people of all ages, backgrounds, sexual orientations and gender identities to strengthen their relationships.

National Domestic Abuse Helpline – women
The freephone, 24-hour National Domestic Abuse Helpline: 0808 2000 247
The Freephone 24 Hour National Domestic Violence Helpline, run in partnership between Women's Aid and Refuge, is a national service for women experiencing domestic violence, their family, friends, colleagues and others calling on their behalf. The Helpline is staffed 24 hours a day by fully trained female helpline support workers and volunteers. All calls are completely confidential.

Domestic abuse – Men’s Advice Line
Freephone 0808 8010327, opening times: Monday and Wednesday: 9:00–20:00, Tuesday, Thursday, Friday: 9:00–17:00
Men’s Advice Line is a team of friendly Advisors who will listen and offer non-judgmental support, practical advice and information.

Helpful tips for mental health

There are lots of things that can be done to improve mental health and general wellbeing during this uncertain time, some of which are detailed below. It is important to realise when self-help is not enough or appropriate. If you are struggling with your mental health and/or have been recommended medication, psychological therapy or a combination of both by your healthcare professional, self-help alone is unlikely to be enough. However, it can run alongside your recommended treatment plan.

There are many circumstances in which self-help is a good idea. These include:

It’s also important to note that whilst these options (either on their own or when used alongside recommended treatment) have shown to be effective for some people, they may not suit everyone. Avoid pushing yourself too hard if you are going through a period of feeling particularly unwell.

Routine: Keeping to a routine can be very helpful when going through periods of uncertainty. It may be that your usual routine has changed, so a new one needs to be made. A helpful routine could include getting up and going to bed at a similar time during the week (maybe with an exception at the weekend), eating at your usual times and scheduling in exercise. If you are working from home, it can be a good idea to continue dressing in your usual work clothes, during work hours. This helps to separate work and home life.

Don’t be too hard on yourself: There can be a tendency to want to, or feel pressured to, improve yourself in some way during this time. There are plenty of adverts for online courses to learn something new or start a new exercise regime. Or a tendency to feel like you have to have a perfectly tidy house or be the perfect home-schooling parent. It can be helpful to lower your expectations, give yourself a break and don’t beat yourself up if you don’t achieve ‘perfection’!

Limit news and social media mentioning COVID-19: It can be a good idea to limit the amount of time you spend reading, watching or listening to the news or social media reports on COVID-19. Constantly thinking about the pandemic may cause you to feel more stressed or anxious. There can also be the added stress of coming across ‘fake news’, so it is a good idea to get information regarding COVID-19 from sources such as UK Government – Coronavirus and NHS NHS Covid-19.

Pick out the good: It’s very easy and can be natural for us to focus on the negatives during this time, particularly with the ongoing news updates. It can be a productive exercise to actively pick out and remind ourselves of the positive things as well, to get more of a balance, e.g., a neighbour checking in on us, completing 10 minutes of exercise or reading a good book.

Accepting your feelings about the situation: It can be helpful to accept that the current situation is out of your control and you can’t change it. If you feel yourself getting worried about it, try and accept these worrying feelings, rather than pushing them away.

Self-help strategies

Exercise
Type of exercise Exercise effects
Aerobic exercise, such as jogging, swimming, dancing and walking
Aerobic exercise, such as jogging, swimming, dancing and walking
  • Research has shown this type of exercise can have a positive effect on mood and cognitive functioning, as well as reducing symptoms of anxiety and depression.

  • It is thought that from a physical point of view, exercise triggers the release of feel-good chemicals called endorphins, as well as helping to cope with stress.

  • From a psychological point of view, exercise may provide positive distraction and improve ‘self-efficacy’. ‘Self-efficacy’ is your belief in your ability to succeed or complete specific tasks or challenges.

  • It’s recommended that you exercise earlier on in the day if you have been diagnosed with insomnia. Exercising too close to bedtime may cause you to feel more awake.

Yoga
Yoga
  • Research has shown that yoga can have a positive effect on mental health and general wellbeing. Yoga, and other meditative movements, may also improve sleep quality and reduce insomnia symptoms.

  • From a physical point of view, it is thought that yoga has a positive impact on the nervous system, as well as reducing stress levels, in particular the stress hormone cortisol.

  • From a psychological point of view, it is thought that yoga can promote increased self-awareness, self-compassion and calmness.

Resistance exercise, such as weightlifting
Resistance exercise, such as weightlifting
  • Research has shown that resistance exercise, such as lifting weights may reduce symptoms of depression and anxiety.

Moderation
Moderation
  • Exercise is ideally done in moderation. Too much exercise can be detrimental to your mental health. It is sometimes linked to obsessive behaviours, which can be associated with poor mental health. Research also suggests that exercising to excess increases stress levels.

  • It’s best to start gently with any new exercise regime, and to get a physical health check from your GP before starting, if possible.

Diet
Type of diet Diet effects
‘Ultra-processed foods’ (soft drinks, fried foods, crisps, sweets and packaged cakes and biscuits)
‘Ultra-processed foods’ (soft drinks, fried foods, crisps, sweets and packaged cakes and biscuits)
  • Certain foods really can affect your mood, in particular depressive symptoms. Research suggests that eating a diet with lots of ‘ultra- processed foods’ may have a negative effect on your mood. Eating this type of food is often followed by a crash in blood sugar levels. This can then make you feel lethargic and low.

Healthy, balanced diet (high in vegetables and fruit, fish and wholegrains)
Healthy, balanced diet (high in vegetables and fruit, fish and wholegrains)
  • Research suggests that eating a healthy, balanced diet may reduce the risk of depressive symptoms.

Caffeine
Caffeine
  • If you notice you feel more anxious or on edge after drinking or eating caffeine (such as coffee, black tea, green tea and drinking and eating chocolate), or are having problems with sleep, it might be worth cutting down

Moderation
Moderation
  • It’s a good idea to apply a healthy ‘everything in moderation’ attitude towards the types of food and drink you consume. Balance is the key to overall physical and mental health.

Steer clear of recreational drugs and too much alcohol
Recreational drugs or alcohol Effects
Alcohol
Alcohol
  • If a person regularly drinks too much alcohol, it can cover up symptoms of a mental health condition. This can prevent the person from getting an early and accurate diagnosis.

  • Alcohol is classed as a depressant and can make symptoms of mental health conditions worse.

  • Whilst alcohol may help you to fall asleep initially, drinking even just a small amount can significantly reduce sleep quality. Many people find themselves awake and restless in the early hours of the morning.

Recreational drugs
Recreational drugs
  • Stimulants such as cocaine and amphetamines may lead to feelings of anxiety, while the after-effects often involve depressive symptoms.

  • Ecstasy can exacerbate anxiety and the long term effects may involve depressive and anxious feelings.

  • Cannabis may cause and exacerbate feelings of paranoia and anxiety.

Sleep
Sleep Effects
Mental health
Mental health
  • Sleep plays a large role in mental health. Lack of sleep or disrupted sleep can have an impact on mood regulation and cognitive function. This can exacerbate symptoms of mental health conditions.

Good sleep habits
Good sleep habits
  • Sleep problems can often be helped by making some small and simple changes to your daytime and bedtime habits.

    • Avoid napping in the daytime.

    • Do some regular exercise early in the day, like going for a walk. However, avoid exercising for at least four hours before going to bed, as this can make you feel more awake.

    • Only go to bed when you feel tired. This may mean going to bed later than normal if it means you can fall asleep more quickly. Going forward, it can be helpful to go to bed at a similar time every night. Once you have a better sleeping pattern, you can then slowly start to go to bed earlier.

    • Do something that you find relaxing before you go to bed (e.g. read a book, have a bath, have a warm, milky and non-caffeinated drink).

    • Avoid using phones or laptops too much for one to two hours before bed (unless on ‘night mode’; i.e. with the blue light turned down).

    • Use of an app called Sleepio (used during the day), may help work through any mental barriers to sleep

    • Avoid lying awake in bed, feeling anxious about lack of sleep. It can be helpful to get up and go to another room for a short period of time. Do something else, like reading before trying again. Avoid lying in bed worrying about things.

    • Avoid getting into the habit of regular use of sleeping tablets that you can buy over the counter. Some may have side effects and don’t address the cause of insomnia.

    • Avoid spicy or fatty foods in the evening, as they can cause heartburn. The discomfort may stop you from drifting off to sleep

Other
Type of self-help Effects
Reaching out and being kind to others
Reaching out and being kind to others
  • Some people experience feelings of loneliness, which may be impacted more during this period. It is important where possible to keep up connections with people, whether it’s checking in more often with messages, phone calls or online platforms.

  • Research suggests that performing acts of kindness improves general wellbeing. If it is safe for you to do so (and you would like to), there are various different community schemes being set up to help neighbours and vulnerable people during the COVID-19 outbreak. Things like picking up essential items or ringing or messaging to check in on people who are isolating can really help.

Green and blue spaces and natural daylight
Green and blue spaces and natural daylight
  • Research suggests that there is a link between green spaces (nature reserves, forests and urban parks) and improved mental health and wellbeing.

  • One study found the best length of time to spend outside in nature is 20–30 minutes, this has been shown to lower stress levels.

  • Emerging research is beginning to suggest a positive link between blue spaces (lakes, rivers and sea) and benefits to mental health and wellbeing. This may be related to physical exercise being carried out in blue spaces, so further research needs to be done to clarify this.

  • Research indicates that exposure to natural daylight may improve general wellbeing.

Keep learning
Keep learning (if you feel like it)
  • Research shows that learning new skills or information can improve peoples’ mental wellbeing by giving their self-confidence a boost and helping to build a sense of purpose.

  • There are lots of different ways of learning and gaining new skills, such as; learn how to cook a new dish, read a factual book or article about something you are interested in. Listen to factual podcasts in your free time or when travelling. There are thousands of free podcasts on many different topics, such as science, history, current affairs and general knowledge, so it’s worth exploring to find subjects that interest you.

Mindfulness and meditation
Mindfulness and meditation
  • Mindfulness is about bringing attention to the present moment, rather than worrying about the future or past. It also encourages people to notice things, including our environment, thoughts and emotions, in a non-judgmental way.

  • Some research has shown improvements to ‘psychological wellbeing’ in people with no clinical mental health diagnosis.

  • There is encouraging research to suggest that when integrated with other therapies, mindfulness may help depression and anxiety disorders.

  • These therapies, mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) are guided, structured therapies, as opposed to stand alone mindfulness.

  • Specifically, research has shown that mindfulness-based cognitive therapy can be effective in reducing the likelihood of relapse in depression.

  • Research does suggest that MBSR and MBCT may be effective for PTSD, however, it is recommended that you work with an experienced and qualified trauma focused therapist. If you feel your symptoms are getting worse at any point, please discuss this with your therapist.

Self-help reference list