Ruminations: The Psychological Stress of Coping With COVID Avoidance

"Even in the 'average Joe', if you want to call them that, the pandemic has taken a really serious toll. Even for those without pre-existing mental disorders, half of them had major signs of depression and a third had signs of anxiety disorder. And those with pre-existing mental disorders, they're getting worse. And significantly worse. Anxiety is worse, depression is worse, suicidal ideations."
"It's a pretty concerning situation. What our results actually show is that regardless of where they started with a specific diagnosis, everyone seems to be getting worse in terms of their depression and anxiety. It affects nearly everyone."
Rebecca Robillard, director, clinical sleep research, The Royal Ottawa Mental Health Centre

"Treatment centres have had their capacity dramatically cut because of the need for physical distancing. Outpatient clinics have been reduced, capacity for withdrawal [treatment] has been reduced, and now even asking for help has become more problematic because there's a belief that there simply isn't any."
"I've had quite a few inquiries from people asking, 'Where do I go now?' And as much as the professional community has tried to address that, the message often doesn't get to the people who need the help."
Gord Garner, executive director, Community Addictions Peer Support Association

"This has really heightened my anxiety. Hunter [her son] is close to three years of sobriety, but I'm really watching to see that he's coping and managing, and that none of the red flags are going off."
"Luckily, most doctors have pivoted and gone virtual, so he's able to access his therapist and know that he's doing OK. But we see it at the centre; the anxiety is going through the roof."
Cindy Manor, senior director of philanthropy, Dave Smith Youth Treatment Centre

Matthew Young, senior research and policy analyst, Canadian Centre on Substance Use and Addiction

Since the SARS-CoV-2 virus roared onto the world stage and was soon declared a global pandemic public messages of self-isolation, mask-wearing, personal hygiene, no-touch surfaces and hand-washing have all conspired to create a fearful and troubled public, one unaccustomed to socially isolating and for whom the go-it-alone self-protection against a sometimes-deadly disease has extracted a heavy price in confidence and mood. The result has been a predictable rise in depression and anxiety.

Those conditions have been exacerbated in people already struggling with mental health issues, but those in the general public who had never previously been troubled with isolating depression and heightened anxiety have also felt its grievous numbing effect. Research carried out at the Royal Ottawa Mental Health Centre has underscored those issues. Dr.Robillard, who spearheaded the recently published study based her research on an online survey of six thousand Canadians.

The survey is incomplete in the sense that it covered the period between April 3 and June 23, quite early in the pandemic. Questions posed to survey respondents saw the youngest participant at age 16 and the oldest 99 years of age. The rise in anxiety and depression was largely spurred by fear of contracting COVID-19, but respondents feared as well becoming more ill from existing illnesses as a result of cancelled or delayed medical appointments.

Lost income resulting from the economic lockdown, along with troublesome family and personal relationships also played into the heightened anxiety. The pandemic resulted in fewer appointments for people in treatment for mental issues, with their doctors or counsellors. Online counselling eventually up and in operation filled the gap to a certain degree, almost reflecting the effectiveness of previous face-to-face interactions.

Dr.Robillard assessed alcohol and cannabis use, finding it increased by up to 15 percent, but on the other hand, some respondents reported declining personal use, so "it's a bit of a mixed bag", she declared. While COVID spares none, young or old, healthy or health-impaired, wealthy or struggling to get by, women and younger people in particular appear to be most affected. Dr.Robillard points out that younger women mostly deal with child care stress during the pandemic, while young people are most likely to be stressed over front-line workplaces, dealing with the public.

"And we know that sometimes the general public isn't very compliant with social distancing measures. Also, even though you're working, you may not be sure you'll be working next month or that you'll have the hours you need to support yourself." Some of the participants in the study agreed to remain with the research longer term, to determine how their mental health would be impacted over time.

Because of the time line of the study, the second wave of infections wasn't included. What was clear, however, was that more resources will be required to handle mental health needs as the pandemic progresses.

"As time goes along, we're seeing some decrease in the anxiety level. People are starting to get a tiny bit less anxious because they're starting to adapt to the situation, it's a bit less of a shock. But for a lot of people, that is still a prolonged period of anxiety and stress, and in the longer term, it can sustain some degree of depression. While anxiety was going down, the depression is going up", Dr.Robillard pointed out.