THE Covid-19 generation have concurrently been navigating another health crisis since the pandemic three years ago, although many may not be aware of it.
Experts have said that mental health matters have been escalating among populations, largely under the radar, including in South Africa.
According to a study published in The Lancet Public Health, while countries have prioritised stricter policies that attempted to control Covid-19 transmission, restrictions in life with lockdowns had a significant impact on mental health during the pandemic.
An IANS report said an international research team conducted a global study on countries’ responses to the pandemic. They found there have been worse mental health trajectories in countries that attempted to control Covid-19 transmission with stricter public health restrictions.
The researchers said that effective policies to contain the pandemic must be accompanied by strategies and resources to address the adverse impacts on mental health.
For future pandemics, the researchers suggest governments could prioritise policies that reduce virus transmission but impose fewer restrictions on daily life, such as restricting domestic travel instead of restricting gatherings.
They suggest an elimination strategy, with timely use of testing and contact tracing could minimise deaths without requiring more restrictive policy measures to contain the viral spread.
Masoodah Mohamed is the leader of the Mind Your Health support group for depression and anxiety. As an affiliate of the SA Depression and Anxiety Group (Sadag), she and her team hold regular meetings at the Nelson Mandela Community Youth Centre in Chatsworth.
She said mental health was largely not attended to, mainly because it was considered taboo.
“Mental health, especially in our Indian communities, has always been an issue. But it has always been something that is stigmatised. People don’t talk about it. If you have depression and anxiety it is looked down upon. People say that you are crazy or not working hard enough or in the worst case, they say just get over it. It is not taken seriously.”
Mohamed said more often than not people don’t choose to be lazy, sleep all day or not eat. These are just some underlying symptoms of depression and anxiety.
“People are struggling. Add in job losses, financial difficulties and even interpersonal relationship problems. All of these stresses were made worse during the pandemic, especially over the hard lockdown. With Covid, people are also struggling with fear: fear of contracting the disease, fear of going out, fear of sending your child to school and fear over the death of our loved ones.
“Something which Covid brought, which is very unique, is something that we call complicated grief. It simply means the inability to actually grieve in the way that we ordinarily do. In our communities deaths and funerals have lots of ceremonies and rituals involved. In a situation where a person has passed away related to Covid, they have to be buried almost immediately without completing those rituals, without even seeing the face of the deceased. I think that has left too many people scrambling with accepting sudden, unexpected loss.”
Taboo
With mental health still largely considered taboo people may not know that they are struggling with mental health challenges.
Mohamed said there are signs to look out for.
“Within ourselves and among others, I think the first thing you will notice is that you are robbed of your peace and your desire to live. To be able to live healthy, we need to eat, sleep and wake up. These are some of the first things that a person with mental illness will stop doing. If you are living with a family member or if you yourself experience it, you will notice that there is change in appetite and struggling to sleep.
“You don’t enjoy the activities that you would usually. For example, if you have a son who enjoys playing sport and you noticed more often than not that he is always cancelling, it becomes a pattern. Or they are not able to get up in the morning. They have a low mood which can also translate into not being able to take care of themselves: personal grooming, basic hygiene, they don’t want to look at themselves in the mirror. They don’t have the desire or don’t see the point in all of that. These are signs that a person is losing themselves.
“Unfortunately, the most serious indicator is where we have thought of dying. If a family member has ever mentioned things like ‘I wish I was just dead’, that is something we should not take lightly at all.”
Frontline workers
Mohamed said there was often even more pressure on frontline workers who are expected to have it together.
“Burnout is definitely on the rise among our frontline workers. Sadag has a lot of online meetings for frontline workers who are dealing with depression and anxiety and feeling a sense of helplessness. The nature of our education and health systems in the country is that they were already under-resourced and understaffed and stretched to capacity before the pandemic. So when it’s a stressful situation frontline workers are even more affected.
“They have not had a moment to take a breath and debrief after experiencing all of the stress of the past two years. Even if you look at teachers, they also have their own concerns, they are also afraid of contracting the illness and spreading the infection while taking care of children at work.
“They are afraid of taking it home where they live with the elderly and their own children. So we are seeing what we call compassion fatigue. This is a very real phenomenon which frontline workers are experiencing, unfortunately.
“We often don’t realise that each frontline worker has another set of responsibilities in their family who they are accountable for. It is a sacrifice, it is a risk. I can imagine that every single work day they are taking extra precaution not only for themselves but for their families too.”
Children, youth
According to a report released recently, the Covid-19 pandemic has profoundly impacted the mental health of children and adolescents.
Studies – published in 2020 and 2021 – found unusually high rates of anxiety, depression, sleep disorders, suicidal behaviour, stress-related disorders, attention-deficit/hyperactivity disorder, and other mental health problems during the pandemic.
Individual behaviours such as hobbies, praying, and listening to music were associated with positive mental health, the studies also found.
Dr M Mahbub Hossain, of Texas A&M University, who co-authored the report, told IANS: “Mental health problems were more common in those with a low socio-economic status, lack of social connections and support, adverse family relationships, and restricted mobility. There is a need for multi-pronged efforts to alleviate the immediate and future health, and the social consequences of the pandemic on the mental health of children and teens.”
Mohamed said we often don’t realise that children may not be aware of the changes around them over the past two years. Coupled with having to catch up with and adapt to different ways of schooling, children are also stressed out.
“When it comes to the Indian community, unfortunately there is pressure on our children to be disciplined and well behaved. So often things like temper tantrums or if a child is acting out, this is automatically considered bad behaviour. A child will struggle to clearly articulate his/her emotions but they will show those emotions in their behaviour, and unfortunately parents have to listen for behavioural changes.
“If your child, for example, is not doing their school work or deliberately missing out on classes, things like excessive crying, seemingly for no reason, all these big emotions manifest in ways that if a parent is not listening to the behaviour, you would probably think the child is just being naughty or spoilt. Any sort of attention-seeking behaviour that a child acts out is usually a cry for help.”
General aggression towards their parents, in class or at home, being aloof and withdrawn, children may not engage in the things that they used to do before, they may not enjoy their favourite meals anymore – these are more signs that your child may need help.
“Sit your child down, give them a hug and ask them what is going on? How are you feeling? You seem very upset. Parents tend to focus on the action and trying to reprimand the action rather than the emotion behind it. Give them the opportunity to speak. More often than not a child wants to be able to express what they are feeling but they don’t know how to.”
Mohamed said parents should aim to have good relationships with their children’s teachers.
“Liaise and find out how your children are doing in class.”
Reach out
Sadag hosts workshops, talks and meetings to assist people with managing their mental health. These are advertised on their Facebook page and other social media platforms.
The Mind Your Health team runs meetings every second and fourth Saturday of every month at the Nelson Mandela Community Youth Centre.
“It’s good to have education, but sometimes people need platforms to speak about how they are feeling during this time in an environment that is safe and confidential,” said Mohamed.
* For more information on the free support group for anxiety and depression, call Masoodah on 081 419 8781 or Aimee on 067 005 1325.