Are COVID restrictions ignoring mental health issues?

[Richard Scott]

It is perfectly normal human emotion to feel distress in sad times and feel frightened in uncertain times. The current situation is both sad for those suffering the effects of Covid-related issues- physical and/or fiscal- and is frightening because we don't know what will happen next or how long it will last for.

Feeling sad and frightened in these times is not a mental health problem, and it does nobody any favours trying to pathologise away normal human emotion.

Of course the added uncertainty and distress may well make existing mental health conditions worse.

The answer is that, yes, the fact that lockdowns and their effects are distressing is taken into account. Medical professionals are well aware that lockdown and isolation are hugely distressing for many people. But so is watching loved ones die of Covid. And there is no easy way of juggling these competing demands.

Feeling sad and having a mental health issue are not the same thing. Please don't try and trivialise mental health issues. Having had a sister with a severe mental health issue I do know a little bit about it. I also watched a loved one die of cancer, there may be many in that boat also with all the missed screenings and appointments.

 

[bramling]

It is perfectly normal human emotion to feel distress in sad times and feel frightened in uncertain times. The current situation is both sad for those suffering the effects of Covid-related issues- physical and/or fiscal- and is frightening because we don't know what will happen next or how long it will last for.

Feeling sad and frightened in these times is not a mental health problem, and it does nobody any favours trying to pathologise away normal human emotion.

Of course the added uncertainty and distress may well make existing mental health conditions worse.

The answer is that, yes, the fact that lockdowns and their effects are distressing is taken into account. Medical professionals are well aware that lockdown and isolation are hugely distressing for many people. But so is watching loved ones die of Covid. And there is no easy way of juggling these competing demands.

I’m afraid this is completely wide of the mark. Mental health is *not* the same as sadness or distress, but is something which deteriorates over time such that normal function is impaired. Financial or work worries are one of the leading reasons for issues developing, as people find themselves in a downward spiral. I wouldn’t claim to be someone well versed in the field, but I have seen how one thing can lead to another in terms of pretty major effects on people’s ability to function. This simply isn’t the same as being sad.

 

[43066]

How do you arrive at extinction? Surely what would happen is average life expectancy would be pared back by a small amount, assuming all other factors remain the same, and assuming there really are no longer term effects on younger people?

Indeed. Of course that is already happening because the population is getting fatter and fatter with each passing year. Average life expectancy has recently dropped for the first time in several generations due to sedentary lifestyles and ignorance about what constitutes healthy eating.

The answer is that, yes, the fact that lockdowns and their effects are distressing is taken into account. Medical professionals are well aware that lockdown and isolation are hugely distressing for many people. But so is watching loved ones die of Covid. And there is no easy way of juggling these competing demands.

Somebody dying in their eighties or nineties is not a tragedy. Someone dying of a preventable cancer in their thirties or forties most definitely is.

 

[Tetchytyke]

I’m afraid this is completely wide of the mark. Mental health is *not* the same as sadness or distress, but is something which deteriorates over time such that normal function is impaired.

Feeling sad and having a mental health issue are not the same thing. Please don't try and trivialise mental health issues.

With respect, that is precisely what I said. Distress caused by sad life events is a normal human emotion, and is not a mental health condition. And we have to be careful that we are not pathologising people who are simply sad and frightened at a situation which is out of their control.

It is not mental ill-health to feel **** because a **** thing happened. And Covid is that thing.

Yes, the isolation and worry will exacerbate existing conditions, but that's not the same thing at all.

 

[Ianno87]

With respect, that is precisely what I said. Distress caused by sad life events is a normal human emotion, and is not a mental health condition. And we have to be careful that we are not pathologising people who are simply sad and frightened at a situation which is out of their control.

It is not mental ill-health to feel **** because a **** thing happened. And Covid is a **** thing.

Nope. Covid Mental Health issues are being caused by taking away peoples' ability to 'Thrive' - i.e. do the things they do that gives them their sense of place on earth. And it shows - they stop being the same people they were before - more closed up, irritable or angry, for example.

 

[Bletchleyite]

With respect, that is precisely what I said. Distress caused by sad life events is a normal human emotion, and is not a mental health condition. And we have to be careful that we are not pathologising people who are simply sad and frightened at a situation which is out of their control.

It is not mental ill-health to feel **** because a **** thing happened. And Covid is that thing.

Yes, the isolation and worry will exacerbate existing conditions, but that's not the same thing at all.

Agreed.

I think we have slipped towards people saying "my mental health is suffering" when what they mean is "I'm sad/scared/angry/whatever". Those are all unpleasant emotions, sure, but they are healthy ones - we are supposed to feel them all at various points in our lives. I'm certainly not enjoying any of this (despite what some think of those of us who feel measures are necessary), particularly as it's coinciding with another health problem, but I wouldn't say I am having a mental health problem.

People doing that detracts from people who are having real problems with their mental health.

As for COVID, the unusual situation will, like say a war (albeit in a different way), mean some people feel bad and some people genuinely suffer for their mental health.

 

[Tetchytyke]

Somebody dying in their eighties or nineties is not a tragedy. Someone dying of a preventable cancer in their thirties or forties most definitely is.

Interesting that you choose to place more value on one life than another.

The missed screenings were not because of lockdown, but because everyone feared the NHS would be overrun. Everyone was diverted to the front line. My wife, a clinical psychologist working in end-of-life care, was kitted out to be a HCA in case of emergency. Her friends from her doctorate, all living and working in Ireland were sent to all sorts of weird and wonderful places.

Perhaps with hindsight it was an overreaction, but the healthcare system in northern Italy pretty much went into meltdown in early March. But it wasn't that Covid was prioritised over cancer, it was simply you can't treat anyone if you don't have a functioning emergency health service.

 

[Richard Scott]

With respect, that is precisely what I said. Distress caused by sad life events is a normal human emotion, and is not a mental health condition. And we have to be careful that we are not pathologising people who are simply sad and frightened at a situation which is out of their control.

It is not mental ill-health to feel **** because a **** thing happened. And Covid is that thing.

Yes, the isolation and worry will exacerbate existing conditions, but that's not the same thing at all.

I think you're underestimating how people feel. Having a family member who has gone through mental health issues I can generally spot the signs easily and, believe me, many people exhibit those signs.

 

[Bletchleyite]

Interesting that you choose to place more value on one life than another.

The NHS does that if things are constrained, so I don't see why he shouldn't. I believe they do it based on likely "quality" time left.

 

[Richard Scott]

The NHS does that if things are constrained, so I don't see why he shouldn't. I believe they do it based on likely "quality" time left.

Agree, don't see a problem with that. If I were in my eighties and not in good health I wouldn't expect priority or even parity with someone much younger who had longer term prospects.

 

[Tetchytyke]

I think we have slipped towards people saying "my mental health is suffering" when what they mean is "I'm sad/scared/angry/whatever". Those are all unpleasant emotions, sure, but they are healthy ones

Indeed. Being angry about restrictions and being frightened about what the future holds are normal, healthy, human emotions. They're not "mental health" issues, and should not be confused as such.

When those emotions start impacting on daily life, a person's function, then you have mental health difficulties.

== Doublepost prevention - post automatically merged: 13 Oct 2020 ==

The NHS does that if things are constrained, so I don't see why he shouldn't. I believe they do it based on likely "quality" time left.

Perhaps, but that's not the sort of value being expressed by describing one death as "not a tragedy".

 

[43066]

Interesting that you choose to place more value on one life than another.

It’s not placing more value on one life than another, it’s acknowledging that someone passing away at end of their natural lifespan has lived their life. Surely you can see a distinction between that and and someone dying at a much younger age of a curable disease, perhaps when they have a young family?!

The missed screenings were not because of lockdown, but because everyone feared the NHS would be overrun.

And potentially hundreds of thousands of cancer patients might now die as a result. Yet another demonstration of how incompetently the NHS is run.

 

[bramling]

With respect, that is precisely what I said. Distress caused by sad life events is a normal human emotion, and is not a mental health condition. And we have to be careful that we are not pathologising people who are simply sad and frightened at a situation which is out of their control.

It is not mental ill-health to feel **** because a **** thing happened. And Covid is that thing.

Yes, the isolation and worry will exacerbate existing conditions, but that's not the same thing at all.

Losing a business that one has spent many years building up is more than just a **** thing, likewise spending day after day worrying how you’re going to keep up with daily expenses as a result of losing your job. And, to be honest, over time so is living a base existence only doing basic tasks like going to work, eating and walking round the block.

I consider my position in this reasonably fortunate. My job is rock solid (though in the current climate is *any* job totally secure?), my house is paid off, and thusfar my monetary loss has only been a relatively minor hit on savings interest. In terms of lifestyle I have a spacious house with a 100m garden. It has messed me up with a sideways move I was hoping to make at work, but this isn’t the end of the world, albeit it’s something I wanted to do. I’m not a massive socialiser so can cope with things like pub closures. Nonetheless I’ve increasingly felt malaised as this has progressed - a general feeling of fatigue, which I attribute to a lack of quality leisure, and perhaps the fact that I feel trapped in a country which appears to be falling apart around me. Add in the effect that people are now generally a lot more irritable, so there’s a hostile mood pretty much everywhere (just on my way to the train I’m on now I saw a pretty big altercation going on over, you’ve guessed it, someone in a shop without a mask!). If I‘m feeling malaised when my position is pretty good, what must it be like for those in less solid positions?

We have to be realistic about this, it seems that we are essentially attempting the impossible, akin to trying to drain the ocean. And surprisingly enough we’re not managing particularly well at it.

 

[Richard Scott]

Indeed. Being angry about restrictions and being frightened about what the future holds are normal, healthy, human emotions. They're not "mental health" issues, and should not be confused as such.

When those emotions start impacting on daily life, a person's function, then you have mental health difficulties.

== Doublepost prevention - post automatically merged: 13 Oct 2020 ==



Perhaps, but that's not the sort of value being expressed by describing one death as "not a tragedy".

You really are missing the point here. There are lots of people who are suffering with mental health issues. Why can't you accept that and stop harping on that they're just a little sad. No they are not! This is a serious issue which you are trivialising and, to be honest, I wish you would stop as starting to find your attitude towards it upsetting having witnessed mental health issues first hand so could you stop, please?

 

[yorkie]

I am not getting into the argument over semantics (edit: but see my further post below)

The facts are a lot of people are feeling depressed, losing hope, angry, stressed and much more. The argument over categorising these things is irrelevant

...Medical professionals are well aware that lockdown and isolation are hugely distressing for many people. But so is watching loved ones die of Covid..,..

Those who call for lockdowns are not properly aware. I know many people who are suffering due to the effects of the measures taken to reduce the spread. As for having loved ones die, when people get to their 80s - which the average Covid death is - people are more likely to die of all sorts of things, including respiratory diseases. We cannot keep people alive forever.

The lockdown fanatics obsess over the numbers of elderly people dying; the facts are that it used to be common for many thousands of elderly people to die of respiratory viruses not that long ago. Was keeping my grandmothers alive for so long that they had zero quality of life to anyone's benefit? It certainly wasn't to theirs.

I'm afraid your post just demonstrates yet again how wrong our priorities are and how you have completely missed the point.

 

[bramling]

Agreed.

I think we have slipped towards people saying "my mental health is suffering" when what they mean is "I'm sad/scared/angry/whatever". Those are all unpleasant emotions, sure, but they are healthy ones - we are supposed to feel them all at various points in our lives. I'm certainly not enjoying any of this (despite what some think of those of us who feel measures are necessary), particularly as it's coinciding with another health problem, but I wouldn't say I am having a mental health problem.

People doing that detracts from people who are having real problems with their mental health.

As for COVID, the unusual situation will, like say a war (albeit in a different way), mean some people feel bad and some people genuinely suffer for their mental health.

Mental health issues arise when people have the feelings you describe, for example feeling sad or angry, and are unable to *deal* with them in a typical constructive way.

This is exactly what happens when people find themselves trapped in a position which they can’t climb out of. I’d have said the current situation is an ideal breeding ground for exactly this.

 

[Bletchleyite]

You really are missing the point here. There are lots of people who are suffering with mental health issues. Why can't you accept that and stop harping on that they're just a little sad. No they are not! This is a serious issue which you are trivialising and, to be honest, I wish you would stop as starting to find your attitude towards it upsetting having witnessed mental health issues first hand so could you stop, please?

I think from reading this message you are sadly suffering mental health difficulties, and I hope you feel you can ask for and get the necessary help. Surely, though, you'd support the idea that people should stop detracting from that by calling being sad a mental health problem, when being sad at points in your life is totally normal and healthy?

 

[Tetchytyke]

You really are missing the point here. There are lots of people who are suffering with mental health issues. Why can't you accept that and stop harping on that they're just a little sad. No they are not!

I am sorry I am not making my point clear enough. I am not diminishing those who are experiencing real and significant mental health problems.

What I am saying is that feeling distressed and frightened by what is happening is not a mental health problem in and of itself.

And there seems to be a lot of people saying their mental health is affected by lockdown when, what they really mean, is that they are angry and scared. Both of which are perfectly normal human emotions.

I wish you would stop as starting to find your attitude towards it upsetting having witnessed mental health issues first hand so could you stop, please?

I have, in the past as a young adult, spent several years receiving intensive psychodynamic therapy on the NHS. So please know you're not alone in experiencing mental health difficulties.

I am genuinely sorry you are experiencing mental health issues. I hope you work through them.

 

[Bletchleyite]

This is exactly what happens when people find themselves trapped in a position which they can’t climb out of. I’d have said the current situation is an ideal breeding ground for exactly this.

Yes, true. It effectively requires "negative" emotions plus a feeling of "no way out".

 

[Tetchytyke]

This is exactly what happens when people find themselves trapped in a position which they can’t climb out of. I’d have said the current situation is an ideal breeding ground for exactly this.

I would agree with you on that, it is a very uncertain and distressing time. For some people it will either exacerbate existing conditions or it will create new issues. I completely agree with you.

 

[43066]

The NHS does that if things are constrained, so I don't see why he shouldn't. I believe they do it based on likely "quality" time left.

Indeed.

We seem to have a peculiar aversion to accepting that death is a natural part of life in this country.

I find it incredible that some posters on this forum cannot not distinguish between someone dying at the end of their natural life (which is sad, but not tragic, it’s just the natural order of things) and someone being cut down in their prime.

 

[Bletchleyite]

I find it incredible that some posters on this forum cannot not distinguish between someone dying at the end of their natural life (which is sad, but not tragic, it’s just the natural order of things) and someone being cut down in their prime.

I'd agree with that, and personally, once I have lost my independence, I would consider a quick respiratory infection a blessing. Ideally I would like to live a full life until the point just before someone has to wipe my proverbial backside for me, and at that point drop dead quickly and painlessly.

 

[yorkie]

I won't enter any more into the ludicrous debate about semantics other than to link to, and quote from, this:

What is Mental Health?

Just like physical health, people can have good mental health or have problems that they need help to overcome

www.educare.co.uk

We often describe mental health as a continuum. We are all at different places on that continuum at any given time, depending on our lives and what might be happening for us.

It is important to remember that EVERYONE has mental health; we may be at different places on the continuum but we all have mental health.

For example, a person with a mental illness may be coping very well and still managing to go to school or work because they are getting help. Another person may be at the thriving end of the spectrum when something happens; for example, a sudden bereavement, and this may send them immediately down to the ‘not coping’ end of the continuum.

Indeed.

We seem to have a peculiar aversion to accepting that death is a natural part of life in this country.

I find it incredible that some posters on this forum cannot not distinguish between someone dying at the end of their natural life (which is sad, but not tragic, it’s just the natural order of things) and someone being cut down in their prime.

As someone who knew a 12 year old (to whom I had a duty of care) who committed suicide, and whose grandmothers were kept alive when they had zero quality of live for no justifiable reason, I completely agree with you.

 

[35B]

What's your definition of "herd immunity", "letting it rip" and is there nothing in between?

To be clear: are you saying that if a vaccine isn't going to end this and we need restrictions indefinitely, to ensure that we never reach a level of immunity whereby restrictions can be lifted? If not, what are you saying?

”Herd immunity” - sufficiently many people within the population with immunity to the disease that an infected individual will not cause spread within the general population. Typically assessed to require a high percentage immune, but numbers by definition not known now.
”Letting it rip” - a policy at current levels of infection of not actively trying to suppress incidence through measures like social distancing or restrictions on human interactions

I am not arguing that the choices are wholly binary, and recognise that there are varying gradations of policy that may be applied, with associated costs and benefits. Vaccination may work even with short immunity periods. What I am saying, contrary to the positions of many on here, is that if immunity is as short lived as some suggest it may be, herd immunity is unattainable and that the consequences for our health, physical and mental, are much deeper than most current discussion allows for.

I don’t propose that long term retention of the current restrictions is viable, though I note that the restrictions required to combat Ebola lasted years, not months. What I do posit, though, is that the psychological impact of a transmissible, fatal, disease in general circulation is likely to be significant for a population that is simply not used to such a disease in general currency. We seem to expect this to be decided as a sprint, when it may be something very different indeed.

 

[Tetchytyke]

it used to be common for many thousands of elderly people to die of raspatory viruses not that long ago

It also used to be common for kids to die of cholera, diphtheria and whooping cough, so I'm not sure of the validity of your point.

The average age of death may be 82.4, but the average life expectancy is 83.6- and that average is dragged down by all the people who die young. Life expectancy is fluid, too: a man who reaches 80 can expect to live another 8 years on average (source: https://www.annuityadvantage.com/resources/life-expectancy-tables/)

So the idea that everyone who dies was at death's door anyway is demonstrably false.

I also find your use of "lockdown fanatic" to describe anyone who thinks we can't just have s free-for-all is a shame.

 

[Richard Scott]

I am sorry I am not making my point clear enough. I am not diminishing those who are experiencing real and significant mental health problems.

What I am saying is that feeling distressed and frightened by what is happening is not a mental health problem in and of itself.

And there seems to be a lot of people saying their mental health is affected by lockdown when, what they really mean, is that they are angry and scared. Both of which are perfectly normal human emotions.



I have, in the past as a young adult, spent several years receiving intensive psychodynamic therapy on the NHS. So please know you're not alone in experiencing mental health difficulties.

I am genuinely sorry you are experiencing mental health issues. I hope you work through them.

I'm not the one suffering, I said my sister had. I still feel your point was trivialising what is going to become a major issue for some. I had a colleague at work who said he had mental health issues, guarantee he didn't, just wanted attention so having experienced it with my sister I find the issue very sensitive.

 

[IanXC]

”Letting it rip” - a policy at current levels of infection of not actively trying to suppress incidence through measures like social distancing or restrictions on human interactions.

I'm not sure many people are a really advocating that, the question I ask is whether this fixation on getting R below 1 is helpful. I would suggest allowing R to rise to allow for some kind of normality, but keeping it low enough that the NHS can cope is the way forward. R value of 1.4 is cited frequently in current economic modelling of this, which is probably about where we are, where, as things stand the NHS *can* cope. Admittedly we will need occasional tightening of restrictions to remain within what might be called the 'target band'.

 

[Tetchytyke]

I find it incredible that some posters on this forum cannot not distinguish between someone dying at the end of their natural life (which is sad, but not tragic, it’s just the natural order of things) and someone being cut down in their prime.

If we want to play the hard-headed pragmatist, someone who dies of cancer also dies at the end of their "natural life". Yes, earlier treatment could have prevented their death. But earlier restrictions could have prevented care home deaths too.

However the effects of restrictions will not be that severe for most people. Businesses fail all the time, and it does not kill their owners. It is a very sad thing to happen, but it is not lethal. And please don't misrepresent that statement as a lack of sympathy.

 

[yorkie]

It also used to be common for kids to die of cholera, diphtheria and whooping cough, so I'm not sure of the validity of your point.

Hardly comparable!

We have had two really good 'flu years recently, in an overall decade which was vastly better than previous decades.

The average age of death may be 82.4, but the average life expectancy is 83.6- and that average is dragged down by all the people who die young. Life expectancy is fluid, too: a man who reaches 80 can expect to live another 8 years on average (source: https://www.annuityadvantage.com/resources/life-expectancy-tables/)

All you are doing is demonstrating how the burden is being shifted onto the younger generation.

So the idea that everyone who dies was at death's door anyway is demonstrably false.

No-one is claiming that, but young people can die of 'flu too. Indeed there is growing evidence to strongly suggest the severity of Sars-Cov-2 is much more greatly skewed towards older people than 'flu, and that for younger people the risks from 'flu are considerably greater than Sars-Cov-2.

Around 12 children under 15 die in England alone annually due to 'flu; what do you propose to do about that?

I also find your use of "lockdown fanatic" to describe anyone who thinks we can't just have s free-for-all is a shame.

That's a deliberate misrepresentation and I find your views a shame.

If we want to play the hard-headed pragmatist, someone who dies of cancer also dies at the end of their "natural life"....

That's one of the most bizarre misrepresentations I've heard; it's utterly absurd to say that.

== Doublepost prevention - post automatically merged: 13 Oct 2020 ==

I'm not sure many people are a really advocating that, the question I ask is whether this fixation on getting R below 1 is helpful. I would suggest allowing R to rise to allow for some kind of normality, but keeping it low enough that the NHS can cope is the way forward. R value of 1.4 is cited frequently in current economic modelling of this, which is probably about where we are, where, as things stand the NHS *can* cope. Admittedly we will need occasional tightening of restrictions to remain within what might be called the 'target band'.

This is an example of a pragmatic view that demonstrates how it does not have to be one extreme or another

 

[35B]

I am not getting into the argument over semantics. The facts are a lot of people are feeling depressed, losing hope, angry, stressed and much more. The argument over categorising these things is irrelevant

Those who call for lockdowns are not properly aware. I know many people who are suffering due to the effects of the measures taken to reduce the spread. As for having loved ones die, when people get to their 80s - which the average Covid death is - people are more likely to die of all sorts of things, including raspatory diseases. We cannot keep people alive forever.

The lockdown fanatics obsess over the numbers of elderly people dying; the facts are that it used to be common for many thousands of elderly people to die of raspatory viruses not that long ago. Was keeping my grandmothers alive for so long that they had zero quality of life to anyone's benefit? It certainly wasn't to theirs.

I'm afraid your post just demonstrates yet again how wrong our priorities are and how you have completely missed the point.

You comment on deaths, as though those who died of the old mans friend were already ready for their trip over the Styx. I have two problems with this frame of reference.

The first is that there are those, even in poor health and requiring care, who have lives that they value and do not wish to end any time soon - I know one who is frail and with COPD, and another who is on lifelong immuno-suppressants following cancer treatment, but able to lead a full life. The second is the wider impact of Covid on those who recover from it, where "long Covid" is increasingly evident as a problem from what doctors increasingly recognise is not just a respiratory disease, despite the main presentation.

I don't support the proposition that the only measure of medical success is the prevention of death, but I struggle with the discounting of lives such as these. If we are all of equal worth, then an approach to epidemiology that reverses the normal approach to quarantine by sequestering the frail while allowing the ill freedom, is unethical. So, for clarity, is an approach that discounts all other value in our lives.