COVID-19: Reflections on psychological impacts

Authored by: Louise Freeland

COVID-19 has transformed everyday life, and people are forced to accept a “new normal” amidst a widespread collective trauma on a scale historically unknown. Psychological impacts of the international Governmental decision to impose lockdown will be extensive, substantial and long term. This is discernible in publications from worldwide mental health charities referencing an exponential rise in calls during lockdown from individuals experiencing anxiety. The Government systems of many countries had the arduous decision to enter an unparallelled period of isolation, with the burden of proof to evidence that the public health emergency outweighs the impact on the population’s mental health.

A published meta-analysis containing qualitative and quantitative data was conducted to analyse the mental health ramifications of isolation (here). Most of the reports used reveal long and short term psychological implications including drastic behaviours such as suicide. Another study (here) used in the systematic review assessed PTSD symptoms in individuals in isolation against a control group. The mean PTSD scores were four times higher for the group in isolation. However, data provided from this review is to be used with a caveat; the samples used were experiencing health pandemics other than COVID-19. There are potentially extraneous variables from differing health crises preventing reliable application to COVID-19.

The media contributes to informing society of the facts surrounding COVID-19, including reasoning behind protocols to increase public compliance. Yet it has historically used scaremongering headlines including mortality rates, causing unnecessary anxiety for people already in isolation.The World Health Organisation publicly acknowledged that many people are experiencing stress associated with the “new normal”, and advised to avoid distressing media outlets (here). One study reports (here) a media bias of prioritising emerging health hazards over it’s impacts on public health.

In order to identify additional support needs, several robust studies addressed risk factors for experiencing mental health problems when isolated. Research suggests pre-existing mental illness was associated with experiencing anxiety several years post-isolation (here). Other demographic factors did not reliably reach statistical significance. A published article by The BPS (here) discusses the pandemic’s dangerous implications for individuals with obsessive tendencies. Government campaigns stating the increasing guidelines for handwashing techniques plus social media platforms displaying pop songs alongside these techniques could cause fixation in some individuals. This “gamification” could escalate excessive practices, creating behavioural reinforcements which potentially complicate future treatment. Such psychological problems will unlikely dissipate post-lockdown, and will require psychological intervention.

Essential adaptations are required to psychological support provided during isolation and beyond, with minimal historical evidence available regarding worldwide isolation on the scale of COVID-19. Several longitudinal studies are underway to enhance understanding on what measures improve mental wellbeing during isolation. Support systems will be updated based on data from ongoing studies of this nature. Individuals in isolation are in an unmonitored space, and psychological intervention would lack adequate support networks to ensure personal safety when confronting such trauma. Instead, the most judicious designation of resources would be prioritising management systems to contain stress levels alongside the outbreak containment phase, delivered through video based therapeutic support. An observational study (here) found isolated individuals overcame experiencing alienation by connecting to a wider group with shared experiences. Indeed, mental wellbeing will come from the protective factors of people unifying as communities through online connectivity. The survival of this pandemic will come from people not as solitary units, but as a collective.

Louise Freeland MSc completed her degree and Masters in Psychology at the University of Nottingham. She has since specialised her work as part of a behavioural team within the field of clinical psychology.