Mental wellbeing during a pandemic

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Maintaining positive mental wellbeing during a pandemic. After reviewing the Lifeplus “Attitudes to mental wellbeing – phase 2 report” conducted by Cambridge Market Research, Dr Elizabeth Robinson RMN BSc (Hons) PhD ENB 985 DipMan IPT comments on the impact and context of Covid-19 and makes suggestions to help maintain positive mental health.

Mental health in the context of Covid-19

Life at times can be stressful and challenging, the Covid-19 pandemic has added to this pressure and turned many lives upside down, significantly changing what we do at home, work, with our friends, families, and how we use our social supports. Furthermore, there are the potential extra worries including finances, the uncertainty of changing restrictions and lockdown, the stress of having to multitask to a completely different level to deal with homeworking and home-schooling, the ongoing threat of dealing with the virus, and potential illness. Sadly, there have been many who suffered significant illness or indeed lost their loved ones to Covid-19; where restrictions have prevented their ability to give support to their loved ones, or indeed receive the usual level of support having experienced their loss. The context of the current pandemic substantially increases the importance of working to optimise our mental wellbeing to prevent an exacerbation of current mental health problems or the development of new ones.

More tips to optimise mental health and wellbeing

Despite the pandemic, there are many positive approaches we can adopt that can effectively optimise a positive mental wellbeing. I offered some tips after reviewing phase one of the study and have added to them below. 

People

We are social creatures, positive contact and connections with others is helpful to maintain optimum mental health. Since the pandemic there have been significant changes in our ability to connect with our social network which can increase our vulnerability to mental health problems. We obtain social benefits from others in many ways, it is helpful to think about the children’s song “head, shoulders, knees and toes” to remind ourselves how to use this support and ensure we appreciate the range of social support and consider where we may need to optimise this.

The “head” represents who in our lives we can get our “heads together” with, have a good catch up or engross ourselves in those stimulating discussions. The “shoulder” relates to the person who will provide the shoulder to cry on during the tough or challenging times. It is completely natural to feel bad when bad things happen so expressing this and sharing your feelings with someone who shows understanding is healthy and minimises exacerbating mental health problems.  The “knees” refers to those we can have a “knees up” with, for a giggle, have fun, or light relief; this helps recharge our batteries and potentially build resilience to deal with stressful events or challenges. Finally, we occasionally need people in our lives to give us a shake, to get started with things we may be avoiding, or else something more definite such as using the “toes” to give us the kick of motivation we need!

Relationships, social contact and connections do not always happen by chance, we need to make plans to sustain these activities and contacts to maintain a positive mental wellbeing. Contact can be in person (rules permitting) or by remote means, Covid-19 requires us to use more creative or imaginative ways to do this.

Activity – physical and fun

There is evidence that physical exercise, pursuing hobbies and leisure interests contribute to positive mental health and can ease symptoms of depression, stress and anxiety. Try to think how you can structure regular activity into your daily or weekly routine – consider what is realistic, achievable and fun. If you are spending long periods of time at your desk, set the phone alarm at intervals to ensure you stand, stretch or take a break. Think about various ways you can remain active and involve others for support (these may be online or in person), including video calls/quizzes, walking, running, cycling. And be social – say hello to others while outside or to a neighbour over a fence. Be active in the home, consider playing music whilst washing up or doing housework, you can sing or dance and be active as you work.

Try to plan “me time” for rest and relaxation. Plan specific time for this activity and try to enjoy the anticipation of the event as much as the event itself. During lockdown you may need to be creative about what this activity should be, it should be something that works for you. This could be anything from planning to watch a film or a TV programme (with someone in the household, or a different household who watches it at the same time), making a video call, planning a long soak in a bubble bath with a good book, or planning a special meal for a “date night”.

Plan regular exercise. See if you can involve others – you may still do it separately but you can set goals and talk about your progress together. When walking outside, take some time to pause or slow things down and use mindfulness techniques to notice your environment, using all your senses: pay attention to what you see, hear, feel, and smell. Be curious about plants as they grow, new leaves coming on trees, bulbs coming through, the colours, the shapes, look at the skyscapes around you, movement, light, textures, the noises around you, the birds, the wind, people, water sounds, etc. The feeling and the smell of the air on your body. Look out for your favourite experience and tune into this, just for the pleasure of it.

Work/home balance

Home and work are equally important. It is not unusual for people to struggle with achieving and maintaining the right balance between the two. Furthermore, Covid-19 has added an additional complication for so many of us, facilities, boundaries, technical issues, home-schooling to name a few.

Try to establish and maintain definitive boundaries that separate work from home. If working from home, identify a specific area to work, if possible try to separate this from your relaxation space, ideally in a separate room, however more commonly it may involve part of your home such as a dining room table converted to a workstation. Plan to work to explicit start and end times to your working day and clear away the area to reclaim it for home use. Whilst it takes time and is a nuisance setting up the workspace at the start of the day, clearing it at the end of the day, it is more than likely quicker than your typical commute to work. Make sure you take regular breaks where you move away from this workspace, if sitting at a desk, ensure you stand, stretch and walk around sufficiently. Keep hydrated and plan regular mealtimes with healthy nutritious food, avoid spending lengthy times in front of a computer desk, followed by an immediate urge to stock up on unhealthy snacks.

Be clear and explicit about expectations of yourself when working in the current conditions, with the resources and technical support available to you at the time, these expectations can be internally driven, causally linking to what you think you should be doing or may be the expectations of work colleagues/bosses. In either situation, ask yourself – do they expect enough, the right amount or too much?

We can often be our own worst enemy and reflect on things we have not done; try to stand back and look at what you have achieved, rather than what has not been done. Try to cut yourself some slack when planning your work, avoid overestimating what can be done in a specified timescale and remain realistic about what is achievable. Remember, you are one individual, consider who else could be called upon for help or should take some responsibility.

– Dr. Elizabeth Robinson, Psychotherapist RMN BSc (Hons) PhD ENB 985 DipMan IPT

Respect yourself

Frequently we can get wrapped up in the hustle and bustle of life – juggling work, kids, home, and other aspects of life. Try to pause and take a moment to reflect on your achievements, try not to overcomplicate this or make it a bigger deal than it is, stand back and notice the full range of your achievements. This may include what you bring to your friendships or give to your kids, your ability to laugh at yourself or have fun, your cheeky sense of humour, how you have helped a neighbour, learned to cook, garden, sew, or even learn new IT skills for example. How many times do we reflect on these achievements, furthermore, how often do we give ourselves a pat on the back for these achievements?

Be honest and try to reflect on the areas you could target to improve. For me, I often smile to myself and imagine this as a school report, where a teacher may write “could do better” in some areas which may include:, making time for yourself, setting realistic expectations of what can be done at work and/or home thus avoiding setting yourself up for a fall.

Goals/targets

Part of the survey results demonstrated that younger people were more likely to set goals or targets to work towards, I believe this is useful technique to use to optimise our mental health and potentially improve our quality of life. Considering all the areas outlined above including how to make the best of our social contacts, obtaining the correct work/home balance, remaining active and respecting ourselves, I have often found it useful to set goals. It is important to ensure these are realistic and achievable, and may be short, medium, or long-term targets. I often suggest to people they could set goals and rate out of 10 (10 equals achieving the goal) how much they currently feel they are achieving the goal. Try to consider what can be done that will raise the score from its current position, i.e., if a person has set a goal to run 5K with a friend and rates the goal as 1/10, I would ask them to consider what they can start to do that would increase their current rating of “1”. I think it is helpful to share your goals with relevant significant others and talk with them about a plan to achieve the goals.

Context of Covid-19

Despite the tremendous challenges of Covid-19, I have been overwhelmed and proud to have seen the best in people, and see people adapt despite such difficulties. I notice the support from friends and neighbours offering practical help, or a listening ear, or even organising a street exercise class! Many of us know so much more about our neighbours, there has been an increase in community support and spirit. Furthermore, I have seen my 80-year-old mother master digital technology and I have been surprised to have had more contact with friends and colleagues nationally and internationally than ever.

I have found it helpful to look at others and notice how they are making the best of this hugely challenging situation. Personally, I aim not to simply get through this but to look back and reflect on what steps I took that got me through one of the greatest challenges we have faced, and who helped me on this journey.

Support for mental health

In addition to suggestions that I have outlined above, I would recommend looking on the NHS website which provides a list of organisations, charities or support groups which offer expert help and support to deal with a comprehensive range of mental health problems including; anxiety, depression, men’s health, suicide prevention, or OCD, sexual abuse, alcohol/drug misuse, Alzheimer’s society, and bereavement. Please note this is not comprehensive list. The website also includes information on mental health and wellbeing (for adults and children) to help a person deal with a range of challenges including reducing stress, loneliness, grief, anger, etc.

There are tips and techniques including breathing exercises, time management tips, coping with money worries, mindfulness and five steps towards improving mental health and wellbeing.

Mental health support – NHS list of charities/organisations/support groups

There is helpful information, including video and audio sessions. Additionally, there is a full range of psychological therapies including interpersonal psychotherapy, counselling, cognitive behavioural therapy, guided self-help, mindfulness based cognitive therapy to name a few. You could also explore a range of stress busting apps.

Finally, Lifeplus has created a simple “Mental Health 5-a-day” approach to support mental health and help you incorporate small daily changes into your routine to improve mental wellbeing.

5-a-day for improved mental wellbeing

About Dr. Elizabeth Robinson

Dr Elizabeth Robinson (RMN BSc (Hons) PhD ENB 985 DipMan IPT) is a psychotherapist and has worked in the field of mental health for over 35 years. Her initial professional training was as a psychiatric nurse, she then studied Health Sciences (BSc.Hons) followed by a PhD at the University of Durham. Her research examined functional brain imaging in depression with interpersonal psychotherapy.

She has worked with acute mental health problems, forensic psychiatry and as a senior researcher in mental health research. Her initial training in interpersonal psychotherapy was in Geneva in 1997 after which she completed her supervised cases and research training in 1998 from expert interpersonal psychotherapists from New York. Whilst working as a researcher she was the lead interpersonal psychotherapist for a number of clinical trials.

She currently provides training in interpersonal psychotherapy, has organised numerous courses nationally, and provides ongoing supervision to therapists such as psychiatrists, psychologists, nurses, social workers and occupational therapists. Within research, she was involved in the assessment, psychiatric ratings and treatment for randomised clinical trials in schizophrenia, depression, anxiety, social functioning, suicide, sexual dysfunction, interpersonal psychotherapy and brain imaging. Although her special interest is in depression, trauma and sexual and relationship difficulties she has considerable experience working with anxiety and phobias and uses a number of psychological treatment models including interpersonal psychotherapy, psychosexual counselling, eye movement desensitisation and reprocessing, anxiety management and cognitive behavioural therapy.