Two years ago this Wednesday, the first isolation started. In a way, it feels like a lifetime ago. But we are just beginning to see the long-term effects of the decision to plunge us all into isolation, specifically the impact it had on our minds.
Figures released last week show that National Health Service mental health services received a staggering 4.3 million referrals in 2021. The Royal College of Psychiatrists, which analyzed NHS data, said England has suffered the “biggest blow to its mental health in generations”.
As many of us predicted at the start of the pandemic, our response to the virus, including the lockdown of society, was not going to be without consequences. I now find that the NHS is awash with mental health issues; I can’t stress enough how daunting it feels to be an NHS psychiatrist now.
As many of us predicted at the start of the pandemic, our response to the virus, including the lockdown of society, was not going to be without consequences.
The acuity, how bad someone is, is at a level that I’ve never seen before, because people have been sitting at home deteriorating and not getting the help they need in a timely manner.
This is partly because many mental health services did close or were working remotely or understaffed, and partly because people were isolated, with no family or friends to push them to get help sooner.
Almost every referral I get now has some mention of the pandemic. Some of them are predictable: loneliness, isolation, and a lack of structure and routine have resulted in increased rates of depression and anxiety.
PTSD rates have also increased in people who spent time in an ICU or witnessed the death of loved ones or, in the case of doctors and nurses, patients.
In fact, a therapist friend of mine told me that she currently has four doctors as patients who cite the pandemic as the reason for their current struggles.
Panic attacks have increased among those who experience shortness of breath when they feel unwell.
Some of the derivatives have a history of mental health problems and the effects of the pandemic have triggered a relapse, sometimes after many years of being well.
For others, they have no history, but the stress, disruption, and unfamiliarity with the situation they were in has led them to get sick for the first time.
The lockdown was stressful for some, but boring for others. As a result, drug and alcohol use has skyrocketed.
In the summer of 2020, psychosis rates were 50% higher than the previous summer, which I suspect is due to people sitting at home using substances, particularly cannabis.
To give you an idea, in the ER we normally see one case of drug-induced psychosis a week. However, in just one night shift towards the end of the lockdown, I saw four patients with him; this was not uncommon at the time, and rates have remained surprisingly high ever since.
I can’t help but think that it could have been different. While our scientists and politicians scoffed at Sweden’s approach (they didn’t have a national lockdown) and warned that it would lead to more deaths, in fact their approach is beginning to be vindicated.
An in-depth study published last month found that lockdowns only reduced Covid mortality by 0.2 percent.
It concluded that the lockdowns caused “enormous economic and social costs” and were “ill-founded and should be rejected as an instrument of pandemic policy”.
This study received little interest from the media, I suspect it would embarrass those calling for stricter lockdowns and criticizing those who are more cautious.
Furthermore, a recent study in The Lancet found that Sweden also fared better when it came to Covid deaths: Where Britain had an excess death rate of 126.8 per 100,000, Sweden had 91.2 per 100,000. .
Unlike the UK and much of Europe, Sweden managed to keep facilities such as day centers and schools open. This had a tremendous impact on the welfare of the nation.
Its National Board of Health and Welfare reported a continuing decline in the number of people seeking treatment for anxiety and depression, particularly among young people. It is believed that a large part of this is likely due to the decision to keep primary and secondary schools open at all times.
Even in senior secondary schools, only children who tested positive or had been formally traced were asked to stay home. Entire schools and classes were rarely quarantined and only in rare circumstances if advised by a local infectious disease doctor.
That’s a stark contrast to the UK, where up to a million were sent home from school during the ‘pingdemic’.
An analysis of national grades published by the Swedish National Agency for Education found no evidence that the pandemic has negatively affected children’s educational achievement. Contrast this with the flood of referrals to children’s mental health services here.
The Royal College of Psychiatrists found that almost 200,000 young people had been referred to mental health services in just three months, nearly double pre-pandemic levels.
While many of us now consider lockdown a distant memory, for some it just proved to be too much. We are on the brink of an unprecedented mental health crisis of a magnitude we can only begin to imagine, and it is a direct result of the pandemic and lockdown.
Motherhood has been stolen from her.
Given everything that is happening in the world right now, the news that Nazanin Zaghari-Ratcliffe has finally been released after six long and horrific years in an Iranian jail is particularly welcome.
It’s nice to have something so wonderful to finally celebrate. But we can only imagine her agony over not only the appalling conditions but also being separated from her family, particularly her daughter, who was only two years old when she was imprisoned.
The news that Nazanin Zaghari-Ratcliffe has finally been released after six long and horrible years in an Iranian jail is particularly welcome.
I have had some patients who were political prisoners and applied for asylum here afterwards, and I have seen how being torn from their family has profound and lasting effects. It is difficult to rebuild relationships and forge a normal life after being away, particularly from children.
I remember a man who said that not only was he robbed of his freedom, but also the opportunity to be a father. Nazanin has also been robbed of the chance to be a mother to his daughter.
It will go a long way to heal these wounds and I hope that the family gets the right psychological support to help in the process.
■ Menopausal women have reportedly been forced to “trade in for £50 bottles of HRT online” due to a shortage of pills, which follows increased awareness and de-stigma around menopause. While I am horrified that women have to turn to the black market, I am confident that this will be temporary and am pleased that it appears that we are beginning to take menopause seriously. The negative view that dogged HRT for two decades may be fading. I have seen so many women diagnosed with depression when describing menopause, but for years GPs refused to give HRT and wrongly prescribed antidepressants.
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