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Reflections on coping with COVID-19

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Back in March 2020, who would have thought we’d still be waging the war against this microscopic enemy, five months later?  

When the restrictions were first imposed, I (perhaps like much of the population) went into the whole experience with a sense of both awe and ignorance. It seemed such a novel experience to listen to the Prime Minister and the Chief Medical Officer almost on a daily basis, followed by respective ministers of the States and Territories. I felt then that the proposed stage 2 and stage 3 restrictions made little impact on my life – due, in part, to my living arrangements and personal habits.

Summer was gently giving way to autumn and I had plenty to do in the garden. I had moved into a new suburb a few months earlier and I was happy to stroll through the new streets and familiarise myself with the cafes and dog parks. I continued to maintain my structure for the day – exercise, work, creative pursuits… But as the days dragged on into weeks, and weeks into months, I began to feel lethargic. As the second wave hit us, I felt that my own personal sacrifices seemed to have served very little purpose.

As autumn ushered in the cold winter and long periods of being alone, increasing social restrictions and loss of freedom led to a decline in my motivation. I lost confidence in our ability to eradicate the virus, and sensed that I had to manage yet another personal risk – my mental health. I have lived with complex mental health issues for a long time and have had practise in recognising risks and managing them proactively – at times quite successfully, and other times relying on professionals.

But the one key thing I have learnt (which regrettably, no school biology class taught me) is that our bodies function within a range of systems. In addition to our various biological systems (the respiratory system, the nervous system, the reproductive system, etc.) we also have an Emotion Response System (ERS).

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Media reporting on mental illness, violence and crime needs to change

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The media is a key source of information about mental illness for the public, and research shows media coverage can influence public attitudes and perceptions of mental ill-health.

But when it comes to complex mental illnesses such as psychosis and schizophrenia, media coverage tends to emphasise negative aspects, often choosing to focus on portrayals of violence, unpredictability and danger to others.

These portrayals can give an exaggerated impression of the actual rate at which violent incidents occur. In reality, such incidents are rare and are often better accounted for by other factors.

This can generate a skewed impression mental illness causes violent behaviour, which reinforces myths, increases stigmatising attitudes and cultivates fear among the public.

Research also shows the media can play an important role in challenging these stereotypes. Portrayals that are responsible, accurate, informative, and “stigma-challenging” have been found to positively influence public beliefs about mental illness.

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COVID 19 … Enough to make you want to pull your hair out!

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During Covid-19 we've heard the concern about the impact the pandemic is going to have on people’s mental health. It’s enough to make you want to pull your hair out. I have found myself thinking a lot about people who literally pull their hair out. People with trichotillomania. “Tricka what?” you ask. Trichotillomania comes under the umbrella of Body-focussed Repetitive Behaviour Disorders.

Trichotillomania is an enduring mental health issue characterised by an overwhelming urge to pull out your own scalp hair, eyelashes, eyebrows, or other body hair.

Treatment of trichotillomania can be hard to find, but people find ways of managing the disorder and living with the impact it has on their lives. People with trichotillomania go to great lengths to disguise the damage from their hairpulling, and many find it incredibly anxiety-provoking to tell another person about their experience or seek help.

Trichotillomania has a tremendous impact on the lives of people with it. It affects far more than physical appearance. Low self-esteem, poor body image, increased feelings of depression and anxiety, isolation, loneliness and fear of intimacy can be common. These experiences, in turn, increase the urge to keep pulling, and so continues the cycle of trichotillomania. More damage occurs from the hair pulling and the self-hatred continues – “look what I have done”. Shame, guilt, further withdrawing and further isolation.

Trichotillomania affects both men and women, but it seems that women are more likely to seek help. This makes sense when we look at the emphasis on hair as an expression of feminity in our society. For both men and women, our hair can be tied up with our sexual identity, how attractive, empowered or liberated we feel - characteristics that people with trichotillomania don’t often feel. There is a deep relationship between hair and self-esteem; we know the saying, “bad hair day”, the day where everything seemingly goes wrong. Well this can be every day for someone with trich.

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Joking about gaining the 'Quarantine 15'? Your words have more of an impact than you realise.

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If you have been spending more time on social media throughout the COVID-19 lockdown, you definitely aren’t alone. Social media platforms have been a well-established part of western life for over a decade and the variety of avenues grows by the year.

In these unprecedented times, many of us have been relying on social media like never before to connect with those we love, to share our struggles and to have a laugh. However, some jokes have not been so funny. 

Some have been problematic and potentially even harmful. In this instance, I’m talking about the memes and jokes that emerged about weight gain in quarantine.You may have seen them too – jokes about signing up for weight loss shows, statements about gaining the “Quarantine 15” and even before and after images of a photoshopped barbie doll.

At first glance, these jokes and images may seem clever or laughable, but for people living with eating disorders, and for people living in larger bodies, such jokes can be harmful.

As a proud survivor of anorexia, what I see in these jokes is a potential trigger to exacerbate illness-driven anxieties and struggles with distorted body image. However unintentionally, they take a serious component of psychiatric illnesses and trivialise it.

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Care farming: creating community in nature

Liz-Everard-and-Julia-Westland Hocking Fellow, Liz Everard, and Flourish Australia Mental Health Consumer Representative, Julia Westland.

2019–2020 Hocking Fellow, Liz Everard on how COVID-19 has highlighted the potential of nature-based interventions.


When I started my Hocking Fellowship project in late 2019, I intended to research a number of therapeutic or care farm communities that exist in the United States and Ireland. My aim was – and still is – to explore how this model of care could be provided in the Australian context. Unfortunately, the COVID-19 pandemic has put my travel plans on hold.

As the virus has spread rapidly around the world, disrupting our familiar realms of work, education and play, many of us face a binary choice: to hunker down at home, or to go outside.

Physical distancing rules mean heading outdoors has become one of the few activities left for those wanting to escape their house. An unexpected benefit of this situation is that people around the world are spending more time in nature. Studies have shown that spending even just 20 minutes per day in nature can lower stress hormone levels, boost self-esteem, and improve mood. Nature is a welcome relief from the increased worry and tension many might be feeling right now.

For some, spending time in nature might involve going for a run, or taking a walk in the park. For others, it is spending time in their garden, or simply sitting under a tree.

The mental health outcomes of spending time in nature have long been documented. They include reduced depression and anxiety; improved concentration, attention and cognitive restoration; and increased happiness, satisfaction, and quality of life. In fact, these positive effects are so well-recognised that more and more doctors are issuing ‘nature prescriptions’ to help treat a range of conditions, including: heart disease, hypertension, high cholesterol, diabetes, chronic stress, depression and anxiety, insomnia, and PTSD.

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My life with schizophrenia: 'I’m here to do my best and make the most of my life.'

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SANE Peer Ambassador Greg Ralls is a professional engineer, husband, father and author, who lives with schizophrenia. He shares some of his experiences in this Q&A guest blog.

When were you diagnosed with schizophrenia and what was your first reaction?

A psychiatrist made the diagnosis in 2005. It was a while coming, as the symptoms first surfaced in 1997 and my first-episode of psychosis happened in 2000, during which time I found myself deeply in crisis.

I kept diaries and wrote letters in those early years, and having recently reread them I can say with certainty, I was floored when told I had schizophrenia and that my first reaction was shock and denial. I wouldn’t be surprised if this reaction is common for people in similar situations. To quote directly from a letter I sent my treating doctor, “I have been diagnosed with schizophrenia. I believe this diagnosis is incorrect.” It’s fair to say that even today, I’m still somewhat sceptical and in denial.

How does schizophrenia affect your life?

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COVID & our mental health | Q&A with Peer Ambassador, Anita Link

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We've been asking our SANE Peer Ambassadors for their response to the COVID-19 pandemic and how they've been managing their mental health during this challenging time. This week on the SANE Blog, we're joined by the wonderful Anita Link who lives with bipolar 1 and is also a wife, mum, small animal veterinarian, writer, and mental health advocate. Check out our quick Q&A session below!

Q. What concerns you most about the impact COVID-19 will have on your mental health?

A:  If I didn’t have access to the medication that keeps me well, that would be a concern. But at this stage, I think that’s unlikely to happen. I’m acutely aware of my privilege and am fortunate to have access to high quality, consistent mental health care. So, I’m not that worried about myself. I’m also nearly 14 years into my experience with my Bipolar 1 disorder, so I have a lot of insight and know when to seek help.

Q. How do you think this pandemic will affect other people’s mental health

A. I’m concerned for the many people new to mental health difficulties during this pandemic. The effects of the coronavirus could trigger someone’s first experience. Others with previously undiagnosed/unmanaged mental health difficulties may go from managing to deteriorating, due to pressures this pandemic has brought with it. It could be challenging for this group to recognise what’s happening and access appropriate care quickly.

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Has COVID-19 created a new-found understanding of complex mental health issues?

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Has there been another topic of conversation over the past few weeks besides coronavirus? Gone is the simple “Hey, how are you?” replaced by “How are you coping?” and “Are you staying sane?”. It’s that last one that gets me. And I’m just as guilty as others because I’ve heard myself ask a version of that very question: “How are you dealing, in amongst the crazy?”.

The very stigma that I, and many braver, smarter and more educated people have been working to address for so long is, in a strange way, coming to the fore and shifting in front of us, thanks to the omnipresent coronavirus pandemic.

Over the past several weeks, I’ve heard people talk about their own mental health, and their need to look after it, more than ever before. And I can’t applaud loudly enough the fact that the subject is being given the air play it deserves, in a way that resonates with so many.

I’ve also heard people say – to me, and in the media – that they have a newfound understanding of anxiety and depression because they are experiencing it for the first time themselves. On face value, I find myself wanting to cheer. Not because I wish hardship on anyone. But because as humans, sometimes we learn best by firsthand experience.

I find myself wondering: wouldn’t it be a positive outcome of this horrendous situation, if more people developed a genuine understanding of what it’s like to be gripped and groped by emotions beyond rational explanation?

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When the carer needs care during COVID-19

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It’s 3 am and I can’t sleep. At the moment, I’m busily trying to juggle my work as a psychologist with family commitments, assisting my parents to care for my brothers (who both have schizophrenia diagnoses), and staying fit and well myself. It's challenging, but I'm grateful that I have family and friends who provide me with regular, unconditional support.

Carers often deal with their own mental and physical health issues and are also often elderly. Because of this, many are considered vulnerable and need to isolate themselves during this pandemic, to stay well.

Unfortunately for many carers, their roles have become even more demanding than usual. I know carers whose loved ones have recently lost support workers due to the current situation. Because of worries about their own health, and the health of their clients, these workers have withdrawn their contracts. Sadly, this means these carers are facing the challenges of COVID–19 alone.

Carers are often so exhausted and busy, they don't reach out and seek help. If they do seek support, sometimes other people don't truly understand what it's like to be a carer for someone living with complex mental health issues. They often have no concept of the daily struggles that can be encountered: being locked out of treatment planning, service providers not understanding how to apply confidentiality and privacy principles, difficulty navigating the mental health system and the National Disability Insurance Scheme (NDIS), and knowing how and where to seek support.

It's been very difficult for carers of people with complex mental health issues to find the appropriate agency to support their loved ones, as many providers still don't understand or accept disability and are slow to change to the new way of working with the NDIS. As a result, a lot of people still haven't received the support they need to help them live independently.

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Fight/Flight/Freeze: How I'm living through COVID-19 as a trauma survivor

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I know I am not alone in saying that the COVID-19 situation has triggered pervasive feelings of powerlessness, entrapment and uncertainty. I also know that I am not alone when I say that, as someone with a history of trauma, these feelings are very familiar and extremely difficult to tolerate.

In working through my trauma, I have learned that when we’re confronted with situations that remind us of our trauma, or where there is any sense that we are in danger, our fight or flight system kicks in. For me, this manifests as extremely high anxiety levels, excessive nervous energy, and frantic efforts to gain control.

When COVID-19 started to impact on my life, when I felt that the wellbeing of my loved ones was in danger and I started to lose control of the things that gave my life meaning and stability (my work, my social life, my home), I quickly spiralled into a panic.

For days I couldn’t breathe, I couldn’t sleep, my mind was constantly racing, and my body was constantly shaking. I came across messages to control what I could control, which was good advice in theory, but paralleled an internal fallacy that I have battled for years – when I can’t control anything else, I can control my body. So, I fell back into old patterns of disordered eating, compulsive exercise and self-harm, in a desperate attempt to regulate that intolerable anxiety. Until I crashed. 

When the fight or flight response is active for long enough and the threat is still ongoing, we fall into the freeze response. For me, this characterised the next stage of my COVID-19 response. I fell into a deep depression, consumed with feelings of hopelessness and thoughts of suicide. I swung between feeling numb and feeling devastated, apathetic and inconsolable. I struggled to engage with the few opportunities for socialising that I had. And sometimes I – an extrovert who was starving for social contact – did not want to engage at all. I spent most of my days in bed, avoiding talking to my friends, turning to food and alcohol for comfort.  

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