The SANE Blog

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.

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.

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?

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.

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?

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.

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.  

Oh dear. I thought it was all coming back. The panic attacks were present again. The periods of dissociation throughout the day. The trembling crying. The isolation.

COVID-19 really had thrown a spanner in the works for someone like me.

When you have lived experience of borderline personality disorder (BPD), it’s so easy to jump back to the mindset of defining yourself when old symptoms start to show. My brain was slowly trying to convince me that I was sick again.

I started to picture myself like I used to be. Slow and lethargic. Angry, confused and fearful of the unknown. I had worked tirelessly for the last three years to have a life worth living. My stability was thrown and all of a sudden, I felt a lost sense of self. All my coping strategies were disappearing one by one and I felt myself heading towards another crisis. The scariest part for me was the prospect of reliving some trauma I believed I had healed from.

Experiencing BPD has its complexities, and I had to remind myself that my experience is going to be felt in waves. I was so used to the stability I had created for myself that I wasn’t prepared for the effect isolation would have on me. I had to remind myself what it felt like when I did experience total isolation, and to build from that.

Living with a diagnosis of Obsessive Compulsive Disorder means that everyday life is often a challenge at the best of times.

I’m always wondering what the next ‘obsession’ will be. What will my brain decide to irrationally cling to this week? It never really goes away, even in my ‘clear’ weeks my brain is ticking away in the background prompting me to obsess over something. OCD is absolutely exhausting.

Of course, it’s not the best of times right now. COVID-19 has taken over all of our lives and there isn’t a single person I know that hasn’t felt the impact of this new normal that has essentially turned everything we rely upon upside down and inside out within a matter of weeks.

For me, my OCD has always been related to health issues and contamination – so a global pandemic sounds nothing short of terrifying for a person who has irrationally diagnosed herself with every disease under the sun since her teenage years – right?

Wrong. I have somehow managed to remain somewhat calm, in control and relatively OCD flare-up free since February. I’ve spoken to my husband and my friends about this at length, particularly as they were mentally preparing for me to spiral into a whirlwind of anxiety that they would have to help lift me out of; and I’ve got to be honest, I don’t really understand how I’ve managed to keep the OCD monster at bay.

The last few weeks have been a rollercoaster for all of us. The COVID-19 pandemic has left us with no choice but to quickly adapt to major changes in our routine. One of these changes has been remote working.

Kitchen tables are now makeshift desks, team meetings are held from balconies, plugs and leads are strewn across sitting rooms – and small people climb on us or furry friends race around our feet.

If you’ve found yourself having to work from home right now, it might be quite an adjustment. There are some great work from home tips available across the internet, but we wanted to find some unique ideas to share with you:

• If you feel the urge to get up and walk around, get up and walk around. Discipline is important, but you're not locked to your workspace. Give yourself five minutes of dedicated, passionate procrastination, then go back to work.

• You're not going to have traffic passing by your desk, which means none of those little small-talk chats that break up your day. They're important and you're going to miss them, so replicate them by texting a friend now and then, or taking five minutes to reply to a tweet or two.

• Because you're not in your professional environment, you're missing your usual prompts. Visualise your normal day and, if there are things you usually do, set lots of reminders on your phone or computer so you don't miss them.

• You are at far greater risk over over-working than slacking off. You might feel like you have to ‘prove’ that you’re working, to earn the trust of your manager. Or you might not trust yourself, and worry that working at home will mean that you’ll get nothing done. Remember that with lowered boundaries between work and home, you’re actually more likely to work too much.

Your home workspace is not the office -- customise it! Put your favourite things in your eyeline. Play music. Wear an outrageous and shameful hat and tell no one.

• Like football players in empty stadiums, you're going to hear your own voice a lot more. Lean into it. Talk to yourself. Have animated conversations. Debate whether you've earned a cup of tea yet. Dance to the kettle.

• Listen to your body. I know it sounds obvious, but you're sitting in a different chair to normal. Or maybe you're working from your couch, or bed. That's fine, but be really careful of your posture, and stretch twice as often as you normally would.

Leave the house once per day, if you can. Remember to maintain proper social distancing if you’re exercising outside. Look at distant objects, it's good for your eyes.

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