Mental Health: the overlooked ramification of the COVID-19 Economic Crash

 

Feeling supported and part of a network is important in the absence of touch. Photo: Jacqueline Herbst / @HowzitJax.

 

While the world was scratching and scrambling, trying to figure out how to cope with COVID-19 and the looming economic fallout, not many leaders attended to the inevitable mental health crisis that was to sprout from the financial catastrophe.

Economic uncertainty affects people in three major ways; by causing a surge in job uncertainty, disturbance of social identity and an overall decline in mental well-being.

Pandemics, financial crises, natural disasters and wars cause tremendous amounts of uncertainty in every aspect of life. With the COVID-19 pandemic, job uncertainty, salary cuts, rising debt, social isolation due to lockdown regulations and the fear of contracting the virus, have taken a toll. It wasn’t long therefore before the chickens came home to roost, driving people’s mental-wellbeing into a proverbial black hole.

Often the anticipation of a stressful event, like losing one’s job causes more angst than the event itself. That is because confirmed unemployment helps one to focus on planning for the future.

Not only marginalised groups, such as low-income families or those with pre-existing mental health problems, but also well-adjusted, highly functional individuals have reported experiencing varying levels of depressed mood, sadness, crying, nightmares, insomnia, irritability and appetite changes. Lockdown regulations that criminalised people’s normal coping mechanisms – like regular exercise, recreational activities and connecting with people – had a compounding effect on anxiety which was further fuelled by transgressors being persecuted by police and singled out by their communities (such in the case of the Ballito family who were reported to the police for allegedly being on the beach in level four lockdown).

Precariousness around lockdown regulations, financial assistance, essential services, police and military brutality and government’s frequent about turns on announcements made by President Cyril Ramaphosa on easing the lockdown restrictions amplified anxiety and feelings of having no control over one’s own life – in turn disrupting people’s mental health.

Job Uncertainty

A study done in 2009 following the 2008 Great Recession that brought about a 28% rise in unemployment within the European Union, showed an increase in suicide rates within the EU, which highlighted the need for public mental well-being programmes in times of crisis.

Disasters like the COVID-19 pandemic cause global economic uncertainty which sets in motion a domino-effect of job uncertainty, general depression, increased suicidal tendency and eventually, measurable mental disorders.

Having a job not only ensures money in the bank, but also access to medical care, actively organized time, social status, a higher purpose, organisational participation, access to training, statutory entitlements and a feeling of accomplishment.

Job insecurity can be defined as an overall concern about the future existence of the job and is a stressor that consumes mental and affective resources and therefore causes psychological strain. During a crisis, people who dwell on their abilities, competency and future employability experience greater anxiety.

Formulating perceived alternatives to these factors, whether grounded in reality on not, allows one to deal with anxiety in a healthier way. Perception forms a person’s subjective reality and feels as acute as real-world objectivity. It also helps when employers share critical information regarding layoffs and pay cuts while withholding such, causes psychological distress.

Social Identity Disturbance

An individual’s identity is based on group membership. Groups give people a sense of belonging and affiliation without which one’s mental stability is compromised. Lockdown policies of social distancing caused people’s identities to be disturbed, giving rise to depression, a lack of continuity in self-image, and uncertainty about aspirations, values, choices and long-term goals.

Individuals who identify strongly with their social work role define their status and character accordingly. These individuals are typically less flexible and therefore restructuring in companies triggers role ambiguity and role conflict which produces stress and damages psychological well-being.

The pandemic created more mental chaos as it triggered cognitive dissonance – a state of contradiction between people’s self-image and the current state of affairs. Cognitive dissonance causes further psychological damage, mental disorders and social dysfunction while people try to adapt to a new normal.

When people are uncertain about themselves, they tend to devalue themselves. However, downplaying shortcomings and valuing strong traits that one has, can help to cope with cognitive dissonance as it ascribes status and social position while the economic and objective reality is not quite the same..

Psychoanalyst, Erik Ekikson, known for his theory on psychological development of human beings and for coining the phrase “identity crisis”, described identity as experiencing continuity and sameness of the self that stems from one’s devotion to certain ideals, values and goals. These goals guide an individual in pursuing objectives that fulfill his or her needs. Since identity points to self-definition as part of a wider community, it is therefore dynamically linked with societal conditions, fear of poverty and societal exclusion and so marginalisation leads to low self-esteem.

It is okay not to feel okay

Durban based clinical psychologist, Dr. Kirsten van Heerden, believes uncertainty plays a major role, but thinks that together with that, the loss of normal structure and routine was very difficult for many people to adjust to.

“Not having a daily routine can make people feel really anxious, and sometimes even de-motivated. I think many people have felt out of control during this time, and we know this feeling wreaks havoc on people’s mental health”.

She goes on to say that anyone who draws a sense of self-worth from the performance of only one identity will battle when that identity is threatened or taken away (such is the case of job loss).

“Knowing your worth is based on more than just what you do makes it a little easier to cope when one aspect of your identity is no longer able to be played out. It is critical that people know they have many aspects to their identity, and are valued for all these aspects.”

She said anxiety was one of the most common issues she has come across during lockdown. People have also been battling with feelings of worthlessness, having no direction, lack of motivation, loneliness and fear.

However, Dr. Van Heerden cautions against diagnosing depression or any other mental health problem based on people’s reported feelings of sadness, crying, nightmares, insomnia, irritability and lethargy: “Those are certainly symptoms of depression, but to diagnose depression it would have to be that these symptoms were considered out of the norm. I think it was a perfectly normal reaction during lockdown to feel anxious, not sleep, and be irritable. We must be careful not to pathologise something that is actually normal under the circumstances. The problem comes when these symptoms persist and it starts to really affect your functioning over a few weeks.”

Being an affectionate society, many people reported a craving to hug a friend. Commenting on the value of physical contact, Dr. Van Heerden said human touch was vital to well-being because it is part of what make us feel connected.

“Social distancing is actually not a great term, people need to stay socially connected to each other as much as possible – it doesn’t take away the desire to hug someone, but feeling supported and part of a network is important in the absence of touch.

Dr. Van Heerden said there was a monumental need for a COVID-19 public mental well-being programme: “in a nutshell, I think we have to normalise feelings for people, help them understand that there is no ‘normal’ way to cope with this unprecedented situation. There is so much motivational pressure to be positive and look on the bright side; we need to let people know it is okay not to feel okay. Then of course it is important to provide coping skills such as keeping perspective, seeking social support, focusing on controlling the things you can and letting go of what you cannot control.”