South Africa has been on level 3 lockdown for almost two weeks , despite the Western Cape having more than half of the country’s Covid-19 cases. Although most industries have opened and schools are slowly reopening too, there are still many who live in fear of contracting the virus.
Many South Africans are happy that the end of lockdown is nearing, however others are still finding this time to work on themselves and/or to spend time with loved ones. Those suffering from different mental-health illnesses, like social anxiety, have more time to feel at ease without being forced into the outside world.
DRUM spoke to clinical psychologist Ntokozo Gqweta about the effects lockdown has on one’s mental health, and some of the common problems that can arise during this time.
“Lockdown means confinement of one into a specific area. This confinement is typically entered into to regain control of or manage something. In this case that would be lockdown to control the transmission of Covid-19. The word ‘lockdown’ therefore brings with it a different meaning for people. But what is clear is a sense of being contained, trapped, confined and limited. People experience confinement in different [ways], depending on their individual preferences and the context. For example, those individuals that enjoy their own space and spending a generous amount of time on their own may find lockdown quite a welcomed experience. Whereas those that love engaging outside with others may feel trapped and frustrated. These individuals may feel anxious and alone even though there might be people (family and spouses) around them. They may experience lockdown as extremely restrictive and confining,” Gqweta says.
He explains that a variety of mental illnesses and challenges may be exacerbated or generated by the experience of being in lockdown. Here lists two of many groups of mental disorders that somebody under lockdown can suffer from.
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“Anxiety disorders are those mental disorders that are characterised by feelings of apprehension, worry and fear that are strong enough to interfere with one’s daily activities. The symptoms may occur over a specific period or may have been present as long as the afflicted person can remember. It can be a specific or generalised sense of worry, apprehension and fear.”
An example social anxiety is when an individual has a crippling apprehension, worry and fear about social situations that involve interactions with others. It is generally a fear and anxiety about being negatively judged and evaluated by other people. These anxious feelings may be exacerbated and reinforced by lockdown, thus perpetuating a state of social paralysis, where the individual's escaping and avoiding tendencies are reinforced.
The other group of disorders is mood disorders. These are disorders that are characterised by a low mood with feelings of hopelessness, worthlessness and negative thoughts which interfere with one’s daily functioning abilities. They can be accompanied by suicidal thoughts. These can occur over a specific time period or be long standing.
"Anxiety describes several disorders that usually bring about feelings of fear, nervousness and worry", says Megan Hosking, psychiatric intake clinician at Akeso Psychiatric Clinic. A panic attack, on the other hand, is sudden and can be very extreme.
"Anxiety can build up over a period of time and goes hand in hand with stress. It is difficult to locate the possible source of a panic attack. It also has more intense physical symptoms such as chest pains.
An anxiety attack can be a symptom of unmanaged anxiety but it will appear as a result of a trigger or stressor. A panic attack doesn’t occur as a result of a specific trigger or stressor and is unpredictable.”
Hosking points out there are also similarities, such as sufferers experiencing nausea, a lot of sweating and discomfort. Probably the easiest way to distinguish between the two is by comparing the symptoms.
People with any one of the disorders in this group have a strong need to withdraw and self-isolate. Therefore, lockdown may reinforce these ways of responding – perpetuating the pattern of unhelpful behaviour that maintains the disorder.
With so much going on for most people, it can be hard to believe there are those who find lockdown beneficial. This doesn’t mean they don’t exist, or the idea is far-fetched. Are there people who see lockdown as something good for them?
“There is no straight answer to it. Some people with certain kinds of mental illnesses may find this time beneficial but others may find it excruciatingly painful.
“Those with anxiety disorders can minimise their engagement in certain situations and environments which trigger their anxieties by managing when and how they engage. The lockdown allows them to avoid the distressing feelings that come with engaging in social situations, especially those with social anxiety,” Gqweta says.
“Those with mood disorders, for example, depression may need to withdraw and isolate. The lockdown can then present them with an opportunity to engage with others in tentative and measured ways allowing them the space to be on their own when they need to. What this means is that people will feel differently given their personal experiences. Some will welcome the isolation provided by the lockdown and others will struggle with it,” he adds.
Some of the coping mechanisms Gqweta mentions are as follows:
Connection and presence
Give people the space they need but communicate with them that you will be available when they need you.
Exercising stimulates the brain to release feel-good hormones like endorphins.
Relaxation techniques, mindfulness practices and self-soothing exercises are some of the ways you can take care of your mental health and of those around you.
Mending broken relations and discarding toxic relationships.
It is important to revisit one's beliefs and ways to fulfill one’s soul in whatever form that may take, for example: meditation, prayer, honouring, etc.
With all this information, there are still people who cannot relate to it but could have their own feelings about lockdown, especially now that we’ve eased into level 3 and things are starting to look “normal” again. Gqweta starts with tentative engagement as a way one can ease into this new level that we are in.
“Start by engaging with the outside world in incremental ways where you begin with small steps towards engaging with others. This can be achieved at first through going to the shops instead of visiting relatives where one can be overwhelmed. One can keep in contact via phone and video calls. One can also begin by going out to exercise. Alone. I think the changes provided by moving from level 5 to 4 and from 4 to 3 have allowed for that incremental re-engaging with the world. Give yourself time to get used to being part of the bigger society without judgement,” he says.