Mental stresses in a pandemic
A symptom of the coronavirus pandemic that is being ignored can lead to depression, writes New Zealander Alison Cole, a senior lecturer at Hong Kong University.
The first symptom of a pandemic is hysteria. The mental health impacts of the coronavirus affect everyone, but public authorities have been slow to address this universal symptom of the global health crisis.
Hong Kong is like a ghost town. Within hours of the first cases reported in Wuhan, face masks were sold out all over the city. Supermarket aisles were stripped bare of hand-sanitiser and antibacterial products. Panicked shoppers hoarded any means of survival for the impending apocalypse. I found myself unwittingly paying $100 for a box of face masks literally sold under the table in a hardware store.
In the early days of an emerging health crisis, the biggest mental health impact is fear of the unknown. The public is woefully ill-equipped in crisis management. Without any prior community education on best practices or emergency planning, people fall back on primal instincts.
As any mental health practitioner will tell you, a classic response to lack of control is catastrophising – viewing a situation as being much worse than it is. The brain tries to take control of uncertainty by planning for the worst possible future, which can lead to a reinforcing cycle of panic.
As this spirals upwards, the brain becomes hypervigilant to otherwise innocuous triggers. The catastrophising mindset can be a causative link to depression, which is why it is essential for the public to receive information from government authorities speaking to these particular primal concerns.
It is also crucial for the official response to be tuned into the local experience. Hong Kong is clearly experiencing a mass triggering of the post-traumatic stress disorder left behind by the Sars virus in 2003. All logical lines of thinking are extinguished in the face of people visibly reliving the trauma of the last time they were on the frontline of a global pandemic.
Within a week, the office where I work had instituted the mandated response from the previous crisis: plastic covers placed on all elevator buttons and replaced every two hours, escalator handrails sprayed with chemicals hourly.
In communities that have already suffered, behaviour can run contrary to official information and risk gaslighting the public into panic. For example, the UN has been cautious in noting that Wuhan is heavily polluted with a higher rate of pre-existing respiratory conditions, with current deaths largely from vulnerable members of the community and most people infected so far have been able to recover.
But the visible reaction of people on the streets of Hong Kong created a gaslighting dynamic where eventually you begin to doubt any recourse to logic. The first stages of cognitive dissonance creep in.
In other countries this can run to the opposite extreme. In seeking support from one of my brothers, he told me in typical Kiwi fashion that his whole flat had swine flu in 2009 and it’s no big deal. By expressly recognising the predisposition of a particular community’s reaction, authorities will be far more effective in managing the mental health risks of a viral outbreak.
It’s important to acknowledge the PTSD-like state in Hong Kong and how to recognise the underlying fears based on the past. And likewise, it’s important to actively discuss the ‘‘she’ll be right’’ attitude in New Zealand and encourage people not to suppress their emotions.
With schools and many businesses still closed in Hong Kong after the Chinese New Year holidays, most people are hunkering down at home in selfimposed quarantine. People are advised to limit in-person interaction with others, and to avoid crowded settings, which rules out gym visits and outdoor exercise.
But physical activity is a common insulator against depression, whereas loneliness and isolation are common contributors to it. Unless your hobbies involve the couch, most people in Hong Kong are now cut off from their interests and passions in life – which are crucial for maintaining mental health.
As corny as it may sound, we need to start talking about how to protect our mental health in this pandemic: we need to YouTube at-home workouts and force ourselves to do them even if it feels silly jumping around a tiny flat.
Start meditating, schedule calls with friends daily, find a couch-based hobby like learning an instrument, coding, picking up te reo. Do anything that has a forward progression that can get your mind off the crisis and keep your brain thinking positively and constructively.
And no, binge-watching Netflix shows on pandemics doesn’t count.
Most people in Hong Kong are now cut off from their interests and passions in life.