COVID-19 related stress is catching up with Canadians, says columnist Jennifer Moss

Health Canada data recently revealed that roughly 11 million Canadians may experience high levels of stress, with two million more of us at risk for traumatic stress as a result of the pandemic. And this month, an IPSOS poll investigating the mental health of Canadians found that 66 per cent of women and 51 per cent of men claim their mental health has been negatively affected by COVID-19.

What may be even more alarming in the IPSOS data is that only one in five people in the group experiencing high stress had sought support for their issues. 

Why does it continue to be so challenging to ask for help – especially now, when it may be most needed?  We do know that, historically, it's been hard for people to get help with mental illness for a multitude of reasons, including: 

• Stigma. Stigma is described as the disapproval of, or discrimination against, a person based on perceivable social characteristics that serve to distinguish them from other members of a society. Unfortunately, we've long suffered from society's stereotyped views about mental illness and how it affects people. Too many people believe mental illness makes us weak, or lesser than, or the other. When we feel vulnerable, it's hard to open ourselves up to judgment, which we may feel we are doing by seeking help.
• Some people don't think they need help. They may have been raised in an environment where you battle mental illness by "sucking it up." We also see this kind of messaging in popular culture, which inevitably downplays the actual chemical process going on in our brains – a process that willpower alone can't alter.
• In many instances, people just don't know they are depressed. Depression often starts slowly and then catches up to you. And, the cruelty of depression is that tasks become extremely burdensome, so that even calling your doctor can be exhausting and intimidating – like driving yourself to the hospital when you have a flu: It makes sense, but it's just so hard to do.

These and other factors have long made it challenging for people who are struggling with mental illness to reach out for help, but COVID-19 has made it even more challenging.

Pre-pandemic, a significant swath of the population couldn't access help even if they were open to seeking it. One simple barrier has been availability, particularly in rural areas and other places where mental health is underserved. Cost of treatment has also been a barrier, with public access to psychotherapists basically non-existent in Canada.

Since the lockdown, access to mental health supports has been very limited. Some clinics are offering virtual support, but can still exclude people because of cost and access to technology. Some free resources, like the federally funded Wellness Together Canada, launched in April, are providing self-assessment tools for rating your level of distress and offering a limited number of live phone sessions with professionals and peer support for front-line workers.

These resources are a good start, but we still have a long way to go. 

The Centre for Addiction and Mental Health (CAMH) says there's an urgent need for a model that offers free and readily accessible mental health care to all Canadians. In a study of nearly 13,000 primary-care doctors in Ontario, only 3.2 per cent were providing publicly paid psychotherapy. We need a mix of public access to psychotherapy and targeted access for marginalized groups in our community who are at high risk for mental illness.

Opening up but not asking for help

While COVID-19 is making it more comfortable for people to talk about their anxiety openly, I'm worried by the studies showing that the pandemic doesn't seem to be leading them to ask for professional help.

I worry this may mean people are seeing their stress and anxiety as finite, and assuming the stress will go away when COVID-19 does. But chronic stress, poorly managed, can change the chemistry in our brains. 

There is some good news. A Sun Life survey has found that people are managing their mental health in ways other than seeking professional help. A majority of the people surveyed said they reach out to friends and family and said they are keeping busy at home. 

These activities can help manage low levels of anxiety and stress, but if stress levels become unsustainable or there are signs of depression, I would recommend looking for professional help as  a primary source of support and using family and friends as a bolster for mental health.

Signs of depression

If you're wondering what the signs of depression are, here's what to look out for:

• Persistent sadness, lasting two weeks or more.
• Loss of interest in your favourite things.
• Feeling guilty, bad, unlikeable or not good enough.
• Feeling useless or unable to cope with life.
• Increased feelings of anxiety.
• Especially low mood in the mornings.
• Feeling more irritable, frustrated or aggressive than usual.
• Trouble concentrating.
• Feeling tired all the time.
• Changed sleep pattern – difficulty getting to sleep, bad nightmares, waking in the night, waking up too early or sleeping much more than usual.

Prevention Measures

It's important to be self-aware so that we can detect when we may be feeling worse than normal for longer than normal. It's just as important to make sure that our stress related to going through a major event like a global pandemic is free from judgment or guilt.

I will continue to repeat this mantra, the one I've been using to cope: "There is no right way to feel right now." So, if you are having a few bad days, that is totally OK and perfectly normal.

However, there are self-help tools to manage anxiety and stress. Here are some useful ones for right now:

• I say this a lot: Don't Doomsday Scroll. Follow trusted news channels and take a media hiatus when necessary.
• Don't overdo it on the tech. Video games and social media can be OK in measured amounts, but playing video games or using social media for longer than a few hours can lead to depressive symptoms.
• Keep a routine with bedtime, hygiene, meals and exercise.
• Keep work and life separate. Make time for doing things you enjoy.
• Stay social, even if you have to physically distance. Don't get used to being at home and not going out – that can be very dangerous for people prone to depression. Get outside and interact with people.
• Help others if you can, perhaps by offering support to people in your community who may need it. As I've mentioned before, altruism is a major factor in how happy we are. The more we give, the happier and healthier we are.

Most importantly, don't think that mental health is a "nice to have" that you tend to in a crisis and put on the back burner when life is relatively calm. 

There has been no time in recent history when as many people have experienced a shared pain like this one. I'm hopeful our collective experience will result in shared compassion – for others, and for ourselves.

Where to get help:

• Canada Suicide Prevention Service: 1-833-456-4566 (phone) / 45645 (text) is available 4 p.m.  to 12 a.m. ET, and chat support is currently unavailable.
• Kids Help Phone: 1-800-668-6868 (phone), Live Chat counselling at www.kidshelpphone.ca.
• Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.
• Hope for Wellness Help Line at 1-855-242-3310 or chat online at hopeforwellness.ca.