The stress and anxiety associated with COVID-19 and the lockdown can add to psychological distress and for those already struggling with mental health disorders, it is now more important than ever to maintain treatment. 

The South African Society of Psychiatrists (SASOP) has urged patients and healthcare providers to be alert to early signs of relapse, to encourage patients to continue with prescribed medication and to keep therapy appointments.

Remaining well and stable.
Prof Renata Schoeman, board member of the Psychiatry Management Group (PsychMG), says that mental well-being is vital in these times as lockdown can aggravate a sense of isolation. According to her, now is the time to stay socially connected while practising physical distancing, to stay informed via credible sources of information, and to generally maintain healthy habits.

“A strong individual and communal mental health status are key to remaining physically strong and socially cohesive during this crisis. It is vital to remain well and stable by maintaining treatment and avoiding the need for hospitalisation as healthcare resources are already stretched by the impact of COVID-19”, she said. 

SASOP’s Dr Maaroganye advises against self-medicating or trying to treat yourself with alcohol, illicit drugs or taking medication in a way not subscribed by your psychiatrist or general practitioner. 

Consultation and treatment. 
For patients needing help or continuity of treatment, public and private sector mental health facilities remain open for scheduled appointments and emergencies. As both patients and practices are naturally concerned about safety, some practitioners are now offering online video consultations. These telehealth facilities are in line with guidelines issued by the Health Professionals Council of South Africa (HPSCA). Pharmacies and suppliers remain open to fill prescriptions, providing continuity of treatment.

The difference between sadness and depression.
People who are not suffering from existing mental health conditions may also be feeling the stress of lockdown and it is important to understand the difference between sadness and depression. 

The healthcare media platform Healthline describes sadness as an emotion that all people feel at some time or other. Sadness may be all-encompassing at times but you should have times when you can laugh or at least be comforted. There are many reasons to be sad during lockdown. We cannot visit our children or parents. A relative passed away and you could not say goodbye. Feeling sad is a natural reaction to emotional upset or pain. But like other emotions, sadness is temporary and can fade with time.

Depression however is not an emotion but an illness. Left untreated, symptoms may last for a long time. The impact of losing a job or having to close a business during COVID-19 could cause the onset of depression.

Healthline lists the symptoms of depression as: 

  • Constant feelings of sadness 
  • Irritability 
  • Fatigue 
  • Changes in sleeping or eating patterns 
  • Difficulty concentrating 
  • Loss of interest and enthusiasm for things which used to provide pleasure 
  • Feelings of deep, unwarranted guilt 
  • Physical symptoms, such as headaches or body aches that do not have a specific cause 
  • Feelings of worthlessness 
  • Constant thoughts about death 
  • Suicidal thoughts or actions

If you believe that you or somebody close to you could be suffering from depression, it is best to call your general practitioner rather than let it escalate. Remember, depression is an illness and not a stigma.

Tips to reduce stress.
The South African Depression and Anxiety Group (SADAG) offers some tips to reduce stress during these unprecedented times:

  • Maintain a daily routine. 
  • Restrict media and social media coverage to prevent it from becoming too overwhelming, only obtain information from credible news sources. 
  • Acknowledge your feelings and focus on things that you can control. 
  • Find things to keep you busy (whether it’s constructive or creative) to help lift your mood.
  • Stay connected with your loved ones via technology. 
  • If you are on medication, remember to take it as prescribed.

Managing the downside.
WHO (World Health Organisation) recognises that while COVID-19 and the lockdown presents a challenge for all of us to cope with, it can be especially difficult for people with existing mental health conditions. Fortunately, by following tips to reduce stress, maintaining treatment during lockdown, recognising symptoms which signal a need for professional help and generally being kind to others during this difficult time, we can manage the downside of lockdown.



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