The stress of isolation and self-distancing and the worry brought on by the cororonavirus pandemic is starting to take its toll on the mental health of Quebecers.
“In the beginning, people were able to tolerate it, but as confinement is progressing we’re seeing it’s more and more challenging for everybody,” said Dr. Karine Igartua, president of the Quebec Psychiatric Association and an emergency room psychiatrist at the Montreal General Hospital.
Igartua said there’s been a spike in recent weeks in the number of people presenting at the ER with mental health problems.
It’s been especially tough for those with pre-existing mental health issues.
“The first three to four weeks was very quiet. Psychiatric patients, just like everybody else, were able to take their own resources and stay home and do what it was asked of them,” she said.
“But in the last two weeks the numbers are starting to climb again.”
Iguarta explained that the loss of a routine can cause people who had been stable for years to relapse.
She gave the example of a woman with schizophrenia who showed up at the ER with her suitcase, convinced she was in massive danger.
“She had her routine … but she had stuff to do and that sort of distracted her from paranoia, and now that she can’t go out, she can’t be seen by her team. She started to really spin out,” she said.
Under normal circumstances, Iguarta explained that social interactions can create a safety net for vulnerable people.
“Because everybody is alone in their own homes and they’re not seeing people, people have a chance to decompensate much further than we would see normally,” she said.
Iguarta worries the emphasis on treating “urgent” medical cases isn’t the right approach.
“Mental health issues may not be urgent but they are important and severe,” she said.
“What we know is that with more and more relapses, and the longer the relapse goes, the harder it is to treat and the more sequela people are left with.”
While psychiatric teams have been reaching out to vulnerable patients and many services are maintained via telemedicine, Iguarta fears the worst is yet to come — for everyone.
“I think we’ve been so focused on flattening the curve of infection, that we’ve sort of forgotten that there’s another pandemic that’s coming and that’s the mental health pandemic related to the confinement,” she said.
“What we know of this pandemic in Europe is that the spike in psychological distress and mental health required services arrived three four weeks after the infectious spike, so we’re getting there.”
The types of issues we’re likely to see include an increase in depression, post-traumatic stress disorder, substance abuse, conjugal violence and of child abuse, according to Iguarta.
Dr. Gustavo Turecki, chair of the psychiatry department at McGill University and psychiatrist in chief of the West Island CIUSSS, agreed.
“We are all collectively experiencing a lot of stress,” he said, adding it’s important for people to learn to recognize your red flags and to develop coping mechanisms.
Both Turecki and Iguarti had tips for bolstering mental health, including good sleep hygiene, trying to stick to a routine and incorporating exercise.
“Keep active. Go out for walks or a run if you can, Turecki said.
Iguarti also suggested making an effort to “see” your friends.
“Don’t just text them, use video-conferencing if you can, do drive-bys — stay two metres apart but say hello,” she said.
“All of these things are super important to try and maintain mental health.”
While not knowing when the pandemic will end is unsettling, Turecki offers a reminder that the situation is nonetheless temporary.
“Keep in mind, this is not forever. It will come back to some form of normal.”