Clues history has left about mental health and pandemics
⚠️Warning: This post contains references to suicide which may be sensitive to some readers.
It is without a doubt that the 2020 pandemic challenges our mental health. Some countless articles and headlines continue to grab our attention and tell us the real pandemic is a growing concern around mental health. Isolation, Social Distancing, Confusion, Anger and Fear all play a part in how we feel.
When you consider what we have had to deal with this year, it is easy to understand with questions such as:
- When does normality return?
- What is normal anymore?
- What will life be like after the pandemic?
- How will it affect me if I catch the virus?
- Why did it happen?
- Will my job be safe?
The problem is, as humans, we like to think we are in control - we believe there is an order in our chaotic world. Being in perceived control is what makes us human or having the ability to move around freely is essential for our wellbeing. 
So, it is expected that the 2020 pandemic will affect our mental health. However, the extent and impact of this is yet to be realised. Prevention is better than cure, therefore by putting measures in place now - we can help ourselves in the future.
The world has changed significantly since the last major pandemic of 1918-1920, so there will be things we do differently today however there are some clues on how it can affect our wellbeing.
Mental Health cases DO increase.
Little research was carried out at the time of the pandemic and the effects on our wellbeing, but historians have looked back to understand the impact of mental health and previous pandemics. The publication by Svenn-Erik Mamelund, PhD, Norwegian Institute of Public Health, Norway titled "The impact of influenza on mental health in Norway 1872-1929"  explains that previous studies of pandemics show a link between pandemics and the effect on our mental health. It explains that the Russian flu pandemic of 1872-1879 saw an annual factor increase of 2.6 for hospital admissions relating to mental health illness in the five years after the pandemic. A similar yearly factor increase of 7.2 for hospital admissions after the 1918-1920 pandemic.
It is unknown what was the source of this increase and would be wrong to speculate the cause. However, this does show a trend that the effects of a pandemic can create issues for our mental health.
Effects on impact not immediately realised
We already can see that even after the pandemic is "over" long term effects continue. Several factors may be responsible for this and ones that we should be wary of today. Uncertainty around our how we live, freedom of movement and economics all play a part.
Svenn-Erik Mamelund explains more in his 2003 paper "Effects of the Spanish Influenza Pandemic of 1918-19 on Later Life Mortality of Norwegian Cohorts Born About 1900".  Some survivors who had the virus went on to suffer from depression, sleeping troubles and were struggling to cope with day to day life and work.
Increase in suicide rates
A warning recently published in The Lancet  warns of a risk of suicide in society. It explains that urgent consideration needs to be put in place to intervene early and make it accessible to those who need it most.
History shows that there is some evidence in previous pandemics of an increase of death by suicide. A paper by I. Wasserman titled "The Impact of Epidemic, War, Prohibition and Media on Suicide: the United States, 1910–1920"  explains that whilst the war and declining alcohol sales in America depressed suicide rates the pandemic caused an increase in rates.
Increased levels of stress
Pandemics have strong side effects that affect our mental health. Isolation, social distancing, uncertainty and restrictions all impact our health. A paper by K Ayers, P Yellowlees titled "Mental Health Considerations During a Pandemic Influenza Outbreak"  explains how they interviewed some survivors of the 1918 pandemic. The article describes and backs up that the theory that the impact on mental health may be immediate or delayed. There may be fear, anxiety and worry as they wait for the pandemic to hit local communities. With these increased levels in anxiety and post-traumatic stresses, there may be an increase in substance abuse.
This article has been hard to write mainly due to my own anxieties and wellbeing. However I felt it is important to understand that the pandemic goes beyond the virus.
The world dealt with mental health differently in 1918, so there are few studies to look at. That said, history has left us some clues about our future. We must consider the effects of the pandemic will impact us for many years to come, not only from a physical or economic perspective but from a wellbeing perspective.
So what can be done?
Help Yourself: If you find yourself struggling from day to day, please consider speaking with a friend or visit your GP.
If you are struggling at work, be open about your thoughts and feelings with your employers. Most places now have support toolkits, resources and some even have employee assistance programmes that offer councilling services. Employers are increasingly training mental health first aiders to support staff directly.
It is important to recognise when you are struggling and being honest to yourself early will help you in the long run.
Reduce the stigma: We all must have the conversation to help reduce the stigma around mental health and can support each other and intervene early.
Support services need to be accessible: Traditional methods of mental health support have all been face to face, whilst there is some movement around digitising the help - support needs to be accessible to everyone for it to be effective.
Reach Out: As we run-up to the Christmas period of what has been a very long and hard road, many people will find the next few weeks extremely difficult as we struggle with the concept of not being able to meet our loved ones. Please take the time and reach out to others, a simple conversation can make all the difference.