If you are feeling anxious or overwhelmed, you are not alone. Most of us have experienced some impact on our mental health from the pandemic. The most common issues are worry about the future, stress or anxiety, ongoing fatigue and insomnia. While some degree of worry is normal, when anxiety becomes overwhelming, more serious mental health illness can result. Your GP can help. Drs Jane Cronin and Kate McCoy of Kilcullen Medical Centric Health in Co Kildare, explain:
The response to the pandemic has had a significant impact on the nation’s mental health, according to GPs. “There was an acute reaction to the initial news of the pandemic last March, followed by a period of adjustment,” explains Dr Kate McCoy of Kilcullen Medical Centric Health. There was also hope. Hope that, on a mental health level, the pandemic would allow us to slow down, be more mindful, and have more time to reflect. Not so, according to her colleague Dr Jane Cronin.
“Since January 2021 the number of people suffering from mental health problems caused primarily by the pandemic has escalated,” she says.
No doubt this has been exacerbated by a loss of coping mechanisms. The most common issues observed by both GPs are worry about the future, feeling stressed or anxious, as well as ongoing fatigue and insomnia. While some degree of worry is understandably widespread, when anxiety becomes overwhelming more severe mental health illness results.
“Adolescents, young mums or families are particularly vulnerable groups that we have seen present with increased frequency,” says Dr McCoy. Teenagers, missing interaction with their peers at school, have relied heavily on social media which has resulted in a trend of rising anxiety and eating disorders that is multi factorial, according to Dr McCoy.
“Thankfully adolescents are mental health savvy and increasingly prepared to seek, access and engage with services.” Dr Cronin is also sympathetic to first-time mothers: “There has not been the same access to ante- and post- natal care, so they have been stuck at home and it has taken its toll.” Add the elderly, normally so resilient, and ongoing social isolation has had a detrimental effect on their mental health.
Help, however, is at hand and often only a phone call away. Both Dr Cronin and Dr McCoy are quick to allay the fear that there is a perceived reduction in access to mental health treatment. “In Ireland psychiatry is part of the GP training scheme so we are all comfortable and confident discussing mental health problems and putting a plan in place with patients.”
It’s imperative to give your GP the heads up about your needs when booking a consultation. “Often Irish patients are reticent about discussing their mental health. It’s important to remember there is no stigma attached to admitting a problem and practices are bound by confidentiality.”
Dr Cronin’s advice is to be clear as it helps in the triage process. Saying “I’d like to discuss my mental health” is not an admission of failure rather it allows the receptionist to book a longer consultation to get to the root of the problem. Other code words to use when booking an appointment are anxiety, tiredness or problems with sleep. Stress is another – whether home or work related. “Low mood is the manifestation of other symptoms and it’s our job to normalise the problems and also provide perspective – prescribing a long term solution. We always seek to reassure patients life will get better.”
The take home message is that you are not alone, says Dr McCoy. “These are unprecedented times and challenges. Mental health should and can be prioritised. There are so many treatment options that can be targeted to you and your situation, and we, as GPs, are crucially placed to offer advice. We are readily available and accessible. So if you are concerned about yourself or your teenager or family member get in contact – we are to help. There is so much to offer that really can and will improve symptoms. What’s important is to make an appointment and talk over the options for treatment rather than allowing a problem to escalate and reach crisis level.”
GP Recommended Resources
- Self help: “We always advocate and teach proactive self help strategies”, says Dr McCoy. “Some of these include practising breathing techniques – breathe in for seven, out for 11. Another is rationalising an anxiety or problem on a scale of 1 – 100, this often puts it in perspective, as does phoning a friend.”
- For fatigue and insomnia: the HSE information on sleep hygiene, especially The Good Sleep Guide and Shake Off The Sleep Monster, is an invaluable online resource; www2.hse.ie.
- Recommended reading: Dr Harry Barry’s books combine insight and advice. Read his latest book Embracing Change, a practical companion to boost resilience and adapt to challenges. Other applicable titles are Emotional Resilience: How To Safeguard Your Mental Health and Anxiety and Panic: How To Reshape You Anxious Mind and Brain. His website also contains videos and other resources; www.drharrybarry.com.
- CBT Therapy: Use MoodGym.com: an interactive self-help programme that provides cognitive behaviour therapy (CBT) training to help users prevent and cope with depression and anxiety. CBT online has also shown to be as effective as face-to-face therapy; online-therapy.com. Other relevant websites include www.aware.ie; www.grow.ie and www.pieta.ie
- For teens: SpunOut.ie is created by and for young people with information on how to live an active, happy and healthy life. Also see www.jigsaw.ie and www.alustforlife.com. For support of people with eating disorders and their families, visit www.bodywhys.ie.
- Counselling: “The older demographic in Ireland can be rather reluctant to try counselling – they don’t feel they have the language to express their feelings and they ‘wouldn’t know what to say’. In reality if they do give counselling a try, the counsellors skill is in getting them to express their feelings,” says Dr Cronin. The CIPC (Counselling in Primary Care) Service is a HSE-funded counselling service open to patients with medical cards on referral from their GP. Patients are able to self refer to many counsellors which can be found on the Irish Association for Counselling and Psychotherapy website. Though cost can be a prohibitive factor for accessing counselling, lower cost or affordable options can be accessed with senior level trainees who are working to get their accreditation hours with counselling professional bodies.
- Apps which are recommended include: Breathe2Relax, Anxietycoah, Moodkit, Headspace and Calm.
- Assessing diet, lifestyle and exercise helps. Often making small significant changes can have a huge impact on mental health.
- Medication: “We prescribe medication where appropriate,”says Dr McCoy. “Medication changes the chemical structure of the brain and often takes four to six weeks for efficacy.”
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