The first lockdown was really tough. But at least we had some sunshine.

It was hard not going to our friends houses, not going out for dinner or to the pub, but at least we could go for walks or sit in the park without the fear of freezing to death.

And although working from home took its toll on many, at least the spring days were long and bright and relatively warm. You can’t underestimate how much of a positive effect that will have had on our collective psyche.

Lockdown 2.0 is going to be different. Yes, it will (hopefully) be shorter, but this time we are hurtling towards the depths of winter. It’s dark, cold and bleak, and for people who have seasonal affective disorder (SAD) this second period of isolation could be exponentially more difficult.

SAD is a type of depression that comes and goes in a seasonal pattern.

It is sometimes known as ‘winter depression’ because the symptoms are usually more apparent and more severe during the winter months. Which isn’t great news as we head into a second lockdown.

It’s important to note that lockdown won’t cause SAD, but it may trigger the condition in people who are predisposed, or it might make a pre-existing condition worse or harder to manage.

Psychotherapist Noel McDermott explains it like this:

‘SAD is independent of lockdown in that it happened before and will happen again. So lockdown won’t cause SAD as such, but it may well trigger it to emerge in some people.

‘It’s best to look at the new restrictions as creating risk factors for the development of SAD in some people.’

He says those risk factors are social isolation, an increase in anxiety, being inside too much, not exercising or socialising enough, loss of work and other meaningful activities such as volunteering.  

‘SAD is a form of depression and it responds to all the things that help with that: exercise, social contact; meaningful activity; good self care,’ says Noel.

‘Additionally SAD responds well to full spectrum light therapy (SAD/daylight bulbs-lamps) and also people report the supplements St Johns Wort and 5HTP are helpful.  

‘Avoid using alcohol, isolating yourself too much, and allowing yourself to ruminate on negative thoughts.

‘If you feel you want to hurt yourself or you feel hopeless and that nothing can change talk to a health professional as you may need CBT and possibly anti-depressants.’ 

Studies show a three-fold increase in depression and anxiety problems in the adult population during the last lockdown.

So, if you know that SAD is something you struggle with, it would be wise to take proactive steps to protect your mental health.

How to protect your mental health during lockdown

Priory psychiatrists and therapists have put together practical tips which they say can be useful for those who need it, while those in serious need should always contact their GP or access professional help online.

Dr Natasha Bijlani, a consultant psychiatrist at the Priory’s Hospital in Roehampton said: ‘Every single one of us is going to be emotionally affected by the uncertainty of the pandemic, as it poses a very real threat to our lives regardless of wealth or status.

Keep your routine going

She emphasises the importance of maintaining structure and routine: ‘Maintaining a routine can undoubtedly help give you a sense of purpose and productivity and offer you some distraction from stress and anxiety.’

Dr Paul McLaren, consultant psychiatrist at Priory’s Hayes Grove Hospital, and Priory’s Wellbeing Centres in London, agrees, adding: ‘People need rhythm and pattern in their lives. To ease stress, take a step back and think about the usual pattern of your life pre-Covid.

‘How does it work when you’re at your most content? Break it down into its main elements and see if you can quantify them. For example, social time, family time, partner time, food, exercise and work. Then see how you can replicate that in lockdown.

‘You will need to be proactive and organise your time. Socialising through video calls will never be as powerful as face-to-face, but it could produce some soothing.’

Dealing with stress

Alison Hardy, a cognitive behavioural therapist, suggests practical exercises to help relieve feelings of stress and anxiety when they occur.

‘When we become anxious, the body’s “fight or flight” response is activated,’ she says. ‘It is a series of changes in the body including the release of adrenaline and an increase in heart rate which are designed to help you be stronger (fight) or to help you move faster (flight), all very useful if we are under attack, not very useful if you are going out to the supermarket.’

She suggests:

• Breathing deeply – this can help the body settle down to its more natural equilibrium. I think it is useful to imagine you are blowing up a balloon of your favourite colour. Take a deep breath in and notice how your stomach rises as you inhale which allows your lungs to take in maximum air, then let a long, slow breath out as if you are filling your balloon with air, and do this three times.

• Question your thoughts – our mind can play tricks on us when we are anxious, and our thinking can become distorted. For example, an abrupt work email may lead you to think that you have made a mistake, or a friend failing to return a text may lead you to think that they are not thinking of you. Before you accept the thought, which will undoubtedly fuel your anxiety, ask yourself is that anxious thought a ‘fact or an opinion?’ If it is an opinion, you may be getting anxious for nothing.

• Acceptance – anxiety, although uncomfortable, is a normal emotion. Accepting anxiety, and the way things are at the moment, can be just like accepting that sometimes we feel angry, or sometimes we feel sad and sometimes we feel happy, and just like those other emotions, anxiety will pass. However, if your anxiety is long-term and really affecting your day-to-day life you should always seek professional support.

Coping with panic

Dr Donna Grant, consultant psychiatrist at Priory Hospital Chelmsford, offers tips to help cope with panic:

‘Observe your thoughts and tell yourself that your mind is reacting to these thoughts and anxiety. These feelings are normal – it’s just the body’s alarm system doing its job when it doesn’t need to.

‘Learn to control your breathing. People often hyperventilate during a panic attack. This means taking deeper breaths than normal which results in you feeling short of breath, causing a feeling of dizziness, disorientation and chest pains.

‘By learning to slow your breathing down, you can help prevent the uncomfortable physical symptoms and stop the panic cycle. Try to get a slower and more stable breathing rhythm by breathing in for three seconds, holding your breath for two seconds, and then breathing out for three seconds.

‘As you breathe, ensure that your stomach expands as you take each breath as this helps to ensure the breathing isn’t shallow, which can add to the problem.’

Learn to use positive coping statements

She adds that when you are feeling anxious and panicky it can be helpful to have ‘coping statements’.

‘These can be used to remind you that panic is not dangerous and isn’t harmful,’ she explains.

Such statements could be:

‘Panic is simply high levels of anxiety.’

‘By remembering these symptoms are nothing more than anxiety, I can prevent further symptoms occurring.’

‘My anxiety and panic will pass naturally given time. It doesn’t last forever.’

‘Reminding yourself of these facts can help to prevent further panic cycles happening,’ says Dr Donna.

Nourishment

Dr Natasha Bijlani says it’s really important to make time for nourishing lunches with plenty of hydration. That means water, not just gallons of coffee

‘Food and drink can greatly affect your physical and mental health,’ she explains. ‘Use time you may have spent travelling to your office to fit in some social calls to friends or family.

‘Avoid drinking too much alcohol or eating unhealthy foods out of boredom. Try to keep to boundaries such as only drinking alcoholic beverages in limited quantities at the weekend.’

Another element of lockdown that Dr Natasha says can impact our mental health is being cooped up with family members, flatmates or romantic partners.

It’s important to keep an eye on those relationships, and to be kind to each other.

‘Emotions can be “infectious” and if those around us aren’t able to keep calm and cope well, we could end up getting stressed, fed up, irritable or low ourselves,’ she explains.

‘It’s important for each of us, where we can, to take responsibility for our own health so that we can help keep up a reasonable level of optimism and engender a healthy environment in our homes which we share with others.  

‘Try to do some things together, such as sharing meals, daily walks, while also maintaining respectful boundaries and giving each other space apart for private time alone.

‘Work as a healthy community. Try and be sensitive, flexible and forgiving without losing your own sense of self or identity. The best way to keep your mood swings under control is to look after yourself by keeping to your usual routine of sleep, diet, exercise and other activities.

‘If you have been prescribed medication for your mental health, then take it as advised.’

Need support? Contact the Samaritans

For emotional support you can call the Samaritans 24-hour helpline on 116 123, email [email protected], visit a Samaritans branch in person or go to the Samaritans website.

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