In case you haven’t heard, the wheels just fell off the world. Since the coronavirus pandemic began, many of us have been confronting unprecedented levels of change and grief. The virus spared no part of our lives: our cities, our careers and, in the worst of cases, our families and friends have all been affected. We have lost social connections, jobs, even homes and loved ones.
It would not be an understatement to say that we are feeling unmoored, even depressed, on a global scale.
In the US, where the coronavirus death toll is now over 100,000, it’s approximated that one in three citizens has suffered serious mental health consequences due to the pandemic. Researchers at Columbia University propose an even larger number, extrapolated from a Lancet study recently done in China. They suggest that about half of Americans are now experiencing depressive symptoms.
If the events unfolding in the States right now are any indication, those numbers may be even higher as of this week.
Similarly, the UK has seen a rise in anxiety and depression during its lock-down. As the death toll nears 50,000, the country contends with the mental health effects of unimaginable loss. Already overwhelmed, the NHS is trying to keep up as best as possible, with online resources and phone lines available to the public.
What are the symptoms of depression?
According to the latest updated version of the Diagnostics and Statistics Manual (DSM-5), an individual must be experiencing five or more symptoms during the same two-week period, with at least one of these being either depressed mood or loss of interest or pleasure.
The most common symptoms of depression are:
- Depressed mood most of the day, nearly every day.
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
- Significant unintentional weight loss or weight gain, or a decrease or increase in appetite nearly every day.
- A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day.
- Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
If you’re struggling with some or most of these symptoms, how can you tell if you should get medical help? Where is the limit between a normal reaction to abnormal life events and a diagnosis of major depressive disorder?
This is a question overwhelmed mental health services in the UK and US are struggling with. Due to the burden coronavirus has placed on an already strained infrastructure, doctors are now faced with the task of deciding who to hospitalise and who might actually improve with a regular self-practice of CBT, phone calls with friends and a solid sleep schedule.
In fact, this is a question many of us are probably asking ourselves. Google searches for depression have been rising steadily since late March. This indicates that people are trying to discern if what they’re feeling will get better on its own and when to seek help.
The four categories
Andrew Solomon, the author of The Noonday Demon: An Atlas of Depression, groups these cases into four categories. The first two are rather straightforward. They contain the people who are hunkering down emotionally to weather this storm and those who have already, in the past, received a diagnosis of depressive disorder or dysthymia (a low-grade form of depression).
The first will likely return to baseline emotional health after the crisis with little need for medical intervention. The second, however, need to keep a close eye on their symptoms and may require medical care. There is a likelihood that their symptoms may escalate during this period and they must use the resources available to them to prevent their depression from spiralling out of control.
The third and fourth categories are a bit more ambiguous. One is made up of people who may be developing a depressive disorder in response to the overwhelming life events brought on by the pandemic.
These may benefit from re-introducing routine and stability into their lives. Having a consistent sleep schedule, eating healthy, staying hydrated, exercising, avoiding the news, talking to friends and loved ones over Zoom or on the phone, and generally minimising destructive and distracting coping mechanisms can help a lot in their case.
The fourth group, on the other hand, may need more than that. These are the people who were experiencing what some researchers call “subclinical depression” before the pandemic.
They could cope just fine with everyday life, but may now have toppled into a full-blown depressive disorder for the first time in their lives. They may not have the resources to get better on their own and should seek medical help.
When to contact your GP
It can be useful to figure out into which category you fall when deciding whether to seek medical help. However, if you’re struggling with everyday life, don’t hesitate to contact your GP. Depression, especially when experienced for the first time or in such isolating and scary times, doesn’t go away on its own.
Help is within reach if you need it. To talk to someone, you can call the Samaritans’ helpline on 116 123 or go to BetterHelp.com to book a quick online therapy session. For a comprehensive guide of mental health resources, available day and night, go here.