How coronavirus is linked to an increase in complex mental illness, including psychosis, in young adults and older people

I can relate to that. Around February, I was hit with a triple whammy. The lockdowns were beginning, I lost my relationship of 14 years and my son moved out of my place into a place of his own. And at 77 my physical resources were much depleted.

So I did fall into a depression, which is always dangerous. But with the help of friends and family I survived. And amid all the restrictions I have actually found a new lover. So my depression has vanished. Amazing what can happen in your 70s.

A counselling psychologist I know has also sent me some remarks on the matter. See following:

“Social isolation might be increasing psychosis more than covid is. For most elderly ladies, old age is one big social event. Their social routines mark the hours and days of the week….

Church on Sunday, followed by lunch with the church ladies, then Monday lunch with the Monday lunch ladies, water aerobics Tuesday morning followed by bingo at the RSL in the afternoon, Wednesday morning is the appointment with the handsome physiotherapist, the afternoon is the card playing group, Thursday is lunch with the Thursday lunch ladies, Fridays is shopping and cuppa with Myrtle, Agnus and Ethel at the cafe, and Saturday is RSL lunch.

During the covid lockdown many elderly ladies have been getting disoriented, losing their sense of what day of the week it is.

Men and younger people too, benefit mentally from socialising and getting out doors. Just walking and getting out of the house can be greatly therapeutic. Outdoor scenery and distractions break the in-home thinking patterns and ruminations. And walking activates the brain both sides and overall, and so emotion can be more easily subject to reason when walking and thinking, and when walking and talking.”

However you look at it, the lockdowns have been a foolish and evil thing. The jurisdictions where there have been no lockdowns show a death rate that is in the middle of places that did have lockdowns. Lockdowns were originally a Chinese idea, well suited to a Communist country but inappropriate in a democracy

Back in March, that question was playing on the minds of mental health researchers such as counselling psychologist Ellie Brown.

Dr Brown and colleagues at Orygen Youth Health and the University of Melbourne wanted to know whether the numbers of people presenting with psychosis would increase either from coronavirus itself or from social isolation, and how people with complex mental health issues would cope.

“We wondered what was out there in the evidence, and what could we pick out that might help us understand what was coming down the track,” Dr Brown says.

Early studies warn COVID could increase psychosis
While it was still very early days in the pandemic, evidence from a handful of papers from other viral diseases, including SARS and MERS, and studies from the unfolding situation in Asia suggested coronavirus might actually lead to an increase in people experiencing psychosis.

What is psychosis?
Psychosis describes a group of experiences that relate to the loss of contact with reality.

This can include one or more of the following:

Feeling confused about what is real and what is not real (psychosis)

Hearing voices when no one is there (hallucinations)
Seeing, tasting or smelling things that other people do not (hallucinations)

Believing things that others find strange (delusions)
Feeling that people are going to hurt you when this is not the case (paranoia)

Speaking in a way that others find hard to follow (thought disorder)

An episode of psychosis describes a time when someone has these symptoms lasting for more than a week, which negatively affects their day-to-day life.

The onset of psychosis is usually seen in people in their late teens to early 20s.

But the data coming out of China suggested there was also a significant increase in people in their 50s and 60s experiencing psychosis for the first time.

“It’s really the older people who were more isolated who were presenting with a first episode, which was very unusual,” Dr Brown says.

But it’s not just the pandemic’s potential to trigger a first-time episode that health professionals are worried about.

Isolation, the mass psychology of fear, and other stressors can exacerbate symptoms or cause relapses for vulnerable people already living with chronic illness.

While the numbers are hard to pin down, months down the track there is a sense that there has been a rise in the number of people accessing mental health services.

According to Orygen there has been a 17 per cent increase in referrals to youth mental health services in north-west Melbourne over the past four months, up 8 per cent from the same time last year. There has also been a 14 per cent increase in contacts with clinicians compared to the months before the first lockdown began.

“We’re just getting the data in the increase in the number of people presenting with psychosis. And that’s just going to be the young people,” Dr Brown says.

Carmel Pardy, who oversees the telephone and online support centre for mental health charity SANE Australia, which supports people 18 and upwards, has also noticed an increase in people accessing the service since the pandemic began.

“We have had an interesting cohort of people who’ve come to us for the first time during COVID,” Ms Pardy says.

The charity is also seeing an increase in the number of carers calling.

But, she says, we won’t truly see the fallout of COVID on mental illness until next year.

The impact of isolation and anxiety
Isolation, disrupted routines, and lack of access to care are some of the themes emerging.

“A lot of people we work with struggle with relationships, so a relationship with a therapist might be the one constant and safe relationship in their life and if they can’t do that it’s been really, really problematic,” Ms Pardy says.

When SANE set up new services for COVID-19, they found many people needed a daily chat.

“You have to remember some of the people we work with may not get incoming calls, so this is an opportunity for someone to call and just check in on them.”

Increasing anxiety is a common report.

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