After over two years of living through a pandemic, New Zealand seems to have settled into a rhythm that is balancing outbreaks in the community with reopening public life and social interaction.
While many are waking from their survival mode and taking stock of what has changed under Covid to re-calibrate life, it is time to reflect on the impact lockdowns and social distancing have had on our mental health.
The Advocate and NZME have launched a major editorial project, Great Minds, to examine the state of our mental health - and solutions for improving wellbeing as the country recovers from the pandemic.
Kiwi academics are starting to paint a clearer picture of where we are at as a nation: we are more anxious, lonely and worried about the future – however, it's not as bad as we thought.
Research by the University of Otago with teams from all three campuses in Dunedin, Wellington and Christchurch found that a third of those surveyed in mid-2020 showed moderate to severe psychological distress and 39 per cent reported low wellbeing.
A 2021 study found that people who were previously diagnosed with a mental illness had about twice the risk of reporting moderate to high levels of psychological distress during lockdown.
People drank more alcohol to cope with anxiety and were about four times as likely to have suicidal thoughts, with 3 per cent reporting having made a suicide attempt over the lockdown period.
One in 10 people experienced family harm because of lockdowns.
But while the impact is noticeable, New Zealand is not experiencing the mental health emergency that was expected, Matthew Jenkins, senior research fellow at the University of Otago department of psychological medicine says.
Jenkins said their ongoing research is aiming at shedding light on our wellbeing to help policymakers with better targeting support services.
"At the start of the pandemic there was the expectation that mental health is going to suffer for obvious reasons. But it is not the crisis that we were expecting."
He said the narrative that everyone is suffering under the pandemic was popularised by media as well as politicians who tend to use hyperbole to push their agendas.
Instead, the researchers found that some groups including youth, those who lost their jobs, immunocompromised people and people with mental illnesses were most at risk for Covid-induced anxiety and depression.
Other demographic groups, including older people, were not as badly affected.
This could be because older people are more financially stable and have a more established system in place to give them support in life, researchers speculate, but Jenkins says there is no published data to support the theory yet.
In a 2020 study that Jenkins co-wrote, two-thirds of participants even reported positive outcomes from lockdown, saying the pandemic offered time for self-development, reflection and personal growth.
Jenkins said their ongoing research efforts need to strike the fine balance between a swift understanding of how our nation is coping and providing nuanced, high-quality reports.
For Colin Birch, a registered counsellor from Whangārei who has been working with people for over 30 years and specialises in counselling for individuals, families, and couples, Covid-19 has meant change in several ways.
Since the start of the pandemic, Birch has seen an increase in clients with anxiety and depression.
"The pandemic has affected a lot of people in the way that they have missed out on important events – births, weddings and deaths. People are worried about not seeing their family and spending time with their whānau."
Increased anxiety was induced by worries about the future, lack of job prospects and the question of how to afford the mortgage.
"Lockdown has also had a bearing on relationships," Birch said.
As couples spent more time together, for some it highlighted issues that existed before.
Meanwhile, young people are burdened by worries about their future, Birch said.
"They are wondering where life is going to be in a few years. Is it worth studying? Will they be able to get a job?"
Anxieties are fuelled by the omnipresence of Covid. News, social media, advertising – the pandemic is a constant topic. Even if people don't navigate the digital world, many are wearing masks on the street – another glaring reminder of the pandemic.
"It's hard to escape," Birch said.
Alienation and discrimination because of deviating views on vaccination is another regularly discussed topic during Birch's counselling sessions.
He said people find it difficult to deal with those who take a different stance on the vaccine. Some of his clients, who are not vaccinated, grapple with being partially excluded from public life.
The pandemic has also changed the way Birch delivers his counselling session - like many others he has moved to Zoom.
"Face-to-face sessions have basically ceased."
He said most people are apprehensive to begin with but once they get started they realise it's not too much different from meeting in person.
"It has some advantages. There is no travel involved and people do the session in the comfort of their own home."
Providing long-distance counselling wasn't a new experience for Birch, who has previously worked for Lifeline and the National Depression Initiative providing telehealth services.
To tackle depression and anxiety, Birch often utilises cognitive behavioural therapy which challenges negative thoughts and questions whether they are balanced and relevant for that person.
In an attempt to self-medicate, people with anxiety have increased their alcohol consumption.
Instead, Birch said, regular exercise, healthy food and sufficient sleep can pull people back into a healthier mindset.
"It's about finding good routines. For some people, it requires medication. But that's only a short-term option. Medication helps us to get over the hump to be in a better headspace to deal with our issues."
Northland District Health Board general manager for mental health and addictions service, Ian McKenzie, hopes future research can clarify how the pandemic has impacted the Northland community.
He said for the past two years, the DHB has been fully focused on providing their mental health services, which gave them no capacity to collect data to paint a bigger picture of Northlanders' wellbeing.
The DHB has, however, worked collaboratively with many wellbeing providers to establish the recently launched Hauora Kotahitanga directory – an online registry to help people quickly find a range of support services.
"The directory is attracting a high number of website visits and a really good level of engagement from directory users.
"The directory is well orientated towards tangata whenua and designed to support our goal of increasing equity of access to healthcare and equity of health outcomes. The directory is a practical response to support wellbeing right across Te Tai Tokerau."
Feeling anxious is a normal emotion in response to stress and potentially dangerous situations. It's a worry about the future and can trigger a flow of negative thoughts. Prolonged anxiety can lead to avoidance, isolation and a range of mental disorders.
To manage anxiety it can help to
• Understand what makes you anxious
• Accept and tolerate normal anxiety
• Take small steps towards doing the things you are worried about, instead of avoiding them
• Learn mindfulness
• Take good care of yourself each day
• Deal with issues that need addressing
• Access personal and professional support
Just like anxiety, feeling depressed is a common emotion often linked to disappointing or upsetting circumstances. It is often connected to being hopeless, fatigued and sad, and can last a few days or even months. If a person feels persistently miserable, the emotion can morph into depression, which is a mental illness.
When feeling depressed it can help to
• Exercise regularly and spend time in nature
• Get good-quality sleep
• Understand what triggers depressive thoughts for you
• Talk to friends, family/whānau members or someone you trust
• Eat healthily
• Identify and reduce stressful activities
• Use relaxation exercises, yoga, meditation or massage
• Make sure you regularly do things you enjoy and that give your life meaning
• Be kind to yourself
Where to get help
If it is an emergency and you feel like you or someone else is at risk, call 111.
For counselling and support:
Lifeline: Call 0800 543 354 or text 4357 (HELP)
Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO)
Need to talk? Call or text 1737
Depression helpline: Call 0800 111 757 or text 4202
For children and young people:
Youthline: Call 0800 376 633 or text 234
What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)
The Lowdown: Text 5626 or webchat
For help with specific issues:
Alcohol and Drug Helpline: Call 0800 787 797
Anxiety Helpline: Call 0800 269 4389 (0800 ANXIETY)
OutLine: Call 0800 688 5463 (0800 OUTLINE) (6pm-9pm)
Safe to talk (sexual harm): Call 0800 044 334 or text 4334
All services are free and available 24/7 unless otherwise specified.
For more information and support, talk to your local doctor, hauora, community mental health team or counselling service.