Coping with the pandemic hasn’t been easy. For young people, disruptions to schooling, social interaction and the general pace of life have left many struggling to cope with the stress of the ‘new normal’ and, according to experts, mental illness is on the rise.
Because of Covid-19, mental health has once again shifted into the spotlight. Research shows that before the pandemic South Africa was already dealing with a high burden of mental health conditions, with roughly a third of the population having experienced a mental health disorder in their lifetime. Depressive disorders are ranked as the fifth-largest cause of disability, with anxiety disorders ranked ninth.
With the onset of the pandemic, the numbers went up. The second wave of results of the National Income Dynamics Study – Coronavirus Rapid Mobile Survey (NIDS-CRAM), found that the number of people in SA suffering from depressive symptoms had doubled between 2017 and June 2020, from 12% to 24% of the population.
The South African Depression and Anxiety Group (Sadag) said their call volumes had more than doubled since lockdown began.
“Before Covid, we were getting about 600 calls per day,” said Cassey Chambers, operations director at Sadag. “We are now getting between 1,200 and 1,400 calls per day.”
This excludes contact made via SMS, email or social media.
“We have seen a huge impact on people’s mental health since lockdown,” said Chambers. She added that the majority of callers to the Sadag hotline are aged between 18 and 35.
Professor Katherine Sorsdahl, from the Department of Psychiatry and Mental Health at UCT, says statistics on the prevalence of mental disorders among young people are “quite scarce”.
“Given that half of all mental health problems start by 14 years of age, we should be prioritising adolescent mental health if we really want to address mental health in the country,” said Sorsdahl.
“The Covid-19 outbreak and lockdown have impacted on the lives of the youth in many ways. The stress caused by worry and concern for their families, unexpected bereavements caused by Covid and the uncertainty about their education and future are just a few of the factors that may impact on the mental health of South African youth. Not to mention the mental health impact of being confined to their homes during lockdown,” said Sorsdahl.
For Rhowan Swarts, a matric pupil from Atlantis in Cape Town, school closures and the extended lockdown made it difficult to stay motivated to do his school work. However, assistance from teachers and an after-school programme called Ikamva Youth helped get him back on track.
Hope Majova, a matric pupil from Khayelitsha, said: “I’m under pressure right now to study. I’m very stressed.”
After falling ill from a non-Covid related illness at the beginning of the year, he was already behind on his schoolwork when the pandemic struck. He found studying at home a challenge but tried to engage online with his peers through a study group. “They supported me a lot.”
Financial struggles brought on by the pandemic meant food wasn’t always on the table for Majova and his family. “But I was able to go to school even though there was nothing in my stomach.”
Dr Brendan Belsham, a child and adolescent psychiatrist, says financial stress affects the emotional climate of the home.
“And it impacts on marriages,” he said. “We know that marital stress has a significant impact on children.”
Belsham said there had been anecdotal reports of more people filing for divorce during the pandemic in South Africa.
“My experience in practice has been that a lot of kids decompensate when their families decompensate.” Decompensation is the deterioration of one’s mental health, typically because of stress.
“Some of the other triggers for children are absence from school. And that has an educational impact, which increases stress on children. As well as the social isolation from just not seeing their friends,” said Belsham.
For Swarts, being unable to go to the gym was a challenge.
“As soon as lockdown happened I was notified that all the gyms were also going to be closed and I didn’t get to have that place of relaxation of letting my mind be free. But at least I found a way to do exercises in my yard, so that helped. And just having talks with my family about a lot of stuff.”
Belsham points out that for some children, school is a refuge from toxic homes. “They are now trapped, many of them, or have been trapped in an environment from which there’s no escape.”
Another significant trigger during lockdown is increased social media use and screen time.
“There’s good evidence for this, that excessive screen time, especially certain forms of screen time, like gaming, and like social media, aggravate various conditions of childhood, including anxiety, depression and conditions like ADHD,” said Belsham.
Mental health struggles brought on by social media are more common among pre-adolescent and adolescent girls, said Belsham. Pre-existing anxiety, low self-esteem and insecurity can be aggravated when children are presented with unrealistic body images, beauty standards or lifestyles on social media.
Communication on social media is also not ideal.
“There are social nuances that are missed in a text or a WhatsApp,” said Belsham. “Even adults can experience this, but in children who are relatively immature, and in adolescents who place so much weight on how they’re accepted by their peers, they can very easily misinterpret a message and assume the worst in terms of what somebody’s saying about them.”
For Tim Hodgson, a final-year electrical engineering student at UCT, trying to study while confined to his apartment has been challenging.
“I struggled a bit, basically living and working in the same space because my desk is in my room, which has made it difficult to not get distracted easily,” said Hodgson.
The difficulties were compounded when his apartment got broken into. Hodgson had trouble sleeping, experienced nightmares and bouts of what he believed was paranoia.
“I would wake up and check my door three, four, five, six times a night to just check that it was locked, and it would be, but it was just paranoia, my mind messing with me.”
Hodgson thrives on group interaction and struggled with the isolation brought on by the hard lockdown. “On top of that, I started dating my girlfriend a week before lockdown started and so we basically started our relationship off with a few weeks of not seeing each other.”
Belsham said he’s seen a rise in depression, anxiety and ADHD since the pandemic started. “And that’s, again, probably because of a combination of family stress, increased screen time, much less exercise, which is important for cognitive functioning.”
Emily Dingle, a 22-year-old high school teacher and postgraduate student, was a few months into her teaching internship when the pandemic struck.
“That was difficult because I kind of started feeling a bit more comfortable in the classroom and developing a relationship with my students. And then suddenly we had to shut down. And everything kind of went online and that was a format that I didn’t really know.”
She had recently moved back in with her parents in Johannesburg after years studying at UCT.
“What Covid did for me was expose a lot of difficulties in the way I dealt with certain challenges. I think living away from home and even just going to work every day, it was very easy for me to kind of avoid confrontations, or avoid dealing with certain issues in terms of relationships.”
Dingle, who had battled with clinical depression as a teenager, sought the help of a therapist after lockdown resurfaced depressive feelings from her past.
“I think often we see therapy as a weakness, and kind of like a concession of defeat, which is really sad. Because I think it really is something where if you need a little bit of help sorting things out, and if you can’t do it on your own, it’s basically like going to a doctor if you can’t fight a cold with over-the-counter meds.”
In older adolescents and young adults, feelings of shame or perceptions of weakness may prevent them from seeking professional help, said Belsham.
“What I’ve also noticed a lot in adolescents and young adults is that they don’t want to be a burden to their parents,” said Belsham, adding that mental health interventions are often costly.
“And then, of course, let’s not forget, those aspects or those sectors of society that don’t have access to private healthcare and that have to rely on government health services, which are insufficient.”
Statistics from Sadag indicate that South Africa spends less than R100 per person for mental healthcare per year and only three out of nine provinces in the country have child psychiatrists.
“Even if a parent wants to take their child for help, or gets referred, perhaps by a school teacher for help, there just isn’t that help.”
According to Sadag, in general, a psychologist’s fees can cost between R600 and R1,200 per session, depending on the region.
How to cope with pandemic worry and stress
Living one day at a time, being thankful, exercising, keeping a routine and connecting with others are some of the tips Belsham offered to cope with the pandemic.
“But, very importantly, I think families need to create an environment of open communication. They need to show their children that it’s okay to not be okay. In other words, if you stress about something if you’re worried about something that’s actually fine.” One way of doing this is by having meals around the dinner table.
Chambers said young people should make time in their daily schedule to rest, relax and recharge.
“Whether by mindfulness, meditation, deep breathing, exercise, having a meaningful conversation, doing something you enjoy, it can really help you to manage your stressors better every day.”
Other practical tips include limiting your time on social media and the news, eating healthily and drinking enough water.
“We can’t control the pandemic, but we can try small tips every day to look after our mental health.” DM
For help and more resources visit Sadag’s website or call their 24-hour hotline at 0800 456 789.