As more restrictions are lifted and life is getting back to normal, a new pandemic is slowly creeping in – Post-COVID Stress Disorder. TheJournal.mt spoke to Psychotherapist Dr Charles Cassar about the impact COVID-19 has had on our lives and how it has affected the general mental health of the Maltese public.

Humans are resilient and have made it through huge challenges. Yet COVID-19 has had a very strong psychological impact on the global population. Heightened levels of stress, anxiety, depression have all been common symptoms displayed during this time.  

Those who are more vulnerable due to age or medical issues have also been challenged by this unprecedented situation since they were forced to come to terms with their fragility and the fight to preserve their lives.

Dr Cassar says that the intense fear and anxiety at the initial stages of the pandemic have also changed due to the perceived security provided by the vaccination programme. Even at the time when the measures had been more restrictive, most people had already started to adapt to a ‘new kind of normal’ which involved a number of leisure activities, albeit limited by the imposed restrictions. Despite this, the impact has now been made: 

“So, while the effects of the pandemic will not be forgotten and time will manage to restore greater elements of ‘normality’, a post-COVID stress disorder can surely be a factor.” 

                                                                        Dr  Charles Cassar

A study conducted locally, commissioned by the MCESD showed that the majority of the local workforce (53%) has been less optimistic about the future since the outbreak of the pandemic, for reasons specifically related to COVID-19. Pessimism was found to be more common among females (60.5%), employers (60.7%) and self-employed individuals (83.1%) who confessed a specified fear of earning less, with health reasons appearing to be much less of a concern for them.  When looking at age and income, it transpired that the less optimistic were the younger (15-24 age bracket) and the middle-income categories (earning more than >€30,000).

So who is at risk of mental health issues?

A recent international study, conducted across seven countries (Australia, China, Ecuador, Iran, Italy, Norway and the United States) has established that the severity of mental health disorders significantly depends on gender, the type of outdoor activities, characteristics of people’s homes, the presence of infected acquaintances, time dedicated to looking for related information (in the news and social networks), the type of source information and, to a certain degree, the level of education and income.

Dr Cassar believes the following groups of people have been the most affected by the pandemic:

• Those who have contracted the COVID-19. Apart from the fear of death itself, there would also be concerns about not knowing what the long-term effects of the virus would be together with the tough feeling of isolation from loved ones and the wider world.
• Individuals who witnessed family’s, friends’ and colleagues’ experience or the potential suffering as a result of the virus due to actual sickness, worry for vulnerable loved ones, loss of jobs or income and not being able to meet family members.
• Those who experienced the deaths of family and friends as a result of the virus;
• Those who have been exposed to dire situations where they were helpless or relatively ineffective in helping others. This could include people such as health care workers or journalists covering stories related to the pandemic.

He adds that anyone can be at risk of mental health issues. While people’s experiences can affect their mental health, there are also other factors that can contribute. These include a person’s resilience; the perception of their experiences; the coping strategies adopted; people’s habits; and the way individuals use means of communication and information.

Yet what are the tell-tale signs of people suffering with PTSD and/or mental health issues, and how can we be of help?

People who suffer from mental health issues would display their turmoil in different ways: 

“PTSD can be manifest in a number of different ways, amongst which a view of helplessness about the future, feeling detached from family and friends, feeling emotionally numb, difficulty experiencing positive emotions and maintaining close relationships.  There would usually also be negative thoughts about oneself, others and the world. Being aware that these can be symptoms of PTSD can help one to apply a more understanding attitude towards people who are in pain and are struggling to get by.” 

Applying increased sensitivity is also important and go a long way.  Being patient and understanding with a person who may seem to be doing a ‘big deal’ over a small issue, or not pushing people to meet face to face when one senses reluctance to do so, can be examples of how to be sensitive to people’s needs and possible anxiety provoking situations. Exercising kindness and being less judgmental, may seem simple, yet are strongly overlooked mindsets.