Niamh Delmar is a Counselling Psychologist and Mental Health Freelance writer. Here, she shares her advice for surfing the second wave of COVID-19.

The World Health Organisation has warned of consequences to mental health if governments and leaders do not work to recognise the problem sooner, rather than later.

While pandemic waves impact physically, the psychological fall-out rolls out in tandem. In the U.K., Public Health Consultant Dr. McGill referred to the Mental Health aftermath of COVID-19 a second wave in itself.

What is different about this time around is that we have more information about the infection and its treatment, detection has improved and there are less terrifying scenes from other countries. We have also become somewhat desensitised, complacent and burnt out.

Lockdown
Not everyone is affected the same way and some actually enjoyed the lockdown earlier in the year and made life enhancing adjustments. However, research indicates that anxiety and stress is emerging as the leading mental health issues.

Studies show the emergence of new mental health problems and the exacerbation of existing ones. People may live in fear of themselves or loved ones becoming ill or dying. A wide range of psychiatric disorders have been found to develop including depression, anxiety, panic disorder, post-traumatic stress disorder and somatic symptoms.

Quarantine has been linked with anger, despair and substance abuse. There has been a surge in prescribed antidepressants and anxiolytics since the pandemic kicked off in Ireland. Grief and loss have been amplified as the healing rituals of wakes and funerals have been absent. Even among the less psychologically vulnerable, people report sleep disturbance, moodiness, emotional outbursts and COVID fatigue

Anxiety  and stress
Those coming to me for therapy are presenting with a variety of issues, but predominantly anxiety and stress. Often they do not make a link with the pandemic. As mental health professionals, we know that there are biological, psychological and environmental factors all interacting when someone is psychologically unwell.

A pandemic is a significant environmental factor at play. The unpredictability and the prolonged nature of it can lead to mental health deterioration over time. Becoming unwell is not always obvious to the individual. Other factors such as financial upheaval, personality, coping mechanisms, past life events and support all influence individual responses to a crisis.

I witness people often minimising their mental suffering as they feel others have bigger problems or feel so fragile perceiving others coping well. Often well- meaning messages are communicated by family, friends and society to stay positive, mediate, distract or exercise.

While there is merit in all of these, it is not as straight forward as that, and it is not enough. An individual, societal and government response is essential for the long-term mental health of the nation.

Off days
It is okay to feel crap and have off days. I have. It is normal to have emotional outbursts, tears, snappiness and moods all over the place. You are only human. Remind yourself it is a global pandemic with uncertainty and much of it is out of your control.

Yes, you may rant or get all sanctimonious, project your frustration or withdraw into your cave. All this is part of the process. The way to thrive is not to let any of that dominate, to become aware of how you are responding and assess what is helping or hindering your coronavirus response and coping set.

Reflect on what has changed about you post COVID outbreak. Accepting that much has changed in your world can also help in this period of uncertainty. We will be influx, plans will change and we will be recalibrating.

There will be anti- maskers, there will be differences of opinion, there will be conspiracy theories and there will be those who are different to you and your beliefs. Try not to let this raise your stress levels and blood pressure. It is as it is.

Positive steps
Try to step back and focus on doing your part. Tune in to what is helpful and informative for you. If you are becoming news obsessed, limit your exposure, frequency, and duration. We need to keep our heads in the sand at times. Throw a few news-free days into your week, and ask someone to let you know if there is anything urgent.

Limit COVID related conversations as they will raise your cortisol levels. You know the basics: eat well, sleep routine, exercise or movement, healthy distractions and interactions and new interests and activities to shine up the brain.

For me, sea swimming freshened my mind up and am hoping to keep it up. There is a bond with other sea swimmers. Take the time to learn more about technology so you can work remotely, take an online class and interact more. My local community Whatsapp group has been a source of support, inspiration, discussion and laughter.

Mind wandering
A major factor in protecting your mental health is your thought processes. With an average of 60,000 – 80,000 thoughts a day, it is worthwhile keeping a distant eye on what is going on in your head and to remind yourself that thoughts are not reality.  

Research has found that people are 'mind wandering' 47% of their day. Thoughts are distorted by your mood, state of mind, history and circumstances. They actually set off a chain of chemical reactions. Worries are based on worst case scenarios, depressive thoughts are negative in nature and stressful thoughts just wind you up.

COVID-related thoughts can get dramatic and emotional. It is a challenge to stay out of the head, not to believe your thoughts, and to just stick with the facts. Have a mental list of what you have control over such as the recommended protocols. We can all adjust our thinking so it is healthier, more helpful, flexible and accurate.

Overthinking and ruminating is a recipe for psychological distress and observing thoughts, but not getting sucked into them gets easier with practice.