The current Covid-19 restrictions in Ireland are set to be in place until 5 May.

At that stage they may be extended, or relaxed. But by then most Irish people, except in specific circumstances, will have been at home for over five weeks. 

The measures were introduced to protect the physical health of the population, but they are also taking their toll on the mental health of many people. 

To better understand the psychological impact of lockdown, China-based clinical psychologist Dr George Hu spoke to RTÉ's This Week.

Dr Hu is the Chief of Mental Health at the United Family Pudong Hospital in Shanghai and President of the Shanghai Mental Health Association. 

China has experienced longer and more severe restrictions on movement than Ireland, but it has now begun to ease some of these restrictions, allowing the rest of the world to get a glimpse of what effect lockdown has had on people’s mental health.

Dr Hu said that in terms of the mental health impact, "We can start from anxiety, we can start from fear, we can start from mood difficulties such as depression.

"And we can move into things like decreased frustration tolerance, decreased emotion regulation skills, negative impacts on marriage and relationships and socialisation patterns."

The lockdown, he says, also has a negative impact on temper, and increased incidence of child protection issues and child abuse.

Many of these occur in the family setting, because most people are now spending long periods of time at home with family members.

However, Dr Hu says "They are not isolated to just families."

"People who are alone can feel the same degree of fatigue, the same degree of pressure, and difficulty with frustration tolerance and emotion regulation." 

People in isolation, he says, also feel less productive.

"People feel just less functional, even though people believe that they should be more functional.

"Theoretically, people think 'Oh, now that I'm working from home, I should be able to do more. I'm saving on commute times. I'm not worrying about getting dressed or changed in the morning, theoretically, I should be more productive.' And instead people are encountering the fact that that's not the case."

Since lockdown restrictions were relaxed in China, Dr Hu has seen an increased number of people presenting to his hospital with mental health problems.

"This pandemic occurred in a real world to real people with already existing real lives, and real lives includes real difficulties right?

"And so add on this layer of the pandemic and all the stresses that it has brought to us. And you know these people now often feel that their pre-existing coping mechanisms are no longer sufficient.

"They need support, they need help, and they need to come in and seek mental health services. So yes, we are seeing a lot, a lot of people with those issues."

Exiting lockdown

Men playing chess in Wuhan

But if many of the mental health problems people are currently experiencing are associated with living in a lockdown situation, will they resolve themselves once restrictions are relaxed? 

That has not necessarily been the experience in China.

"In many cases, there's an initial feeling of elation," says Dr Hu. "Elation that I can get back to my old life, I can see the people I want to see, I can go the places I want to go, I can do the things that I used to do.

"There is this excitement and elation at that prospect. But that’s pretty quickly followed by disappointment, and even grief or mourning or loss, because people quickly realise that the normal life that they expected now to come back into is quite different.

"Perhaps businesses that they used to frequent are no longer there, they've been shuttered or they've no longer become viable."

"There is nowhere to go with friends they want to socialise with, and relationships have changed.

"People have changed during this lockdown, and relationships have changed too. And so there's a certain amount of grief and mourning that's associated with that."

Learning to cope

Since the beginning of this pandemic, people have looked to China for a roadmap of how the virus progresses through a society. 

Now people are looking to China for a pathway to recovery. 

So are there lessons we can learn from China about how to deal with the mental health impacts of living alongside Covid-19?

Dr Hu says the first thing people should do is to pay close attention to their mental health now.

"They should pay attention to how they are coping now. They need to develop mechanisms that will assist them in the post-Covid world.

"One of the things I can talk about is a flexible mindset. We need to train ourselves to look at things in different ways, to train ourselves to become flexible in the way that we conceive of things and the way that we think of things.

"We need to find a way out of a more black and white or binary system and into one that is more nuanced.

"Practise looking at things from different perspectives, identifying the silver linings, identifying the light at the end of the tunnel, and keep a conscious eye to what you need to cope. 

"Ask yourself how can I develop skills, positive coping skills, how can I give myself what I need and really pay attention to taking care of myself and paying attention to that?"

The new normal

A market in Wuhan, where the virus was first detected

Dr Hu says the sense of disappointment which follows the initial elation triggered by the lifting of lockdown restrictions does not last forever. 

"It doesn’t mean there will never be a sense of elation in our lives again.

"Change does not only result in fear and insecurity, change eventually will result in a new stability. The new normal doesn’t have to be scary.

"We will arrive in a place  that is more stable, but we may have to walk through a place that is more unstable first.

"This is not the end of the story. Fear, instability, insecurity, these are not the end of the story. We will come through this, even if it's not soon. And even if we have to do so stepping from stone to stone, we can do it." 

An interview with Dr George Hu can be heard on This Week, on RTÉ Radio 1 from 1pm