What's the problem?

Since the beginning of this year, most of our conversations and interactions have not only been dominated by COVID-19 but have also been dictated by the measures put in place to stop its spread.

All we have been hearing is how it has been wreaking havoc across the globe.

Our brains have been exposed to all sorts of new stats and terminologies, from death tolls to hospital admissions and from social distancing to frequent hand washing.

So what impact is it having on our brains?

"There are many ways in which COVID-19 affects the brain," says David Eagleman, a neuroscientist at Stanford University. "One of the most obvious is that during this time of lockdown, there's been a lot of stress and anxiety, and that causes the body to be flooded with stress hormones.

"And that is essentially a fight-or-flight scenario that puts our bodies into where we're constantly stressed out."

How is lockdown affecting us in different ways?

Some people have had more time to reflect, while others have improved their relationships with friends and family, or focused on their health and lifestyle.

"But it has also created a lot of uncertainty for a lot of people, uncertainty around their work, their education, finances, relationships," warns Chetna Kang, consultant psychiatrist at Nightingale Hospital, London. "For some, it's been quite stressful and it has increased their anxiety, because of loneliness and isolation."

Parents, especially single parents, have been forced to juggle lots of responsibilities – working from home, doing housework, looking after their kids and facilitating online learning.

Kang noted that there are also those who have had to navigate the challenges brought on by an addiction.

"Over the last few months, I've noticed an area that has become more challenging for some people is around addictions," she says. "So some became more dependent on social media, not just for entertainment, but as a distraction from challenging circumstances at home and in their relationships, almost like an avoidance.

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"And in one particular case, out of boredom, they also started smoking cannabis and drinking more heavily… by summer he was driven by either his drinking or his smoking cannabis or he was on his screen.

"It's almost like he existed because these three things existed and because he just couldn't be with his own emotions."

Has it been disorientating being in lockdown?

Eagleman notes the coronavirus lockdown restrictions have affected our ability to estimate how much time has passed.

Our brain judges duration by assessing how many memories it has but since we've been locked within the same four walls day after day, it has been difficult to write down clearly distinguishable memories.

So our recent memories all blur together, making it difficult to assess how much time has passed.

"Our ability to simulate forward has also been diminished by lockdown," adds Eagleman. "When you are worried about food and shelter and water, you can't think very far forward.

"This is why during the past eight months, people haven't really been spending time reading big long books or getting involved in big giant projects, but instead sort of doing lots of little things."

What has it been like for people?

Gina Lawrence, a southeast London resident, works as a medical sales representative.

Lawrence had always been keen on outdoor activities, regardless of the weather, and thrived on her social connections, until she stopped finding joy in going out and meeting people.

"I realized there was a bit of a change because I wasn't that interested in seeing people so much," recalls Lawrence. "I was quite happy just to stay in, which is very unlike me."

Lawrence has lived on her own since her daughter went to university in 2016. She enjoyed being on her own but suddenly found it quite lonely.

"I suppose it started to escalate when I couldn't really make any decisions about things," says Lawrence. "So that was something that alerted me to not being right.

"I was then having lots of anxiety, panic attacks, not sleeping very well – and then started to get lots of ailments."

As Lawrence had had cancer 13 years ago, her physician sent her for lots of tests – but fortunately they showed nothing untoward.

Last year, she found winter evenings very challenging, as it would get dark at 4pm. By her own admissions, she would find herself thinking "I've got another six hours of darkness before I go to bed. How awful is that?" She would experience panic attacks at night and also had trouble sleeping.

Her doctor attributed it to menopause, which was odd since she had had it 20 years ago. She was prescribed anti-anxiety medication but it gave her headaches and the new medication caused insomnia.

'It was as though my energy was locked'

"At the start of the first lockdown in March, I completely panicked, living on my own and went to stay with my brother and sister-in-law," says Lawrence. "Initially it was going to be for three weeks, but it was three months.

"They saved my life, really. It was just fantastic to be with them, have the company to speak to somebody every day.

"I think when I was at my worst, I just wanted the day to end and I'd be waking up late, which is really unlike me, just trying to minimize the amount of time I had to be available during the day, whereas now there aren't enough hours in the day.

"I just have so much energy. It was as though my energy was locked and now it's been released."

Although Lawrence would return home for some hours during the day to do her work, she says she would just sit in the chair and stare into space. She couldn't focus and didn't know how to cope with it.

"These feelings were so alien to me, I'd never, ever experienced it in my life, ever," says Lawrence. "I felt I needed to find my own way through it and it was difficult to tell people that you had anxiety, quite possibly a bit of depression.

"Over a period of time, I did start to tell people that I hadn't been feeling so well. Some people were sympathetic and concerned. Other people just thought, 'We're all a bit depressed because we can't do very much', but that was OK.

"But now I think if I hear of anybody that is suffering with anxiety and depression, I think I know what it feels like."

'I wish the ground would swallow me up'

Lawrence acknowledges she is lucky to have overcome her anxiety despite the lockdown. Some others have struggled especially with added pressures.

Naz Ibraheem lives in Massachusetts with her husband and three teenage children. Her 16-year-old daughter Saira has Asperger's syndrome, and her 13-year-old daughter Aleena has autism spectrum disorder. Ibraheem also has a son, 14-year-old Ahmar.

The pandemic has turned Ibraheem's already challenging life "upside-down" – but she is used to dealing with uncertainty.

"I think my kids' autism has taught me a lot. I would've been a different person if I had typical kids," explains Ibraheem. "We kind of take a day at a time we see if there's any progress, if my daughter regressed, if it's going to be a good day or a bad day."

Saira suffers from social anxiety and does not use any social media platforms. She feels isolated and misses the structure that her school routine offered.

"Saira has been losing a lot of hair since the lockdown started and that's because of the stress she's taking," says Ibraheem. "She's also very conscious of herself and is very camera-shy. For her online classes, she's supposed to turn her camera on but she struggles with it."

On the other hand, Aleena's challenges are very different to her sister's.

"She's in her own world," says Ibraheem. "She does a lot of what she calls 'silly talk' – which is when she repeats something she really likes or doesn't like, or certain words that she's not allowed to say, she says them in private.

"This way, she gets it out of her system – but now she is doing ten times more silly talk than she used to."

It is a sign that Aleena is regressing as things get stuck in her head when she cannot get the answers and reassurances that she is seeking.

"When I tell her we don't know when a vaccination is going to be available, she paces around the house, upstairs and downstairs, giggling one minute and then sobbing the next because she doesn't know when it's [COVID-19] going to go.

"She wants to talk about it all the time and that gives her more anxiety. It's like a snowball effect."

Aleena has had these setbacks because of the change in her routine. Ibraheem finds virtual schooling lacks structure and although her kids' school is offering two days of classroom learning for many kids, for Aleena and Saira they offered four days in school.

"Unfortunately, they both have anxiety of going to school and catching coronavirus," says Ibraheem. "They absolutely refuse to wear a mask and go to school because they're too afraid.

"My husband would never agree. He is a physician and struggles with his own anxiety and depression. He's extremely cautious and careful so he also declined this offer."

Ibraheem also manages her husband's medical practice. Dealing with all these responsibilities and catering for her kids' special needs has put a lot of burden on her.

"I struggled myself initially because I'd take on everybody's anxiety and then at the end of the day, I'd be exhausted, mentally and physically," she says. "So I'm under the care of a psychiatric nurse practitioner as well.

"On my darkest days, I feel like I'm going to lose my mind. I sometimes wish the ground would swallow me up."

What do the experts say?

Eagleman stresses the importance of keeping our brain active and engaged. He believes the main challenge of the pandemic is to get our brain to seek novelty.

Fortunately, people have been seeking out new ways of doing things, from online museum visits to drive-in raves, where everybody dances in their cars and honks to applaud.

"The important thing is to keep seeking novelty," says Eagleman. "The brain is always seeking sort of a middle spot between novelty and familiarity. It's important to keep routines during this time… and then seeking new things that you can do."

Meanwhile, Kang emphasizes the importance of taking care of uncertainty early.

"Uncertainty puts us in a position of being scared and fearful. We get worried and worrying gets us busy doing nothing," adds Kang. "It's a really unproductive space to be in and it makes us catastrophize.

"Lockdown is creating a stressful situation but if you look after your mental wellbeing, you'll find that you have more resilience.

"And you won't be so vulnerable to the limitations of lockdown or the collective consciousness of fear that lockdown seems to be creating because we're also affected by other people's attitudes," explains Kang.

Kang believes we must focus on the factors that are in our control to achieve a positive mindset and protect our mental and physical health. 

She also suggests pursuing activities that bring stillness and quiet, like meditation, mindfulness, yoga, tai chi, a walk in nature, even if it is for just a few minutes.

"All of these things slow us down and quieten the mind. It's very nourishing, on a biochemical level as well as psychologically and spiritually," says Kang.

Having practised as a psychiatrist for 20 years, Kang knows that to prevent chronic effects of COVID-19 restrictions on your mental health, it is important to seek help.

"Just like the body can break down and be repaired, so can our mind," adds Kang. "Most mental health conditions are transient. They're an opportunity for growth and to improve our quality of life."

Should we be worried?

Lawrence believes this winter, especially with the COVID-19 restrictions, will be a test for her anxiety but she feels confident she is going to be ok.

"I think I've got a lot of ideas and perhaps that was lacking during the time that I was feeling unwell," says Lawrence.

Meanwhile, Ibraheem is worried for her family's mental wellbeing.

"In the last eight months, my kids have only been out once or twice, for their eye appointment or doctor's appointment," says Ibraheem. "So obviously that's not going to have a good effect on their brain afterwards.

"It feels overwhelming and I think we're going to be so isolated."

Video Editor: Sam Cordell

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