The mental health effects of COVID-19: Interview for Times Radio

Interview with Prof. Wulf Rössler, MD; MSc.

16.09.2020 - Interviews, Mental health

Professor Wulf Rössler has recently appeared on both radio and television, discussing a potential mental health crisis as a result of the continuing COVID-19 pandemic.
Speaking on Times Radio, he discusses with host Phil Williams the drastic rise in cases of depression, the mental health repercussions of COVID-19, but also the positive sides of this pandemic.

So we start tonight with a frightening statistic about the effects of COVID-19 lockdown on our mental health. The number of adults in Great Britain experiencing depression has doubled during the pandemic, according to the office for National Statistics. Almost one in five of three and a half thousand participants in a survey, said they had experienced depression in June. It’s important to stress, obviously, that that’s not a diagnosis, but it’s symptomatic of what people have been experiencing since, what February-March really, when we were locked down. Charities and health professionals have reported increased demand for them as well, due to the psychological toll the lockdown has taken.

We can speak now to Professor Wulf Rössler, who’s Chief Medical Officer at The Kusnacht Practice. Evening to you.

Wulf Rössler: Hello

Look, first of all then, thank you for joining us as well, we appreciate your time. First of all give me your view of this doubling that we’ve seen, and does it surprise you, and is it consistent with what you’re seeing across Europe?

WR: Well yes, this is what we see all over Europe, but in a psychiatric terminology we would call that sub-threshold disorders. That means all that is reported now are stress reactions which do not reach the threshold of a diagnosis, of let’s say anxiety, or depression, or something like that. But it’s an indicator for stress reaction and people obviously are stressed about the current situation.

And what can they do about it? I’ve spoken to a number of people who say to me that they almost, they know what they need to do, but they’re so low they don’t have the energy to motivate themselves. And that’s a really difficult place to find yourself in.

WR: Well, I mean that’s a good point. First of all, I mean there is something about COVID-19 where we would say how can we cope with such a situation. This is the degree of familiarity for example, this is the controllability, predictability, or that it’s also transparent how the whole COVID-19 crisis will develop. And familiarity, I mean it’s obvious that’s very new.
I mean most of us have never experienced a pandemic, we don’t really know how to control it. We are told by our governments how to deal with it, and even if you look around I mean governments tell different things; not only nationwide they tell locally, at least as I know from continental Europe, you know they are quite diverse recommendations.

And so all this together is something that makes it difficult to cope with the pandemic. And if people say they feel low and have no energy and something like this, I mean you, well probably would advise those people, you know not just to stand up and enjoy your life or something like that, but what is mostly important is that you get control of your daily life. What you shouldn’t forget, in case you don’t work or something like that, is that your day should be structured. That you get up regularly, you know, that you have your meals regularly, I mean just as you used to have it.

And this is very important, and not to start drinking and using substances prematurely, you know, don’t drink too much, don’t smoke too much and things like that. These are all inappropriate and dysfunctional stress reactions. And so, we mostly start with these people, if we advise these people on the behavioural level on what I just said.

And because of the doubling in these statistics it’s fair to assume, isn’t it, that some of the people who say they’ve experienced depression won’t have ever experienced it before. What’s happening in the brain of these people?

WR: Well, I mean imagine it’s not only the brain. I mean there are many, many physiological, hundreds of physiological reactions when you react or respond to stress. I mean what is most important also for the brain is that we produce more cortisol under stress. You see the whole body gets in this flight modus and there are a lot of hormones produced and cortisol is one of the most important. And we do know that cortisol, for example, impairs your memory; so you know that people cannot remember exactly what did I think, what did I, I don’t remember this or that, things like that.

But that’s not altered, it’s not only the brain you know, I mean it’s everything. You feel your body, you feel that possibly your blood pressure rises, your body is producing more, what we call interleukins; which by the way, all these inflammatory substances the body produces are all important for mental disorders impacting on the brain. But inflammatory processes are very important during, as a stress reaction.

We do know that not only your heart rate might rise, your blood pressure rises, you know, you get more easily colds, things like that. All we experience, and this is what happens in your body you know. And there’s nothing really you can do in a sense, but you take some medication about it. But it’s more about trying to regulate your life on this behavioural level to normalise also your physiological processes.

How worried are you that, you know, five years from now, ten years from now, we’ll still be feeling the mental health repercussions of COVID-19? Because at the moment governments seem to be predilected towards actually trying to find a vaccine, and trying to manage movements of people. And not necessarily focussing on individuals’ mental health.

WR: Well honestly, I mean that’s what we all hope, that they find some, they find some vaccines, you know, to leave all this pandemic behind us. But I mean, even if they find some vaccines which are effective it will take years until the whole world is vaccinated; you know, I mean this is very clear, this pandemic we have to go through for many years. So, I mean it changes our lives in a way we have to adapt to. There is no doubt that there’s certain, even cultural approaches we used to have- hugging people, shaking hands, things like that you know. This is quite difficult not to do in the future, but we have to deal with it.

But what I wanted to say is, you know, if you look at the impact of COVID-19 on our mental health there’s always two pillars on which everything lies. On the one side is our personal vulnerability for COVID-19, or for stress. And on the other side are the environmental factors which impact, and have, and recall stress reactions. And it depends really where you live in this world, I mean, and what your environment is like. I mean if you are living in the third world, and if you work somehow in the informal sector, you know, it’s not so much about the mental health, it’s about that you have a choice between starving and getting infected, and this is not a good choice.

I mean this is really a matter of industrial countries, where our lives are mostly secured that we also get occupied with our mental health. But we have to learn, and we will have to learn. And I think, and you know, I don’t want to be so negative about everything because this crisis situation has also brought about some positive things; just mentioning one thing, for example, is the introduction of the home office. Today this is something new in our world and it gives us the opportunity to experience what it means to be able to work, for example- much more concentrated when you work at home, or something like that.

So we made new experiences, and it also will allow us, for example, to show more solidarity with people who are vulnerable to this pandemic. So I do not only want to emphasise the negative sides that we have to expect, but possibly we should be open also for positive things to come.

Thank you very much for your time and expertise tonight, Professor Wulf Rössler, Chief Medical Officer at The Kusnacht Practice.