This pandemic is a crisis of mental health too
Author and recovered anorexic Samuel Pollen reflects on the mental health challenges of lockdown
Three months of lockdown has laid our habits bare. We miss the obvious things: friends and family, pubs and cinemas, football matches. But we also miss rhythms and routines we never really appreciated before. We miss driving to work, and buying a coffee on our commute, and putting on clothes. Whole segments of our lives have been excised. Habits have a poor rep – we talk of bad habits, drug habits, breaking habits – but the truth is, without them, we feel unmoored.
This is especially true for people with eating disorders, who depend on habits to make it through the day. I’m speaking from personal experience here: I was 12 when I developed anorexia. My life became rigorously scheduled. I would rush home from school, change, run for half an hour, read for an hour, eat a meticulously portioned meal, and so on. These habits weren’t ‘healthy’, of course, particularly when you add them all up. But they kept me on a mostly even keel. The hardest days of all were the ones where I was forced to deviate from this routine: a weekend visit to my grandparents, when I didn’t know when or what we would eat, or a friend’s birthday party, or – worst of all – Christmas.
Age 12 or 13, I would not have coped well at all with a global lockdown.
And it’s more than just habits: coronavirus has created a perfect storm for people with eating disorders. Many people in this situation have ‘safe’ foods: foods that come precisely portioned from the supermarket, in plastic or foil; foods with calorie counts that they can recite like nursery rhymes. The early weeks of coronavirus, these foods were hard to come by in supermarkets, if you could make it to one at all.
Then we all had to learn to socialise in a new way: the ubiquitous and oddly intrusive Zoom call. Even as a long-recovered anorexic, it involves far too much staring at my face for my liking. We spent more and more of our lives in front of computers, on social media, seeing people’s workout routines and attempts at home cooking and topless selfies. For a time, we were only supposed to exercise once a day (or not at all, if we were classified as ‘vulnerable’). All of this is hard enough to navigate in good mental health. Throw an eating disorder into the mix, and it’s devastating.
Beat, the UK’s leading eating disorders charity, reported a 73% increase in contact to their various helplines during the early weeks of lockdown. On social media, they saw a 162% increase. I suspect this is, unfortunately, the tip of the iceberg. Many eating disorders go unrecognised – particularly in BAME communities, in LGBT+ people, and in men. Lockdown is likely to have made this problem far worse. It’s forced people into strange and unpleasant social situations, while cutting them off from any real support network. It’s created a backdrop of suffering and death that makes it very hard to feel like your own problems are a priority.
coronavirus is a huge, urgent practical test of how serious we really are about mental health.
We know all too well that we’re living through a public health crisis. But this particular public health crisis is so big that a dozen other public health crises eddy off its wake. Life-enhancing surgeries have been delayed; domestic violence has bloomed; mental health problems of all kinds fester in isolation and confinement. For now, we don’t really know how big any of these problems are, because even under Zoom’s intrusive eye, even when all of our colleagues see our children and our spouses and our bookshelves, there is so much that they don’t see. That makes these problems all too easy to ignore.
Many people have pointed out how coronavirus is reinforcing existing inequities and inequalities in our society (Emily Maitlis on Newsnight, for one). So far, mental health hasn’t been a huge part of this conversation, perhaps because the full effects of lockdown on our collective mental health may take years to play out, and we are triaging problems at the moment. That’s understandable. At the same time, we know early intervention is vital in successful (and for that matter, cost-effective) mental health treatment. As with so many aspects of coronavirus, the sooner we deal with this problem, the better. Or conversely: the longer we leave it, the worse it’s going to get. (I will mention in passing here that eating disorders have the highest mortality rate of any mental illness – higher than some cancers.)
For years now, we’ve talked about ‘mental health awareness’ as if this is an end in and of itself. We have a ‘Mental Health Awareness Week’, instead of a ‘Mental Health Week’. But awareness is the easy bit. Turning theory into practice is hard, and coronavirus, as well as being many other things, is a huge, urgent practical test of how serious we really are about mental health.
A small but significant step would be to replace Mental Health Awareness Week with a Mental Health Action Week that is focused on creating meaningful positive change. We need less brands telling us to speak up, and more solid commitments to, for example, changing management structures to support mental health. We need less vacuous talk of ‘parity of esteem’, and more counsellors in schools.
The past few months have exposed the yawning gaps in our social fabric, and how many of us are at risk of falling through them. And in just the past few days, Marcus Rashford has shown how focused political pressure can quickly make the impossible possible. So, what are we waiting for?