Psychiatrist Natasha Bijlani Talks about Covid-19 Depression Amid Concerns about a “Second Wave”

The coronavirus outbreak has resulted in people experiencing huge uncertainty about the future, and this can be very difficult to cope with – leading to depression.

According to the Office for National Statistics, nearly one in five said they were suffering from depression in June. Younger people, those with disabilities, women and keyworkers were more likely to be affected by depression during the period surveyed.

Dr Natasha Bijlani, consultant psychiatrist at Priory’s Roehampton Hospital in south-west London, says: “Many of my existing patients’ recoveries have been affected by the current situation, but I am also seeing many new referrals. Patients have been coming to me with depressive and anxiety symptoms they had never experienced before.

“Many people have lost their jobs which has led to great financial hardship. And work isn’t just about the money; it’s about having a sense of purpose, identity and structure.”

For all age groups, “untreated depression and anxiety invariably worsen and can have devastating consequences. Fortunately, both depression and anxiety are very treatable and respond well to treatment, particularly if initiated early”

Depressive symptoms can be variable and differ in intensity as well. ‘Diurnal mood variation’ is where you experience more intense symptoms in the morning and find they gradually improve throughout the day.

What to do when you are waking up depressed

Take it one step at a time in the mornings.

If you wake up depressed, the idea of working your way through the day can feel like a real struggle. Rather than thinking about the day in its entirety, focus on the first thing that you need to do, which could be making a cup of tea, feeding your pet or taking a shower. Whatever it is, keep it simple. Once you have finished the task, take a minute to recognise the big step that you have taken and use this to motivate yourself to do another simple task, which could be pouring yourself a bowl of cereal, brushing your teeth, or opening the curtains. Breaking the morning down into easy-to-manage steps can stop it from becoming overwhelming.

Make small changes to your routine

Even the smallest tasks can seem impossible when you’re depressed. If you find that you’re waking up depressed, it’s a good idea to try and prepare as much as you can the night before, so you do not have to do so much in the mornings. For example, have your outfit laid out ready for the next day, so you don’t have to worry about this when you wake up.

You may also want to think about adjusting your schedule in the day, if possible. If you are waking up depressed and feel that your depression symptoms are worse in the morning, try to be flexible with yourself. Set big chores, work tasks or other activities for later in the day, when you may have a little more energy. It may also be beneficial to speak to your manager at work so that they are aware of your situation and can provide the right level of support, which could include starting the working day slightly later.

Seek professional support for depression

Regardless of whether or not you already have an official diagnosis of depression, reach out for an assessment and professional support if you are concerned about the fact that you are waking up depressed. It is important to do this if you are experiencing other depression symptoms too. 

You may want to book an appointment with your local GP, who will be able to provide an initial assessment and access to specialist care and support.

You can also visit a consultant psychiatris. They can provide you with an assessment and put together a treatment plan for managing your depression, which can include therapy, a residential programme and medication if needed. The types of therapy used to treat depression often include cognitive behavioural therapy (CBT), or dialectical behaviour therapy (DBT) for depression, which can be delivered as 1:1 therapy or group therapy sessions.

If you are able, stick to a daily routine

Keeping a good structure to your days can be very helpful.

“To feel comfortable and be in a state of mental and emotional equilibrium, you need to have stability in your life,” says Dr Bijlani.

She advises, “If you are prone to worry, overthinking and anxiety, you should do whatever you can to minimise it.

“Ensure that you allow yourself sufficient time for restful sleep, eat a healthy diet and get some regular daily exercise.”

It is important to “make time to do something relaxing and enjoyable for yourself each day”. It might be useful to “consider adopting a regular routine so you have structure and ensure you get as good a balance as possible for your individual needs”.

Dr Bijlani, adds, “Try and remember that you are not alone in your experience of the global situation. Share your worries and concerns and try to connect to others as much as possible.”

Dr Sheetal Sirohi, consultant psychiatrist at Priory’s Woking Hospital, says it is useful “to reach out to someone who is a good listener, discreet, trustworthy, reliable, non-judgemental and supportive, so they can offer a different perspective. Remember, you don’t have to go into issues straight away. Take your time and do it when it feels right. You might prefer to talk to them about something completely different to begin with, ask them how they’re doing, or relax for a while with a cup of tea (as long as it is compatible with the restrictions/social distancing guidelines).”

With talk of a second wave, it is important to treat the process as a marathon rather than a sprint. Dr Bijlani emphasises the importance of “maintaining a steady output to keep you functioning in the long run, rather than exhausting your emotional and physical resources too quickly which could leave you depleted for the future. And avoid drinking alcohol or taking recreational substances. This is likely to have a detrimental impact in the long-term”.

Maria Simpson

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