Prior to COVID-19, as a country already not boasting economic stability. Many people were already dealing with troubled lives, tough business climates and pressures, coupled with constant political unrest, crime and financial woes but to name a few. Led to a plethora of people in a state of mental distress, once again, this was all before the lengthy lockdown.
According to the South African Depression and Anxiety Group (SADAG), they have received an increase in calls since the start of lockdown from an array of people feeling anxious, lonely, worried and depressed.
SADAG points out many callers are stressed about a combination of issues including the spread of COVID-19, finances, relationship problems, job security, grief, gender-based violence and trauma.
Going on to say, “COVID-19 and the lockdown has affected many South Africans, and it has had a serious impact on people living with a mental health issue often making their symptoms more heightened. SADAG has been receiving calls from people with no history of anxiety or depression who are feeling overwhelmed, anxious and stressed”, says SADAG’s Operations Director Cassey Chambers.
But when zooming into KZN just how are Newcastillians faring under the weight of the pandemic?
Looking to obtain insight into the mental state of our local communities within Northern KwaZulu-Natal, The Newcastillian – Online Daily News chatted with Dr Fatima Seedat, a well-known and respected psychiatrist in the Newcastle community.
Dr Seedat is a Specialist Senior Psychiatrist with a private practice in Newcastle, who also utilises the Mediclinic Hospital Kintsugi Wellness Centre to admit and treat patients, who urgently require voluntary psychiatric intervention.
Elaborating on her experience, Dr Seedat explains, “I have been affiliated with Mediclinic Newcastle since commencing practice in Newcastle 12 years ago. I have both my masters and fellowship in psychiatry and have a special interest in anxiety and depressive disorders.”
Whilst in the thick of COVID-19, during lockdown level 5, and most of level 4, Dr Seedat explains, their unit closed (Kintsugi Wellness Centre), primarily as a result of the anticipated lockdown.
Saying, “This was an unprecedented time in our history, and patients were extremely anxious about the unknown, and were uncertain about the safety of their families. The concern regarding access to essential needs, such as access to food supplies, as well as the concern regarding the care of their children, as many nannies and domestic workers, would be unable to travel during level 5 to work and home.”
Therefore, as a result, Dr Seedat specifies, patients tend to be single parents, or breadwinners within their respective households, with the level of responsibility being placed on them during this time of confusion and uncertainty, significantly increased. Resulting in many patients who required psychiatric in-hospital interventions delaying their admission to the hospital, which was understandable but not ideal.
Digging into some of the reasons why people did not reach out for help, according to the doctor, was due to the uncertainty of the virus, and the fear of contracting COVID-19. This also resulted in patients being apprehensive about being hospitalised, even though the Kintsugi Wellness Centre is a separate building from the Hospital.
With the lockdown easing to level 4, Dr Seedat states. “During level 4, we returned to our practice, due to the need for patients to continue with chronic psychiatric medication and requiring their prescriptions. Some patients who work in Newcastle but reside in other provinces, and vice versa required assistance with obtaining their scripts and this service was provided, with prescriptions being emailed to the pharmacies.”
Adding, the medical sector attempted to consult telephonically with patients, as many remained apprehensive to consult in person. “However, this was not entirely successful, as many patients were confined to their homes and were unable to obtain much privacy during their sessions, and the rapport that is established in person, was missing.”
Furthermore, patients could not afford data costs, which meant Skype or WhatsApp video calls were not possible, and often, mothers and fathers would have to care for their young children, making it difficult to express their emotions, whilst babysitting or lacking privacy to discuss their stressors.
When seeking assistance and undergoing psychiatric treatment, Dr Seedat explains patients require a comfortable space in which to disclose their innermost thoughts in order to discuss their concerns and challenges.
Pointing out the reason why she is sharing this information, Dr Seedat says, it is due to the fact she believes the majority of her patients were and continue to be experiencing significant stress and anxiety, as well as depression.
Stating a number of patients she consults with are significantly depressed. As they were unable to access intervention sooner, or many were not willing to confront their depression and obtain a psychiatric evaluation, prior to it developing.
A truly dark and heart-breaking result of untreated depression can lead one down a destructive path, with the potential of self-harm or worse death.
“The stigma surrounding psychiatric and emotional disorders remains a significant issue that we deal with on a daily basis and is one of the factors why patients are reluctant to obtain assistance, possibly until the condition escalates, and results in an attempted suicide, which is often the case.”
When looking at mental health, Dr Seedat adds the circumstances facing the people of Newcastle and surrounding regions, as the Kintsugi Wellness Centre admits patients from Vryheid, Piet Retief, Ladysmith, Dundee, Glencoe, Dannhauser, Madadeni, Osizweni, amongst other areas are significant.
Whereby the doctor states, “With regards to the financial stressors experienced, this has been a major contributing factor to the stress experienced by our residents. Many people have faced retrenchment, have been forced to work from home, or on a rotational basis, which they are unaccustomed to doing, and with ArcelorMittal experiencing significant cutbacks, and retrenchments, our patients have been earning significantly less than ever before.”
Adding to people’s problems, Dr Seedat explains, one element negatively affecting Newcastillian’s mental states, is the reality that major businesses which provided much-needed employment within our town succumbed to cut-backs, with some businesses having to even close their doors. And this has left many mourning the loss of their favourite shops, restaurants and places to socialise.
“The increased cost of essential supplies, including food, has never before been such a major stressor to our patients, and many are already under debt review, and others have faced, the repossession of their homes, and vehicles. Others cannot afford to pay school fees, and the stress is being experienced by the youth as well as their parents,” Dr Seedat emphasises.
Furthermore, Dr Seedat says our learners are struggling to adapt to the new system of attending school. Stating, “They are not utilising their time effectively and the disruption of their routine has seen a significant increase with regards to substance abuse, and the concern regarding the increase amongst the adolescents in teen pregnancies. The adolescents have been non-compliant with contraception use and the lack of supervision and disruption of their school academic year, has had detrimental effects on their mental wellbeing.”
With people of all age groups facing overwhelming challenges, she highlights that suicide attempts have increased among adolescents as well as adults, seeing some people as young as 12 years old, having attempted suicide. This all due to the increased pressure of not attending school. Plus, their parents fear surrounding their children contracting the virus, and of course, the lack of support they are experiencing, being forced to work independently from home and not socialising with their peers, have all had a large effect on the youths mental status.
Additionally, Dr Seedat points out, domestic violence has seen a significant spike, with the number of abused spouses increasing dramatically.
Whereby she says, “Never before have people been confined to their homes by the law, and their fears of contracting a dreaded virus, and the use of illegal alcohol and substances has been on the increase, with increased numbers of patients reporting domestic violence, and an increase in the number of people wanting to end their long term relationships or marriages. Infidelity issues have also never before been as much in the forefront with people expressing frustration about having their every movement being scrutinised by their spouse, as well as their illicit relationships being exposed due to people being confined to living quarters. Increasing frustration at not being able to socialise without restrictions has and continues to be a major stressor.”
Adding that increased use of cannabis, with its detrimental mental health effects were observed. This, as people struggled to access nicotine in lieu of illegal cigarettes becoming increasingly unaffordable, resorting to self-medicating practices for depression and anxiety with cannabis. Which according to Dr Seedat, worsens the symptoms and one’s apathy in the long term
Highlighting, parents were preoccupied with their own stressors and gaming kept children entertained, seeing many adults also resorting to distracting themselves with social media and other forms of entertainment.
According to the doctor, this resulted in children becoming more addicted to playing games online or on their gaming consoles, with parents allowing them to continually play games with no structure or routine prior to the schools opening. This subsequently resulted in an increase in conduct issues when children had to re-adapt to a school environment.
“Family life and relationships have according to my observation, been irreparably damaged in many cases, and this is as a result of the pandemic, due to the economic and social consequences,” states Seedat.
Currently, the doctor and her colleagues are assisting many individuals who are struggling to come terms with the death of their loved ones, many of whom died from COVID-19, alone in hospital, with only telephonic contact from the hospitals to inform the relatives of their loved ones passing.
She adds that other patients succumbed to death from co-morbidities, many of whom were unwilling to consult their medical practitioners timeously due to fear of contracting the virus, and as a result, their condition often deteriorated, sadly resulting in death.
Going on to say, “COVID-19 has left and continues to leave a trail of destruction in its path, of which we as mental health care practitioners are now attempting to assist our valued patients in trying to pick up the pieces of their lives and attempt to continue to fight the pandemic, and adapt to the “ new way of living”. COVID-19 is sadly with us to stay, and although the figures are not what they were during the peak in July and August, we are sensing apathy amongst our patients, who are now unwilling to be as vigilant as they once were, as they are currently trying to continue providing for households with no work and limited financial resources.”
Looking at people struggling to cope, Dr Seedat adds, never before have as many patients of mine expressed suicidal thoughts. Saying, “Not all have definite suicide plans, but over 80% have expressed moderate difficulty in coping primarily due to COVID-19 and the consequences of the pandemic, including the lockdown and the impact it has had on everyone and their lives.”
Post being infected with COVID-19, depression and anxiety is a phenomenon being experienced by said patients, who are still struggling with persistent symptoms of fatigue and fear of being re-infected, according to Dr Seedat.
“For some, the experience was terrifying, for others the ordeal of being tested repeatedly and the restrictions the pandemic had on them, is a perpetuating stressor.”
While the Kintsugi Wellness Centre offers people with mental illness a safe place of refuge. During the peak of the pandemic, the centre offered a refuge of a different kind. The centre was evacuated and the nursing staff deployed to the general hospital due to staff shortages. This a result of the high number of staff contracting the virus. But what happened to the patients being treated?
Dr Seedat elaborates, “Many patients had to be transferred to out of town facilities, due to the need remaining high for admission, with the facility not being operational. This was due to unforeseen circumstances and part of the disaster management plan, implemented by the hospital, of the need to quarantine staff in the unit, as many staff could not return to their homes due to their family members being at risk of infection.”
This, she concludes, resulted in concern about patients and the unit. “We have had to assure the community that this was due to extraordinary circumstances, the unit was completely sanitised and all patients who are admitted to the facility undergo a COVID -19 test to ensure that their risk of being infected in the unit is extremely low. Staff and mental health professionals ensure adequate PPE to protect the patients as well.”
The management and maintenance of ones mental health is imperative to more than just happiness. It is the key to how you see life, people and the world. Your outlook then plays the lead role in your decision-making process throughout your day. Thus, do not leave your mental health to chance, visit a professional today if you are experiencing symptoms of depression or anxiety.
Authors: Quinton Boucher and Calvin Swemmer
Edited: Calvin Swemmer