With the introduction of different measures to restrict our movement, as part of efforts to reduce the number of people infected with COVID-19, we are making huge changes to our daily routines.

The new realities of working from home, home-schooling of children, and lack of physical contact with other family members, friends and colleagues take time to get used to. Adapting to lifestyle changes and managing the fear of contracting the virus are challenging for all of us. It is important not only to consider our physical health during such challenging times but also to pay attention to our mental health. It is normal to feel worried, stressed, and anxious when we are facing uncertainty. However, the sooner we take care of our mental health, the healthier and better equipped we will be, to cope with the current situation.

1. Minimize newsfeeds and reduce how much you watch, read, or listen to news that makes you feel anxious or distressed

Keep informed about the latest situation and news is important, however, too much will be harmful to ourselves. Minimise newsfeeds and reduce how much you watch, read, or listen to news that makes you feel anxious or distressed. We can set a specific time of the day to seek the latest information and focus on other activities other than that period. I suggest we get information, advice, and recommendations from local and international authorities only. Some false and misleading contents on social media may provoke negative feelings. Moreover, be aware of how much time you spend in front of a screen every day. Make sure that you take regular breaks from on-screen activities.

2. Make new daily routines

Although most of us are having new realities, we can make new daily routines. For example, having regular mealtime with healthy food, allocating time for working, resting, exercising and doing things we enjoy. Keeping regular contact with people close to us by telephone and online channels can provide some support to each other.

3. Be encouraging to your friends or family members

If your friends or family members have mood problems, give support to them, and encourage them to share their thoughts and feelings about what is happening to them. I want to emphasise that we should not say things like “it’s all in your head”, “calm down” or “stop stressing” since feeling depressed or anxious is not a choice. On the other hand, we can use positive speech such as saying “you are not alone”, “although I may not understand exactly how you feel, I care about you and want to help” and “tell me what I can do to help you”. We can also encourage them to speak with a mental health professional.

Sometimes we need to give them more positive feedbacks like celebrating small victories on the road to recovery. This can be very encouraging for them.

4. Educate ourselves about mental health

Moreover, we need to educate ourselves. Once we understand the symptoms, course and consequences of depression and anxiety, we can support them better.

1. Set aside some time each day with your children to do assignment or crafts

During the pandemic, many schools are temporarily closed and sending home classwork or posting assignments online for kids to complete. Parents do not need to spend seven or eight hours a day to instruct children, but it is a good idea to set aside some time each day to work on school assignments. This will add a little bit of structure to the day while also keeping students in a mindset that encourages learning.

Apart from completing school assignments, quick and easy kid crafts can be made using items that probably already have around the house. Creative interaction between parents and young children not only provides cognitive benefits but also creates a unique bonding experience. Moreover, these interactions usually bring fun for the entire family. While it is important to avoid crowds and maintain social distancing, getting outside in the open air is a great way for kids and their parents to expel some energy. Try going for a walk or taking a hike on those lovely days.

2. Maintain stable and buffering relationships with your children and instil a sense of safety

If you are worried about your children’s mental health, you are encouraged to maintain a stable and buffering relationships with their children and instil a sense of safety.

Parents could be a positive role model in coping with a difficult situation. We could help children to express their feelings at their own pace and in the appropriate ways. We should not criticize or blame our children. Instead, we should accept and tell them it is normal to have feelings.

We could instil a sense of safety by comforting them and engaging in regular daily routines to maintain predictability and avoid worries due to uncertainty.

3. Look for signs if you suspect your children may be bullied at school

Bullying is a big issue for children in schools. If you suspect your children may be bullied at school, here are several signs you may be aware of.  

Physical signs include unexplained bruises, cuts, scratches, missing or damaged belongings or clothes.

Emotional and behavioural signs include frequent tears or anger, mood swings, feeling ill in the morning, becoming aggressive and unreasonable.

Other signs include children become unwilling to go to school, their school grades begin to fall, they are often alone or excluded from friendship groups at school. Sometimes they are unable to speak up in class and appear insecure or frightened.

1. Discuss with a doctor about appropriate treatment options

Indeed, there are much more patients with mood problem than before. What is even worse is that those who have recovered from a mood problem had relapsed again. Talk to a doctor and let the doctor help you identifying what's wrong and reducing symptoms that interfere with your work and personal life. 

Treatment depends on the type of mental illness and severity. Sometimes, a combination of treatments works best. If you have a mild mental illness with well-controlled symptoms, treatment from your family doctor may be enough. Some may require a team approach to make sure the medical and social needs are met.

Although medications won’t cure mental illness, they can often significantly improve symptoms. The best medications for you will depend on your situation and how your body responds to the medication. The commonly used medications include antidepressants and fast-acting anti-anxiety drugs. Antidepressants are used to treat depression, generalized anxiety disorder and sometimes other conditions. They can help improve symptoms such as sadness, hopelessness, lack of energy, difficulty concentrating, lack of interest in activities, agitation and insomnia. Antidepressants are not addictive and do not cause dependency. Fast-acting anti-anxiety drugs help with short-term relief, but they have the potential to cause dependency, so ideally, they would be used short term.

Other forms of treatment include psychotherapy, counselling and support groups.

2. If your friend or a family member has mental health issues, show your compassion to them

For individuals, we can show compassion for those with mental illness like sitting next to them, talk with them about their lives. We should be conscious of our language and encourage equality between physical and mental illness.

Seek help from a mental health professional if you have these symptoms:

• Dramatic changes in sleep and appetite
• Decline in personal care
• Recent social withdrawal
• Loss of interest in activities previously enjoyed
• An unusual drop in functioning, at school, work or social activities, such as quitting sports, failing in school or difficulty performing familiar tasks
• Problems with concentration, memory or logical thought and speech
• Loss of motivation or desire to participate in any activity
• Suspiciousness of others or a strong nervous feeling
• Odd, uncharacteristic, peculiar behaviours
• Suicidal idea or deliberate self-harm

The fear of being labelled with a mental illness may be a roadblock to those who would need to seek help.

Local research about the general public’s attitude toward mental health in 2019 showed that around 40% of the respondents were relatively unwilling to live with someone with mental health problems, or even as neighbours. From the data, we could see there is still a social stigma surrounding mental health in HK.

This social stigma is improving over the years. The same research reported that most of the respondents agree that those who experience mental health problems should be more included in society. Also, the Hong Kong government is putting more mental health support resources to the community in recent years.

Social stigma for patients with mental health issues still exists in Hong Kong. Things are being done in the city to tackle stigma. For example, switching some of the mental health services to primary care level is one of them since psychiatric institutions maintain and reinforce stigma. Indeed, the two most common mental health related diagnoses in primary care are anxiety and depression. In fact, primary care physicians are often the first to identify, diagnose, and initiate treatment for common mental health conditions.

In addition, fighting stigma also requires public information campaigns to educate and inform the community about the nature, extent and impact of mental disorders to dispel common myths and encourage more positive attitudes and behaviours. These could be done by social media, advertisement and publicity.

During this hard time, we encourage everyone to express their feelings and gratitude, pay more attention to themselves, think positively, engage in physical activities and don't let the fear of being labelled with a mental illness prevent you from seeking help.