The Problem with Lockdowns

In the matter of using lockdowns as pandemic prophylaxis, we have taken the position that any policy has rewards as well as risks. To shut down a country in order to limit the spread of a viral contagion is not a win/win proposition. Sometimes the benefits outweigh the costs. Sometimes the costs outweigh the benefits. Sometimes it’s a toss up. If the latter, savvy and hopefully competent leaders should make the best decision.

As we know, in some countries and even in some American states, officials refused to lock everything down. One might remark that some of them had higher covid cases. But, again that needs to be balanced against the suicides and the illness caused by the lockdowns. 

At the least we know that the American mania about shutting down public schools has come at a serious cost. One notes that many other countries, assessing the relative pandemic risk to children, kept their schools open.

The consequences have been dramatic. Children are falling behind. Children are losing ground. Minority children especially are being hurt by the policies. Meantime the teachers’ unions and their Democratic enablers whistle past the graveyard. And, of course, the children’s parents continue to vote for the politicians who are sacrificing their children’s future in order to look like they are doing something to curb the virus.

And now we have news about how lockdowns have damaged children’s mental health. The data comes to us from Great Britain, and that is not a reason to ignore it.

From Max Pemberton at the Daily Mail:

While there were calls for stricter lockdowns and tighter restrictions, many clinicians – particularly those working in mental health services – were concerned that lockdowns would have a profoundly negative impact on our wellbeing and that ministers, politicians and public health officials should be taking this into account when weighing up the pros and cons of our response to the pandemic.

Precisely….

We ought all to be asking how government policies have impacted mental health:

We are starting to see exactly how the lockdowns set in motion a series of events – from stopping face-to-face treatment, to isolating large groups of people and even the fear of the virus itself – that had a profound effect on the mental health of the nation.

It is understandable that the stresses and pressures of lockdown, the unfamiliarity of the situations we found ourselves in and the uncertainty would result in increased rates of depression and anxiety.

Post-traumatic stress disorder rates have also increased from people who spent time in intensive care or witnessed loved ones or – in the case of doctors and nurses – patients dying.

Panic attacks have increased among those who experienced shortness of breath when unwell. Some of these conditions will be short lived, while others will prove a long-lasting legacy of Covid.

But, depression and anxiety are one thing. Psychosis is quite another. Pemberton reports that on recent research in Great Britain that has shown a dramatic increase in psychosis:

But research published this week threw up one surprising and utterly unexpected finding – an increase in psychosis. Figures show there was a 75 per cent rise in first-episode psychosis between April 2019 and April 2020. The rise continued throughout the summer, with rates more than 50 per cent higher than the same summer period the year before. This is certainly not something clinicians were predicting. 

Doubtless, they are using the term psychosis more broadly that I might prefer, but still, it is a condition not to be toyed with:

The first is that, while psychosis is considered a symptom of severe psychiatric illness, we actually know that it can be triggered in susceptible individuals by stress.

The policies produced a massive amount of stress.

There’s no doubt that lockdown was hugely stressful for lots of people in different ways – the extreme isolation that some faced, the prospect of losing their job, the loss of routine and structure, and financial insecurity.

For others, they had to spend a prolonged period of time with family members or flatmates that they might not get on with, or have complex or even abusive relationships with.I think these severe stressors will have led to psychotic episodes being triggered in some people. 

Some will have had psychotic episodes before and this stress will have triggered a relapse, but there will also be some who may be susceptible to psychosis (some people’s brains seem more likely to develop it than others), but for whom it was triggered for the first time by the stress of lockdown.

It goes on:

People ran out of medication, or were unable to collect it from pharmacies because they were unwell or scared to go out. Without regular support from community psychiatric nurses or care coordinators in community mental health teams, some simply forgot to take their medication or didn’t take it regularly. 

Many would turn up to A&E scared and confused, with the first symptoms of a relapse of their psychosis, asking for help. Others had depression or other mental health problems, and had stopped taking their medication and become very unwell, to the extent that they became psychotic for the first time.

And then, the lockdown caused so much stress that some people, especially young people, turned to illegal drugs to manage their stress. Dare we mention that our culture at large is having an extended love affair with psychiatric drugs. Why would children not believe that chemical substances are the solution to psychological problems:

One of the big triggers for psychosis is drugs, particularly cannabis, but also crystal meth and spice. I was struck how, throughout lockdown, we were seeing incredibly high levels of drug-induced psychosis coming into A&E.

To give you an idea, in A&E, we might typically see one case of drug-induced psychosis a week. Yet on just one night shift towards the end of lockdown, I saw four patients with this, and this was not uncommon through lockdown and indeed has remained surprisingly high. 

Many were youngsters, particularly students (and a disproportionate number of overseas students), who were stranded in halls. Bored and isolated, they had turned to drugs.

Just in case you think that this story has been ginned up by the right wing media, as in The Daily Mail, the Guardian, not part of the right wing media, has the same story:

Brian Dow, the deputy chief executive of Rethink Mental Illness, said: “Psychosis can have a devastating impact on people’s lives. Swift access to treatment is vital to prevent further deterioration in people’s mental health which could take them years to recover from.

“These soaring numbers of suspected first episodes of psychosis are cause for alarm. We are now well beyond the first profound shocks of this crisis, and it’s deeply concerning that the number of referrals remains so high. As first presentations of psychosis typically occur in young adults, this steep rise raises additional concerns about the pressures the younger generation have faced during the pandemic.

While political leaders pat themselves on their backs about their drastic policy measures to fight the virus, we should also take into account the costs that the general public, especially the younger generation,  has had to bear.