Overcrowding and affordability stress: Melbourne’s COVID-19 hotspots are also housing crisis hotspots



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Rebecca Bentley, University of Melbourne and Erika Martino, University of Melbourne

Melbourne is once again grappling with increasing COVID-19 rates. Ten suburbs in Melbourne have been designated COVID-19 outbreak hotspots: Broadmeadows, Keilor Downs, Maidstone, Albanvale, Sunshine West, Hallam, Brunswick West, Fawkner, Reservoir and Pakenham.

The outbreaks have sparked discussions about lockdowns and travel restrictions for people living in these parts of Melbourne and generated intensive suburb-specific testing.

The outbreaks have been attributed to family gatherings in homes and people failing to self-isolate, even after positive test results. This has occurred alongside possible breaches of infection control protocols in hotels accommodating people in quarantine – with security guards from major hotels having contracted the virus.




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Socio-spatial clues

While chance and circumstances converge to create outbreaks there are also some obvious factors related to where and how people live that impact their capacity to isolate.

As we potentially face a two year-long wait for vaccines (16 are in clinical evaluation internationally (with one being developed in Australia), we need to acknowledge the spatial concentration of these sites of vulnerability is not random. There are socio-spatial clues as to why we have had outbreaks in these locations.

Four measures: overcrowding, homelessness, housing affordability stress and financial hardship often occur in the same areas.
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First, the hotspots have some of the highest rates of housing precarity and financial hardship across Melbourne. People in overcrowded or unaffordable or insecure housing may have less control over their immediate environment and less capacity to isolate themselves than other community members.




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Homelessness and overcrowding expose us all to coronavirus. Here’s what we can do to stop the spread


The recent Melbourne outbreaks have occurred largely in areas with:

  • high housing affordability stress: where those in the lowest 40% of income spend more than 30% of their household income on housing,

  • overcrowding: measured in terms of the number of people in a household, their age and gender in relation to the number of bedrooms in a dwelling, and/or

  • homelessness: where a person does not have suitable accommodation alternatives and their current living arrangement is in a dwelling that is inadequate, has no tenure, or if their initial tenure is short and not extendable or does not allow them to have control of, and access to space for social relations.

While housing security seems like an obvious problem to fix, it remains a long-standing, difficult issue for governments to tackle. Going into the COVID-19 pandemic, Australia exhibited high rates of homelessness and spiralling housing costs.

Many people in Melbourne and Sydney live in overcrowded or inadequate forms of housing as a result of what has become known as our “housing affordability crisis”. Alongside this, the numbers of people who require emergency accommodation far outstrip our cities’ capacity to house them on a medium- to long-term basis.

Second, people without savings may be compelled to go to work despite feeling unwell. They need to meet their weekly housing costs and don’t have savings enough to go two weeks (or longer) without income. This can occur even if people have negotiated reduced rent with their landlords.

Where housing and COVID-19 collide

When one considers these housing and financial factors from the perspective of COVID-19 suppression, their geographical clustering should not be disregarded. The areas in Melbourne with high rates of household overcrowding, homelessness, housing affordability stress and (related to this) financial hardship (often measured using people’s self-reported capacity to access funds in an emergency) map closely to areas where there are now high numbers of COVID-19 cases.




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Using publicly available data, we created a simple index describing capacity isolate based on the above four characteristics. We created maps of Greater Melbourne to examine the relationship between current COVID-19 cases and these housing and financial vulnerability factors. Our index shows Hallam, Sunshine West, Albanvale, Broadmeadows, Falkner, Reservoir and Maidstone are all in the top two quintiles.

Housing Vulnerability Index for Greater Melbourne.
NATSEM – Social and Economic Indicators – Synthetic Estimates SA2 2016; ABS – Data by Region – Family & Community (SA2) 2011-2016; and UNSW CFRC – Overcrowded Households Australia (SA2) 2016. Data were accessed on 26 June 2020 from AURIN Portal (https://portal.aurin.org.au/), Author provided

Over the last decade, Melbourne has seen itself become more spatially segregated. And household overcrowding and precarity are geographically clustered.

Acknowledging correlation is not causation, these findings suggest solving some of Melbourne’s housing problems might reduce the spread of COVID-19 now and in future outbreaks as we await a vaccine.

Taking this further, when assessing where in cities we are likely to see a spike in cases in the future, we should take housing-related vulnerabilities into account alongside other factors.

While steps have been taken by the Victorian government to address some of the issues we have flagged, such as the one-off payment of up to A$2,000 for eligible renters who are unable to afford rent, and the A$1,500 payment to people who test positive and have no leave cover, more could be done in the medium to long term to reduce the risk of overcrowding, housing related financial stress and precarious forms of housing (that lead to homelessness) across the city.




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The past months of COVID-19 restrictions have highlighted how critical housing and financial security are to our health and well-being at both an individual and population level. The Victorian Council of Social Service has noted disasters can be “profoundly discriminatory” in where they occur, and in their impacts.

Successful COVID-19 suppression requires safe and equitable cities and addressing housing vulnerability is one of the many challenges we must take up.The Conversation

Rebecca Bentley, Professor of Social Epidemiology, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne and Erika Martino, Research Fellow, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Pregnant in a pandemic? If you’re stressed, there’s help



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Monique Robinson, Telethon Kids Institute

If you’re pregnant during the COVID-19 pandemic, you might be feeling a unique type of stress.

You might be uncertain about how an infection could affect your unborn baby. That’s over and above the stress you might be feeling about the pregnancy itself, and its impact on your relationship, job or lifestyle.

But there’s professional support to help you manage these stresses. And there’s lots you can do at home to ease your worries.




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How will the coronavirus affect my unborn baby?

One of the first studies to look at the effect of coronavirus infection while pregnant found the health of unborn babies or newborns of women infected in their final trimester did not differ to those expected with uninfected pregnancies.

But this small study, from Wuhan in China, was rushed to publication and didn’t look at infection earlier in pregnancy.

A review of 41 pregnancies complicated by COVID-19, as well as another 38 complicated by other coronaviruses (SARS, severe acute respiratory syndrome and MERS, Middle East respiratory syndrome) gave us more information.

It found a small but significant increase in preterm birth (before 37 weeks’ gestation) in COVID-19 pregnancies.

However, the researchers couldn’t differentiate between spontaneous preterm birth and babies who were induced to arrive before 37 weeks.

So far, the evidence of harm to you or your unborn baby is limited, and should not cause concern.

Pregnancy can be stressful anyway

Separate to the fear of being infected with COVID-19 is the fear and stress related to simply living through the pandemic while pregnant.

Pregnancy can often be stressful as lifestyle, relationship and income changes create challenges for families.

Pregnancy can be stressful at the best of times.
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Worries about the baby’s health are present in any pregnancy, but adding concerns of what infection would mean for the unborn child can exacerbate feelings of anxiety.

Before the pandemic, about 20% of women had a clinical anxiety disorder (for example, generalised anxiety, specific phobia) while pregnant.

We now have some early indicators of how the COVID-19 pandemic is affecting that statistic.




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And when you add the pandemic into the mix

Canadian researchers surveyed nearly 2,000 pregnant women in April 2020 (in research yet to be peer-reviewed). They found 57% of pregnant women showed anxiety symptoms but 68% reported an increase in pregnancy-specific anxiety.

Only one of the 1,987 participants had a confirmed case of COVID-19, with another 25 cases suspected but not confirmed. So, for most participants, just being pregnant during the pandemic (without being infected) led to three times as many women being anxious during the pandemic than before it.




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Pregnant women are also concerned about how the pandemic will affect their maternity care, including who can visit them in hospital and after the birth of their baby.

A review of pregnancy stress during previous infectious disease outbreaks, including SARS, MERS, Ebola and Zika, found that as well as feeling vulnerable, pregnant women were anxious about disruption to pre- and postnatal care, and exposure to treatments not fully tested in pregnancy.

We can’t avoid stress, but we can manage it

We know stress during pregnancy has been linked to a range of poor outcomes for the child, such as pre-term birth, being more susceptible to disease, and behavioural problems through childhood.

Post-traumatic stress symptoms in pregnant women following the September 11 attacks and various natural disasters have significantly affected both emotional and cognitive development in children later in childhood.

But there is good news. While we cannot avoid the stress that comes with the COVID-19 pandemic, we can manage it.




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In fact, it’s not necessarily the stressful event itself that can lead to poor outcomes. It’s how a pregnant woman assesses the stress of the event and how she chooses to move forward that might determine what happens to her child.

So, if we can manage our stress and not let it overwhelm us, we may be able to avoid the negative consequences of stress in pregnancy with benefits right through our children’s lives.

Here’s what you can do

Social support is key for managing stress, but social distancing makes it harder to gather with the friends and loved ones who might typically provide that support.

Still, there are many online pregnancy support and birth groups targeted to particular stages of pregnancy. These could provide reassurance and a sense of belonging while the outside world looks different.

You can still exercise outside. But if you prefer to exercise at home, there are many online pregnancy yoga and pilates classes.

Yoga and pilates classes for pregnant women are available online.
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You can practise guided relaxation and meditation with an app. And if you can work from home, this might give you some much-needed flexibility.

You can also use local, evidence-based telehealth to access mental health care. There are also many free, online programs providing self-guided mental health support.

As long as the COVID-19 pandemic is here, with its accompanying uncertainty, we can best focus on limiting the long-term effects of stress on our mothers, babies and families.The Conversation

Monique Robinson, NHMRC Early Career Fellow, Telethon Kids Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

7 tips to help kids feeling anxious about going back to school


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Mandie Shean, Edith Cowan University

As COVID-19 lockdown measures are lifted, some children may experience social anxiety about the prospect of returning to school.

People with social anxiety may fear embarrassment or the expectation to perform in social situations, or worry exceedingly about people judging you poorly.

In certain situations, people with anxiety may find their heart beats quicker as adrenalin is released into their blood stream, more oxygen flows to the blood and brain, and even digestion may slow down.




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These are helpful responses if you need to run away or fight danger. But social situations are generally not life threatening, and these physical symptoms can interfere with socialising.

People with social anxiety may fear looking silly, being judged, laughed at or being the focus of attention. For anyone, such experiences might be unwelcome but for those with social anxiety they pose an unacceptable threat.

Social anxiety in Australian children

One Australian report found that about 6.9% of children and adolescents surveyed have a diagnosed anxiety disorder, 4.3% experience separation anxiety and 2.3% a social phobia.

Social phobia (social anxiety) is more common in adolescents, whereas separation anxiety (intense anxiety over leaving caregivers, such as parents) is more prevalent in children.

These figures only account for those who have a diagnosis of anxiety. They do not include undiagnosed young people who experience high stress in social situations.

Not all children will be happy to be back in school.
Tom Wang/Shutterstock

Any recent prolonged absence from school may have increased social anxiety, as avoiding what you fear can make your fear become greater.

This is because you do not get to learn that the thing you fear is actually safe. Your beliefs about the threat go unchallenged.

Anxiety can also increase through what pyschologists call reduced tolerance. The more children withdraw from the situations that cause them fear, the less tolerance they have for those situations.

Anxiety can affect education

The educational cost for students with anxiety is considerable.

The research shows students with poor mental health can be between seven to 11 months behind in Year 3, and 1.5 – 2.8 years behind by Year 9.




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That’s because these students experience more absences from school, poorer connection to school, lower levels of belonging and less engagement with schoolwork.

7 strategies to help overcome social anxiety

So what can children do to overcome anxiety as they return to school? Here are some useful tips.

  1. deal with some of the physical symptoms. It is hard to think if your body is stressed. Use calming strategies like mindfulness or breathing exercises. Slowing your breathing can reduce symptoms of anxiety, depression, anger and confusion. Useful apps to help you control your breathing include Smiling Mind (iOS and Android) or Breathing Bubbles (Android only).

  2. anxiety increases while using avoidance techniques such as avoiding eye contact, not raising your hand to answer a question, or not attending school. So the most effective way to deal with social anxiety might be to face it. Allow your child to have small experiences of social success – give their opinion to one person, start a conversation with someone they know – so they can learn to feel safe in these social situations.

  3. fear and anxiety are normal and benefit us by helping us to respond efficiently to danger. Rather than read your body as under threat, think about the changes as helpful. Your body is preparing you for action.

  4. while avoiding your fears is not the answer, being fully exposed to them is not the answer either. Providing overwhelming social experiences may lead to overwhelming fear and failure, and may make anxiety sufferers less likely to try again – or at all. Start small and build their courage.

  5. supportive listening and counselling are less effective than facing your fears because these approaches can accommodate the fears. While you want to support your child by providing them with comfort and encouragement – ensure you also encourage them to face the fears that cause the anxiety.

  6. you cannot promise negative things won’t happen. It is possible you will be embarrassed or be judged. Rather than try to avoid these events, try reframing them. Remember that that we all experience negative social feedback, and this does not make you silly or of less value. It makes you normal. Or, rather than see it as embarrassing, maybe it can be funny.

  7. remember it is the “perception” that something is a threat – not the reality. Reasoning with your child to help them see your perspective may not change theirs. This reality only changes with positive real experiences.

Breathing Bubbles in action.

What we think is truth is often revealed as untrue when we face our fears. There is joy in social situations. Keep turning up to them.




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The Conversation


Mandie Shean, Lecturer, School of Education, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

No wonder isolation’s so tiring. All those extra, tiny decisions are taxing our brains



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Ben Newell, UNSW

Anxiety, depression, loneliness and stress are affecting our sleep patterns and how tired we feel.

But we may be getting tired for another reason. All those tiny decisions we make every day are multiplying and taking their toll.

Is it safe to nip out for milk? Should I download the COVIDSafe app? Is it OK to wear my pyjamas in a Zoom meeting?

All of these kinds of decisions are in addition to the familiar, everyday ones. What shall I have for breakfast? What shall I wear? Do I hassle the kids to brush their teeth?

So what’s going on?




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We’re increasing our cognitive load

One way to think about these extra decisions we’re making in isolation is in terms of “cognitive load”. We are trying to think about too many things at once, and our brains can only cope with a finite amount of information.

Researchers have been looking into our limited capacity for cognition or attention for decades.

Early research described a “bottleneck” through which information passes. We are forced to attend selectively to a portion of all the information available to our senses at a given time.

These ideas grew into research on “working memory”: there are limits on the number of mental actions or operations we can carry out. Think of remembering a phone or bank account number. Most people find it very hard to remember more than a few at once.




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And it can affect how we make decisions

To measure the effects of cognitive load on decision-making, researchers vary the amount of information people are given, then look at the effects.

In one study, we asked participants to predict a sequence of simple events (whether a green or red square would appear at the top or bottom of a screen) while keeping track of a stream of numbers between the squares.

Think of this increase in cognitive load as a bit like trying to remember a phone number while compiling your shopping list.

When the cognitive load is not too great, people can successfully “divide and conquer” (by paying attention to one task first).

In our study, participants who had to learn the sequence and monitor the numbers made just as many successful predictions, on average, as those who only had to learn the sequence.

Presumably they divided their attention between keeping track of the simple sequence, and rehearsing the numbers.

More and more decisions take their toll

But when tasks become more taxing, decision making can start to deteriorate.

In another study, Swiss researchers used the monitoring task to examine the impact of cognitive load on risky choices. They asked participants to choose between pairs of gambles, such as:

A) 42% chance of $14 and 58% chance of $85, or

B) 8% chance of $24 or 92% chance of $44.

Participants made these choices both with their attention focused solely on the gambles, and, in another part of the experiment, while also keeping track of sequences of letters played to them via headphones.

The key finding was not that increasing cognitive load made people inherently more risk-seeking (tending to choose A) or risk-averse (B), but that it simply made them more inconsistent in their choices. Increased cognitive load made them switch.

The fruit salad or the cake? Well, it depends partly on your cognitive load.
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It is a bit like choosing the fruit salad over the cake under normal circumstances, but switching to the cake when you are cognitively overloaded.

It is not because a higher cognitive load causes a genuine change in your preference for unhealthy food. Your decisions just get “noisier” or inconsistent when you have more on your mind.

‘To do two things at once is to do neither’

This proverbial wisdom (attributed to the Roman slave Publilius Syrus) rings true – with the caveat that we sometimes can do more than one thing if they are familiar, well-practised decisions.

But in the current business-not-as-usual context there are many new decisions we never thought we’d need to make (is it safe to walk in the park when it is busy?).

This unfamiliar territory means we need to take the time to adapt and recognise our cognitive limitations.




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Although it might seem as though all those tiny decisions are mounting up, it perhaps isn’t just their number. The root cause of this additional cognitive load could be the undercurrent of additional uncertainty surrounding these novel decisions.

For some of us, the pandemic has displaced a bunch of decisions (do I have time to get to the bus stop?). But the ones that have replaced them are tinged with the anxiety surrounding the ultimate cost that we, or family members, might pay if we make the wrong decision.

So, it is no wonder these new decisions are taking their toll.

So what can I do?

Unless you have had ample experience with the situation, or the tasks you are trying to do are simple, then adding load is likely to leader to poorer, inconsistent or “noisier” decisions.

The pandemic has thrown us into highly unfamiliar territory, with a raft of new, emotionally tinged decisions to face.

The simple advice is to recognise this new complexity, and not feel you have to do everything at once. And “divide and conquer” by separating your decisions and giving each one the attention it – and you – deserve.The Conversation

Ben Newell, Professor of Cognitive Psychology, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

While we wait for a coronavirus vaccine, eating well, exercising and managing stress can boost your immune system



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Julia J Rucklidge, University of Canterbury and Grant Schofield, Auckland University of Technology

Social distancing may remain necessary during the 18 months or more we’ll have to wait for a coronavirus vaccine.

This can feel like we have little control, but there are several evidence-based protective measures we can take in the interim to ensure we are as healthy as possible to fight off infection and prevent mental health problems that escalate with uncertainty and stress.




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Coronavirus and underlying medical conditions

There is recent evidence that some younger people suffer strokes after contracting the virus, but the majority of people who end up hospitalised, in intensive care or dying from COVID-19 have an underlying medical condition. One study showed 89% of those hospitalised in the US had at least one.

These underlying medical conditions include high blood pressure, high blood sugar (especially type 2 diabetes), excessive weight and lung conditions. An analysis of data from the UK National Health Service shows that of the first 2,204 COVID-19 patients admitted to intensive care units, 72.7% were either overweight or obese.

All of these health issues have been associated with our lifestyle including poor diet, lack of exercise, smoking, excessive alcohol and high stress.

It’s obvious we have created a society where being active, eating healthily, drinking less and keeping our stress under control is difficult. Perhaps it’s time to push back. This may be important for major conditions like heart disease and diabetes as well as the added threat we face from emerging infectious diseases.

One study shows only 12% of Americans are in optimal metabolic health, which means their blood pressure, blood glucose, weight and cholesterol are within a healthy range. This rate is likely similar in many Western countries.

There is now a body of evidence linking our unhealthy lifestyle with viral, especially respiratory diseases. High blood sugar reduces and impairs immune function. Excessive body fat is known to disrupt immune regulation and lead to chronic inflammation. Insulin resistance and pre-diabetes can delay and weaken the immune response to respiratory viruses.




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Improving immunity through lifestyle choices

If we are going to restrict and change our lifestyles for 12 to 18 months while we wait for a vaccine, and if we want to protect ourselves better now and in the future, we could address these lifestyle factors. They not only affect our recovery from viruses and respiratory infections, but are also the biggest cost to the quality of life in most countries.

Optimising the health of the nation must be at the forefront. And this is long overdue. There has been a substantial under-investment by most developed countries in preventive medicine to reduce chronic diseases and improve both longevity and quality of life through healthy lifestyles.

Healthy organisms are naturally resistant to infections. This is true in plants, animals and people. Maintaining optimal health is our best defences against a pandemic until a vaccine is available.

We identify three modifiable risk factors:

1. Diet

Research shows better nourished people are less likely to develop both mental and physical problems. Certain nutrients, such as vitamins C and D and zinc have been identified as essential for improving immunity across the lifespan. A better diet is associated with a lower chance of developing mental health problems in both children and adults. Low levels of specific nutrients, such as vitamin D, have been recognised as risk factors for COVID-19. These nutrients are easy (and cheap) to replenish.

What does it mean to be better nourished? Eating real whole foods – fruits and vegetables, nuts, legumes, fish and healthy fats and reducing the intake of ultra-processed foods.

2. Exercise

Being physically fit adds years to your life – and quality of life. High cardiorespiratory (lung and heart) fitness is also associated with less respiratory illness, and better survival from such illnesses.

How do you get fit? Set aside time and prioritise walking at a minimum, and more vigorous activity if possible, every day. Ideally, you would get outside and be with important others. The more the better, as long as you are not overdoing it for your individual fitness level.

3. Stress

Stress impairs our immunity. It disrupts the regulation of the cortisol response which can suppress immune function. Chronic stress can decrease the body’s lymphocytes (white blood cells that help fight off infection). The lower your lymphocyte count, the more at risk you are of catching a virus.

How do we lower stress? Meditation, yoga, mindfulness, cognitive-behaviour therapy, optimising sleep and eating well can all help in mitigating the negative impact of stress on our lives. Taking additional nutrients, such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc, during times of stress has a positive impact on overall stress levels.




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Modifying lifestyle factors won’t eliminate COVID-19 but it can reduce the risk of death and help people to recover. And these factors can be in our control if we and our governments take the initiative.The Conversation

Julia J Rucklidge, Professor of Psychology, University of Canterbury and Grant Schofield, Professor of Public Health and Director of the Human Potential Centre, Auckland University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Are you worried someone you care about is thinking of suicide? Here’s how you can support them from afar



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Milena Heinsch, University of Newcastle; Dara Sampson, University of Newcastle, and Frances Kay-Lambkin, University of Newcastle

We’ve now been social distancing for several weeks. While these measures have allowed us to slow the spread of COVID-19, they’ve also upended our day-to-day lives.

If you’ve found yourself experiencing feelings of fear, anxiety, depression, boredom, anger, frustration or irritability, you’re not alone.

Older adults, health-care workers, people with pre-existing mental health conditions and people experiencing financial pressure could be particularly vulnerable to psychological distress at this time.

When feelings of psychological distress increase, suicidal thoughts and behaviours may also increase.

So how do we know when to be worried about someone we love, and how can we support them from afar?




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Recognising the signs

During COVID-19, we may all be feeling more stressed than usual. That’s why we need to stay connected with each other online, on the phone and via text messages.

But it’s important we’re attuned to whether this extra stress and uncertainty is developing into something more for any of the people we care about.

Some warning signs for suicide might be easier to recognise when you can see a person’s facial expressions and gestures. But there are cues you can pick up on during text, phone or online communication.

Social withdrawal can indicate a person is at greater risk. Perhaps a friend or relative is increasingly difficult to contact via phone or text, disappears from social media or starts saying they just want to be alone.

A persistent drop in mood might be revealed on the phone by a flat tone of voice, talking less than usual or more slowly, and by shorter text messages or none at all.

You may be able to tell if a friend is becoming socially withdrawn by the tone of their messages.
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Some people might say things like “you’d be better off without me” or “there’s nothing to live for”, which suggest they can’t see a way out of their situation and may be thinking about suicide.

If you’re worried someone you know might be suicidal, reaching out and having a conversation could save their life.

Talking on the phone or online

Choose a time and place where you can talk openly and without getting interrupted. This might be challenging when whole families are at home together for extended periods. But these can be sensitive and confronting conversations and it’s important to protect the person, as well as people in your family or household.

You could start the conversation by asking your friend or loved one how they are. You might also let them know you’ve noticed a change in them: “you don’t seem yourself”.

Starting the conversation may look different if you’re online. Perhaps someone has posted a comment or image on social media that seems unusual for them, or which makes it seem like they’re thinking about suicide. If so, contact them directly by sending a private message. It’s OK to talk online, just not in a public forum.




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Once you’ve started the conversation, ask directly about suicidal thoughts and intentions (for example, “are you thinking about suicide?”).

And be prepared they may answer “yes”. Then you just have to listen with supportive statements. Say things like “that sounds really tough” rather than “don’t be silly”.

Some people considering suicide might actually find it easier to talk online.
Jonas Leupe/Unsplash

Being at a distance can be an advantage

You might feel worried about having a difficult conversation on the phone or online, but this style of communication actually has some benefits.

People may feel more comfortable revealing suicidal thoughts, without fear of stigma, when communication isn’t face-to-face. And sometimes people find it easier to communicate via emoji, GIFs or images rather than having to find the words to express how they’re feeling.




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Further, listening on the phone or via messaging gives us time to think about how to best respond, and to let our initial reactions pass.

This is important because negative reactions, like criticising or dismissing someone’s feelings, may make the person less likely to seek help and increase their thoughts of suicide.

Encourage them to get help

If you’re worried about someone and you think they’re at risk of suicide, offering help is important. Our research with people who had previously attempted suicide found although participants wouldn’t necessarily seek help, many said they would accept it if it were offered.

While talking with the person you’re worried about is an important first step, you may be able to guide them towards professional help. For example, they may want help to make an appointment with a GP or counsellor, or to call a crisis line.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Lauren Rogers, a research assistant at the University of Newcastle, contributed to this article.The Conversation

Milena Heinsch, Senior Research Fellow, Centre for Brain and Mental Health, University of Newcastle; Dara Sampson, Academic Research Manager, University of Newcastle, and Frances Kay-Lambkin, Professor, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus: tiny moments of pleasure really can help us through this stressful time



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Desirée Kozlowski, Southern Cross University

If I told you that last night I built a blanket fort in the living room, crawled inside with my cat, a glass of wine and my just-arrived copy of the New Yorker, would you think less of me?

After all, we’re in the midst of a global coronavirus pandemic. Borders are closing, people are sick, dying, losing their jobs, and locked in isolation. And there was I, playing – as though I didn’t have a care in the world.

Meanwhile, you might be reading this holed up at home, screaming with fury at those bloody hoarders. Or perhaps you’re on a train valiantly trying to keep 1.5 metres away from the next person, shrinking back as they cough and splutter.

Wherever you are, whatever you’re doing, whatever you think about the pandemic, the economy, or your compatriots, a tiny part of you knows you could do with a bit of pleasure right now.




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The effects of sustained stress

When we’re first exposed to something stressful, like a deadly new disease, our body reacts with a cascade of small changes such as releasing adrenaline and other chemicals, and activating brain regions related to fear and anger.

In many cases those changes make it more likely we’ll meet the challenges we face.

But if the stressful conditions continue, and especially if we feel powerless to fix the situation, the consequences of the stress response increase.




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Our risk of chronic diseases increases, immune function can be compromised, and we become more vulnerable to mental health problems.

We can feel depleted, disconnected, anxious and depressed. We can become fixated on negative thoughts and on looking for signs of threat. Sound familiar?

The good news is the effects of stress on the brain are reversible.

Pleasure in times of stress

It may seem too simple to be true but shifting our attention toward the small, everyday pleasures in our lives can offset the consequences of stress or negative events.

US researchers reported last year that experiencing pleasurable emotions, for example having interesting things to do, serves as a buffer between chronic stress and depression. So, among people with sustained, high levels of stress, those who reported more pleasurable moments were likely to experience less severe depressive symptoms.

Pleasurable experiences might even be of most benefit in times of stress.

We experience pleasure in a myriad ways. Perhaps one of the most potent of pleasures, and one that springs most easily to mind, is a lover’s caress.




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But to maximise the pleasure in every day, we should look more widely, to a multitude of sources.

If we’re too busy reading those alarming headlines to notice the beauty of the sun setting outside our window though, it’s a missed opportunity for a moment of delight.

When I recently asked people on Twitter to share the things bringing them delight in these challenging times, I received hundreds of replies within a couple of hours.

Each one was a small vignette conveying a personal moment of simple pleasure. Gardens and dogs and children and nature featured strongly, and many people reflected on the added pleasure of recalling such moments.

Indeed, recollection and anticipation – along with relishing pleasure in the moment – are effective ways to maximise the value of positive experiences or emotions. We call it “savouring”.

Luckily, we can get better at savouring with practice. And the more we savour, the less stressed we feel. And that’s why I’m here.

If we increase the pleasure we experience, it can lift our psychological well-being. In turn, higher well-being is linked to better immune function.




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It’s about boosting our personal capacity

My message is not to avoid the facts or pretend nothing has changed. It’s to intentionally build in moments of reprieve and restoration. It’s to turn your attention to what is still good and rich and fun – to really focus on those things.

This is how we can harness the protective power of small pleasures, for the sake of delight itself and to build grit and resilience.

So, there may never have been a better time to build a blanket fort, or to bring out a game of Twister, or to lie on your back in the garden making fantasy creatures out of passing clouds. Find excuses to giggle.




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Making pleasure happen

In difficult, frightening times, no one is immune to worry; it’s a natural response. But what we can do is take steps to protect ourselves, as much as possible, from its physical and psychological ill-effects.

The challenge is to make this happen, to tear yourself away from analysing the COVID-19 curve and intentionally, systematically engineer more small delights into your day.

Do you like the sunshine? Then know when the sun falls on your balcony, in your garden or in the street near your place. Take a cup of tea or coffee with you and soak up the warmth.




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Pets? Run, play, be silly with them. Eating a tomato? Plant the seeds and watch something grow, from nothing, because of you. Sing. Dance. Delight someone with an act of kindness.

Plan your opportunities for pleasure. Put them in your diary. Set your alarm for them. Commit to share them with others. Photograph them. Post them on social media or share them directly with friends and family. Anticipate them gleefully and reflect on them with delight. This is our time to be here. Savour.The Conversation

Desirée Kozlowski, Lecturer, Psychology, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus is stressful. Here are some ways to cope with the anxiety



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Louise Stone, Australian National University and Katrina McLean, Bond University

One of our patients was recently talking about her anxiety around the coronavirus epidemic. This woman’s stress was understandable. She had survived a serious infection with swine flu, but only with a prolonged stay in intensive care.

I guess we all walk on the edge of a cliff […] anything can happen to anyone at any time. We are never really safe. But people like me? Now we know the edge of the cliff is right there, and we can’t help looking down.




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While some people may be more susceptible to becoming seriously ill with the coronavirus than others, none of us are immune to the pervading sense of anxiety that has taken hold around the world.

For Australians in particular, this crisis has come immediately after a horror summer of bushfires, which took their own toll on our collective mental health.

But there are some things we can keep in mind, and some practical steps we can take, to keep coronavirus-related anxiety under control.

A tangible threat versus an invisible enemy

It hasn’t been an easy start to the decade. In the face of the summer’s bushfires, many of us contended with threats to our health, our homes and even our lives.

Even those not directly affected were faced with constant images of charred bushland, injured wildlife, and homes burnt to the ground.

The bushfires put a strain on our collective mental health, and it’s very likely some people are still struggling.

Natural disasters, though, are visible and tangible. There are things we can do to avoid the threat, manage the danger or mitigate the risk. We can see the smoke, check the app, buy an air purifier, prepare our homes. And despite the vivid images of floods, fires and cyclones, we know the storm will pass.

Epidemics are different. A novel epidemic is unknown, evolving and a global risk.

We are faced with a variety of information (and misinformation) online. Guidelines contradict each other, different states have different approaches, and experts disagree.

Meanwhile, infection rates climb as economies fall. We know we may contract the virus, and as yet we know there’s no vaccine to prevent it.




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While the bushfires united us, coronavirus seems to divide us

There’s an ugly side to ways we can deal with the stress of an unknown enemy like the coronavirus.

Some people blame potential carriers for their own illnesses, scapegoating people they see as high-risk. This is not helpful.

We also seek to manage our anxiety by trying to prepare ourselves and our families for the possibility of isolation or quarantine.

While this is reasonable to a degree, practices like stockpiling toilet paper and other goods can feed, rather than relieve, anxiety. Empty supermarket shelves can create panic, and further disadvantage people who might be living from week to week.

Epidemics isolate us from each other physically too, and this will only happen more and more.

So how can we put things into perspective?

We can take heart in knowing many people will develop only mild disease from the coronavirus.

There are of course vulnerable members of our community: those with compromised immune systems due to illness or age. We need to protect these people as a community by creating safe spaces for them to live, work and access health care, rather than fostering panic.




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Our greatest asset lies in our own bodies. We may not understand how to best protect ourselves, but our bodies are experienced managers of novel immune challenges, and they will manage the risk as effectively as they can.

Ultimately, our best chance at surviving this virus relies on nurturing our bodies: avoiding exposure through hand-washing and isolation where appropriate, eating well, exercising, managing chronic illnesses, and getting enough sleep.

The anxiety a pandemic generates is inevitable. At the end of the day, we all need to learn to live with a degree of risk we can’t avoid.

Practical strategies to keep anxiety at bay

The World Health Organisation has developed some practical tips for dealing the stress of this outbreak. Here are a few of them:

  • accept that it’s normal to feel sad, stressed, confused, scared or angry during an outbreak

  • find ways to talk about how you feel with others, especially if you are in quarantine

  • remember to keep an eye out for your children during this time, and for loved ones who already have mental illness. They may need help dealing with this added anxiety

  • if you feel overwhelmed, seek support from a health professional

  • don’t use smoking, alcohol or other drugs to deal with your emotions. Keep your body as healthy as possible by eating well, exercising and getting enough sleep

  • limit worry by limiting media exposure to a few trusted sources

  • draw on skills you have used in the past that have helped you to get through difficult times.




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If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Dr Wendy Burton, a GP in Brisbane, contributed to this article.The Conversation

Louise Stone, General practitioner; Clinical Associate Professor, ANU Medical School, Australian National University and Katrina McLean, Assistant Professor, Medicine, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Explainer: what is lupus and how is stress implicated?



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Lupus is the body’s immune system attacking itself.
from http://www.shutterstock.com

Eric Morand, Monash Health

Thanks to Selena Gomez and Dr House, most of us have heard of lupus. But most of us don’t know what it is, and until recently, none of us were sure whether stress could be a risk factor.

The simplest way to understand lupus is “your immune system gone wrong”.

We have evolved powerful immune systems to detect, attack, and destroy invading microbes. But if the immune system makes an error in the “detect” stage – incorrectly recognising some part of us as foreign – it will attack it with all of the tools at its disposal.

This self-directed, or “auto”-immunity, is the basis of countless diseases, from juvenile diabetes to multiple sclerosis. But unlike those examples, in which the immune system attacks just one tissue, in lupus all tissues of the body can be targeted.




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This can mean anything from a rash and arthritis to the immune system disrupting the function of the brain, heart, and kidney. Some sufferers may have minor symptoms such as tiredness and joint pain that resolves within a few months, but for some the disease can last for years and require transplantation of damaged organs.

These symptoms can arrive in any order at any time, and cause a severe loss of quality of life and reduction in life expectancy. As lupus mostly affects young adult women, the impact of this is great.

Why does this happen?

We are much closer now to being able to answer this question, thanks in part to being able to analyse gene expression in people with the disease.

We know from genetic studies that at least some risk of lupus is inherited from our parents, but we also know that inheritance explains only a fraction of the risk of getting lupus. So other factors must contribute.

It now appears that a large subset of lupus patients’ disease is caused by mechanisms the immune system normally uses to combat viruses. The immune system produces virus-fighting hormones (called “cytokines”) such as interferon – which activates the production of antibodies and destructive inflammation intended to kill the infection. When this happens by error, and is directed at the self, tissue inflammation and damage occur.

Current treatments are limited to non-specific immune suppressant drugs “borrowed” from other diseases such as arthritis, and drugs used to stop an organ recipient’s body rejecting the donor organ. Although life-saving in many cases, these drugs have major side effects and don’t control all patients’ disease.




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How is stress related to lupus?

As a rheumatologist I treat patients in hospital with musculoskeletal diseases and autoimmune conditions. A patient of mine suffering from lupus had, some time prior to diagnosis, been the victim of an assault, which caused post-traumatic stress disorder (PTSD).

This case posed to me, and more importantly to the patient, the question of whether stress could have led to the development of lupus. Until recently this question has been effectively unanswerable.

A new study looked at data reporting on the association of trauma and PTSD with the incidence of lupus. It found that PTSD was associated with a nearly threefold increase in risk of subsequently developing lupus.

A study found a link between PTSD and auto-immune conditions in service personnel.
from http://www.shutterstock.com

A past history of trauma, regardless of carrying a PTSD diagnosis, was associated with a similar threefold increase in the risk of lupus.

These findings confirm a previous study of ex-service personnel, in which PTSD was both disturbingly prevalent and also a powerful risk factor for the development of autoimmune diseases, including lupus.




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The association of stress and the immune system dates back to the 1930s, when pioneering endocrinologist Hans Selye found that there are distinct changes in the body in response to a threat. The term “stress” was also attributed to Selye, albeit coined much later.

Crucially, Selye also observed that stress results in disturbances in steroid hormone production. As we now know, the body’s naturally occurring steroids act through the same pathway as steroid drugs used to treat lupus. This provides a possible mechanism for the connection between stress and the control of immunity.

Intriguingly, some organ manifestations of lupus, such as severe skin or blood disease, are notoriously resistant to steroids, and recent laboratory studies suggest interferon activation in lupus may be responsible for this steroid resistance. Thus, stress, changes in steroid production, and failure to suppress interferons may represent a chain of events influencing the development of lupus.

The ConversationSo this new study means we’re a little less unsure about the causes of auto-immune diseases. And while sufferers can’t change past life events, knowing the causes brings us closer to understanding, and to better treatments.

Eric Morand, Head, School of Clincial Sciences at Monash Health, Monash Health

This article was originally published on The Conversation. Read the original article.