Tag: stress

  • The Mental Health Impact of COVID-19

    The Mental Health Impact of COVID-19

    Initially, the pandemic had a significant and negative impact on our mental health. Here is some data that looked at self-reported levels of distress, anxiety, and depression across the USA in 2020:

    As you can see, anxiety, depression and distress all spiked in March and April but remained relatively consistent from June 2020 to January 2021. 

    By September 2020, the average mental health of all people in the UK was still 2.2% worse than was predicted if there had been no pandemic. However, it wasn’t anything like the initial rate of people’s mental health being 7.9% worse at the start of the pandemic. 

    The pandemic has not impacted everyone’s mental health in the same way. If we look at the data of people surveyed in the UK in both April and September 2020, more than one in five people had their mental health significantly impacted at both time points. However, both women and younger people were affected more by COVID-19 than older men:

    There is also some evidence that suggests that ethnic minorities and those with pre-existing mental health conditions were impacted more severely by the pandemic. Unfortunately, these impacts only further exaggerate many of the already existing mental health inequalities. 

    Lockdowns didn’t seem to worsen people’s mental health as severely as people imagined. Similar to what Daniel Gilbert said in his surprising book, ‘Stumbling on Happiness’, we can adjust more to whatever happens to us the longer it goes on. If something positive happens to us, we imagine that we will feel way better for way longer. But eventually, we get used to it, and our happiness levels return close to what they initially were. On the other hand, if something terrible happens to us, we imagine it will impact our mental health way worse and for way longer than it typically does. By June 2020, many people had already found their new equilibrium. 

    By comparing internet searches before and during lockdowns, Google searches increased the most substantially for boredom. Statistically significant increases also occurred for loneliness, worry and sadness. Other studies had also found increased searches for psychological stress, fear and death before lockdowns started. These searches then stabilised at the start of the lockdowns before reducing as the lockdowns continued. 

    Another finding that may surprise many people is that searches fell for divorce and suicide once countries imposed lockdowns.

    I’m not sure if this is true, but I have heard that suicide rates also decrease during wars. So even though many people feared that lockdowns would increase suicidal ideation, I think that sometimes wars and pandemics give us a reason to feel sad. stressed or worried. Understanding why people feel the way they do and why they have to do what they are doing gives them insight and meaning and hope that things will get better in the future. Which can reduce the risk that someone will want to die by suicide instead of increasing it. 

    Possible future mental health consequences of the COVID-19 pandemic

    Although most countries are now out of their most severe lockdowns and many people are returning to a new sense of normalcy, we are not entirely in the clear yet. 

    The following graph by Banks, Fancourt and Xu in Chapter Five of the 2021 World Happiness Report indicates that we are now in phases three and four:

    The COVID-19 pandemic has brought on more awareness of the need for mental health treatment worldwide.

    However, there is still insufficient mental health support in many places. One of the latest figures I saw from the World Health Organisation suggested that somewhere between 75 and 95% of people in need of mental health services in low- and middle-income countries cannot access adequate mental health support. 

    Even where I was working in Melbourne, Australia, in 2020, there was a shortage of psychologists who could take on new clients because the demand for mental health services was so high. 

    Therefore, countries need to find new ways to increase access to evidence-based mental health treatments and support. It is especially true for disadvantaged or discriminated against groups, as they are likely most impacted by the COVID-19 pandemic. 

    Many of the long-term consequences of the COVID-19 pandemic are still not fully known. People have died, jobs have gone, businesses have closed, products have become harder to find or more expensive. Inflation and interest rates may have to increase to keep up with the printing of money and the countries’ spending during the pandemic so far. 

    There are lots of uncertain things about the future. Each of these things may come with potentially negative mental health impacts too. I am probably less cynical and more hopeful than the graph above shows about how people respond over time, but no one can fully predict what lies ahead. 

    Dr Damon Ashworth

    Clinical Psychologist

  • How to Improve Your Motivation

    How to Improve Your Motivation

    People often ask me how they can improve their motivation. Generally, I tell them that there are two big motivators in life. One is your values, or what is most important to you in your life. The other is fear, or trying to prevent the worst from happening.

    Research by Tversky and Kahneman found that losses loom much larger than gains. This means that fear is usually better for motivation than values because we are more willing to try to avoid something terrible than we are to create something good. This bias is one of the main reasons your direct ancestors survived long enough to reproduce. So without their loss aversion, you may not be here today.

    The problem with only using fear for motivation is that it triggers our fight-or-flight response. In addition, it increases our cortisol levels if we activate this response too often, which isn’t so great for our mental and physical health in the long run.

    Being motivated by our values, on the other hand, is very rewarding. We aren’t just in survival mode. We are creating the life we want, and it feels enriching.

    Intrinsic vs extrinsic values

    Values are not the same thing as goals. Instead, they are guiding principles for life. They help you identify whether you are on the right track in your life or not. If you are unsure which values are most important to you, this clarification exercise can help.

    The biggest problem with values is that it can be hard to know why your most important values are essential to you. Is it because society says they are? Or movies and TV shows? Or marketing companies? Or is it because your family or religion says so? Or just because it feels essential deep down?

    Research has found that we are much more likely to experience motivation when motivated by our intrinsic rather than our extrinsic values. Extrinsic means something outside of us. Intrinsic implies something within us.

    I remember back when I was doing my doctoral studies. I was not on a scholarship for the first six months and was studying for free. Then I was placed on an academic scholarship and was paid to learn. Being paid to study (an extrinsic factor) diminished my intrinsic motivation to study and made it harder overall. Before receiving the scholarship, I thought it would have been the opposite and that getting paid to learn would have helped me remain focused and finish my research even quicker. It did not.

    Professional sports players who start getting paid to play can feel the same way. Growing up, you couldn’t keep them off the court or field. They just loved the game. But now, it’s a job. Some NBA or NFL players refuse to play unless they get more money or are playing for a contending team. Their intrinsic motivation has become overshadowed by their million-dollar salaries.

    Volunteering in Vanuatu was the opposite. Because I was no longer getting paid to offer mental health support across the country, I could fall in love with psychology and therapy all over again. I was helping people to improve their mental health and the overall quality of their lives. I felt connected with my essential values and experienced lots of motivation.

    Three Intrinsic Ways To Build Motivation

    In his excellent book ‘Drive: The Surprising Truth About What Motivates Us’, the author Daniel H. Pink says that there are three ways to increase your intrinsic motivation:

    1. Autonomy

    • What do you want to do?
    • Why do you want to do it?
    • Is it for others or for you?
    • If it is for others, do you feel forced to do it, or is it because it is important to you?
    • If it’s important to you, what personal value is being highlighted as very important for you:
      • Dutifulness?
      • Obedience or Loyalty?
      • Altruism?
      • Empathy?
      • Sympathy?
      • Being supportive?
      • Being kind or compassionate?
      • Not being indebted to others?
      • Equality or fairness?
      • Something else?

    2. Mastery

    • What skills do you want to build?
    • What do you enjoy learning?
    • What areas interest you?
    • What comes easily to you that doesn’t come easily to others?

    3. Purpose

    • What are you passionate about?
    • What is personally meaningful to you?
    • If you didn’t have to earn money, what would you do?
    • What would you want your epitaph or tombstone to say?
    • What would you want to hear someone say at your 80th birthday during a talk about you and the person you have been?
    • What do you want your legacy to be?
    • What do you want to add to the world?
    • How would you like to be remembered?
    • If the world was going to end in 2 years, and you couldn’t do anything about it or tell anyone else about it, would you do anything different to what you are doing now?
    • If your kids didn’t listen to what you said and only looked at what you did, would you change your daily actions or what you do? If so, what would you do differently?

    Is FEAR Holding You Back?

    Let’s say you know what you want to change but still struggle to do it. Perhaps FEAR is holding you back from making the changes you want to. FEAR is an acronym Russ Harris created in his books The Happiness Trap’ and ‘The Confidence Gap’.

    FEAR stands for:

    F = fusion with unhelpful thoughts

    If you are fusing with unhelpful thoughts, you need to practice defusion skills to let go of unhelpful thoughts and increase your motivation. Defusion techniques involve recognising thoughts, images, and memories for what they are. They are just words and pictures. You then allow them to come and go as they please, without fighting them, running from them or giving them more attention than they deserve. Google search Acceptance and Commitment Therapy (ACT) defusion exercises and try some until you find one that allows you to let go of unhelpful thoughts. My favourite activity is on the app ‘CBT-I coach’ in the ‘quiet your mind’ section called ‘observe thoughts – clouds in the sky’.

    E = expectations that are unrealistic

    If you have unrealistic expectations, review your goals and write the new ones down to improve your motivation. Break these goals down into smaller steps, give yourself more time to achieve them and allow yourself to make mistakes. For example, you are hoping to obtain seven hours of sleep per night, and you only sleep five hours currently. Start with improving your total sleep time by an average of 10 minutes over the next week. Once you achieve this, you can then aim for another 10 minutes. Within 12 weeks, you could get to where you want to be, so try to take the long-term approach instead of looking for a super quick fix. It is okay if you do not reach your sleep goal in one night. Just stick to your plan, and do not give up until at least two weeks have passed. Everyone has a terrible sleep from time to time, so it is important to keep realistic short and long-term goals to ensure your motivation remains high.

    A = avoidance of discomfort

    If you avoid discomfort, challenge yourself to improve your motivation by taking action. Remember that gradual exposure is the most effective intervention for any anxiety disorder, including post-traumatic stress disorder. With anxiety, we want to avoid it, but this only keeps the fear alive as our brain tells us that what we are avoiding is dangerous. So instead, we must challenge ourselves to do what we want and make room for our emotions in these moments. By doing this, we will generally realise that doing what we feared was not nearly as bad or uncomfortable as we imagined. Try expansion ACT exercises or a body scan meditation to increase your ability to sit with painful or difficult emotions. The CBT-I coach app has a body scan meditation under the ‘quiet your mind’ section that I recommend checking out.

    R = remoteness from values

    If you are not living consistently with your most important values, reconnect with them to increase your motivation. Then see if your plan or desired outcome will help you live more consistently with your most important values. If your plan will, put the list of your top values in a visible place to remind yourself why you are currently doing what you are doing. If your plan will not, change it to be more consistent with what is most important to you.

    Remember, change is generally always hard but worth it if it will help us live the life we want to be living in the end. Remembering why you are doing something is also the key to improving your motivation to push through when things get tough.

    Good luck with improving your motivation, and do let me know if these strategies help!

    Dr Damon Ashworth

    Clinical Psychologist

  • What Values Do You Try to Live Your Life By?

    What Values Do You Try to Live Your Life By?

    Values are guiding principles for our lives that are endless pursuits. We cannot achieve a value in the same way we can accomplish a goal. However, at any point in time, you can connect with them, act in accordance to them, and receive the vitality, energy, improved self-worth, greater emotional well-being and happiness that are often the result of living consistently with our values.

    To figure out your most important values, first write if each value in the list below is very important to you (V), quite important to you (Q), or not important to you (N).

    It is essential that we choose the values that feel right to us, rather than pick the values that we think our parents or society might want us to follow.

    Then, for only your very important values, score from (0-10) how much you have been living according to this value over the past month, with:

    0 = not following this value over the past month,

    1 – 3 = following this value occasionally,

    4 – 6 = following this value sometimes,

    7 – 9 = following this value often, and

    10 = always living by this value.

    VALUES LIST

    1. Connecting with Nature: Importance of value to you (V, Q, N?) = ________, Consistency with value if it is very important to you (0-10?) = _________
    2. Gaining wisdom: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    3. Creating beauty (in any domain, including arts, dancing, gardening): Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    4. Promoting justice and caring for the weak: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    5. Being loyal to friends, family and/or my group: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    6. Being Honest: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    7. Helping others: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    8. Being sexually desirable: Importance (V, Q, N?) = _____, Consistency (0-10?) = ________
    9. Having genuine and close friends: Importance (V, Q, N?) = ____, Consistency (0-10?) = _____
    10. Having relationships involving love and affection: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    11. Being ambitious and hard working: Importance (V, Q, N?) = ____, Consistency (0-10?) = ____
    12. Being competent and effective: Importance (V, Q, N?) = _____, Consistency (0-10?) = ______
    13. Having a sense of accomplishment and making a lasting contribution: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    14. Having an exciting life: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    15. Having a life filled with adventure: Importance (V, Q, N?) = ____, Consistency (0-10?) = ______
    16. Having a life filled with novelty and change: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    17. Being physically fit: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    18. Eating healthy food: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    19. Engaging in sporting activities: Importance (V, Q, N?) = ____, Consistency (0-10?) = ______
    20. Acting consistently with my religious faith and beliefs: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    21. Being at one with God: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    22. Showing respect for tradition: Importance (V, Q, N?) = ____, Consistency (0-10?) = _____
    23. Being self-disciplined and resisting temptation: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    24. Showing respect to parents and elders: Importance (V, Q, N?) = ____, Consistency (0-10?) =____
    25. Meeting my obligations: Importance (V, Q, N?) = ______, Consistency (0-10?) = _________
    26. Maintaining the safety and security of my loved ones: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    27. Making sure to repay favours and not be indebted to people: Importance (V, Q, N?) = ______, Consistency (0-10?) = _________
    28. Being safe from danger: Importance (V, Q, N?) = ______, Consistency (0-10?) = _______
    29. Being wealthy: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    30. Having authority, being in charge: Importance (V, Q, N?) = ____, Consistency (0-10?) = ____
    31. Having influence over other people: Importance (V, Q, N?) = ____, Consistency (0-10?) = ____
    32. Having an enjoyable, leisurely life: Importance (V, Q, N?) = ____, Consistency (0-10?) = ____
    33. Enjoying food and drink: Importance (V, Q, N?) = ______, Consistency (0-10?) = _________
    34. Being sexually active: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    35. Being creative: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    36. Being self-sufficient: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    37. Being curious, discovering new things: Importance (V, Q, N?) = ______, Consistency (0-10?) = ______
    38. Figuring things out, solving problems: Importance (V, Q, N?) = ______, Consistency (0-10?) =______
    39. Striving to be a better person: Importance (V, Q, N?) = _____, Consistency (0-10?) = ______
    40. Experiencing positive mood states: Importance (V, Q, N?) = ____, Consistency (0-10?) = ______
    41. Feeling good about myself: Importance (V, Q, N?) = _______, Consistency (0-10?) = ______
    42. Leading a stress-free life: Importance (V, Q, N?) = _______, Consistency (0-10?) = _______
    43. Enjoying music, art or drama: Importance (V, Q, N?) = _____, Consistency (0-10?) = ______
    44. Designing things: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    45. Teaching others: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    46. Resolving disputes: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    47. Building and repairing things: Importance (V, Q, N?) = _____, Consistency (0-10?) = ______
    48. Working with my hands: Importance (V, Q, N?) = ________, Consistency (0-10?) = ______
    49. Organising things: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    50. Engaging in clearly defined work: Importance (V, Q, N?) = _____, Consistency (0-10?) =_____
    51. Researching things: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    52. Competing with others: Importance (V, Q, N?) = ________, Consistency (0-10?) = _______
    53. Being admired by many people: Importance (V, Q, N?) = _____, Consistency (0-10?) = _____
    54. Acting with courage: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    55. Caring for others: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    56. Accepting others as they are: Importance (V, Q, N?) = ____, Consistency (0-10?) = _______
    57. Working on practical tasks: Importance (V, Q, N?) = _____, Consistency (0-10?) = ________
    58. Seeking pleasure: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    59. Avoiding distress: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________
    60. Avoiding self-doubt: Importance (V, Q, N?) = ________, Consistency (0-10?) = _________

    It will be difficult/impossible to always live by all of our very important values, because some values will come into conflict with each other. However, if you are have scored it a 5 or below in your consistency rating, then try to set a goal for the next month of how you can live more consistently with this value.

    Dr Damon Ashworth

    Clinical Psychologist

    PLEASE NOTE: These value descriptions were taken from a values cards exercise that I did during my doctoral degree. I am not sure who developed it, but will happily give credit to them if anyone can let me know who did.