The locked-down mind — how the COVID crisis is affecting our mental health and that of our children

The locked-down mind — how the COVID crisis is affecting our mental health and that of our children

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Well. Hello, welcome, to another cambridge, conversation. This one entitled the, locked-down. Mind. One. In four of the world's population, we think at the moment are confined. To just four walls or in some cases just one room, never, in the history of humankind, as far as we know it has our civil liberty been eroded, in this way owing. To a pandemic, but. What is the implication, of this what are the consequences, to. Our mental, health not just our physical health of coronavirus. Infection, well. With me to discuss this is Edie balm or he's head of department, at the University, of Cambridge Department of Psychiatry earlier. This year in The Lancet psychiatry. A journal he called for urgent research into, what, the implications, for mental health will be in terms, of the short term and long, term effects, of kovat and also, with a Sarah Jane Blake Moore who's an expert in Adolescent, Mental Health of course adolescent. Times are a turbulent, period in your life whether. There's a pandemic or not so, what are the added effects of handling, a pandemic and dealing. With the consequences, on your family. Being locked down have, on the developing, brain as well so, we'll, talk for about 20 minutes and then, we're going to be asking you at, home to put your questions to Ed and to, Sarah Jane. Sarah. Jane first of all might. As well find out how you've been coping with the lockdown has it been business as usual I suspect your department's, been shut, like most of the University of Cambridge. My. Department, sucked in. March towards, around, the 20th of March and I've. Been working at home since I mean everything. Had to go online my research my teaching, and also. My teenagers. Obviously. Can't be at school at the moment so they're also at home. Hmm. A lot of people are saying they're trying to work at home but the bandwidth, they can't get on the internet because, there's. A lot of downloading, a Netflix going on it, well when when my children. Do, a lot of online, lessons. With their school and. Yeah. The. Wi-Fi can be troubling, sometimes. What's. Your experience said. Well you know so, hello everybody first of all but I mean I actually, quite enjoyed lockdown, in some ways. And. I think that is because. You. Know I'm lucky, enough to have a family and have. Some, garden. And. I, could do a lot of my work from home. And. In some ways it's more efficient. So. Many people is saying actually I'll know that you, know echoing what you'll say many people are saying that they don't miss the commute I certainly. Don't miss the commute but. I think what it does make me reflect is that the you know the impact of lockdown is not going to be the same for everybody and. You. Know there are many people living in much more difficult circumstances. Where. I think the you, know the impact of social. Restriction, on their mental health is going to be in. The opposite direction to. The effect, its had on me and I, think that's something that we do need to be very thoughtful about as we sort of continue this discussion about. The. Impact of college. It's not really the same for everybody. Of. Course there are impacts in. Terms of physical, health and very, much that's been the focus of much of the reporting, much of the media attention has gone on what, is happening is people acutely, affected. And infected. With coronavirus, there. Are then, the mental health repercussions of, being, locked down loss. Of what the. Impact. On your family life but then they may also well be mental. Health and. Neurological. Consequences are, being infected with coronavirus. I would think as well on there as anyone talking about that and I haven't heard anything mentioned. About that, you. Know there's quite a lot of talk. About. Particularly. Neurological. Complications of, comedy I think you, know as we go through this conversation what we have to remember is that you know we didn't know any college. Six, months ago nobody did this is a very new thing that's sprung, upon us, and when the. Pandemic. First hit rightly, everybody's, attention was focused on the acute medical complications. And. People, were surprised, to see that they were quite. Common. Neurological. Complications. The. First report came out from Lu Han. About a third of. Colic. Patients, had, some kind of neurological complications particularly, the more severely, ill people and that. What's, not, a complication, Ted what were they saying they wrong with them okay. So it's a mix of things and. If you look at the sort of largest data, sets that we have available which is still quite small it seems like about a half of the, neurological, complications are. Strokes, of one sort or another which. Remind. Us that one of the things this virus, does is, it changes the blood coagulation. System. It makes blood more likely to clot and you.

See Evidence of that traveler body including the brain so strokes are quite common, but. There are other complications. Have been reported, to, psychosis. Has. Cropped. Up in. A surprising. Number of cases, and. Cattle itis which is inflammation of the brain has. Been reported. And. There are a number of other disorders. Some of them suggesting. That, the problem is not so much the virus, as the body's, immune response to the virus so we're seeing sort of neurological. Presentations. That would normally be regarded, as autoimmune, disorders, coming. Out of it as well and that's just the acute. Side. Of this. And. In the long term of course we're going to be finding out about this because we're effectively doing a massive natural experiment, here aren't we involving, the entire world's population. Mm-hmm. Well, you know to be honest I think natural, experiment, it's sort of out there with herd immunity as, a sort of you, know a. Difficult. Soundbite, in in how we talk about this you. Know when hesitate use the phrase, in. Relation, to something that is causing so much distress to so many people, but. You're right if you do step back at it and you look at it from a sort of a cold-blooded. Scientific. Point of view in, some ways this is a remarkable, experiment we. Have a large. Chunk of the population exposed. To a virus and we also have the. Entire population, exposed to the unprecedented social. Restriction, measures in place, and. That does, give us scientifically, an opportunity, to find out a lot more both. About the virus itself and and. -. This kind of social isolation. Before. All this started Sarah Jane you are actually doing, quite a lot of studies already on. The. Youth of today how, their development. Might be impacted, by social, media and it's. Interesting that social, media had attracted quite a lot of negative. Press around. Development, and depression, and and. Actually might turn into a bit of a panacea, in this, situation. Yeah. So, just to go back to. The. Concept. Of a natural experiment to me the. Phrase natural, experiment, just highlights, the massive. Uncertainties. That we that exist around this, situation. We. Just don't know we have never been, in this situation before in terms of things like lockdown and the, consequences, our lockdown on child. Development and mental health and that's where I think this is an actual experiment, it's not a scientifically. Designed experiment, but we have no idea what the consequences, will be and we will find out in time but. Yeah so my research. For. Many years has focused on the, development of the brain and particularly the development of the social brain and social, behavior during. Adolescence, in. Humans, we know that adolescence, is a pit of sensitive, period, of social. Brain development and. Adolescents. Become particularly interested, in their social world their, social world is generally, quite complex. And. They have to figure out where they are where, they are in the social hierarchies, they become really interested in what their friends think about them and this is all because they're adolescents, the. Period, of adolescence is, about developing, a sense of self-identity, and, particularly a sense of social. Self that is how other people see you so, your peers, you. Interact with your peers really matters, during, adolescence we, know so having sure that and so sorry to interrupt sir is it Sarah Jane so having school shut then is. Actually, a major impact for these people because the normal socialization. That would go on the normal interactions, that would help that developmental. Process, and not there the support networks are also not there in the same way, for. Two months, like. Everyone, weren't allowed, any face-to-face. Interactions, with their peers there they are now but you know in these socially, distant, small groups which is not how adolescents, or. Children, naturally interact, with each other they don't go for socially distant walks the, main way they do their social interaction, is at school that's where they organize to see each other after school at the weekend so yeah the shutdown, of schools is we, assume, and we predict as having a huge impact on. Their social, development, if. You look, at evidence. We have from animals, there, are animals that are very social, as well. Okay. It's arguable whether or not animals go through the same adolescence, in quite the same way humans do but if. You do the, equivalent of what the lockdown has done to some of our teenagers, to, experimental. Animals how does their mental. Health and mental. Development get. Impacted, yeah. Animals do actually go through adolescence all, species, of animal go through a sort of period.

Between Going through puberty, and becoming. Fully sexually, mature adults so for example mice, and rats which are which. Are the. Animal. Animals. In many labs that do research in this area go, through about 35. Days of adolescence, and what's interesting is that in that in that short period of time you, can measure things like increases, in risk-taking. Increases. In the exploration, of their environment, and changes, in social behavior so, animal. Adolescent. Typical behavior, that we see in humans can also be seen in adolescent. Animals and. If. We do the equivalent, of a lock down on them what, happens to them yeah yeah. So there's a lot of research on that from the last over, the last 30 or 40 years where. Animals. Particularly, mice and rats are deprived. Of social interaction. During. Adolescence and, what that research has shown many many times is that, social. Isolation has. Unique, effect, on brain development and, behavioral. Development and, mental health during. Adolescence and, in many ways it, is more damaging, so social isolation in, adolescence. Is more damaging, than the same social isolation either, before adolescence, or in adulthood. If. I could just remind everyone don't forget to send your questions, for us because in about 10 or 15 minutes time then, Sarah Jane and Edie will be able to answer the questions that you're sending in so, do submit those now tell us tell us a bit about yourself, in your context, as to why you would like to know that too that, will help the discussion, so, ed that from what Sarah Jane is saying there's quite a high likelihood that, these. Individuals, that we're seeing potentially, impacts. On today could become cases. For, studies in the future that you're, going to be looking at effectively they're going to turn into patients for you in the future if we're not gonna, if we don't do something about this. Yes. I think, risk, I, mean. I think it's just worth picking up on something else that sort of Sarah. Jane implied which is that at. The moment we. Suspect. That social. Restriction, is having a major impact on mental health but we. Don't know as much about, that as we we'd like to in it if I can just reflect from the point of view of the local, NHS. In, Cambridge, and surrounding, areas. You. Know when we when locked down here and subsequently. We. Have not seen at the surge of cases coming through for mental health treatment in, fact the number of people wanting, access, to mental health services has dropped off a cliff as. It did for, physical, health other. Than college at the time it was people basically staying away from hospitals and doctors of. Do. You think. I. Was just gonna say it do. You think then that we're brewing up at what we're dubbing a clinical, iceberg, here where you're. Seeing the tip of the iceberg, those are the ones that are coming, to your attention but under the waterline there is this enormous burden, of, ill. Health whether that's mental ill health or physical health as being brewed up because, we're diverting a lot, of energy effort, and resources, into, looking after people who have, coronavirus. All might have coronavirus. Yeah. I think that's exactly what's going on and I mean you, know again in Cambridge that and it, just rightly, pivoted. Towards. Kabat and. You. Know the whole of Edinburgh Hospital was pretty much. Repurposed. As a copy hospital. Many operations, are canceled and so on and so forth and we see the same in mental health but. It will emerge, as, I think, lockdown. Lifts a little bit one of the things that I would expect to see is. A sort of a late surge, in, mental. Health. Referrals. Coming through sort of a second not exactly, a second wave in terms of the virus but a second. Surge. Of, medical. Complications this, time perhaps. Not so life threatening the. Very. Early states. And. Sarah Jane what's worrying you the most then when if you had to make a list of things that you think of a the, biggest risks, looking, downstream, of where, we are now not so much short term but longer term thinking.

To The future what's. Got you, the most worried. Well. Because, I work with. Particularly. The need for social, interaction, and social learning during adolescence it does worry me that adolescents, are still not having. Allowed, to have normal social interactions, with their peers but. Actually, just to come back on something that ed says I think what's really important is that there are individual, differences of course it's not that all, adolescents are going to be. Suffering. From this I mean, I remember, watching. A video from. Bernardo, is right in early. On in the lockdown here in the UK. Interviewing. Young, people, and children who were the victims of bullies at, school and. For. Them not. Having to go to school every day not having to be put into this very stressful environment every day was, a positive thing so for some children and young people not, having to go to school you know school is a stressful place both socially and academically, and not having to go there every day might, be a positive thing but I think now and, again, going. Back to what ed was saying about. Referrals. Declining. Early on in lockdown I wonder. Whether now. That it's been 3 months where young people haven't been able to see their friends and have been really quite isolated, whether, now, is when you'll start to see the increase in anxiety. And possibly. Depression, and young people as, a cause of the lockdown again it's completely speculative. But that's what pretty worries me, if. I'm a thread in a question we sarah-jane, from from let's just very briefly and then we'll come back to you in a second ed because Liz says surely. The widespread use of social media by children. Must, mitigate, some of the adverse effects of the constraints, on social. Contact, that's, coming about through not being able to go to school so this, is sort of what I hinted that just now yeah where did previously we thought social media is a bit of a demon, but in fact it may actually be coming to our rescue have, you actually got any evidence on this or are you taking advantage of the situation to, get some evidence around, this, absolutely. And thank you les for reminding, me that I didn't answer that question. Yes. I mean social. Media, is a, very. Normal. Way. That young people, interact. Socially, now at the moment and has been for the last few years which, can only be a positive thing, really given, that that's the only way a lot of young people are able to interact, with each other right now. So we, together, with my colleagues Aimee Auburn and Olivia - mobile we just wrote a paper on this and The Lancet Child, and Adolescent, Health where. We talked about the potentially, mitigating, effects, of social media. Particularly. What. We call active social, media that is where you're communicating, actively. With your friends, like messaging, them or video. Calling them as opposed. To passive, social. Media just like scrolling, through other people's news feeds which, the. Only, evidence, about. How social media affects, mental health and adolescents yet but, the small. Amount of evidence there is suggests, that they're kind of passive, scrolling, can. Be can have negative effects whereas, the active engagement in social interaction can, be quite positive so yes I think that's right there is there is potentially, a mitigating, effect there and. If. I may bring up one topic for you from, Edie. Who, says there, seems to be a fair amount of anecdotal, data, anok, data as he, dubs it about, disrupted. Sleep driven. By anxiety changed. Routines and other factors, of course, all of those things are going to compound mental health problems aren't there but he goes on to say do we understand, perhaps from historical, parallels, war time what. The lightly effects of these sleep disturbances, could be on the population. Well, I agree it's, a certainly. An interesting question and there has been a lot of talk. About it I don't again it's an area where I don't think we have, as. Much data as we'd like. And, I'm, not sure that it's clear what, the mechanisms, of these come, and sleep disturbances, you also hear people talking about very vivid or unusual, dreams as, a sort of knob down earrings.

And. I think for most people that is going to be. Some. Kind of essentially. Psychological. Reaction, possibly, compounded, by the Sun the. Disturbance, that everybody's, had to their usual routines, I. Think, it's also just, worth bearing in mind that. It. Is possible that the the virus may have. Longer-term effects, on brain. Organization, I think one thing that is emerging anecdotally. Again but I think it's a very interesting lead, tickly. In the u.s. people are talking about these long-haul, as so-called. So. These are people that have had copied they. May have been in hospital and they've been well enough to be discharged, but their recovery is very slow. They're. Getting a lot of fatigue I think, a lot of sleep disturbance, probably, all a mood disorder, and, I, think that's one possible. Factor. For some of the sleep disturbances, that we're seeing but these people that the. Whole. Complications. Psychological, complications, after infection I think that is something, that we are going to watch out will very care of me. These. Symptoms very. Much parallel. Chronic. Fatigue syndrome what, we used to dub or sometimes still call em II don't, they. Yep. They do and of. Course any stands, for. Myalgic. Encephalomyelitis, so, it was originally thought to be a. Brain, infection. And. Then, sort, of opinion shifted and. It. Became converted, to the concept, of chronic fatigue syndrome. Which, of course doesn't imply any particular infectious, cause but it's always been known that chronic, fatigue is. More. Common following, viral infection. There's, been, a controversial, area but. I think that going back to the earlier conversation about natural, experiment, I think, you know the. Longer-term, consequences have, copied. Give. Us a great opportunity to understand exactly what's going on and what, is it that drives chronic, fatigue after, viral, infection, we should be able to answer that question we've. Been able to. Sarah. Jane there's a point. Here from Vanessa who says how compare and support children with their social development during, lockdown do you have any advice or tips us very good point isn't it weaved weld very much on the negatives what can we do about this problem. Yeah. I mean, from. A. Really. Point. Of view from talking to many many parents. About. Their own their. Own children, I think. Okay. So now that young children and young people and all of us can meet are allowed, to meet outside. Socially. Distanced. You, know we can we can be encouraging, our our children to do that it's, tricky though because, it's not the way they normally will. Arrange to have their social interactions, they, don't not, natural for them to go on socially, distanced, walks. With a couple of other people it's much more common for you, know teenagers, to hang out in big groups in cafes, for example, which isn't gonna be possible for a long time I imagine but. Yeah I mean I just from my own point view I'm trying to encourage mine too to. Meet up with their friends. Outdoors and. Like. My younger, son, who's 12 he, goes by king with couple of friends now in the, forests around here but. I'm prior, to that and I guess this could be the case if further. Lockdowns, happen, where it becomes stricter, again I was. Actually kind, of oh yeah. I was encouraging, my my children and, many of my friends were to, get online and, -, as opposed to you know years of telling them not to use their screen so much I was encouraging. And. Interact. With their friends online. So. You found yourself going from a bad, parent to good, parent as it were then well. I was. Who really is the kind of world expert, in social, media mental, health and adolescents. Was. You know slightly laughing, that for years people have been so down. Lessons. And now all, of a sudden they, were encouraging, their their children to take, up but. Yeah I mean it is it. Is tricky I think another thing is talking. To, children. And yeah. And teenagers, about how. They're coping and what and what they miss, and what they want to do is is probably a good thing as well. Edie. Really interesting, point raised by Simon, which I wish I thought of this actually, he says in contrast, to the tip of the iceberg comments, about lack of patience, that came. With his NHS, do. Ed and Sarah, Jane think that the simpler, life and karma, lifestyle, of lock down could, have helped, a cohort, of people who were previously suffering, with worries. Issues. Mental, health complaints do you think that - we started, this thing by saying neither of us missed the commute, didn't miss something in that.

Well. You know I think it's an optimistic way of looking at things you. Know there is. Literature. To. Suggest that actually when. Populations, are confronted. By a common enemy that can, be good for mental health, the. Sense of being all in it together. But, I come back to one of the things I said at the outset which I don't think this is hitting, us all the. Same way, you. Know I'm you. Know and, I'm quite. A comfortable, position now I think there are plenty of people you know scenario. That I think we all seen servicing, for example is women typically. Who are, victims. Of domestic violence, you may be locked down in a very hostile, home. Environment, with nowhere to escape to I mean, that's obviously, going to be a very different experience to. Lockdown. Compared, to my own so. I think we, have to be careful about you, know those sort of generalizations. I think it's nice to hold on to the idea and, maybe. We'll wells there may well be some truth in it but, while. We are united. In. Response. To the virus there is some mental, health benefit, but, I then, predict that as lockdown, eases, and particularly as the, make consequences. Become a bit more obvious, and. We are no longer so, united perhaps in the way that, this. Experience, is affecting us all then. Whatever, benefit there may have been from that experience, of being. United against a common foe may evaporate, and what we may be left with is a rather polarized. Society. Where people who have lost employment, or in. Other ways in, other ways soccer particularly, during the, acute. Phase the pandemic may find themselves in a very, different situation in terms of the mental health. Did. You want to come in on that Sarah, Jane because of course one, of the other aspects, of this is that the children themselves are, going to be victims, of what happens to their parents, and if life. Deteriorates. Because your parents lose their jobs or their livelihoods and, money becomes tight that's going to have presumably. A big impact as well I think. One, of the biggest issues is the inequalities, I mean inequalities, in this country were already quite large before, covered, but the, inequalities, now have just been, massively. Increased. Particularly. For children and young people, so for example in terms of education there are some children, who are getting really good online, lessons. From their school and who, are learning, almost, as much as they would do if they were at school but, on the other end of the spectrum there are many many children, who are getting no learning. At all so they're effectively, missing what will be if they go back in September, six months of school, and, and. That's for the right a variety of reasons, sometimes it's because the school doesn't have the resources to, do, good. Online teaching, often. It's because the children live in homes where there's no space there's no Wi-Fi there's, no laptop, there's not a family environment. That's conducive to. Online learning but. These inequalities are, really, troubling particularly, because they will affect the already, disadvantaged. Children. And adolescents. The most and so, there's a lot of discussion, in education. Policy about how to handle that for example. In. Terms of GCSEs. And a-levels next. Year so this year they were counseled, and children. And, people are being given. Remarks. By the teachers. Next, year the question is what to do because while, some year ten for example children. That's the a year before GCSEs. Will, have. Got. A decent, amount of learning over this lockdown. There are many yo ten students who will effectively. Miss about. 1/4 or 1/5 of the content, of their GCSEs, so how do you handle that should you cancel, exams, and and.

Move To the assessment. Based. Grading like like has, happened this year or, do you reduce the content, of exams or push back the exams back it's. All up in the air it's a really really big problem and the, children, who are of, course the most disadvantaged. I mean, for them you. Know shutting down school it's not just about a, deprivation. Of learning. And academic attainment. But. Also the lack of social interaction, and structure, and extracurricular, activities sport and, for. Some children home is not a safe place it's not it's not safe. For them to be at home and they. Are not there. Nutritionally. Neglected they're not getting enough to eat and then, worse in some cases like in cases of abuse so this, is a massive, crisis. Really that were in in terms of the. Social care of young people and children. Interesting. Point raised by Natalie, who says my daughter's four and she's, just beginning to have conscious, memories, she. Won't remember a, normal. Time. Before. Coded so. How can we support very young children so they don't suffer, long-term. Issues, I think that's an important, point isn't it because a child, could grow up thinking this is normal, and therefore, there could be lifelong legacy, effects of the. Way we're having to behave at the moment because what they crystallise. In their mind as the, normal way to behave actually. Isn't, yeah. Children. Development. Psychology work, with the young children so my mind what my work to focus on teenagers, but um developmental. Psychologists, who work with young children. Knowing. Young children is that they are highly adaptive. So, they can adapt to new circumstances one. Of my friends. Who's a teacher a primary. School teacher was saying that what's. Amazing is how quickly they've adapted to the sort of whole concept, of social distancing, in this small children in schools, I mean it's at it sounds horrendous in some ways this idea that young children have to socially distance but they've and. Also. Adapted to the some, teachers wearing a face masks, and that thing that kind of thing it's it's, what. The teachers say it's amazing how, adaptable. Young children are and in terms of. The. Long term effect I think, well we don't know going back to the whole idea of a natural experiment we don't know but, perhaps it will depend on the duration. Of this, of. This situation we're in so if it's if. It's two or three months with no school and, a. Much, reduced play. Place important. For young children then. Maybe that will have less. Serious, long-term consequences. Perhaps none on young children's, development then, if this goes on for many months or even years. Edom. Catherine says I'd, like to ask what's, been the impact of the media and the, very motive, language, and images. That have been flooding our screens has. That had a rolling exacerbating. Mental health issues so, apart. From just the effects, of possibly coronavirus. Infection, is there. Coronavirus. Impact, secondarily, through being terrified, and, scared out of your wits because, of what might happen. Well. I mean I think it's very plausible idea. You. Know there's certainly a lot of you. Know there's a torrent, of media. About College of course I mean I personally I'm. By. Myself rationing. My exposure to it, and. I'm just looking at mainstream websites I think if you start going into sort. Of the, wild deserves. The internet and picking up on some of the conspiracy theories. Where. This virus has come from and how it, might be having its effects you, can be exposed to some deeply. Alarming, and. Completely. Fake news, about, what's going on. She's only gonna make the. Anxiety, levels worse if. People are already anxious and that's why they're searching, for sort. Of esoteric. Information about, Liz so, I think that is a real, risk. But. I just wanted also to come back to this thing, that we've been talking about this would the inequalities, of the impact, and. I, think one other, group that's worth mentioning is, the people that had pretty. Serious mental health disorders, before Colleen, hit and. Their agreement was either you know we are quite worried about in terms of. Future. Mental health we know that people. Who had serious mental illness have, you. Know shortened, dramatically, shortened life expectancy compared. To. Others. Even before call it and that mortality. Gap as we call it is actually white so, it seems from, the data we've been getting. Ahold of in Cambridgeshire, but actually, having a serious mental illness it.

Puts You at higher risk of having, a very bad outcome, from the infection, and then even if you're not infected you know you still got a form of how do you access services, we, talked about digital, in in the lives of young children which. Is, actually. A live, statement but you, know mental. Health services in fact the NHS as a whole is. Not very, sophisticated digitally. You know we're gonna have to sort of see a dramatic, acceleration. Of, how. The. NHS has adopted new. Technologies, if we're gonna find safe ways to reach. Out to patients and talk to them and interact. With them bearing. In mind of course that particularly. The sort of people, are. Anyway. Sort, of more isolated, or struggling. With a long-term condition may be impoverished. May. Not have digital connectivity I mean it's easy to assume that the whole world is connected digitally. But there are you, know a substantial, number of people who. Are not and despite. The question, about. The possible adverse impacts, of, media. I think there is still much more to gain from. Digital. Contact, with the outside world and there is a significant, group of people who will be deprived that intro, in a bit. Thank, said just, to remind everybody do keep your questions, and comments and perhaps reactions. To what we're saying coming, in via the chat just. On the basis of what you were saying at Delphine says any research on the impact on elderly people in in senior, homes and. The impact of the lockdown on their health my intuition, is that loneliness, kills, people I guess, that's the point that mental health has, a mortality attached, to it mental, ill-health has a mortality attached, to it too doesn't it it. Certainly does yeah and you know I think as I've sort of briefly, mentioned, it sort of I one. Of my, scandalous, facts I think of life, before it was that serious. Mental illness is attached to. You. Know 10 to 15 years less, life, expectancy. Than you'd expect. For. Somebody of the same age but without a serious mental health problem so, these are. You. Know people. At serious, risk not, just have psychological. Problems but a physical, health problems to back. One of the things that I think is most positive. About. The. College experience has. Been the perhaps it's beginning to sort of forces, to recognize. That mental health physical health go, together, a, lot. More commonly, then, perhaps the, traditional. Medical. Way of thinking about things would, lead us to believe. Everything. Through the prism of its own specialization. But. Kabat reminds us that actually physical mental handing. Thank. You for that now Sarah, Jane um Fred's, made a very important point here which, as. A parent myself with, Jordan they were using, computers, at home to get their education at the moment I'm, I'm, concerned, about this to assess what, do we know about the potential short, and long-term effects, of completely replacing, in person, contact with. Virtual, communications, as the, lockdown is done for many people, is this a replacement is, this, replacement different. To the social isolation you've, been talking about. Which. Is strange we should do because we've had the ability to do studies, comparing. In-person. Social. Interaction, with online interaction. For many years but I don't, know any research, that has systematically. Said longitude, when he studied that I, mean, I think anecdotally. Though we can we all know that it feels very different, it's.

Great That we're able to. Have. Soon calls with our friends, and keep in touch with our families, via, the internet and and, via video. Videoconferencing. But it, is absolutely, not the same as a, real-life, in-person. Interaction. Where you're in the same room for a number of reasons and. So, I, would. Predict if I was going to do this it's current I would hypothesize, that. It. Can't. Replace, this. Kind of interaction that we're having now can't, replace. Real-life. Interaction. In terms of the social needs of the. Developing child and, the developing adolescent, and even adults I mean we all need social, interaction, and actually, who are talking about loneliness, just now it made it reminded, me of the very big BBC. Study I don't know if anyone remembers that from a couple of years ago Claudia, Hammond carried out a big. Survey, with thousands, of respondents. On loneliness, and actually. Surprisingly. I mean loneliness, amongst older people, is such a big worry especially, at the moment if they're, shielding. But. What. This what the results of her BBC, study showed was that the group, that self-reported. Being the most lonely, was, surprisingly. 16. To 24, year-olds so. This is a group who also has. The high end stack test and use of online. Social. Interactions, social media and yet, they are they feel, most lonely I think that's quite an, interesting phenomenon. And it's actually a phenomenon. That in. My, group where we're about to start studying the. Effects, of so. Just. Going back again back a bit we. Were already starting to, become interested, in studying the effects of social isolation on, the adolescent, brain and adolescent mental health this is with a postdoc. Researcher, called Livia term over who's currently at MIT but she'll be joining, my lab in Cambridge in a couple of months and for, about a year we've been planning studies, looking at how social isolation affects, 16, to 24, and then. That was before Kovac, so that you. Know then this this yes, going back to that phrase and natural experiment, happened where young. People and everyone, is are being. Deprived. Of their normal levels of social interaction, but yes. So we want we want to understand, how. Social. Isolation. Affects. The brain the brain's, reward system, the, social brain and. Behavior. In in. Young people aged 16, to 24 and how social media might mitigate. Those. Effects and try to understand, how the links between loneliness. And, mental. Illness. Similar. To what I was asking edie just now just a second we just thought we would just do with this because he's directly relevant because. Liz says she's got four teenagers, two, of them are missing their social interactions, but two of them seem much happier than usual is there any evidence that for some teenagers, at least this new existence is actually, beneficial. Just. Very briefly I think that might be right that, for some teenagers, actually school, was a stripper socially stressful, environment, where they didn't, know where they were in the social hierarchy maybe, they didn't really know which group to hang out with maybe they weren't included so much and this, just takes them out of that kind of pressure cooker like, I've. Heard that for, many people, Edie. Yeah. So I just wanted to kind of loop back to the loneliness, thing and make one point. Which is. Because. Of this at a risk of infection. There. Has been, more. Loneliness, at the, moment of death, than. We, normally see so. Patients. Have, been kept, away from their families, dying. In a hospital and, I. Have, not you, know personally. Been involved with that but I've talked to many colleagues on. The medical side you have and they they have founded themselves. Very stressful, but they also say. That the families have found it extremely difficult. And. I, think you, know if, we think about what we might do differently, next time around. That. Is one area where I think there is distress, that you know we could we did mitigate if we thought differently, about how. To allow families to interact, with loved ones. As. They come under, death. So. What would be your strategy then how would we change things because at the moment it's all it's, all informed, by keeping, people safe and, not causing more infections, so what would you do to surmount the problem. Well. You know I don't I don't have a pat answer to, it but I think that I what. I would say is that in. General. We've, all by this virus. And. There. Are a lot of things that we did first time around that seemed, to make sense at the time and some of them are took the test of time and some of them hand, but. What we also know is that although. It's only been six months that we've been acquainted, with. Kabat. It's not going to go away in the next six months you know there's a very real risk of this coming around again I think what is really important, and this.

Is Where science and research I think play such an important role is. Helping, us to plan a better, response the, next time we see this coming and I. Would suggest that the point, I was making about, families. Being and isolated from the ones at the time of death it's just such a thing that, might be worth the second Lord I don't think we necessarily, first. Time around thought, where that was going to be an important, issue and. I'm. Not saying it's going to be easy. But, I think now. That we know more, clearly what to expect that is one small, way in which we might be able to optimize our response and there could be many, others as we, continue. To understand more about as far as. As. Sarah, Jane was saying she's actually found herself actively. Doing. A vault fast as it were and and encouraging, her children, online, I find. Myself saying thank goodness that we have the Internet, if, this had happened say. 15. Years ago when, there, wasn't the same Internet. Connectivity that we have today I think we would have been in a much worse place wouldn't we arguably. I. Should, say yeah I often think about that. If it happened when I was a teenager I would have only had the landline my parents landline phone to communicate with my friends and you know there was one of one landline phone and it was expensive, so pro wouldn't happen very much so yeah I think that. Just highlights, the fact that. If. There's a positive about, this that it's that it's happened now when we are able, to, connect. With other people online. A, little, bit of a handbrake turn coming, up Edie Shawn says I specialize. In addiction. During, lockdown, I've been unable to enter the prison to work with a cohort of prisoners who are trying to recover from addiction. I believe. That online porn, has increased. Significantly. What. Are your thoughts on the increase in addiction, I mean porn can be addictive to Kanton. Yeah. Porn. Can be I mean frankly, anything, that you. Might. Regard. As normally, rewarding, can. Become abnormally. Addictive, I mean I think that so. But. Certainly alcohol, and drug use I mean, I said earlier that when when, we looked at what happened, to people. Seeking, mental health services, in gamebird show but. Almost everything that drops off a cliff when. Walked down hits when you look at the data and we're not seeing it back to where we'd expect it to be the one exception, actually, is dragon. On call. We're. Already seeing more people, seeking. Treatment for addiction, than, we would have expected, this. Time last year. Do. You think that's just because of the commute because I've. Had it put to me that some. People are saying to me because, I'm not spending an hour on the road going, home from work and I'm not spending an hour on the road in the morning going to work so I can sleep in for longer actually, the, evenings, now quite a bit longer and I can go to bed a bit later and I'm finding I can fit in a few more drinks. Yeah. I. Mean you know I think there are likely to be you. Know a number of different sort, of circumstances. For individuals. In. Boredom. Self. Medication. You. Know particularly people aren't accessing, their tepees and. Another certain health services you know they may turn, to the bottle or, other. Drugs as a, way, of medicating, themselves, out of you, know the distress that they feel about the situation they're in. As. With all of this you know one. Of the problems is that lockdown. Has deprived, of us deprived. Us of contact. With. Patients. And patients. In contact, with services so to, some extent we have to guess what's, going on in all these walk down homes, around, the country. But. As I say all, really we're seeing a, spike of new. Referrals, come through and I think addiction, exacerbation. Of addiction you know perhaps the sense that the world is not operating. Normally the normal rules don't apply. Is. Certainly going to be fueled by this. For. Teenagers sarah-jane because of course that they're potentially. More impressionable, during. The adolescent, phase and more likely to perhaps, embrace, illicit. Substances, definitely. But one one discussion that's been had a lot with. People. Who were teenagers, including teachers, is that actually, locked down meant that teenagers, were not able to go out and get drunk and take drugs when. They might normally have been doing that at the weekends that's quite an interesting.

Change. And, in some ways you know positive, but then the worry is that as soon as they're allowed. To socialize again, they'll they'll, make up the lost time but. Yeah I do some work in South Africa, within, with, teenagers in rural South Africa and this. Is not about the research well it is research on them teenagers, who have depression there but. My colleagues, over in work, now working, in the hospitals in South Africa, because they got kind of reassigned, to hospital work as soon as Kovich started. At the outbreak happened out there but they were telling me the other day that alcohol, throughout, lockdown, which is very very strict in South Africa has been banned since you can't buy alcohol. Because. They knew that this was a real risk of people you, know who couldn't, work just. Turning to alcohol and then that creating lots of violence. And domestic abuse, which is already a real problem in South Africa, anyway, they started. To. Reintroduce. The same alcohol, about 10 days ago and my, colleagues. In the hospitals in South Africa said there was a huge, surge, in alcohol-related. Accidents. And even even, mortality, as soon as they started to smell it again. One. Of my colleagues at the BBC when, all the panic buying was happening at the beginning and you couldn't buy a bhag bhag, roll for love nor money in the shops she. Emailed me and she said she'd been panic buying and I wrote back and said what and she said she, Arad's so. I think it's it's, perhaps class, dependent, isn't it isn't it different different sectors of society this, perhaps applies, to more than others or is it the classic u-shape, where you've got the extremes. At the top and bottom end of the social spectrum who, are most vulnerable to this what do you think I don't. Know but we should have the data on that I mean there must be data on alcohol sales over, the last three months and who's been buying it what. Do. You know ed if that exists. I'm. Sure it does exist but I haven't seen them - nothing, that's a good good way of looking at the problem actually because that's and that's something that people have been able to do they might not have been able to come talk to their GP but they have been able to make that the supermarket, panic. My name is Sharon and I. Just wanted to go back to the. Point that you were discussing, earlier about connectivity, no. Digital connectivity could we have survived without zoom. It's. Just worth reflecting that you, know connectivities. And very mixed blessing actually when it comes to academics as, you'll know Chris I mean if, you compare the rate at which copied. Has, gone global. To. The, rate at which let's say Spanish flu but, and they make around 1918. One team moved. Across the world this is like happening at a different pace and. A lot of the cities that have been hit hardest like London New York of course are highly connected feral. Arms so. Our, physical. Connectivity. Has. Arguably. Been part, of what's made us so, vulnerable to Khalid, and maybe our digital, connectivity, is, what's going to help us get. Out of it at the other end. And. One other aspect of connectivity that I think is worth highlighting, is, is what, this. Crisis, has done, to. The sort of culture. The communication, and collaboration and, sharing you. Know the, scientific community under. Normal circumstances. Is slightly. Sort of you know siloed, and, secretive. And well, not secretive, but. You. Know there is a sort of strong, competitive. Culture. And one, of the positives. Of comedy, is how, its goldeneyes. The, global. Scientific community so you have much more sharing. Of information, earlier. Much. More connectivity, in, that sense of information. Exchange knowledge exchange I think that's a real positive. It's. Time to wrap up so I think I should offer you both a sort of passing, or, departing. Thoughts. Thought, for the day as it were so Sara, Jane your your parting, thought, for the day on where you see this going next and perhaps something for people to think about on their way home. Yeah. Well it. Will be very interesting, to see the results of many, many studies that are currently being carried out on mental health during, coded I know I saw this morning a preprint. From. Two. Big studies one in England one in Scotland.

Showing. That. Anxiety. The levels of anxiety have. Massively, increased, particularly. In young people, and in women, since. Since. The lockdown. And. It will be so important, to understand, how the, lockdown and anxieties, around covert affect mental health because. As Eddie said earlier this is probably going to be with us for quite a long time and, there will be epidemics, in the future so we've got a lot to learn. Edie. Yeah. I think my thought, is let's just let's. Learn. Back. I think there is a tendency sometimes to look back and. Spend. Too much time thinking about what we could have done differently, in this country and elsewhere and, I think what really is informed, is that. We take a very constructive. Attitude, the, future make sure that we learn the lessons and we think as positively. As we can about. The longer-term consequences of, this. And. I think not just reducing. It the ventilators, nicey thinking. About the longer-term. How. Can we use what we've already learned, to. Make a next wave. Less. Terrifying. Than the first and. To make sure that particularly. The vulnerable groups in society, that we've been talking about a fair bit today that they have the. Best possible chance to, survive this without too much white in the social inequalities. Sarah. Jane was talking about earlier. Well. Thank you both very much indeed very thought-provoking Edie, balm oh and Sarah, Jane Blakemore and if, you'd like to listen to any more or catch any more of these cambridge, conversations. There on the cambridge conversations, youtube, channel if you look up cambridge conversations, you, can find the so, far three previous, editions alongside, this one there'll, be another one along soon thanks for listening I'm Chris, Smith bye-bye.

2020-06-30 08:35

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