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Opinion What is crisis fatigue and have we reached that point?

Dr Philip Kieran addresses the issue of crisis fatigue and offers some helpful ways to counteract it.

OVER THE PAST few months we have been bombarded with 23-hour news cycles and continuous reports of large groups gathering in cities and towns across the country  – seemingly disregarding the rules over the current lockdown.

I can see how this ignoring of guidelines would anger people as the rules are set in place to keep us all safe. However, the more I thought about it the more I recognised this a symptom of a wider issue, this is one of the many faces of what we can term crisis fatigue. 

Crisis fatigue has a number of components. These include individual stress, anxiety and even depression in some cases. There is, however also a larger societal presentation. It happens when the severity of the situation we find ourselves in becomes lessened as we all become complacent in the face of continued crisis/peril/danger.

Don’t get me wrong, the dangers of Covid are still very real and very present, but we can become exhausted by the worry of it.

Challenging times

With the relaxation of Covid restrictions, we will see numbers increasing and hospitals becoming ever more crowded at the worst possible time (hospital numbers often peak in January/February) and I don’t feel that we managed to get the numbers low enough in this lockdown to enable really efficient contact tracing to take place.

This efficient contact tracing would allow early detection of outbreaks and would stop them from spreading to the community at large. 

Looking forward, I predict a winter of some degree of isolation ongoing and then we need to look at what this does to people and what we can all do to try and improve our ability to cope with this. How can we all work to increase resilience in the face of these challenging times?

The main symptoms of individual crisis fatigue I see in my surgery day-to-day is a sense of isolation and hopelessness. I am seeing more patients than usual who just lose motivation and enthusiasm for their work and free time.

A lot of these people previously had personal lives which hinged around meeting friends and family and travelling to see their relatives in different counties.

Over the past number of months, the Covid pandemic crisis has slowly ground down their resilience and some of them now are presenting to me with symptoms of increased anxiety, tiredness and a feeling of bleakness when looking to the future.

They are finding it more and more difficult to see a way out of this back to “normal”. I try in our consultations to do three main things:

  1. To listen to their worries and complaints – isolation can make you feel you are of less worth and that your problems aren’t worth talking about
  2. I try to encourage people to look at the longer term. In the next six months, I feel we will be well into a vaccination programme which will go a very long way to relaxing social and business restrictions, so there is as light at the end of the tunnel and, lastly
  3. To look at individual actions and behaviours that you can undertake to improve your mood.

The last part of this is something I have been discussing with patients since the first lockdown. I was recently approached to take part in the Zenflore Mind your Mates campaign and it gave me a broader platform to pass on any advice I was already giving my own patients. Open discussion about our mental health is so helpful and we as medical professionals can offer help where it’s needed.

The main aspects of the advice I give are to look after your mind, to look after your body and to look after your friends. There are a few simple things which have been proven to improve your mood and resilience. 

Self-help map

Firstly, take time for yourself. Try to find something that you enjoy doing which gives you a moment to think clearly. This could be painting/colouring, gardening or sitting quietly and gathering your thoughts.

This type of mindfulness can help to relieve stress and anxiety about the future. There are a number of apps which can help guide you through this if you need help. 

Watch your food and drink. I think most of us were guilty in the first lockdown of splurging a bit and I know I personally am still carrying a few extra Covid kilos. Try to make an effort to eat a healthy diet with a good quantity of fruit and veg.

This higher fibre lower fat/sugar diet can encourage a healthier gut flora (better bacterial composition) and this can increase hormones like serotonin which is important in improving our mood.

Also, with increased working from home, it can become easier to have an alcoholic drink more frequently. Try to stick to below the recommended limits of 17 units for a man and 11 for a woman per week, with at least four alcohol-free days per week. Along with looking after your diet and alcohol intake getting a bit of regular exercise is key to maintaining health.

A brisk walk (aim for 30minutes daily) has been shown repeatedly to improve overall health dramatically. This can consist of 1 30-minute block or 3 10-minute blocks and you don’t need to be running yourself into the ground. I always say to my patients you should be slightly out of breath but not gasping (able to talk but not sing). 

The last part of all this is to reach out to talk to your friends and family. I had someone tell me that she goes for a walk and rings her friend that she used to walk with. The two of them chat away on their earphones while they both walk in their separate locations.

This she told me is nearly as good as going together. Ideas like this show that we can have good meaningful social contact with others even if we can’t physically meet up with them.

I’m not saying we all have to be back doing six Zoom/WhatsApp table quizzes a week again but maybe pick up the phone and text or ring someone you haven’t spoken to in a while. It will do you both the world of good. 

A Cork native, Dr Philip Kieran is a full-time GP in Washington Street Medical Centre. As a graduate of University College Dublin, he started his medical career in 2007, leading him through several specialities and left him with a love for complex medical issues and in particular endocrinology and sexual health. When not in the surgery Philip is most often at home with his wife and two young boys.

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