By Steve Hubrecht

The second wave of the COVID-19 pandemic in B.C. coinciding with the shorter, darker days of winter and — should the ‘curve’ of cases continue to rise for the next several weeks — just in time to possibly result in an ‘isolation’ or ‘lockdown’ Christmas. It’s not exactly a rosy scenario, and mental health professionals here in the Columbia Valley have expressed concern about the potential impact on people’s social, mental, and emotional well-being.

“What I see happening is that whatever stressors you have, this second wave is adding a lot more stress for people. If your baseline is X, adding the stress of the second wave on top means you’ll get X plus more,” said Invermere Counselling counsellor Sue Bradley, adding this can affect people’s already existing anxiety, depression or relationship issues. “With the second wave, it brings a lot of unknowns. That entails a loss of controls and a loss of connections. That’s difficult for a lot of people.”

Since the pandemic began, and especially now with the second wave starting, almost everybody is in what counsellors and psychologists term a ‘high arousal state’, due to a perceived increased level of threat, said Bradley’s fellow Invermere Counselling counsellor Alana Cotterall, adding that “for instance, with the current pro-mask versus anti-mask debate, if you are pro-mask you feel the threat of the virus, a threat to your health. If you are anti-mask you feel a threat to your freedom. Either way, you feel a threat. So quite a lot of people are walking around in this heightened state. No wonder everybody gets emotional. Their self-care or regulation resources are getting outmatched by what’s out there in the world, and they can’t complete the stress cycle.”

Stress cycle, outlined Cotterall, is a term used to describe how people tend to go through a stressful event, then use self-care and stress regulation techniques, outlets and resources to deal with the event, before hopefully coming “through the tunnel.”

“Unfortunately, a second wave means that many regular self-care resources and many strategies to lessen stress are not even available to us, or are not available in the same way they were before the pandemic,” said Bradley. “We can’t go to the gym, for instance, or we can’t go out for a coffee with a friend.”

Both Bradley and Cotterall say there will likely be a ‘mental health wave’ following closely behind the actual second wave of the pandemic, and said that they saw a similar phenomenon here in the Columbia Valley with the first wave.

“Even right now with the second wave just starting, the stress level seems higher than what we saw in late summer,” said Bradley, adding the mental health wave associated with this second pandemic wave may end up being worse than the one associated with the first pandemic wave.

“With the first wave, there was a bit of a mitigation in that you could tell yourself ‘this is a short-term thing. It won’t last forever.’ Now with the second wave, there can be feelings of ‘we did everything right. We locked down. We followed protocols. We did everything right. And we are still now facing a second wave’. So it may seem things are not changing, or not going to get better,” said Bradley.

Both Cotterall and Bradley added that the timing of the second wave’s arrival coming just as people gear up for the Christmas holiday season is not ideal from a mental health standpoint.

“Christmas can be tricky at the best of times, even without a pandemic. It can be a time when we see more depression and more disappointment. A lot of people put really high expectations on Christmas, and when it doesn’t live up to those expectations, that can be hard,” said Bradley.

“We need to be careful of our expectations and make sure we keep them realistic. You could make plans to get together with extended family once the second wave has passed. Your big Christmas celebration doesn’t necessarily have to be on Dec. 25.”

“We need to keep in mind that although Christmas will look different, and that will be difficult for some of us, we can still make purposeful connections during the holidays,” said Cotterall. “Focus on what you can do. It’s too easy to focus on the things you can’t do.”

East Kootenay Addiction Services Society (EKASS) executive director Dean Nicholson echoed many of Bradley and Cotterall’s sentiments about the effect of the pandemic and its second wave on mental health and well-being and noted that these effects could easily have negative consequences for those that struggle with substance use and misuse.

“What we’ve been hearing generally in the world is that there is a worldwide increase in substance use as well as anxiety and depression. Globally this is having a big impact on people’s mental health and that will continue the longer this goes on. So for a second wave to now start as we come into winter, with its shorter, darker days and the possibility of not being able to celebrate Christmas with family and friends, that’s concerning,” Nicholson told the Pioneer. “The concerns expressed globally, we’re seeing that locally in our population as well. We’re hearing from some of our clients, not all but some, that they are drinking more, using substances more, having more anxiety.”

Nicholson said the increase in anxiety, depression, drinking and substance use relates to a number of big risk factors that all have been heightened by the pandemic, and which could easily be further aggravated by the second wave, such as increased loneliness, more social isolation, more boredom, a lack of meaningful purpose, and a decrease or change in options to reduce stress.

“The whole situation with COVID-19 and how it isolates people is tricky: at the same time as it increases the risk factors for people to misuse substances, it also decreases the options for helping people manage substance misuse,” said Nicholson. “Pre-COVID-19 we would have looked at ‘what can help you use it less’. Now a lot of those strategies — meaningful work, social support, connection — there’s less of them, and the ones that are still there have changed.”

Nicholson added he’s also heard that the Canadian Emergency Response Benefit (CERB), though clearly well-intentioned, may have had a net negative effect on a minority of people in terms of substance misuse, in that they suddenly find themselves with more disposable income at precisely the time they are more isolated and bored, and they spend the unexpected cashflow on alcohol or drugs.

“To be clear, I am not blaming the people receiving the money, and I’m not blaming the benefit itself. What I am saying is that it can be a trigger, to suddenly have more money in your hands, if you are already struggling with substance misuse,” he said. “It’s an untended consequence of a well-intentioned program.”

Another issue that COVID-19 has created for those who struggle with substance misuse or addiction is the pandemic’s affect on the global supply chain, which Nicholson noted includes virtually every product in society, drugs included.

“There are more restrictions on what is coming into the country. So quality controls, such as they are for certain substances, are much less. The quality of these substances is much more variable that it otherwise would be,” said Nicholson. “If you have a supply that is not safe, or is less safe than it was before the pandemic, and you add the stigma around use, we’re going to have the conditions to create a problem.”

Nicholson added that the type of substances used or misused hasn’t changed much during the pandemic, as far as he can see. Alcohol is still the most widely used or misused substance, followed by cannabis, and then other substances. Recreational opioid use was once uncommon in the East Kootenay, but has been on the rise for the past six years, and has morphed in recent years into fentanyl use, said Nicholson, but this predates the pandemic. “Another new one in our area that we’ve seen is crystal meth, which has really come in during the last three to four years,” he added. “It’s still a very small number of people using it, but there really was almost none not that many years ago.”

The pandemic has also not greatly changed the number of people coming to EKASS seeking services, said Nicholson, although he pointed out that during the spring lockdown, the way EKASS delivers many of its services changed as a result of social distancing protocols.