TORONTO -- A new survey looking into how Canadians’ mental health has changed since the start of the pandemic has revealed that Ontario and Atlantic Canada have experienced the largest spike in anxiety and depression.
Across all provinces, the number of people who reported their anxiety as high has quadrupled since the COVID-19 outbreak.
The rate of high levels of depression has more than doubled -- and experts say it could get worse.
The survey also asked respondents about their levels of anxiety and depression if social isolation continued for just two more months, and the percentage of respondents reporting a high level of depression went up again in response. This suggests some respondents were anticipating an increase in their feelings of depression.
“The prediction is if it continues, depression is going to get worse and anxiety will sort of remain relatively high,” Dr. David Dozois told CTVNews.ca in a phone interview Tuesday. “And this is only asking people if social isolation [were] to continue for another couple of months.
“Depending on whether there's a second wave of cases and so on, we could be in this for the long haul.”
Dozois, a psychology professor at Western University, is a member of Mental Health Research Canada’s (MHRC) board of directors, and helped design the survey.
The survey was conducted by Pollara Strategic Insights on behalf of MHRC, and involved more than 1,800 Canadians 18 years or older across all provinces and territories.
Since the COVID-19 outbreak, 61 per cent of those surveyed said they had experienced some or more anxiety, a jump from the 28 per cent who said they had at least some anxiety before COVID-19.
Although only five per cent of those surveyed had high anxiety before the pandemic, 20 per cent reported having high anxiety since the outbreak.
Those who reported experiencing at least some depression increased from 19 per cent before the outbreak to 33 per cent after it. And the number of those experiencing high levels of depression went from four per cent before the outbreak to 10 per cent since the outbreak, with a rate of 16 per cent predicted if social isolation continues.
Dozois explained that the initial large jump in anxiety levels makes sense because anxiety is rooted in “thoughts of future and threat and impending doom.
“And then once we're in it for awhile, I think … the facts sort of sink in a bit more and you start to recognize, ‘wow, I'm socially isolated. I'm not doing as much as I used to do. I'm tired of bingeing on Netflix,’ that kind of thing.”
That’s why people could start to feel the effects of depression more and more, he said, as the crisis goes on.
THE IMPACT ACROSS CANADA
When the data was broken down by region, Atlantic Canada and Ontario led the country in both anxiety and depression.
Anxiety levels increased by 28 per cent and 27 per cent among Atlantic Canada and Ontario, respectively. Depression levels increased in Atlantic Canada by 13 per cent, and in Ontario by 12 per cent.
However, an important factor is the timing of the survey: it was conducted from April 22 to April 28, the week after the Nova Scotia massacre that killed 22 people.
Dozois said this definitely could have played a role in the survey results regarding Atlantic Canada’s collective mental health.
“At this point with the data … [it’s] confounded with events that are specific to location,” he said.
“It’s been quite a trauma-filled couple of months for Atlantic Canada for sure. So yes, I think that could have an impact.”
More studies and surveys will help to refine the data and provide a better picture of how much COVID-19 on its own is affecting Canadians’ mental health outside of other tragedies.
Other aspects of the region-specific data provide a sometimes counter-intuitive picture.
According to the survey, the smallest jump in anxiety levels was reported in the Prairies, specifically Manitoba and Saskatchewan, with a 20 per cent increase, and Quebec, with a 22 per cent increase.
For the Prairies, the relatively low rates of COVID-19 could play a part, Dozois said.
However, Quebec also had the smallest increase of depression rates, with only a five per cent increase.
Considering that Quebec has the largest number of COVID-19 cases, and the highest death toll in the country, it’s a result that Dozois acknowledged is confusing.
He said researchers are “not sure why” Quebec has the smallest increase in depression levels.
“From other surveys, we know that Quebec tends to have lower self-reported levels of anxiety and depression than do other provinces,” he said.
He said there was a possibility that the magnitude of COVID-19 cases in Quebec could mean people are spared the anxiety of imagining hypothetical doomsday scenarios, since things are already so bad.
“Maybe people are recognizing, OK, we can get through this. And they sort of see it for what it is rather than speculating and catastrophizing in their own minds,” he said. “But again, this is just speculation.”
Surveys can only tell us so much, Dozois pointed out.
“I think we need different types of more experimental studies to kind of determine [causes].” In a more specific study, they would be able “to control for other variables.”
According to the summary report, researchers are hoping that the survey can inform policy makers on how to better support Canadians who are currently struggling with their mental health.
“I think COVID's probably opening the eyes of government and policy makers to sort of say, ‘Wow, we really do need to be supporting mental health,’” Dozois said.
He pointed out that the Canadian government has put money into the Wellness Together Campaign, which was launched in April to serve as a virtual mental health support platform. But he stressed that access to care needs to improve.
FACTORS WEIGHING ON CANADIANS
Economic concerns are among the largest factors impacting Canadians’ mental health during the pandemic.
The survey found that 57 per cent of those who had become unemployed due to the pandemic listed their recent job loss as a negative impact on their mental health.
“That takes a huge toll,” Dozois said. He added that a job loss often provokes feelings of “failure,” which can contribute heavily to depression, even without adding the stress of losing an income.
Among those still employed, 42 per cent said the fear of losing pay or hours at work was affecting their mental health negatively.
A further 43 per cent of respondents were worried about a family member losing their job, and almost half of the respondents listed the general economic downturn as a drain on their mental health.
When it came to health concerns, “people are more concerned about their family members catching the virus than they are about themselves,” Dozois said.
Only 35 per cent actively worried about catching the virus, while 47 per cent were concerned a family member might get sick.
The survey found that 28 per cent of Canadians are drinking alcohol and using cannabis more during the pandemic, but respondents indicated that this was overall having a “neutral” effect on their mental health — not making them feel worse or better as a whole.
More data would be needed to look specifically at this issue, Dozois said, especially since it relies on self-reported information, but right now the data is inconclusive on the impact of the increase in substance use.
“We know that alcohol is a depressant and long term it would have an effect on people's levels of depression and other mental health issues,” he said.
Self-isolation is one of the big drains on Canadians’ mental health: 41 per cent reported being apart from others as something that’s egatively impacting them.
“It's really difficult to connect with people socially [right now], and I think people are experiencing zoom fatigue and things like that that really are interfering with their ability to really connect like we used to,” Dozois said.
“I mean, we miss our hugs and those kinds of things.”
HOW TO COMBAT ANXIETY
Many factors considered in the survey are out of our direct control, such as job losses, the overall economic landscape, how long we’ll be isolated for and the emotional toll of watching others get sick and die.
But the survey also looked at factors that had a positive effect on the respondents’ mental health.
While 36 per cent of respondents reported that checking the news daily had a negative impact on their mental health, reading essays, short stories and books that were unrelated to the pandemic provided positive benefits to 44 per cent of the respondents.
Physical exercise, interacting with pets, and engaging in entertainment such as music, movies and television also affected respondents positively.
Social media such as Facebook, Twitter and Instagram was still more positive than negative, but had the lowest positive impact, with 21 per cent reporting a positive boost as opposed to 17 per cent who reported a negative impact.
Dozois said when it comes to staying connected with loved ones and friends, it’s important to do so in “active ways.”
Although communication with those outside of your household is largely going to be through digital means during the pandemic, setting out specific times for video chats or engaging in group activities with the internet as a conduit will leave you feeling more connected than just commenting on an Instagram post.
“My parents live in Calgary. I've been doing Zoom cribbage games with them as a way to kind of connect and catch up with them,” Dozois said. “I have one board and we have two decks of cards and we're away we go.”
Dozois added that he hopes research like this helps to enlighten the general public, not just policy makers.
He said it’s important to recognize that many of the people around us are experiencing the same mental health issues that we might be during this crisis.
Instead of getting angry “that people aren’t remembering to go down a certain aisle the right way in the grocery store,” we should “cut people slack.
“We can't physically connect, but … we can certainly, I think, be caring people as Canadians.”
