«Mental health isn’t a given»

Think the nation’s mental health has been peachy since we got out of the pandemic? Think again. According to a recent report by the Swiss Health Observatory (in German): «Rather than recovering, the population’s mental health has deteriorated since the period before the pandemic. There are fewer «very happy» or «very satisfied» people, with more reporting moderate to severe symptoms of depression (12 per cent) than in 2017 (9 per cent). Today’s figures are also higher than those reported in 2020 and 2021.»

Feelings of loneliness have risen dramatically (14 per cent vs. 5 per cent in 2017), particularly among young people. Thirty-two per cent of 15- to 24-year-old women surveyed reported feeling lonely. Twenty-two per cent of their male counterparts felt the same. Only a slim majority (around 52%) of all respondents said they had no symptoms of the mental illnesses mentioned in the survey. Alarmingly, only a third seek professional help for suicidal thoughts, meaning many of those who experience them aren’t in the healthcare system.

Generation gap: young people are affected worse

In general, young people still appear to be under more mental stress than before the pandemic. 15- to 24-year-olds score worse than average on indicators of positive mental health as well as almost all symptoms of illness mentioned in the survey. A total of 36 per cent of young women reported having more severe symptoms.

The conclusion? Switzerland’s mental health isn’t looking good. That’s why I reached out to Pro Mente Sana, an independent mental health organisation with more than 40 years of history. It serves as a contact point «for people with mental health concerns, their relatives and professionals».

Mental health: recognise, react, help

Larissa Speziale, Head of Health Promotion + Communication, is just the woman to help me get a handle on all this. For our interview, she drew on the knowledge of «Pro Mente Sana» colleagues, including Nadia Pernollet, Head of Psychosocial Affairs and Dalit Jäckel, Head of Prevention & ensa Switzerland. She also shared important tips on improving resilience and what to do during a mental health crisis.

There’s a high number of cases of depression and depressive moods these days. What’s making our society sick?

Larissa Speziale: Experts believe various factors are at play. As the Swiss Health Observatory survey reveals, loneliness is one of the major issues. But that also raises the question of why. Here are some possible reasons:

• Generally speaking, a sense of uncertainty or lack of control over one’s life are a burden on mental health. The post-pandemic situation, war in Ukraine, climate change, inflation and other factors might be contributing to this.
• Society hasn’t yet been able to cope with certain new demands and challenges, causing mental stress levels to rise sharply. For instance, technology has developed rapidly, and our brains haven’t adapted to it yet. It’ll probably take a little longer for that to happen.
• Media consumption, including social media, are mentioned time and time again in discussions about mental health. The discrepancy between the virtual world and the real world is widening. Our level of electronic communication has increased dramatically, posing a major challenge for brain function. It takes a lot of energy (linked article in German).
• There are a number of everyday aspects too, such as distractions cropping up when we’re trying to get something done. A lot of people underestimate this, but recent research demonstrates that distractions are enormously exhausting for us. The human brain needs two to six times as much energy to complete an activity if you’re interrupted during a task.
• Another important point is social stress, which the human psyche is most sensitive to.

What support do you recommend for either everyday life or challenging times?

There’s a whole range of possibilities:

• Sport and exercise in the fresh air
• Maintaining relationships
• Talking about stressful situations and feelings
• Reducing distractions
• Taking breaks
• Setting priorities
• Doing other things that promote individual well-being
• Getting professional help at an early stage if necessary (from a specialist or an independent support organisation)

Why are young women affected particularly badly?

Young women are more likely to use social media than young men, who’re more likely to game (website in German). Subsequently, experts have surmised that young women’s mental health is impacted negatively by the constant comparisons they draw between themselves and others on social media. They also feel societal pressure and experience pronounced loneliness.

What specific services are out there?

We’ve been offering psychological first aid courses for several years. These work in a very similar way to established first aid courses. In the «ensa» course, laypeople learn how to give first aid to those experiencing mental health problems or crises in their personal or professional lives. First aiders provide support until a professional takes over. At the same time, they help to dismantle the societal stigma against people with mental health problems. Rooted in science, the positive impact of the courses has been put to the test – and proven – around the world.

**Let’s say someone you know is mentally unwell. What would you advise doing first? **

The most important step of all is to approach the person and speak to them directly. It’s helpful to explain to them where they can get professional help and that it’s important to make use of it. Mental illnesses are treatable and, in most cases, can be healed too. The earlier you intervene, the more favourable the outcome.

Are there symptoms you should look out for in yourself?

Potential warning signs could be feeling low, out of sorts, anxious or hopeless for several weeks. You may also have no motivation, be easily irritated or be sleeping badly. The «How are you?» campaign has created a self-assessment that evaluates you and provide advice. It’s important to talk to someone about the results and/or get professional help. Mental illness can affect anyone – you’ve nothing to feel ashamed or guilty about.

How can you support a relative who’s struggling and keep your own mental health in check at the same time?

The very first step is recognising that something’s up. It helps if you have a basic knowledge of mental illness. After spotting the warning signs, you have to act. Specifically, this means calmly talking to the person about how they’re feeling in a place where you won’t be disturbed. Communicate and listen openly and without judgement. Advice like «pull yourself together» isn’t helpful here – it’s impossible for people in psychological distress to do that. If you’ve been supporting someone, it’s also important to take care of yourself. It can be helpful to talk to someone else about what’s been happening (without betraying the confidence of your friend or relative). Doing things to boost your mood and well-being may also be useful. Depending on the person, examples might be exercise, relaxation or creative activities.

At what point does medication make sense?

When the situation’s acute and the person’s in crisis and suffering severely. Anti-anxiety medication, for instance, can bring calm to a stressful overall situation (e.g. acute psychosis with paranoid components). Psychotropic drugs can also be helpful if the patient’s sleep is severely disrupted. A lack of sleep leads to a deterioration in your general health, so it’s important this basic human need is addressed – with medication if necessary. As is the case for any psychotropic drugs, it’s important that the focus isn’t on medication alone. Patients should also be made aware of alternatives and complementary measures for symptom relief and get the chance to discuss them. It’s also important doctors provide information about the drugs – the type of medication, impact, side effects and any risks of developing a dependency.

Some patients may either expect too much from a «wonder drug» or be afraid to take medication…

Again, that’s why it’s important that patients receive transparent information about what to expect from a drug. They should know what the medication can do for them – and what it can’t. Mild depression, for example, is fairly treatable without medication. It goes without saying that the patient has to be ready and willing to go on medication. Drugs can only be administered against the patient’s will if they’re in an emergency situation that puts their life at risk. Psychotropic drugs aren’t a cure, but they can support the recovery process by stabilising the patient to the extent that they can actively participate in it. There’s no wonder drug. It’s up to the patient to do the work – and they should be supported to do this in a therapeutic setting.

What’s a good strategy for preventing mental illness?

Mental health isn’t a given. However, just like physical health, it can be maintained. Social interaction, regular exercise and relaxation, accepting yourself and believing in yourself are important. Learning new things, being creative or taking part in something can also do you good. How do you recognise what’s good for you and when? It helps to practise being aware of your own feelings and naming them. It’s okay to not be okay sometimes. Having some flexibility in difficult situations and developing your ability to express emotions helps you overcome crises and cope better with challenges. If you make an effort to notice your feelings, you can recognise any downturns in your mental health early and get professional help.

Who should you go to first if you have questions about mental health?

You can reach out to a GP, psychologist, psychiatrist, counselling centres or peers with lived experience. Our organisation has an extensive list of specific recommendations.

What can be helpful if you’re just feeling a bit down?

Again, it’s important to take notice of your feelings, talk about them and ask yourself what would make you feel good. The «How are you?» campaign guides you through everyday ups and downs and gives advice about various emotional states.

These dark winter months are putting many people’s mental health under additional strain. As experts, what’s your take on this?

The lack of light and heat can actually lead to seasonal depression in winter. The sleep hormone melatonin plays a major role in this. Due to the lack of daylight in winter, we produce more of the sleep hormone than in summer. Melatonin comes from the «happiness hormone» serotonin. And to get that, we need vitamin D, which is produced by sunlight. When this is lacking, we get tired, lethargic and melancholy and experience the winter blues. But there’s a reason for this. Our ancestors were able to save energy when it was dark and cold and food was scarce. In people with seasonal depression, this effect is significantly stronger. Exercising in the fresh air, getting enough sleep and doing light therapy can help.

Has mental health become a mainstream issue in our society yet?

People are talking about mental health more, which is a good thing. However, mental illness is still very taboo and stigmatised, so education is extremely important. Switzerland’s mental healthcare system is already stretched (article in German). This underlines the importance of increased efforts and investment in prevention in order to tackle the problem at a societal level.