“But I suggest if you are having these feelings, then tell someone, especially if the pandemic has left you struggling with your head junk for the first time. Starting with a GP. More GPs have saved my life than paramedics, because thankfully the former has put me on the right path before I’ve needed the latter.

Things do get better. I hate when people say that because sometimes they don’t for a long time, but for me anyway it’s worth sticking around to see if they do”.

Brianna Parkins: Holidays are for drinking unnatural-looking cocktails by a foreign pool. Irish Times August 12th 2020;

Mental health issues have grown exponentially since the onset of the Covid 19 pandemic. Most people (including doctors and other frontline workers) have experienced episodes of extreme anxiety and sleepless nights. The uncertainty of dealing with a microscopic enemy that we cannot see yet we are told is all around us – the risk not just from the obvious symptomatic individual but also from surfaces they have touched and even more alarmingly the asymptomatic innocent spreader. This was compounded by the lack of knowledge of how to treat the disease and the emergence of knowledge around “ Long Covid” – patients who continue to suffer longterm effects long after the initial acute phase of their illness.  The uncertainty remains but by getting back to the basics of handwashing, mask wearing and social distancing we have learnt that we can mitigate the spread. New therapies to curb the severity of the illness in those who have needed hospitalisation also brings some certainty to bear on the situation and the commencement of vaccination is a source of hope for all.

Anxiety, panic attacks, feelings of helplessness and depression have been triggered in people who have enduring mental illness also. It is not surprising that people with pre existing anxiety and depression symptoms have got worse in the face of social isolation, relentless talk of Covid 19 on social and main stream media and lack of access to their usual group or one on one talk therapies due to service restrictions. 

In the midst of all this GPs have continued to be accessible – maybe in a different format to previously by phone or video consultations or if deemed necessary PPE protected face to face encounters. Under normal circumstances GPs provide 90% of the daily mental health consultations provided in the health service. This service (as illustrated by Briannas article) really does make a difference to peoples lives. Mental health consultations are often a source of professional satisfaction for GPs also – feeling you have made a worthwhile contribution often by just being there at a time of crisis. Sometimes that necessitates referral to secondary care for further treatment.  Sometimes prescribing of medication or sign posting to support services to help people through an acute phase is needed. More often than not simply listening in a non judgemental manner is all that’s needed – many people already know what they need to do to help themselves – they just need the opportunity to verbalise it.  

As GPs we have an extremely varied workload – we never know what is coming through the door or who will be on the phone next. It is one of the attractions of the job and one that keeps us on our toes and by necessity encourages life long learning. Mental health issues contribute in some way to virtually every consultation – the anxiety associated with what could be causing a pain is often worse than the physical pain itself. By helping our patients to deal with their mental health issues we are making a valuable contribution to their lives and enhancing our own.

  • by Dr Margaret O’Riordan, President of the ICGP & GP in Tipperary