Over a year spent living through a pandemic is no easy feat, and the toll it takes on people's mental health is something that can't be downplayed.
March 11, 2021 marked one year since the World Health Organization declared the COVID-19 outbreak a pandemic. In the time since then, over 2.6 million people have died from the virus and nearly 120 million have been infected.
While the end of the pandemic is slowly coming into sight now people are beginning to receive vaccines, there is undoubtedly still months ahead where the coronavirus will be at the forefront of people's minds.
What is COVID-19 fatigue
At the beginning of 2020, as COVID-19 was beginning to spread around the world, many people quickly transitioned to be on to high alert. Supermarkets were emptied of essential supplies and many parts of the world went into lockdown.
The early days of the pandemic were marked with extreme concern. People were unsure of what COVID-19 was, how bad it would get, or how to deal with the virus.
A survey of 2000 people conducted by the University of Otago in April 2020 found that the first lockdown reduced people's wellbeing, particularly among young adults.
Almost 40 percent of respondents reported low wellbeing and about one-third said they felt moderate to high levels of distress. However, over 60 percent of people also experienced "silver linings" at alert level 4, such as more time with family.
As time passed, people felt less motivated or inclined to follow expert advice, and grew tired of following guidelines recommended by health officials.
Dr Dougal Sutherland, a clinical psychologist at Victoria University of Wellington, describes COVID-19 fatigue as the mental and emotional load of needing to be alert and on guard in a way that most people have never done before.
"At times, there's a constant state of alertness, readiness, and then there's the up and down as we go in and out of lockdowns," he tells Newshub.
"So relaxing and then having to get up again and being prepared and being on alert and on guard. It's that mental and emotional load or weight of having to deal with this ebbing and flowing fret."
In New Zealand, we haven't had the experience of COVID-19 decimating the country as bad as it has others, but that doesn't mean it hasn't affected us.
Auckland has been in four lockdowns of varying severity since the pandemic began, which Dr Sutherland says could contribute to people's anxiety.
"I think levels 2 and 3 are probably more difficult to cope with than levels 1 and 4," he says.
"If you think about anxiety, those two key characteristics of anxiety are uncontrollability and unpredictability, and those two characteristics are much more prominent in level 2 and particularly level 3."
At level 4, although the restrictions are more severe, he says there's more certainty. People know they can't leave their house, and while frustration comes with that, "there's not that sense of worry or confusion or lack of clarity".
"This [confusion] then takes extra effort and energy to deal with. Either you're an essential worker or you're not, and that's it. If you're not, you're not doing anything," Dr Sutherland says.
"Level 3 is like, maybe I could go and get takeaways, maybe I am an essential worker, I think I am. How far can I go? That whole worrying and wondering is quite exhausting, I think, for people."
What are the signs and effects of COVID-19 fatigue
The constant mental workout of living through a pandemic and coping with the effects of that begins to take its toll. Dr Sutherland says people begin to notice the accumulative effect of built-up fatigue and tiredness since there's no holiday from break with the virus.
"You don't really get a holiday from things, so you become tired, mentally and emotionally. You're more emotionally on edge, so more likely to be annoyed and ticked off by little things," he says.
"I think we've seen that more recently as well, that people have gone from a state of acceptance to a state of annoyance, irritation, and anger."
People who worked from home during lockdowns, particularly the first one last year, may have felt the effects of COVID-19 fatigue more since the boundaries between their job and home life were blurred.
"You think this. I've been at home for six weeks, I've got to get back into work, sort of just forgetting that I wasn't at home sitting around doing nothing, I was at home working. Perhaps people have forgotten about taking those breaks and, to be honest, you probably need to be taking them more often because of the extra tax, the extra stress that comes with being in COVID," Dr Sutherland says.
"Somebody described it to me. They said it wasn't that we were working from home, it was more like we were living at work. Although you try and put those boundaries around you… the first thing you do when you wake up in the morning, possibly before you're out of bed, is check your email and then you get sucked down that rabbit hole. And then it's 9:30am and you think, 'gee, I better get out of bed'."
The effects people can look out for are a rise in frustration, mental tiredness, strained relationships, and poorer physical wellbeing, Dr Sutherland says.
"There's irritability that's coming out a lot more at the moment, anxiety for a lot of people as well," he says.
"In the longer term, we do know that when large groups of people experience similar difficult events, it can actually have a bit of a resilience effect because it sort of bonds people together. It's still a bit early to tell, really."
He adds that if people were struggling with their mental health beforehand, then the lockdowns may have been difficult to cope with. But on the other hand, if they were feeling okay, then it may have been easier to live through.
This point was also emphasised by Janet Fanslow, an associate professor at the University of Auckland's School of Population Health. When responding to the lockdown survey data that was conducted by the University of Otago, she said mental health problems can escalate and intensify during lockdowns, but this shouldn't be misconstrued as the cause.
"The lockdown did not cause the problem, but instead the conditions of lockdown may have intensified pre-existing problems."
How to deal with COVID-19 fatigue
There are several things people can do if they believe they're experiencing COVID-19 fatigue, Dr Sutherland says.
"In many ways, it's going back to the basic habits - are you attending to all aspects of your life that you need to?"
The first is to ensure you're having a proper break from work and thinking about when you last took a holiday. The second is to consider if all aspects of your health are being taken care of.
"Are you taking care of your mental health, are you taking care of your social relationships as well, are you taking care of your physical health, are you taking care of, for want of a better term, your spiritual well-being," he says.
"Thinking about it in that holistic way and going back to saying, 'what do I do to keep me well and have I stopped doing any of that'."
The Mental Health Foundation also has several wellbeing tips to help people get through the pandemic.
They recommend limiting the amount of news you follow, exploring different ways to relax, and sticking to a routine, which includes eating at regular times, changing your clothes, and going to sleep and waking up at the same time each day.