Experts have warned that psychological wellbeing is likely to suffer as a result of the coronavirus pandemic. Linda Stewart finds out how a student, a mum and a support worker are coping with the new normal.
Student Emilia Bayliss (22), who was diagnosed with borderline personality disorder, was about to sit her final exams. She lives in Lisburn with her partner David (24), who studies IT.
"When I was very young, about 13 or 14, I was diagnosed with depression and anxiety but I've since been diagnosed with borderline personality disorder. I still have anxiety and depression but it's more of a symptom than an actual disease," Emilia says.
"Before lockdown I found being able to get out to a park or the quarry near my house for a walk was good for my mental health, but unfortunately that is not quite as available during lockdown.
"Another thing that was very beneficial was that if I was having a down day, my partner and I would go out and take some photographs because I love to model and he loves to take photos.
"But since the lockdown I've had to very much internalise a lot. I was lucky I had enough savings to buy a new video game which I have been playing quite a bit."
But lockdown has had an effect, she says, admitting she has been sleeping more than normal.
"For the first few days I didn't open the blinds really - I kind of hibernated myself and when I finally got outside to do a shop it was a bit shocking," she says.
"I'm making more effort now to keep the blinds open and have a more strict routine. I'm really into planning for the future - places I would like to visit and holidays even in two or three years time. It encourages me to look to the future.
"It has helped. I still have days which are more difficult than others but I think everybody is struggling in lockdown."
Emilia says one of the first rules she made for herself was that she would reduce the amount of time spent looking at information about coronavirus online. A family member was diagnosed with Covid-19 and she found herself obsessively combing the internet for information.
Now her relative is doing better and Emilia has restricted herself to looking up Covid-19 once in the morning and once at night: "You have to set rules for yourself."
"We are quite lucky because my partner and I had lived together for a while before this and we got along well. I'm trying to give him his own space to do his own things and get a routine that will work for us without forcing him into it," she says.
Emilia says there is some solidarity in knowing it's a worldwide phenomenon.
She has a mental health page on her Instagram, @emiliavslife, which connects with people in other countries, and says the outbreak appears to be having a worldwide impact on mental health.
Emilia has been going to weekly private sessions with psychoanalyst Professor Dr. Melania Anna Duca Canavan for a number of months and is still able to avail of those sessions remotely.
She says she is lucky to be able to afford to go to Melania for help. Originally, when she told the GP she had a history of mental health problems, she was told there was a two-year waiting list for support.
"If I had not been to Melania I would be in a much worse position and I would be struggling a lot more than I am," she says.
Homelessness hostel support worker Stephen Donnan (31) lives with depression and anxiety and is working towards qualifying as a counsellor and psychotherapist. He lives on the Shankill estate in Belfast with his husband William.
"I've lived with depression and anxiety since I was about 16 and it's been ongoing since then," he says.
"There are periods when I've had really good mental health - and that could be years - and periods when I have poor mental health."
Stephen takes anxiety medication and also finds that going to a personal trainer twice a week boosts his mental health.
"Meeting with friends, writing, going for dinner with friends, drinks, coffee - I am not somebody who handles being on my own very well. I'm a social creature and if I'm feeling anxious, I feel better in the company of friends who understand," he says.
"If I'm feeling a bit low, I usually call a friend and arrange a time to meet and hang out or do something - it's proximity to another person that isn't a colleague or my husband. I don't like always burdening him with how I'm feeling. While he's very supportive, it shouldn't just be on him."
Stephen says that at the start of lockdown he was proactive at maintaining a semblance of normality and is lucky to still be going out to work.
However, the hostel where he works has been segregated to curb the spread of infection and the support work has been scaled back: "I'm trying to be useful to my clients in a different way."
Many of his coping mechanisms have been curbed by lockdown.
"I really enjoyed the personal training I did every two days, but the gym has closed so I don't have that outlet to vent off some steam," Stephen says.
"It has been hard trying to develop new ways of coping and it hasn't always been easy.
I'm trying to connect with people in a different way - I'm lucky we live in an age where distance isn't an issue and you can talk to friends and family on WhatsApp or Facebook."
One of the signs of a dip in mental health, he says, is withdrawing from people and not telling them how he is doing.
"I'm trying to be honest with people when they ask how I am and to do things that don't involve social media and the news - and that is very difficult because I like to tweet," he says.
Trying to stay away from watching too much news and do simple things like read, listen to music or watch comedy can distract from the anxiety, Stephen says. But he feels he was a little naive about the long-term impact of lockdown.
"Because I am an anxious person, I was prepared for lockdown - I had all the things in terms of food and supplies and I was pragmatic in terms of the worst case scenario," he says.
"But as the days go on and it becomes the new normal it's very worrying. I was in a good place where I had a good support network around me but I worry about people who don't," he says.
Stephen says that it's jarring that despite being in a good place mentally, lockdown is forcing him to act in the way he would if he was having a dip.
However, as part of his counselling training he put together a personal wellness recovery action plan which helps him recognise the signs of a mental health dip and counteract it.
"Most of the strategies on my wellness recovery plan involved leaving the house and interacting with other people. There are things that are still in there, but it's given me the opportunity to think of other things that will help. I have the opportunity to look after myself and it gives me a project to work on rather than wallowing in the depths of despair," he says.
Stephen says it keeps him up at night wondering how he is going to look after his clients.
"More people have died from suicide than from Covid-19 here since the start of the year," he says. "There is a pandemic happening at the minute and people are worried about staying indoors.
"But there's going to be a public health emergency building underneath us and that is mental health - people are getting socially isolated and aren't able to access services and resources to help themselves. The next thing will be a wave of suicides because it will be very difficult for people to go back to normal after this. Are we prepared for it when that happens?"
If you are affected by any of the issues raised in this article, contact the Samaritans on 084 5790 9090, or Lifeline on 080 8808 8000
Naomi Quinn (44), from Swatragh, had a psychotic breakdown last year which led to her becoming an inpatient at Holywell hospital, where she now volunteers. She lives with her 13-year-old daughter Megan, and also has two sons, Declan (20) and Conor (22).
When my son was born I took postnatal depression - I was put on antidepressants and I suffered from anxiety and panic attacks. I've suffered with that from forever," she says.
Naomi was on antidepressants for many years but began to go downhill in the last few years with depression and isolating herself at home. But when she went to the GP about it, she was told she only had 10 minutes to talk.
"That was like a kick in the gut - it took a lot for me to go to the doctor and say what I had to," she says.
Naomi was referred to mental health services but when she got home she Googled services and joined an online group run by mental health charity AWARE every Tuesday.
"I honestly believe to this day that that group and subsequent groups have saved me, because I was so isolated on my own at home with nobody to talk to. There are days you go on and you can have a good laugh with the other people on there, or you can spill your guts about how you are feeling.
"To have that outlet is brilliant," she says.
Last year Naomi had a psychotic breakdown and was an inpatient at Holywell for four months.
But a doctor there recognised that antidepressants were not working for her and changed her medication.
Since coming home to her family in July, Naomi has been symptom-free and now volunteers at Holywell at the Oasis, a resource where patients can unwind and take part in activities. However, due to Covid-19, the Oasis has been closed, she says.
"My coping mechanism now would be FaceTiming to see the other volunteers who are at home too. I play guitar and piano - music is another thing that takes me away from negative thinking. Meditation is good too - I don't do it that often but when I do it definitely helps," Naomi says.
"My brother Michael lives in Scotland so he wasn't here when things were bad, but he's always on the end of the phone."
She goes to a clinic once a week for treatment for a snapped Achilles tendon and does her shopping that day: "I don't go out of the house unless absolutely necessary."
But Naomi admits she has spells of sitting and staring into space during lockdown.
"Usually when I stare into space I think about, 'What if it's like this in September?' I think about supplies into the country and shops, how they're going to cope with it," she says.
"It's scary. If I sat for long enough I would get myself into a state about it, because nobody knows really. Not even the people in power know, they are just flying by the seat of their pants."
Naomi says she was allocated a CPN (Community Practice Nurse) by mental health services but she hasn't heard from anybody since lockdown.
"I understand that they have a lot of patients and maybe they're trying to get around everybody by telephone and it's taking time but I haven't heard a peep from anybody," she says.
She says she worries about the outcome if what happened to her last year happened now: "I know how the system works but for somebody that doesn't know, I'd be afraid for them.
"The only thing that has been consistent is AWARE. They have the group on Tuesday and a mindfulness group on Wednesday. There are different things you can do online."
Naomi says her daughter Megan has done really well through it all.
"I am just amazed at how well she has coped with it all," she says.
AWARE is currently offering peer led online support groups, a telephone support line and email support during the COVID-19 pandemic. Full information and useful resources can be found at aware-ni.org/covid-19-support