Deutsche Welle: Some people with depression turned to social media as a tool to self medicate when therapy was not available. Do you think that's a good alternative?

Elise Paul: It certainly depends on what people are using social media for. If they are using it to disclose difficulties and seek support, it can be a positive thing, but if they're using it to avoid coping with their difficulties then it could be a negative thing.

We've also found that excessive looking for news and scrolling for news on COVID was related to declines in mental health, so it really does depend on how you're using social media.

How well are therapists actually prepared for dealing with the additional problems that their patients are experiencing now because of the pandemic?

I think it's difficult to say. As an epidemiologist I can't speak on behalf of therapists, but I would say that therapists are people too. Even though we've all been impacted in different ways, we have all gone through the pandemic together over the past year and a half and there will be an increased need for therapy.

I hope that this will be an opportunity for governments, policymakers and even the general population to pay more attention to mental health and to direct more resources into that direction.

A lot of people are obviously feeling the weight of the pandemic. That cannot be compared to a real, serious, clinical depression. So people being moody now — is that just a phase or is there perhaps the danger that they'll actually fall into a proper depression?

I think that it's important to consider how mood swings and irritability are affecting one's life. If it is making it really difficult to carry out your activities, things that you need to do, if it's impacting your work, your parenting, your relationships, then it is important to seek help.

Whether or not you feel you meet some clinical threshold, I think it's important to consider how it is impacting one's life.

How can you differentiate, also as an outsider, and say: "Okay this person now is really in danger, they're not just having a day off but are actually ill"?

Excessive days off from work are certainly one sign. Another sign that friends or family might notice is avoidance behaviours. Some people tend to withdraw and show some of the classic symptoms of depression, such as sleeping too much, reduced energy, lethargy.

Other people can be irritable, lash out, show a lot of anger. So it is important to acknowledge that it can look different in different people.

You mentioned that there is greater awareness of mental illness these days. Could that actually be an upside to the pandemic?

I think it's definitely a good thing, I hope that will come out of this pandemic. It's just unprecedented that we've been cut off from things that we enjoy. We've gotten the opportunity to think about the difference between attending a concert live versus seeing it online. What's it like to be in a room with five of your friends versus on a walk on a rainy day with one of your friends?

So we've really had the opportunity to think about, and as researchers, to study what is it about our daily lives that is necessary to maintain mental health, regardless of whether or not we've slipped into depression, but just on a daily basis.

How do you cope with the pressure of the pandemic?

As best I can, I try to do things every day that keep my body and mind able to cope. I drink lots of water, I try to go to bed every night at the same time and wake up at the same time, I eat healthily. I watch my caffeine and alcohol intake. I exercise every day and I also meditate every day.

I have meditation apps on my phone, even if it's just five minutes in the morning, it really helps me to internalize a calm, soothing voice. 

Dr Elise Paus is an epidemiologist focusing on statistics, behavioural science and health at the Institute of Epidemiology & Health of the University College London (UCL). 

Monika Jones conducted the interview