International Berliners have been particularly affected by the isolation of lockdown and the limited availability of mental health services in the city (symbol image).
Photo: IMAGO / Petra Schneider
In another time, Hanna might have been a poster child for the New Berlin. Since moving to the Hauptstadt from her native Hungary five years ago, the 33-year-old hairdresser and make-up artist has worked tirelessly to build a creative career, freelancing for a range of theatre and film productions. As business improved, she could finally afford to rent her own apartment – and, early last year, she took the plunge. For the first time in her life, she had her own space. “I had moved away from home for school at the age of 18, where I lived in a dorm and then a shared apartment,” she remembers. “Coming to Berlin, I couldn’t afford a space all to myself, so I was moving from WG to WG. Finally, I got to a place in my life where I could afford to pay for an apartment on my own, and I loved it.”
Shortly afterwards, the first Corona lockdown was announced. The novelty quickly wore off, giving way to loneliness and depression; Hanna found herself alone in her flat. Now, a year later – in the virus’ second wave, and the daily news narrative of fast spreading corona ‘mutants’ – Hanna is feeling seriously hopeless. She has been searching for a therapist for six months, but Berlin’s mental health services seem to be overwhelmed with high demand. Since hitting a low point at Christmas – eating pasta alone in her apartment while everyone she knew was with loved ones – she has been considering giving up on Berlin and moving back to her parents’ place in Hungary.
Hanna’s story is no isolated case. While the physical and economic costs of the pandemic are clear, countless Berliners are also suffering from various forms of psychological hardship – often in private, and often to an overwhelming degree. Mental health professionals are now sounding the alarm about Corona’s long-lasting emotional damage.
In doing so, they are identifying a surprising group of at-risk Berliners – not isolated seniors or homebound schoolchildren, but people in their twenties and thirties, above all singles and those from outside the city. It might seem counter-intuitive that a demographic usually seen as young, carefree and privileged would face a heavier psychological burden from the pandemic. But the very flexibility that makes millennial Wahlberliner life seem so romantic can very quickly turn sour, particularly when the pandemic blocks off a person’s usual sources of belonging, companionship and income.
“It just became harder to get out of bed”
Like many single Berliners, Hanna has found it challenging to live alone during the pandemic. She had been thrilled at first, and even when the lockdown was announced, she dedicated herself to decorating the space. “For a while I was making things pretty,” she says. “I ordered plants and hung them in my handmade macramés, I sewed new curtains.” With work on pause, Hanna enjoyed catching up on television and books, trying out new recipes and developing an exercise routine. She spoke to family and friends on Skype and went for walks with acquaintances from work. “It was all looking good,” she remembers. “But then at some point it just became harder to get out of bed in the morning, and I gradually stopped all the activities I was doing. I suddenly realised I didn’t really have friends here because I was working so much anyway … Suddenly nothing made sense.”
At some point it just became harder to get out of bed in the morning, and I gradually stopped all the activities… Suddenly nothing made sense.
As spring turned to summer, Hanna made an effort to fight her malaise. Hopeful that things would soon be returning to normal, she found some work opportunities and set out to build stronger friendships: she attended the picnics she used to turn down, reached out to people she knew for company and – after a week recharging in Hungary – decided to find someone to date. A handful of Tinder and Bumble meetups came to nothing, however. And Hanna soon felt the depression returning. “I was trying so hard, but in the back of my mind it was already too gloomy,” she says. “By the end of summer, I was back in bed, not feeling motivated to do anything at all.” Hanna ate a lot of junk food. Some days she only left the bedroom to use the toilet. She was thoroughly alone. “One night, I woke up from a dream where I was dead and no one found my body for weeks.”
The day after her disturbing dream, Hanna decided to seek help. She immediately began looking for a therapist online, sending messages to a number of suitable-looking practitioners she found via the Association of Counselors and Therapists website. “I was proud of myself for taking this step,” she says. Hanna had battled depression in her teens and twenties, but it was a taboo topic back in Hungary. “I was happily thinking that in Germany you’d get so much support for mental health issues,” she says, “but boy was I wrong!” Hanna got no responses from her first round of messages, and when she broadened her search to all English-speaking therapists, she still failed to secure a place. “I have contacted about 100 therapists so far,” she explains. “Most of them don’t even reply, and if they do, it is just to say that they have no capacity for new patients at the moment. I feel like I am on the verge of a breakdown.”
Berlin’s international millennials are feeling the strain of the coronavirus pandemic. Artwork: Agata Sasiuk
Second lockdown blues
Across Berlin, the pandemic’s psychological toll is adding up. This is the “hidden cost” of COVID-19, regularly overlooked in discussions that emphasise the trade-off between physical health risks and economic consequences. While the long-term mental health effects of the coronavirus are not yet clear, the data is already revealing a bleak picture. Health insurer AOK Nordost reported that the average length of time taken off work due to psychological problems between January and August 2020 in Berlin rose by 16 percent. Covering a period from June to October 2020, a preliminary study led by the Hochschule Merseburg in Saxony-Anhalt into the effects of Corona’s first wave found that 40 percent of respondents reported that their frame of mind had worsened.
But it’s the second lockdown that appears to have been the most psychologically challenging for Berliners. According to Laura Fricke, general coordinator of the emergency mental health service Berliner Krisendienst, the number of calls for help and counselling have risen dramatically since the second lockdown began. While call numbers were roughly normal for the pandemic’s first few months, they began to climb throughout the autumn before spiking in November and December. “Comparing December 2020 to December 2019,” Fricke explains, “we saw an increase in calls of about 18.5 percent, or about 1000 cases.”
The reasons for contacting Berliner Krisendienst – which provides free emergency mental health assistance, usually via phone, in German, English and other languages – are closely linked to the consequences of lockdown, she explains: callers mention the effects of the Corona measures on their daily existence, their social lives and their economic situations. “Some call because of their increased anxiety to go outside and to get infected while they do groceries. People suffer from loneliness a lot,” she explains. “We can generally say that mental health problems, including substance misuse and addictions, have seen a significant deterioration during the last months.”
With the second lockdown people have grown tired and irritable. They want their old life back, but they don’t know when all of this will stop.
This is a trend also seen by Pilar Isaac-Candeias, a Schöneberg-based psychotherapist, who says that many of her patients have found the second lockdown hardest: “The first lockdown was in late March, the sun was shining and it was an adventure. By the second lockdown it was winter, and we’d already had a year with restrictions, and now the measures have gotten stricter. People have grown tired and irritable. They want their old life back, but they don’t know when all of this will stop.”
Increased risks of relapse
Most at risk are Berliners with pre-existing mental health conditions, now exacerbated by the effects of the pandemic. Fricke says that these struggles have in many cases been compounded by the lack of social contact – causing loneliness and anxiety – and reduced availability of support services, which many people have found to be less accessible than before.
In Karen’s case, the pre-existing conditions were there, unsuspected by most of her friends and colleagues. For them, she was that high-achieving, hard-working 31-year-old friend from Vancouver who’d moved to Europe 12 years ago – first to the UK and then recruited to work at the Berlin office of a big international marketing firm. The fleißig type, she would go the extra mile (often on an extra weekend) to please a client. She was rewarded for her results with a bonus last year (despite the circumstances) and was on her way to a promotion.
But then in late January she didn’t turn up to a big-deal Zoom meeting with important clients. She didn’t answer calls from colleagues and bosses trying to figure out what happened. Three days later they received an email with her resignation and a sick note from a psychiatrist. What her colleagues and many others didn’t know is that Karen had history of mental health struggles; since her brother died at the age of 19, she’d suffered spells of depression and had been seeing a psychotherapist for 15 years. Her friends knew, but all the same were helpless witnesses to her spiralling back into depression.
Working from home since last September (her choice), Karen slowly began to isolate herself, first of all seeing less and less people, before eventually stopping communication with her friends altogether. She lives alone with her mini dog “Muzi”, which she bought herself as a gift for a very lonely Christmas (she had spent the holiday period alone, turning down invitations to celebrate with friends on account of it being “too risky”).
No one’s seen her since January except for her two closest friends, who take turns to stop by her Friedrichshain flat and check up on her – even though she won’t let them inside. All they know is that her psychiatrist put her on antidepressant pills and that she gets out of bed to walk Muzi. Karen’s parents in Vancouver, worried sick, considered braving the lockdown to visit and rescue their daughter – but she begged them not to. “Don’t worry,” she texted. “I need time.”
Young, free and more at risk?
The suffering of younger people seems to be a particular feature of the pandemic. Although senior citizens may be more physically at risk from the effects of the virus, their mental health during the pandemic appears to be a lot less affected. A study from the Hochschule Merseburg (between June and October) suggests that against all expectations, young adults and millennials, particularly singles, have had a harder time dealing with the pandemic and its effects than older demographics. While about 30 percent of respondents aged over 50 said that they felt worse during Corona, the figure was about 45 percent for those between 18 and 40. Similarly, while a minority of those in the older generations (35 percent of 51-85-year-olds) said their mental well-being had been affected by the pandemic, the number rose to up to 60 percent for people between 18 and 40.
This impression is backed up by data from COSMO, a coronavirus research project run by the Robert Koch Institute and several universities. When asked to express their feeling of anxiety and loneliness, people in their twenties systematically rated the highest (between 1.9 and 2.2 on a scale to 4); meanwhile the older the respondents, the lower the results (people 65 and above had the lowest at 1.3 -1.7). The study which was conducted from March 2020 to January 2021 also shows that both loneliness and anxiety got worse over time, to peak in the end of the study.
The results appear to be counter-intuitive: one would think that younger generations, among the least vulnerable to the effects of the actual virus, should be less affected psychologically; however, they seem to be more severely hit by lockdown life and other measures to combat the pandemic.
Solo, not sunny
There are particular reasons for the relative vulnerability of Berlin’s younger residents. More so than other age groups, they appear to be especially affected by the lack of social life and fears for the future. “For people under 30, they would usually be setting off into life after finishing exams or wanting to work and travel,” Isaac-Candeias, who in addition to offering sessions in German, Spanish and Portuguese, is a board member of the Berlin Psychotherapeutenkammer (Chamber of Psychotherapists), explains.
“Now they are completely burnt out. For this generation, it’s completely different. When you’re 50, your life is pretty well set – maybe now and then a few parameters change, but you know who you are, what you do and how you live. With 20- and 30-year-olds it’s precisely the developmental task to ask yourself who you want to be, what you want to do and to try things out.”
Where recent high school graduates would be meeting people at university or exploring potential new futures for themselves, they are instead stuck at home on the computer. Worse, the all-important peer group factor is missing for young adults during the pandemic. “The feeling of being down, this not being able to set out into the world and try things in a group, not breaking out of the parental home – all that is not there,” she says. “And that makes you afraid of the future.”
More specifically, young singles seem to be finding the pandemic more difficult than those in relationships. A survey by online dating service Parship found that singles under 30 are suffering the most from loneliness during the pandemic, even more so than those over 60: around 36 precent of singles between 18 and 29 reported feeling more lonely than usual, compared to an overall average of 29 percent.
Isaac-Candeias agrees that loneliness is a serious problem for many young singles, especially those who – like Hanna – live on their own. “Man is a social being,” she says, “and we know that people get sick when they aren’t touched: the immune system suffers, and that’s what happens when you live all alone and there is no child running around you, no partner stroking your head, no one taking you in their arms and so on. It is really hard!”
Dating has become too difficult – and too weird.
For Hanna, the excitement of sprucing up her apartment eventually gave way to a bleakness rooted in social isolation. “I realised, who am I decorating the flat for anyway?” she remembers. “I had no boyfriend, not even a friend with benefits. So what for? And why am I working out?” Still, Hanna speaks with disappointment about her recent weight gain. “These are my last good years to find a normal guy, settle down and have children, to work and travel, and yet Corona is taking them away from me. I’ve never even been to an FKK beach to show off my body before it gets all saggy.” The worst of it, she says, is that she hasn’t touched another human being since last August. “Dating has become too difficult – and too weird.”
Vulnerable Wahlberliner
The mental health situation is perhaps most challenging for solo Berliners who have moved to the Hauptstadt from elsewhere, particularly other countries. Not only are many young foreigners cut off from their families by international travel restrictions, but they also lack an established support structure, as Isaac-Candeias observes: “All the young international people who come here to study – they don’t have anything yet, they have to build everything up here first, and they are lucky if they somehow find a hole where they can live. But even then, they just have their computer and nothing else.” Those with jobs as waiters suddenly lost their income, while anyone working cash-in-hand hasn’t been entitled to any state support. Additionally, with the pause on cultural and social life, many young Wahlberliner find themselves locked off from the usual means of finding community – and from the various spaces, not least the queer club scene, that might have drawn them to the city in the first place.
The vulnerability of international Berliners during the Corona pandemic is compounded by the limited availability of mental health care, especially in languages other than German. The Krisendienst offers multilingual counselling – but this is an emergency service, not regular therapy. “There are too few therapy places,” argues Isaac-Candeias, who receives eight emails and six phone calls a week from people who want her services. “And migrants, people who are looking for therapy in another language, have no legal right to it. Even if I pay my health insurance contributions but only know Spanish, I have no entitlement to therapy in Spanish – the health insurance company just says they don’t care.”
Hanna has been seeking a therapist since November, but to no avail. She cannot afford to pay privately, since her November– and Dezemberhilfe money won’t stretch to cover the €80 sessions. Recently, she contacted her general practitioner – who had previously given her a referral but did not mark it “urgent” – to tell him she’d been having suicidal thoughts and wanted to see someone as soon as possible. The GP suggested looking into Berlin’s crisis centres, since therapists are currently overloaded with patients.
As bad as the situation is, this is only the beginning. Long-term consequences will be felt in the future, when the economic impact really kicks in and new data, especially in relation to the second lockdown, is released. For example, suicide rates won’t be disclosed until later this year. But already, mental health professionals all over the world are warning about the delayed consequences of the lockdown and the pandemic stress. “We know from experience that with depressive states caused by exhaustion people hold themselves together and use all kinds of coping mechanisms during stressful phases,” explains Isaac-Candeias. “It’s only later that the depression kicks in.”
So, with the effects of the virus ongoing, will the next wave be the psychiatric one?
