What do we mean by “low mood”?

It is common to experience low mood after any illness. We know that relatives are just as likely (if not more so) to experience low mood than the person affected by COVID, irrespective of whether they had a hospital stay or recovery at home.

The following are all common indicators of low mood:

• Feeling sad or empty for much of the time (you may feel worse first thing in the morning).
• Becoming more tearful than usual.
• Feeling irritable and intolerant of others.
• Losing interest in activities that you used to enjoy.
• Finding it difficult to make decisions.
• Paying less attention to your appearance.
• Having thoughts of harming yourself or that you would be better off dead.

Some physical symptoms can also be related to low mood:

• Moving or speaking more slowly than usual.
• Decrease (or increase) in appetite.
• Lack of energy.
• Low sex drive.
• Disturbed sleep, for instance difficulty falling asleep or waking up early in the morning.

The NHS Website has a mood assessment quiz that you might find useful – here

If I’m experiencing low mood – what does that mean?

Firstly, it is really important for us to reassure you low mood is not a sign of weakness or anything to be ashamed of. Thinking like this can become a vicious circle and lead to a spiral of feeling worse. Sometimes when thoughts go round and round in our heads, they can easily get distorted without us realising it. One good way of checking this is to imagine that a close friend of yours had experienced severe COVID, been in hospital and was now at home but with ongoing physical symptoms that limited their activities. Imagine that your friend confided in you that they were experiencing symptoms of low mood, what would go through your mind? Would you think “What a weak person!” or “They should be ashamed of themselves!” – probably not. We are often much more balanced in the way we think about other people than we are about ourselves. Try applying your balanced, compassionate thinking to yourself.

For most people low mood will improve on its own, particularly as you start to get back to doing things you enjoy and give you a sense of accomplishment. If some of the things aren’t going to be possible for a while, or even at all, then finding alternatives will be important.

Managing low mood

It’s easy to feel helpless when experiencing low mood but it is possible to tackle this by focussing on the things that you are able to do at the moment which you enjoy, find relaxing, which give you a sense of achievement or help you to feel connected to others.

Our key advice is to:

• Keep to a routine – People experiencing low mood can easily develop poor sleep patterns, staying up late and sleeping during the day. Try to get up at your normal time and stick to your routine as much as possible.

• Set achievable goals – it can be helpful to make a daily plan of things you can do that you enjoy and give you a sense of accomplishment. Don’t wait until you feel like doing things, instead do something each day whether you feel like it or not.

• Stay connected – Even if you can’t physically meet up with friends and family, don’t withdraw from life. Talking to others can improve our mood. You might feel that you haven’t got much to talk about, that doesn’t matter people will realise you haven’t been able to do much – but listening is the most important part of communication, so ask about their lives, and they will probably be interested to hear about your recovery.

• Eat well – Not having a routine can also affect your eating. Try to make sure you continue to eat regular healthy meals.

• Don’t drink too much alcohol – When people are feeling low people sometimes find they start drinking more to cope with or hide negative emotions, or just to fill time. However, alcohol won’t help you solve your problems and could make your mood even worse.

• Keep physically active – Physical exercise is not only important for your physical recovery it will also help your psychological wellbeing. There’s evidence that exercise can help lift your mood. If you haven’t exercised for a while, start gently by walking, even just walking around your home or garden (if you have one). Keep this in line with your current physical limits and any specific advice you’ve received from health professionals.

Keeping low mood in its place

Recovering from an illness like COVID can be an uphill journey, experiencing low mood can feel like making this journey with a heavy bag on your back. However, low mood isn’t like a solid object it has the ability to expand to the space to fill the space we give it.

This can be a big problem at home. People who are experiencing low mood very often think that they can keep low mood in its place by not talking about it, they think that if they tell people how they are feeling this is somehow “giving in” to low mood or passing it on to others. In fact, most of the time, the complete opposite is true. There’s a lot of truth in the saying “a problem shared is a problem halved”; although you might think that your low mood isn’t affecting those around you, it almost certainly will be. Those close to you will probably notice that you don’t look like your normal self, but they may also notice that you are more short-tempered and snappy. They may notice that you don’t show as much interest in other people and shared activities.

Talk to your loved ones. Try to you find a way to tell them how you are feeling. This may seem frightening and you may be worried about burdening them, but almost certainly they will know something is wrong and you talking about it can help them to understand and get rid of any misunderstandings they might have (for instance that they have done something wrong or that you’ve stopped caring about them). You will also probably find it a big relief to not feel you have to hide it from now on.

You should not only talk about your low mood. This may make you and your loved ones and you feel worse.

Try spending 10 minutes each day talking about how you have felt that day. You could balance that with asking your loved one how they are feeling too.

You might both also want to share something positive that has happened in the day or something you have seen, thought about or done that you are grateful for (reflecting on, even very simple things, we are grateful for each day has been found to be one of the most effective simple techniques to boost psychological wellbeing).

Additional resources for low mood

There are some audio guides available on the NHS website here – nhs.uk/conditions/stress-anxiety-depression/moodzone-mental-wellbeing-audio-guides

Seeking help for low mood

If you find that your mood is still very low after a couple of weeks you should talk to your GP.

They may offer you treatment for depression which might be psychological therapy or antidepressant medication. Psychological (or “talking”) therapies are available free on the NHS and you can get them online or over the telephone through your local “Improving Access to Psychological Therapies (IAPT)” service.

You can also refer yourself to your local talking therapy (IAPT) service without seeing your GP. Find your local talking therapy (IAPT) service here: nhs.uk/service-search/find-a-psychological-therapies-service

If you need to access urgent help

The NHS also offers urgent mental health helplines.

You can call for:

• 24-hour advice and support – for you, your child, your parent or someone you care for to speak to a mental health professional.
• An assessment to help decide on the best course of care.

See – nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline

There are a number of national services run by voluntary organisations that offer confidential advice from trained volunteers. You can contact them 24 hours a day/7 days a week.

• Call 116 123 to talk to Samaritans , or email: jo@samaritans.org for a reply within 24 hours.

• Text “SHOUT” to 85258 to contact the Shout Crisis Text Line .

Sleep problems

During any illness it's common to sleep more as your body fights the infection. While you're recovering, it's also common to have disturbed sleep patterns. You may struggle to get back into a good routine.

You can help get back to a better sleeping pattern by:

• having a comfortable bedroom temperature
• making sure your bedroom is dark – blackout blinds can help
• taking time to relax later in the evening
• getting ready for bed at the same time each night
• avoiding screens – like phones or laptops – for at least 2 hours before bed
• trying to get up at roughly the same time every day
• avoiding caffeinated drinks – like tea and coffee – before bed
• trying not to snack or eat a large meal late in the evening
• setting aside time during the day to write down any worries you have
• discussing your worries with family and friends if you feel able
• keeping a 'sleep diary' to help you work out what helps and what doesn't help you get a good night's sleep

If you can’t get to sleep within half an hour of going to bed, get up and relax in another room until you feel tired again.

If you're feeling very tired during the day and are struggling to stay awake, a 30 minute ‘power nap’ can help. It shouldn’t affect your sleep at night as long as it’s not too late in the day.

Read further information about sleep problems and insomnia