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Gwen Madiba

“Welcome to uOttaKnow, a forward thinking, expert-driven, current affairs podcast produced by the University of Ottawa. Hello, my name is Gwen Madiba, your host of uOttaKnow and a proud two-time graduate of the University of Ottawa’s Faculty of Social Sciences. I am also the co-president of the Equal Chance foundation. uOttaKnow connects you with experts from the University of Ottawa to address the most pressing issues facing society today. As you all know only too well, COVID‑19 is one of the biggest stressors in our community right now. Although the risk to physical health is worrisome, how will the pandemic-related isolation, economic restrictions and major uncertainty affect people in the long run? To answer that question, I called Dr. Nafissa Ismail, a neuroscientist, researcher and professor with the University of Ottawa’s School of Psychology. Dr. Ismail has devoted her career to studying the effects of stress on the brain and how it can heal.” 

“Dr. Ismail, since March, many of us have had to change our routines, and our stress levels have been going up. Although the initial shock may have faded for some since then, what are the psychological effects that can be expected at this stage in the pandemic?” 

Dr. Nafissa Ismail

“Yes, the current situation is particularly stressful for everyone. It’s not an easy situation at all, and it’s especially tough on people who already have psychological illnesses or substance abuse-related disorders. As you said, this situation has really changed our routines. Our daily way of life has been turned upside down—not only because of the pandemic, but also because of the preventive measures that have been put into place. Those measures are of course necessary to slow down the spread of the virus. And when we put all that together, we see that people have been under a tremendous amount of stress. Faced with a stressful situation such as this one, which has been with us for a while now, people have a greater tendency to develop symptoms of depression and anxiety.” 

Gwen Madiba

“Dr. Ismail, do you think we’re seeing a mental health crisis as a result of the pandemic, or has our collective mental health always been in a state of flux?” 

Nafissa Ismail

“We’re definitely seeing a pandemic-related crisis. It is, of course, early days in assessing the impact of the situation. However, we already have preliminary data to work with. For example, 88% of respondents to a Statistics Canada survey reported having symptoms of anxiety since the start of the pandemic. Half of respondents also said they felt that their mental health has deteriorated significantly. So, we’re already seeing an increase in psychological disorders among people since the start of the pandemic.” 

Gwen Madiba

“For the past few months now we’ve been hearing about a new wave, a second wave. What can we expect from a potential second wave, and how will people be affected if the situation continues?” 

Nafissa Ismail

“Of course, with a second wave, you can expect to have to go back into confinement and to return to the measures that were put into place initially to slow the spread of the virus. A situation like that is so hard for us humans because we’re very social creatures. When you’re living in an isolated environment, when you know you can’t do what you want and when you can’t socialize to the extent you need to, it takes a real toll on our physical and mental health, and it exacerbates symptoms that were already there. So, what we’re seeing, for example, is that as this pandemic drags on, people are experiencing chronic stress. It’s no longer just a stressful period; rather, stress has become a constant in people’s daily lives. With stress come higher levels of cortisol in the body and, in tandem, increased inflammation. As a result, you can expect to see more cases of depression, anxiety and post-traumatic stress.” 

Gwen Madiba

“Dr. Ismail, how does that kind of prolonged agitation affect our brain?” 

Nafissa Ismail

“Prolonged stress, or chronic stress as we call it in science, causes our level of cortisol—a stress hormone—to rise. Inflammation in the body also increases. Besides affecting our physical health, chronic stress leads to changes at the blood-brain barrier. That is the membrane that usually shields the brain from what’s going on outside in the rest of the body. However, chronic stress makes this barrier more permeable, allowing inflammatory proteins in the body to cross into and reach the brain, resulting in neuroinflammation. That inflammation then, in a manner of speaking, remodels the brain—changing not only its structure, but also its functioning. So, some regions of the brain are definitely more vulnerable to neuroinflammation than others. One such region is the hippocampus, which plays a key role in learning and memory. Neuroinflammation as a result of chronic stress causes the hippocampus to shrink in volume. That shrinkage can lead to memory and learning disorders, in addition to increased symptoms of depression. There are also changes in activity levels in the prefrontal cortex, a region of the brain that plays a key role in our decision-making, problem-solving and planning ability. With chronic or major stress, the prefrontal cortex becomes less active, which affects our ability to make good decisions, solve problems and concentrate. So, you can really see the impact on the brain. The amygdala region of our brain is also very sensitive to neuroinflammation and chronic stress. However, unlike in the prefrontal cortex, activity levels in the amygdala region actually go up, making it harder to control our emotions. And that’s how chronic stress leads to increased anxiety.” 

Gwen Madiba

“So, from a neurological perspective, how can we preserve or reinforce our resilience, and what do you recommend people do to maintain their mental health?” 

Nafissa Ismail

“The good news is that we know from animal studies that the harmful effects of chronic stress on the brain can be reversed. It all depends on the length of exposure to chronic stress and the person’s age. There are also differences between males and females, men and women. The best way, then, to protect our brain and to make it more resilient in this time of chronic stress is to really try to manage stress in a healthy manner, in order to reduce the levels of cortisol and inflammation in the brain. There are several things you can do for that, such as trying to cope with stressful situations better. Coming to terms with a stressful situation can seem daunting at times. However, you can start by chipping away at the factors associated with the situation, which will take it down a notch and make you feel a little bit more in control. You could also try to put a little more structure into your life. People often feel stressed when they have a lot of tasks or things to take care of but do not have enough time to get everything done, which then becomes a major source of stress. So, you could try maybe to give yourself a little more structure in order to manage your time better and to get things done when you need to—and try to get a better night’s sleep. Sleep is very, very important at this time and during periods of chronic stress. You often find that chronic stress and elevated levels of cortisol and inflammation in the body really interfere with sleep. So, try to relax before you go to bed. You want to try to get the level of cortisol and inflammation in your body down and relax so you can sleep when you go to bed. People should also not hesitate to ask for help when they need it, because people need to feel supported. The more support you have, the more connected you will feel, the more resilient you’ll be, and the better you’ll be able to cope with stress. That is really important. And sometimes you have to realize that a situation is stressful because you perceive it to be so. And since they are often situations you really cannot do much about and you’re stressed out when you’re in the thick of things, you could perhaps try to change your attitude towards them. Try maybe to put a positive spin on things. It’s not easy, but try to see things a little differently because, the fact is, the situation is temporary. Maybe instead of seeing things as stressful, try to see them as an adventure or as something temporary that you’re going to tackle with the help of others and get through, and everything will be fine afterwards. So, by changing our attitude, we won’t be as stressed in that situation. We’ll also become more resilient and able to protect our mental health and our brain.” 

Gwen Madiba

“Dr. Ismail, a little while ago you said we should never hesitate to ask for help. These past few months, we’ve seen people in our community really pull together. Do you see positive signs in how our society perceives mental health and how people are supporting each other during this pandemic?”

Nafissa Ismail

“Yes, absolutely. It is really heartwarming to see how we as a society have come together to show that while, yes, we have to physically distance, and, yes, we are physically separated, we’re all in this together. So, simply being aware that the pandemic has an effect on mental health is already a lot because, not so long ago, people wouldn’t talk about mental health-related disorders. They shied away from talking about them. It was taboo and frowned upon. But that has changed now. Now people will talk about them, people are willing to get help, and people are prepared to support others around them when they see they need help and are suffering or in distress. We are seeing a major shift in society, and that is very, very encouraging. The federal government and provincial governments have put a number of mental health supports in place for Canadians during this major crisis. That is huge because, not so long ago, many people could not access those services. But now they are being made available to people when they need them, because they need them right now—not in two weeks or in a month from now. Making these services so that they are available when people need them is so important and goes a long way in protecting people’s mental health. The better we’re able to protect our mental health during this pandemic, the stronger we’ll come out of it on the other side, and the better able we’ll be to take action and rebuild our lives—and draw on that much-needed strength down the road.” 

Gwen Madiba

“Thanks so much, Dr. Ismail, for all of this important information you’ve shared with us today. I’m sure it will help many people. Thank you so much for taking time out to speak with us.” 

Nafissa Ismail

“Thank you for having me.” 

Gwen Madiba

“Thanks to our guest, Dr. Nafissa Ismail. You can follow Dr. Ismail’s work at the NeuroImmunology, Stress and Endocrinology (NISE) lab at socialsciences.91��Ʒ���ϳԹ�.ca/nise. Resources are available to help with mental health problems—see the Canadian Mental Health Association website at ottawa.cmha.ca. For immediate assistance, call the Ottawa Crisis Line at 613‑722‑6914. For more information about mental health and the University of Ottawa’s response to COVID‑19, see the description for this episode. 

“uOttaKnow is produced by the University of Ottawa’s Alumni Relations team. This episode was recorded at Pop Up Podcasting in Ottawa, Ontario. The University acknowledges that it stands on unceded Algonquin territory. To find out more about uOttaKnow, go to 91��Ʒ���ϳԹ�.ca/alumni.”