As the coronavirus pandemic upends daily life around the world, an unprecedented mental health crisis is beginning to emerge.
Health care professionals in many countries have described a crisis that is affecting many millions of people, whose lives have transformed even if they are not among those touched directly by COVID-19.
On Thursday, the UN presented a report warning of a coming surge in mental health problems, the latest in a series of similar warnings.
This week, an international survey of almost 11,000 people by Spain's Universitat Oberta de Catalunya found that more than half of all adults had recently felt depressed or hopeless about the future: 57% in the United Kingdom, 67% in Spain, and 59% in Italy.
Business Insider spoke to three people about their experiences of living through a mental health crisis.
'Sloping off several times a day just to cry'
Dave Powell, 34, a sports journalist from Oswestry, in Shropshire, had never suffered from mental ill-health.
2019 had been a tough year for him. His father had died but he had returned to work the next day at the Chester Chronicle local newspaper in northwest England.
His second child, a son, was born in September. He also went through the change of switching to working remotely, months before that would become a reality for many others.
But if he felt stressed, he would relieve the tension with a game of football or basketball. He was getting on with life, or so he thought.
When the coronavirus pandemic hit the UK in March, and normality was brought to a sudden halt, Powell began to struggle.
"The reality was I had buried so much last year. Not grieving my father was the trigger," he said.
Two weeks into the lockdown, despite having his loving family around him, Powell felt himself slipping.
He said: "I am not a tearful person. I've always been quite measured. I don't usually get too high or too low but I just felt absolutely crushing lows throughout the day.
"I wasn't able to motivate myself and I'd find myself sloping off several times a day just to cry. I'd make sure that nobody saw me. I'd go to the garage... I thought, 'I'm gonna have a heart attack if I don't do something.'"
"I ignored pleas for me to seek help from my wife for some time before we eventually sat down and I laid out how I was feeling. She could see how ill I was.
"I found talking it over helped enormously and I agreed to seek help, which has been hugely beneficial."
Initially, Powell felt loath to approach the health service, fearing he'd be a burden on a system amid the coronavirus crisis. But he eventually spoke to his GP by phone. "The doctor was absolutely fantastic. It just reaffirms my belief in what a wonderful health system we have.
"It wasn't just a case of 'I will prescribe you xyz.' He was trying to find the root causes of what it was and gave me a few coping mechanisms. I do take a very low dose of medication. But I don't feel that that's what gets me through the day. I feel like it's talking about it."
Recently, Powell went public with his experience with severe depression in a series of posts on Twitter.
—Dave Powell (@_DavePowell) April 27, 2020
"I just wanted to share a wider message and at least bring some good from what's been a bit of a tough situation. I just wanted to help some people and it has actually.
"I've had several people contact me via Twitter to share their own experiences; friends that we've got who I didn't even know were struggling. They're looking to try and find some help themselves now.
"You think everything is rosy with everyone and you're the only person with the problem but it really isn't the case."
'The stigma of mental illness has taken a temporary break '
Jenna Oldridge is a 32-year-old teaching assistant working with teenagers with special needs. She lives in Newport, Wales, with her husband.
She has had severe anxiety all her life, triggered by a family bereavement as a child. She says she has suffered problems including obsessive-compulsive disorder, depression, borderline personality disorder, and, at times, paranoia and delusions.
Oldridge used to use powerful anti-depressants, but stopped in 2018. She says many people would not have known she was unwell.
She told Business Insider: "When I go home after a day's work they don't know that I literally eat my dinner and I just lay in my bed.
"So I function, I've contributed to society, I pay my taxes or whatever but I feel exhausted. I feel fatigued. There are days in the morning before I go to work that I might have a panic attack or I might be crying. But then I go to work and I get through the day, and nobody really sees that."
By the beginning of 2020 she was in what she described as a "good place," holding down a part-time job. But the coronavirus lockdown has made her work precarious, and exacerbated her anxiety.
"Because I work for an agency, given the lockdown I was then worried about how I am going to get paid," she said.
"I've been furloughed. The contract that I have signed says they only have to support me for a minimum of three weeks. After that, it's sort of at their discretion. So I have got to speak with the benefits people," Oldridge said, using the British term for unemployment support.
Oldridge says she has in some ways found it easier to cope with lockdown because of her long experience of mental illness, and believes that the wider population's brush with isolation is helping them understand mental health more broadly.
"When the lockdown started, everything just sort of stopped," she said. "Because I'm used to days where I wouldn't go out or days when I wouldn't bother with people, just because I didn't feel that up to it, in some respects, it is easier to adapt to not going out. I'm used to having some level of anxiety. There is a level of acceptance."
But there are challenges too.
Online shopping, for example, has become a trial: "Since it's started, I've ordered two click and collect shops from [UK supermarket] Tesco, and when I bought shopping into the house I've wiped things down and it never feels good enough.
"I feel like all these carrier bags, you know, they're not my old carrier bags that I kept in a cupboard. 'Do I keep them? Do I throw them away?' And once I put the shopping away and I've decided if I'm going to keep those bags or throw them away, I realize I was a bit irrational there."
Oldridge saw a counselor every week before the lockdown, but that treatment abruptly stopped it.
This loss of help has played out nationally. The mental health charity Mind found in a survey that almost a quarter of those who tried to access mental health support did not get anywhere, due to canceled appointments and overstretched services.
'They turn to Samaritans because they have nobody else'
Sue Peart is a volunteer with the Samaritans, a storied British charity which offers help to those in need.
The counseling organization, which has 20,000 volunteers around the UK, available by phone or email, 24 hours a day, and aims to always respond to those in need.
Following a career in magazine journalism at the Daily Mail newspaper, Peart became a Samaritan two years ago, working at one of its south London branches.
It has remained open throughout the lockdown, even as many other mental health services were forced to close.
Some volunteers have had to stand down because of self-isolation, but Peart has kept up four shifts a week, taking phone calls. She has she has spoken to people as young as 12 and those in their late 80s.
Reflecting on the last six weeks, she said: "You know I'm not actually sure if the number of calls has risen, it probably has, but it always is busy.
"The number of emails has risen and I think that that's because under look down, in some circumstances, people have difficulty finding a private corner where they may want to have a long involved conversation."
Peart believes the mental health trauma has hit hardest people who had an underlying psychological problem.
"If you are lonely, if you are isolated, if you have mental health issues, if you are depressed, if you are in an unhealthy relationship, or if you're in an abusive family situation, if you have concerns about your finances, all of those things will be exacerbated by lockdown."
Work furloughs and job losses have also taken a particular toll, beyond the financial.
"Going to work is about so much more than going to work. It takes you away from your home situation, which can be bad. It's a social group, it's your colleagues you can chat with and know a bit about you but not too much, and you know a bit about them but not too much, and it makes you feel connected.
"If you take those things away, it really can be very hard for people. I think the importance of human connection has come through with lockdown."
Now, she said, people turn to Samaritans "because they have nobody else to turn to and they want to hear a human voice. It was a revelation to me to understand just how huge and widespread a problem it is."
The coronavirus is the biggest crisis The Samaritans have ever faced and has launched an emergency appeal.