The World Health Organization (WHO) has warned that long after the pandemic COVID-19 has been brought under control, healthcare providers will have to deal with the diverse mental health issues afflicting populations in different countries. People are likely to be battling anxiety, depression, stress, emotional distress, insomnia, disorientation, even personality disorders like obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) for quite a while to come. These mental health issues began emerging almost immediately after the WHO declared COVID-19 a Public Health Emergency of International Concern in January 2020.
Not Just Patients and Their Families, but Healthcare Professionals Also Are at Risk
The American Medical Association (AMA) has warned that, “Physicians and other frontline health care professionals are particularly vulnerable to negative mental health effects as they strive to balance the duty of caring for patients with concerns about their own well-being, and that of their family and friends.” However, for most people, it is the uncertainty surrounding the disease, especially lack of any preventative actions like vaccines, or information about the most appropriate interventions, which is the most disturbing aspect.
Containment, Then Total Eradication Is the Only Way Forward
The biggest challenge facing all healthcare providers globally is how to contain the spread of the novel coronavirus, and then rid the country of the disease. As South Korea has demonstrated, the slightest relaxation in vigilance as permitting people to congregate in church on Sunday resulted in a sharp spike in identified new cases, thereby undoing all the containment and mitigatory measures the country had undertaken. Given how highly contagious the disease is, eradication can be the only option to prevent its recurrence.
Recognize the dangerousness of the novel coronavirus: Being in denial is suicidal. COVID-19 is dangerous for two reasons — it attacks the respiratory system, and many patients are asymptomatic till it is too late for any medical intervention to have a positive impact. Like many other viral infections, no medicines, except for symptomatic relief, need to be administered. However, some kind of relief measures would be required for those suffering from acute respiratory distress, like putting them on ventilators. Those who work for designated essential services run the risk of bringing home the infection.
Watch Out for These Mental Health Issues
With the lockdown in India, several economic and social challenges have emerged, which in turn have created mental health issues. The rising death toll in various parts of the world is creating a sense of panic among many people who fear for the health and very lives of their loved ones. Survival guilt among those who suffered from the illness, and might have infected others is a little understood mental health issue. The prospect of losing employment and sources of income; facing losses and even the horrific specter of closing down your business; inability to pay EMIs making you lose that dream home you bought; having to take children out of the elite schools they are in because you can no longer afford their fees; or even not being able to place food on the table daily — these are only some of the fears besetting people. Acute anxiety, stress, and depression are automatic outcomes. Sleep disorders like literally getting nightmares, and inability to fall sleep or stay asleep are likelier now than ever before.
Infodemic: The overabundance of misinformation about the coronavirus, especially on social media, is compounding issues. Aggravating the fear of social stigma that attaches to illnesses like AIDS, the divisive factors in societies are fueling fears surrounding the social “other”. This has added to the sense of segregation, fearfulness, and suspicion. Some psychiatrists are warning of the likelihood of increased emergence of paranoia, schizophrenia, and fear psychosis as the pandemic rages on.
Social Distancing Has Become a Major Stressor for the Youngsters
Add the necessity of maintaining social distancing, which most people are unaccustomed to, and the youth and adolescents are prime targets of feelings of isolation, loneliness, and even helplessness. There is only so much that they can eat, sleep, and hang on to their phones. The future looks very bleak to them, and they can’t even look forward to vacations. Proactive steps need to be taken to address psychosocial issues before they adversely impact the youth irretrievably. A few universities are prescribing home based activities for their students for grade points to compensate for study lost to lockdown.
Youngsters need to be socially active: Without being able play outside, meet friends and family, and lack of social events to look forward to; youngsters are more at risk for mental health issues than might have been realized by healthcare providers as yet. The long term impact of the COVID-19 on physical and mental health cannot be assessed just yet. It is vital to involve them actively when planning survival and mitigatory strategies.
Mental Health Issues Surrounding Food
The well to do are stressed because they are unable to source exotic ingredients. However, for most people the issue is the inability to buy groceries, vegetables, fish, meat, eggs, and dairy products; either because they are not available locally, or because their daily earnings have stopped. There is the added fear of food stocks running out. Unseasonal rain has destroyed crops in many places. This has led many people to hoard essential items. Two disorders which could potentially emerge from this are eating disorders — anorexia (people being too scared to eat) and bulimia.
Different Target Groups Would Have Different Psychosocial Needs
It is important to divide target groups by age, education, and social levels. The elderly and people of the upper middle class and upper class are likelier to develop OCD as they try to ward off infection. The poor who don’t necessarily have access to running water, let alone alcohol based hand sanitizers, don’t run any risk of developing such mental health issues. However, they are likelier to go into depression as they face starvation due to lack of work. Similarly, the concerns of people with elderly parents living in a different city, town, or in the village homes would be different from those of young couples who are expecting their first-born. The first would be beset by anxiety, stress, and a feeling of helplessness. The latter might become hypochondriac.
Frustration and isolation: The young couple who had hoped to gain appropriate employment in the coming months, and get married to begin their own family would be suffering from extreme frustration and anger. The elderly and physically challenged would feel neglected, and social distancing is likeliest to hit them the hardest.
Struggling to Stay Positive? Do This
Not following the daily news too closely, and getting away from social media periodically is a good way to prevent getting depressed. Instead, catch up on domestic work which often remains pending as it is low priority; read the books you have been meaning to; take up a new hobby, or just follow the old one; listen to your favorite music while going about your daily chores. It is also the perfect time to spend quality time together, and get to know each other better. Unfortunately, modern living often deprives people of the joys of communicating freely within the family about dreams, aspirations, and other topics. Pray together, laugh together, work together, and eat together to bring your family closer together. Share and amplify positive stories.
Coping Strategies
Try upskilling whether you are a techie, or in any other profession. Practice yoga at home to calm your mind and keep your body fit. Do deep breathing exercises to cleanse your respiratory and circulatory systems. Learn how to cook interesting, nutritious meals using the simplest, and most basic ingredients. Meditate to clear your mind. Do a spot of gardening, if possible. Take to writing. If there are elderly people in your locality, try to help them by running errands or reading to them without jeopardizing your own health. Watch all the movies you missed. Watch comedy shows. Give your imagination a free run, and visualize delightful scenes or places. Indulge in a bit of nostalgia to recall happy times with family and friends. Be supportive of others struggling with mental health issues.
Contact Your Psychologist Now, Virtually If Need Be
If you or a loved one is displaying any signs of developing mental health issues, contact your psychologist now on phone, WhatsApp, Skype, or Google Talk. You could also seek help from our department of psychiatry.
Useful links: Check these out for more information.
https://wwwnc.cdc.gov/eid/article/26/7/20-0407_article
https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
https://www.ama-assn.org/delivering-care/public-health/managing-mental-health-during-covid-19