New Delhi: While the world is grappling with what has been classified as a pandemic by the World Health Organisation (WHO), psychiatrists sense a rise in acute stress reaction and post traumatic symptoms among people with no history of mental illness. According to the experts, the monstrous novel coronavirus (COVID-19) will indeed have long-lasting impact on the economy of the world and other things but it’s going to have gruesome psychological scars as well. In fact, the cases have already started coming up. For instance, a 62-year-old woman who has no history of mental illness and was in quarantine for 14 days is now facing difficulty in sleeping. Since the last eight days, she is getting thoughts, continuously and is unable to sleep.
If COVID-19 can impact people mentally fit individuals then one can imagine how adversely it can affect individuals with underlying mental illness including anxiety, depression, and others. And the major cause will be coronavirus outbreak leading to a lockdown. At this juncture where stepping out of the house can risk you contracting the infectious disease, and the only way to stay safe is by staying locked up in the house, NDTV asked experts how can one ensure mental well-being under such circumstances.
Talking about the current behaviour pattern and our reaction to the crisis, Dr Shelja Sen, Child and Adolescent Psychologist and Family Therapist says,
What we are facing right now is something we have never experienced. There is a tendency right now for everybody to try to keep in the loop all the time through WhatsApp updates, by watching the news and there has been a certain weird kind of FOMO (fear of missing out) that’s coming. They want to catch up on every possible news piece and that’s creating a kind of toxicity or catastrophisation which is not going to help anybody. It’s very important that people understand that if you want to stay updated, check it once a day but don’t let this fear hijack your life.
Impact Of ‘Coronavirus Disaster’ On Mental Health
According to Dr Harish Shetty, Social Psychiatrist, this is a disaster that will have long lasting impact. Dr Shetty who has worked in riot and disaster hit areas, talks about the possible impact of coronavirus on mental health while drawing similarities with that of a disaster. He says,
In the past, fears outdid earthquake and riots. Even when an earthquake or cyclone is over and everything is settled, some people will get paranoid at the sound of anything resembling to that of an earthquake. Similarly, in coronavirus, there will be long term impacts. Currently, we are in the altruistic phase where everybody is helping everybody. Once the altruistic phase is over, there will be fear of disillusions. At that point in time, in the long term, panic attacks will increase, nightmares will increase, and fear of illness will rise.
Further sharing instances of how the epidemic has already started affecting people with existing mental illness, Dr Shetty said,
A patient of bipolar told me he believes that he is responsible for the entire corona epidemic. I had to speak to him and adjust his dose. In the morning, I met an engineering boy who has not stepped out of his house for four days and wants to attempt suicide. He had no mental illness.
According to the doctor, those who suffer from psychosis will see an increase in anxiety and panic attacks and once the disease is controlled, there will be cases of acute stress reaction, post traumatic symptoms and some might even suffer from anhedonia – the inability to experience emotions, be it joy or sorrow.
In the early stage, symptoms like lack of sleep, harsh eating, very fast palpitations, anger and irritability have already started showing up. The major reasons behind this are staying within four walls and a decline in the quantum and intensity of communication. Individuals who have never worked from home are facing some severe difficulties in terms of communication.
My son who works in an advertisement agency finds it very difficult to connect with the team and communicate. It takes much longer time to get everybody on the call together. He is getting a little irritable now, says Dr Shetty.
In the late post impact phase of the disaster or pandemic, we will see a variety of symptoms among different groups of people, but more among elderly (above the age of 65), especially the one living alone. Talking about why elderlies are prone to having symptoms of mental illness, Dr Shetty says,
There are three reasons; firstly, they are being repeatedly told that they are more vulnerable than others. Secondly, so many of them are staying alone. In a globalised world, there is a massive disconnection and people staying alone connect with their kids only over the phone, skype, zoom, and others. Thirdly, the loneliness is known to bring down longevity and increase the chances of depression.
According to a study titled ‘Loneliness and social isolation as risk factors for mortality: A meta-analytic review’ published in the journal Perspectives on Psychological Science, individuals lacking social connection (both objective and subjective social isolation) are at risk of premature mortality. The subjective feeling of loneliness increases the risk of death by 26 per cent. While social isolation increases the mortality risk by 29 per cent, living alone was found to be even more devastating – taking the mortality risk to 32 per cent.
Maintaining Mental Peace In The Time Of Coronavirus
Elaborating on how older people should keep themselves busy and divert their mind from all the negative thoughts, Dr Shetty said,
In the past, they would go for a walk with other elderly and crack a lot of naughty jokes. They should make sure to do it on a zoom call or over a phone. They should actively keep in touch with those people. They should take a little walk inside the house, as prescribed by the doctor, not more. Also, pick up the marriage picture and go back to all the experiences in your life. For a mother, it’s the birth of a child. Pick up the pictures of your kids you have and go back to all the birthdays which you have enjoyed along with others and go over the experiences in a fantasy like it’s happening now. Fantasy at times is more powerful than reality. Reliving beautiful memories calms down your nerves, helps you to sleep well, and makes you feel much better. Most importantly, don’t stop your pills for diabetes and hypertension. And suspend all wars inside your family and talk to them. Don’t sit like a Nirupa Roy or Guru Dutt.
According to Dr Shetty, sleep is affected across all age groups and in order to improve sleep, one can do yoga, limit screen time, play with their family and friends, and do little exercise at home.
Keep the day for things that really matter. This is the time when everybody is together at home with their loved ones, with their families; use this time to explore more relationships, doing fun things together, deepening our relationships rather than staying with the updates all the time, says Dr Shelja.
We are living in a time where we get all sorts of information from all sides and sometimes it becomes a tad difficult to differentiate between misinformation and facts. Misinformation can often trigger fear and have adverse effects on one’s health. In order to avoid this, Dr Shetty says,
Don’t talk about the virus all day. Keep in touch with the information provided by the central and state government. And don’t forward information related to the virus to anybody.
The current lockdown and social distancing are even harder for extroverts than introverts. Talking about how extroverts can survive the lockdown while being sane, Dr Shetty says,
Use your extroverted nature to assist people. Get involved in activities of volunteerism like I saw young women organising food for 50 people in slums. Volunteer without compromising with precautionary and preventive measures laid out by the government. Also, introverted people need to be very careful that they don’t end up becoming too introverted. We all have a safe space, keep in touch with that.
How To Help Migrant Workers Prone To Social, Psychological And Emotional Trauma In Lockdown
According to the psychosocial issues among migrants during COVID-19 listed by the Ministry of Health and Family Welfare, migrant workers are concerned about food, shelter, healthcare, fear of getting infected or spreading the infection, loss of wages, family which can lead to anxiety and fear. Sometimes, they also face harassment from the local community. All this calls for psycho-social support.
As part of such support, the ministry has listed some measures which include treating every migrant worker with dignity, respect, empathy and compassion; recognising specific and varied needs for each person/family. It also asks to help them to acknowledge that this is an unusual situation of uncertainty and reassure them that the situation is transient and not going to last long. Normal life is going to resume soon.
In a document, the Health Ministry has called for being understanding and patient with migrant workers. It has also stated to provide the right information and guide for these workers to access sources of help.
In a video shared by the health ministry, Dr Pratima Murthy, Professor of Psychiatry and Head of Department of Psychiatry at National Institute of Mental Health and Neurosciences, says,
Get the right information because when you have the information you tend not to get afraid and not to get panic. Be positive, most people will recover from this. Keep yourself busy during self-isolation, have a proper routine. Sleep well, eat well, and do adequate exercise, do something to calm your mind like yoga, and deep breathing. Reach out to friends, develop a hobby. Be happy. Be safe and be sensible.
(If you need support or know someone who does, please reach out to your nearest mental health specialist.) Helplines:
AASRA: 91-22-27546669 (24 hours)
Sneha Foundation: 91-44-24640050 (24 hours)
Vandrevala Foundation for Mental Health: 1860-2662-345 and 1800-2333-330 (24 hours)
iCall: 022-25521111 (Available from Monday to Saturday: 8:00am to 10:00pm)
Connecting NGO: 18002094353 (Available from 12 pm – 8 pm)
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.