Dr Abdul Majid
HOD, PG Department of Psychiatry
SKIMS Medical College Hospital
COVID-19 pandemic is of exceptional nature since the virus, though being invisible, has shaken the whole planet. This disaster is also different from earlier disasters like earthquakes, floods, man-made disasters in the sense that in disasters; relatives, friends and neighbors would come to each other’s rescue but in COVID-19 era, the patients and their close relatives could not get social support. The patients and families were left to struggle the lone battle and amid all this some patients and families were stressed to an extent of development of psychological distress and subsequent mental health issues.
Since the disease was new and many things about it were not known, initially patients and their families were stigmatized which further resulted in mental agony. This stigma and fear was more prominent during the first wave in 2020 but as the disease is being understood better than before the levels of stigma have declined. However the mental health issues have been more prominent during the second wave in 2021 as the severity of illness has been more in severity and death caused have been much higher hence devastating many families of their bread earners.
Apparently everything on ground seems to be in place but there was a huge impact on healthcare services, academic activities, business establishment, tourism and transport industry. It also has an impact on life events associated with uncertainty, ambiguity, and loss of control, anxiety, depression, anger, worries about one's own health and that of loved ones, and unemployment which subsequently resulted in emotional distress. Young adults are at low risk of physical health complications from COVID-19, they may be distressed by the pandemic's secondary consequences, including the lockdown and associated social standstill, economic decline, educational and professional compromises. Young people also narrated that they feel distressed by missing out on exams and the risk of not receiving the grades they felt they deserved and the uncertainty of their future.
Not only general population but also health-care professionals dealing with COVID-19 are under increased psychological pressure and experience high rates of psychological distress due to the prolonged duty hours, dealing with critical patients, disruption of routine clinical practice, the sense of loss of control, and the subsequent fear of potential destabilization of the health. Many of us have experienced sudden loss of loved ones. Pre-pandemic, one vital aspect of this process that helped us grieve was being surrounded by our loved ones and friends.
Currently, we are almost a year into the isolating effects of the COVID-19 pandemic and the purposeful distancing helps to keep it safe in the pandemic but takes away some of the comfort in gathering together to mourn. Death has not been so dignified in the last year or so as most of the victims were buried in absence of their loved ones since COVID death protocols had to be followed. The rituals and religious gathering were not conducted as was the norm which resulted in an incomplete grieving process.
The effect is much beyond just medical concerns. The increased incidence of psychosocial problems, exacerbation of pre-existing psychiatric disorders, stress and mass panic have all contributed to one of the most concerning causes of morbidity and mortality. Fear, financial crisis and stigma are among the few factors for self harming behaviours. It is important to identify the warning signs of mental health problems & self harming behaviours such as talking about feeling hopeless or having no purpose, talking about feeling trapped or in unbearable pain, talking about being a burden to others, Increasing the use of alcohol or drugs, Acting anxious, agitated or recklessly, Sleeping too little or too much, Withdrawing or feeling isolated, Showing rage or talking about seeking revenge, Displaying extreme mood swings.
Just talking about self-harming behaviour isn’t what is toxic. It’s the way we talk about it that matters the most. Self harming behaviour is contagious, and the media must be part of the solution, not the problem. It is time for the media to change the narrative about self harming behavior — which is often overlooked entirely, or discussed only in the most sensational ways.
To prevent distress/ agony and self harming behavior starts we have & we need to learn new ways to mourn. Fortunately, technology has started to fill in some of the gaps for us and creative solutions to connect with the community at a distance. Recognize the loss, reach out & share it on the telephone. It is also important to take breaks from the news, set goals and priorities, Connect with others. It is the responsibility of the media to avoid sensationalization of news of self harming behavior. Avoid dramatic, emotive or sensational pictures or video footage. Do not glamorize a death or lead vulnerable individuals to over-identify with the deceased.
There is a need to follow ABC’s of de-stressing one self:
A) Adequate sleep: 7-9 hours of sleep and maintaining a sleep cycle. Be sure to stick to your regular sleep pattern and get enough sleep. Schedule a normal bedtime and wake time during the week. Evidence suggests that people who sleep less have more mental and physical health problems.
B) Balanced Diet: more of fluids, vegetables and fruits, less of fats, carbohydrates, sugar and salt. Regular meals
C) Connect to your family, friends, neighbors and relatives (offline or online)
D) Devote yourself to GOD and Social Causes, say no to Drugs of Addiction.
E) Exercise can significantly improve both your physical and mental health. It is important to stay active, even if you are currently staying home. Get involved in indoor offline games and if possible outdoor games by following COVID appropriate behaviors.
F) Find Help: Find help/advise, In case stress persists, don’t hesitate to contact a Medical Doctor, Mental Health professional (Clinical Psychologist or a psychiatrist) wherever available.
G) Get Vaccinated: Only way to make our community safe and secure from further onslaught of COVID-19 is to protect yourself and others by getting vaccinated.
H) Hobbies: Rejuvenate old hobbies and try new hobbies like art work, painting, telling stories, getting involved in day today chores, kitchen gardening etc.
Last but not the least every calamity provides an opportunity, so we have and need to explore further to learn from the current scenario like
Improvise on our manners and etiquettes like proper way of coughing, sneezing etc
Innovate like holding online classes, seminars, online medical consultations, online religious obligations, and condolences.
Introspection, what we were doing and what needs to be done.
Disasters and calamities have been part and parcel of the journey of mankind and the distress created by these have actually guided the people how to negotiate through the difficult times and come out victorious. We need to take cue from these historical facts that our ancestors have gone through and learn from their experiences and the utilization of the limited resources they had that time. At the same time we need to identify those who are vulnerable and can succumb to these situations resulting in psychological distress. Such people need to avail services from mental health facilities to get their issues addressed and avoid adapting to self harming behavoir, self medication or say NO to using drugs of addiction.
We need to acknowledge the efforts of all our COVID heroes, The front line workers, who have and will always strive to make our lives better by risking their lives in the line of fire. All of us actually are front line workers by contributing whatever we can by observing COVID-19 protocols like Social Distancing, use of Masks and use of sanitizers/ frequent hand washing to make this place a better place to live.