Fear, worry, and stress are normal responses to perceived or real threats, and at times when we are faced with uncertainty or the unknown. So, it is normal and understandable that people are experiencing fear in the context of the COVID-19 pandemic.
Added to the fear of contracting the virus in a pandemic such as COVID-19 are the significant changes to our daily lives as our movements are restricted in support of efforts to contain and slow down the spread of the virus.
Faced with new realities of working from home, temporary unemployment, home-schooling of children, and lack of physical contact with other family members, friends and colleagues, we must look after our mental, as well as our physical, health.
We are now in an era of global digitalization that has provided us with an opportunity of being connected to everything and everyone across the globe. With the emergence of the Covid-19 pandemic, digital platforms became the only means for people to maintain social and emotional ties.
Almost everything that was once a part of our physical world was somehow given a shape and modified to our online world, to prevent a halt to our social, academic or occupational lives.
The shift from the physical to the online world increased screen time for everyone. Screen time refers to the amount of time spent and diverse activities performed online using digital devices.
Irrespective of age, people are pushed to rely on digital platforms. Education, shopping, working, meeting, entertaining and socializing suddenly leapt from offline to online. Here, digital technology came as a blessing in disguise, enabling individuals to remain emotionally connected despite social distancing.
Prolonged screen time:
Dr Yasir Hassan Rather, Department of Psychiatry, Institute of mental Health and Neurosciences (IMHANS) Srinagar said prolonged screen time has caused concerns related to its impact on physical and mental health.
“While mindful use of digital devices is linked with well-being, excessive screen time is reported to be associated with negative mental health outcomes such as psychological problems, low emotional stability, and greater risk for depression or anxiety,” he said.
Dr Yasir said that the negative consequences often result when digital use is impulsive, compulsive, unregulated or addictive.
“Restricted social interactions imposed by the pandemic aggravated the over-use of digital devices for socializing which included virtual dates, virtual tourism, virtual parties, and family conferences,” he said.
The unprecedented digital life during the pandemic also gave rise to increased levels of anxiety, sad mood, uncertainty and negative emotions like irritability and aggression, a normative response to the pandemic.
However, anxiety and aggression also meant an increase in cybercrimes and cyber-attacks. This has raised concerns about the impact of screen time on mental health.
Negative Impact of increased Screen-time
• An increase in screen time can harm physical health.
• Reduction in time spent on physical activity.
• Prolonged continuous screen viewing can cause digital eye strain (e.g., dry eyes, itchy eyes, blurry vision, and headache).
• Watching or reading on screen at close distances can increase the risk of children developing myopia.
• Excessive screen time can lead to obesity.
Screen time and adverse psychological consequences
Using mobile or any other screen near bedtime would simply displace sleep time. The combined effect of watching at a bright display screen along with emotionally arousing violent or fast-paced content in the form of movies or digital games can lead to psychophysiological arousal and cause sleep disruption. These sleep disturbances in turn have been associated with physical health problems and poor psychosocial functioning including impaired academic performance.
The use of screens while engaging in gaming, accessing social media, and watching online streaming services can be associated with behavioural addictions such as gaming disorder.
Children and adolescents are the main populations which are involved in video gaming. The lockdown caused by the COVID-19 pandemic has further increased their use of video games and, consequently, the risk of gaming disorder (GD) symptoms. Overall, males have been found to play VGs more frequently than females, and adolescents seem to spend more time on VGs in comparison to children.
Lockdown and Children:
Dr Yasir said quarantine and isolation may also lead to an acute stress disorder, PTSD and grief in many children. He said children may experience a range of psychological issues such as anxiety, fear, worry, depression, difficulty sleeping, and loss of appetite.
“Children with various physical and mental disabilities – and especially mental health disorders – are more vulnerable during this trying time,” he said.
The kind of therapeutic inputs that children with various disabilities may have been receiving may not be readily available now – various therapies, special schooling, psychotropic medication, etc.
“Social isolation may worsen the living situation of children in abusive environments as well as children with special needs,” he said.
“Economic hardships and the potential worsening of parental physical or psychological illnesses, including substance use disorders, may take a toll on all children. Children may even go through loss and grief at this time,” he said.
Adolescents and COVID-19:
He said that adolescents are likely to have a preoccupation with them, a sense of insecurity, mostly identify with their peer group and are often prone to risk-taking behaviours.
“Some adolescents may have feelings of being invincible and may take risks by not maintaining personal hygiene and social distancing,” the senior psychiatrist said.
Dr Yasir said some may be withdrawn, afraid of leaving home and worried about their health as well as that of their family members.
“They may also lose regular contact with friends because schools, colleges, and universities are closed. This may lead to feelings of boredom, loneliness, sadness, aggression, and irritability towards siblings and other family members,” he said.
Few may engage in negative coping mechanisms like engaging in substance-taking behaviours, etc. to handle their boredom, loneliness and emotional changes.
“The uncertainty about examinations and its impact on their career choices can exacerbate the stress due to the prevailing Covid-19 pandemic,” he said.
How can parents help children?
1. Children must be provided unambiguous and clear information regarding the pandemic in an age-appropriate language.
2. Balance should be maintained while answering children. Too much information can cause panic and severe anxiety.
3. There should be limited media exposure, especially if there is fear-mongering or exposure to alarming content. Discussion of the upsetting topic should be avoided in front of children.
4. Questions should be answered honestly. Their worries should not be dismissed and parents should not make false promises.
5. Parents’ anxiety should not be transferred to children. There should be no hesitation to seek help if parents are suffering from emotional issues.
6. Repetitive reassurance-seeking is a sign of distress in children.
An evaluation by a mental health professional nearby or online should consider significant distress in children or if a child already has a mental illness.
7. Medicines should be used sparingly and judiciously as per the prescription of a doctor. Medicines should not be discontinued abruptly.
8. Parents should find a way to take care of themselves – medically as well as psychologically as they are the biggest pillar of support of family.
9. Healthy and discrete boundaries between the personal and professional temporal spaces is helpful.
Online world the new norm:
Dr Yasir said as the new normal is the online world, routines should be formulated that balances academics, play and interactions via the online as well as the physical world.
“As much as your child is exposed to the online world, we need to instil the concept of being off from online world time. This will develop in children after we explain to them how the world has changed now. We need to have set timings for meals and sleeping time,” he said.
“Creating opportunities of exercising should be part of the routine. Family playtime/ interaction time which doesn’t involve talking about studies, being in a room together, means where families collaboratively play or interact and create happy moments. Being in touch with friends and relatives via the online mode to stay connected,” he said.
Mental health needs of children need nurturing:
The pandemic brought a complex array of challenges that had mental health repercussions for everyone, including children and adolescents.
Grief, fear, uncertainty, social isolation, increased screen time, and parental fatigue have negatively affected the mental health of children.
Dr Suhail Naik, consultant paediatrician GMC Srinagar, as the children are going to school after almost three years their mental health needs nurturing environment.
“Schools are reopening after 3 years, children are ready to enjoy school life and obviously for a long time they have lived a stressful and screen dominated life,” he said.
He said schooling is not only a new dimension of their life but very important for optimal physical and mental health development.
“Keeping the biology of brain development in perspective and tender fragile emotional state of kids in consideration, it is highly recommended that we should not make their life stressful and struggle to achieve the highest possible academic standards,” Naik said.
The schools, teachers and parents should not put any extra pressure on their students and it is time for kids to enjoy their schools as a part of holistic development, which they have miserably missed for the past three years.
“They shouldn't be put under unnecessary stress to complete their syllabus to get top positions and distinctions at the cost of their psychological and mental health,” he said.
“It is time to welcome them with affection, love and care. Let them enjoy their books, classrooms and playgrounds to explore the new dimension of life. The teachers shall focus on better education instead of focusing on examinations,” he said.