Coronavirus may be hijacking bodies and taking lives, but it’s also in its wake wreaking havoc on people’s mental health. The fear of the disease coupled with social distancing norms are making people feel more and more isolated, stressed, anxious and depressed. So how does one cope with the panic and uncertainty and yet keep a calm head?
By Shriya Roy
Maintain social distancing. Practice self-quarantine. Stay home. Limit physical and social contact with others. These phrases have now become our new normal. But there’s just so much a person can stay isolated. Humans, after all, are social animals who thrive on physical and social contact with the outside world. It’s no surprise then that these stringent measures to keep people apart are resulting in a lot of stress and anxiety. Coronavirus may be hijacking bodies and taking lives, but it’s also in its wake wreaking havoc on people’s mental health.
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Mental health experts warn that losing everyday social connections comes with a huge psychological cost and the impact could be severe in the long term. Many quarantined individuals have, in fact, admitted to short- and long-term mental health problems, including stress, insomnia, emotional exhaustion and substance abuse. The situation only gets worse if someone already suffers from depression, anxiety or stress. “People already suffering can be driven to drastic actions. Suicide risks, insomnia, sustained irritability, violent behaviour can show up and increase during this time. But people have to understand that this is a normal reaction to an extremely abnormal situation.
Undue labelling and criticism should, therefore, be avoided,” advises Nimesh G Desai, director, Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi. He also believes we should stop using the phrase ‘social distancing’ and instead term it ‘physical distancing’, as one shouldn’t stop bonding emotionally with family and friends during this tough time.
Living with anxiety
A 35-year-old man, who was placed under home quarantine in Tamil Nadu after he returned from Sri Lanka, ran out of his house naked and bit an 80-year-old woman on the neck. She was admitted to a hospital, but could not survive. In Germany, Thomas Schaefer, the finance minister of Hesse state, committed suicide after becoming “deeply worried” over how to cope with the economic fallout from the crisis. He was found dead near a railway track. In Delhi, a man suspected to be infected, committed suicide by jumping off the seventh floor of a building at Delhi’s Safdarjung Hospital soon after he was admitted there by airport authorities. His samples later tested negative.
These are just a few of the many cases from around the world where people have been unable to deal with the stress and anxiety, going on to take drastic steps.
“Faced with sudden social isolation or quarantine, individuals may react with fear and anxiety, which can then give way to depression and despair, or anger and acting out. A person may be faced with the realisation that their plans for their immediate future have suddenly changed. They may have to be taken to an unfamiliar setting and separated from their families. They could be anxious about their own health, concerned that they could fall ill at any given time. Their anxiety may likely be worsened if they feel they are unable to conduct their routine affairs or to provide for their dependents,” explains Shaunak Ajinkya, consultant, psychiatry, Kokilaben Dhirubhai Ambani Hospital, Mumbai, adding that dramatic situations, including seeing loved ones stricken by disease and suffering or seeing somebody die from the illness, coupled with fear for one’s own safety and the safety of loved ones, may give rise to symptoms of traumatic stress, resulting in acute stress disorder or post-traumatic stress disorder (PTSD). Studies, in fact, show that long durations of quarantine and social isolation are associated with an increased prevalence of PTSD.
The monotony, too, starts to take a toll on people’s minds, leading to a negative impact on mental well-being. Take, for instance, 24-year-old Lucknow-based Shivani (name changed on request) who has been struggling with mental health for a long time now. She says her anxiety has doubled due to the lack of social interaction. “It’s extremely important for people like me who are struggling with mental health to be able to get out of a given space when required. Otherwise, it starts to build up and that aggravates the situation. Furthermore, the uncertainty adds to the fear and worry never leaves. Even the smallest of the news makes me really anxious. Screen time on the internet, having nothing else to do as an alternative, just makes things worse,” she rues.
There are other factors to consider, too, like feelings of loneliness, boredom and frustration that can endanger anyone’s peace of mind. So what does one do? “Handling anxiety and depression during isolation and quarantine requires a multipronged approach. Symptoms of mild depression are, to a large extent, a normal reaction to any stressful situation. Empowering individuals to make small decisions, helping them restore or establish routines during the period of social isolation and directing them to utilise healthy ego defense mechanisms, such as humour, go a long way in maintaining mental health equilibrium. However, as the period of isolation drags on, individuals may become more susceptible to the development of more serious psychological symptoms where a visit to the nearest mental health professional may become a necessity,” says Ajinkya.
Haven turns hell
The general belief stands that one’s home is a haven, where you are safe from every evil. For a lot of people, however, that’s sadly not true. This was further amplified with news of increasing domestic violence cases across the country during the lockdown.
Then there’s the emotional stress that spending a lot of time with family brings. Constant comments and taunts, opinionated family members, fighting parents, can all leave one extremely agitated. Twenty-four-year-old Kritika (name changed on request) went home from Delhi to Bhopal after classes were cancelled in her university in the wake of the pandemic. Having been away for almost six years, going back had always been a luxury for her, but with the social distancing norms this time, the same luxury began to feel like discomfort. “The constant bugging, being asked what I want to do with my career, etc, gets to me… add to that the fact that my parents are constantly fighting. Living away from home all these years, I was away from all this stress, but now having to deal with all of this with no let-out is leaving me with no mental peace at all,” she says.
In a somewhat similar boat, 25-year-old Sukriti Khuranna (name changed on request) chose to stay put in Delhi and work from home instead of going back to her hometown to avoid the emotional stress and turbulence at home. “Going home would mean hearing my parents fight and listening to taunts for the smallest of things. My parents leave no chance to put me down by giving me examples of how my cousins, etc, are doing extremely well. Apart from that, they are constantly at each other’s throats and don’t shy away from even hitting each other. It’s a conscious choice I made to stay away as the stress of the pandemic itself is a lot and home wouldn’t have been my safe space,” says Khuranna.
Ajinkya says it’s natural to feel upset in such circumstances. “Feeling overly agitated, as if you’re going to burst with anger, whenever you’re around family isn’t a new phenomenon. Going in with a clear mind and making a deal with yourself to take on any situation in a rational way is a good start… But at the same time, it’s important to acknowledge that you have the right to naturally get upset by others’ unthoughtful actions,” Ajinkya says, adding, “When people fail to develop a strong self, their well-being usually depends on what others say or don’t rather than on what they personally think and feel about themselves. This happens because many people try to manage the anxiety of everyone in the family instead of their own. It is better to introspect and see how one is managing one’s own thoughts and feelings rather than being so concerned with others’ behaviours.”
Then there are those for whom stepping out of the house to work is a necessity to escape the negativity at home. Take, for instance 40-year-old Raashi Damodar (name changed on request) who is a senior manager at a consultant firm in Gurugram. At work, Damodar is the boss and handles a team of 20. She is extremely passionate about her work and spends most of her time in office. One reason for that, however, is that she hates spending time at home, something that she has had to do now full-time while working from home. “Having chosen not to have kids was a well thought out decision… its impact, however, didn’t go down well with my family and I have had to deal with the consequences since. No matter how successful I’m at work, the moment I enter my house, I become the person who deprived the family of a kid. My work is my safe space. But now, having to spend all this time at home is nothing short of punishment for me. I have panic attacks in the middle of the night… and to think that there is no definite end to the current situation makes it even worse,” says Damodar.
In such a scenario, Ajinkya suggests one to be less reactive. “Change happens only when we shift the way we perceive the situation. Feeling less stressed around family is all about learning to manage your own part in your relationships with others instead of trying to manage everyone else’s feelings. Being related doesn’t mean you’ll get along in every situation. You are only responsible for yourself, your behaviour. Be respectful, but also be strong enough to excuse yourself if a conversation or situation gets out of hand,” he says.
Friend & foe
Coronavirus may have made it necessary for us to stay apart and practice social distancing, but even before the virus struck, millennials were living life vicariously through social media, isolated from their surroundings. They are, hence, a little more adept at handling the current situation. “The younger generation getting isolated is true… but their sense of belongingness has also increased now because of the external biological threat. This means the isolation within families can now be addressed by this young lot,” says Desai of IHBAS. Talking about the use of social media at this time, he says, “A correct balance needs to be maintained between technology and the outside world. Sensible introspection is necessary.”
Social media has become both a friend and foe during this time. “Social media has a huge impact on our culture. It shapes the way we think, how we feel and, yes, it has had an effect on our everyday routines as well,” says Ajinkya, adding, “The use of the internet should be allowed and tolerated, but the use of social media should be monitored for the dissemination of inaccurate messages.”
Stressing on the need to engage oneself to get through this tough time, Sameer Malhotra, director and head, Department of Mental Health & Behavioural Sciences, Max Hospital, Saket, Delhi, says, “In the current situation, it’s important to maintain the recommended physical distance. However, social distancing doesn’t imply no interaction with family or friends. One should interact with them and children should take this time to gel with the elders. One has to be positive during such times.”
Another area where the internet has come to the aid is counselling and mental therapy, as social distancing has made it nearly impossible for support groups and mental therapy and counselling sessions to take place. So now, a lot of the mental healthcare services have moved from face-to-face meetings to online ones. “Virtual meetings are happening with the help of different mobile applications and online platforms. People share their experiences and try to help each other the best they can,” says Delhi-based Satish Chaitanya, a member associated with the Alcoholics
There are some people, however, who don’t feel at ease with such sessions. Kolkata-based Aastha Saxena (name changed on request) has been in and out of therapy sessions for the past four years. Before the social distancing norms, she would have her sessions once a week. “Since the pandemic broke out and restrictions were put in place, my therapist shifted her sessions online via Skype. To be honest, it’s not the same. Although I am talking and sharing like I did in the earlier face-to-face sessions, it just doesn’t seem to work or connect for me. The barrier of the virtual world keeps me from talking about a lot of things that I would be more comfortable sharing in person,” she says.
Chaitanya, too, agrees that online meetings can never replace physical ones. “A person can express himself/herself more freely in a physical meeting. Online meetings are more generic in nature. Here, a person can’t open up completely because the personal touch of a one-on-one session is missing,” he says.
In the current situation, however, online meetings are the only option, especially for people recovering from any kind of substance abuse, as otherwise they might go into relapse as a result of the isolation. “They can be in touch over phone with a support group member, therapist or counsellor where they can open up and discuss how they feel… Listening to life stories of people who have gone through such instances in the past and have come out of it also helps a lot in reducing anxiety levels,” says Chaitanya, adding, “It’s very important that there is guidance provided to them.”
Desai from IHBAS says people who are already under treatment are vulnerable and there is always the stress around the discontinuity of treatment. Tele-counselling, tele-consultation, WhatsApp, email, Skype, etc, can help in this regard. “Human adaptation is huge. The adaptation will work the same way when all this ends,” he says.