The Corona Pandemic and Mental Health
A Look into Psychological Issues from an Expert’s Perspective
Given the current situation, with a global pandemic on the loose, transfused in our population is fear. This fear stems from isolation, which unfortunately has dire potential to cause unhealthy disruptions in our daily life. Adeela Hameed of Kashmir Images conversed with an RCI registered Clinical Psychologist, Ms. Isha Malik, to know about possible psychological ailments that may affect people in quarantine/isolation, and cognizecounter-measures that can be taken to prevent the same.
Here are excerpts from their conversation:
- With the lockdown continuing for several months now, how has our mental state changed from normal?
- Lockdown due to COVID-19 outbreak has reoriented our relationship with the outside world and even with our family members. It has changed the way we think, our work routines, our priorities and preferences. It’s quite rare that threat of this disease has occupied much of our thinking. Continuous lockdown has resulted in heightened anxiety, a lot of uncertainty and confusion, and constant sense of insecurity for oneself and loved ones. People are also experiencing increased irritability, frustration, sadness, and feelings of hopelessness or helplessness. While social distancing is required to prevent infection, isolation and loneliness is taking a toll on the mental health of people, especially those with any pre-existing psychiatric illness. Our attitude towards socialization has altogether changed. We know now that to touch, or be with other people and breathe air in an enclosed space might be risky. The comfort of being in the presence of others is slowly being replaced by a greater comfort with absence, especially with strangers. Instead of asking, “Is there a reason to do this online?” we ask, “Is there any good reason to do this in person? This might continue for a couple of years and we might need to be reminded and convinced that there is a need to do certain tasks face-to-face. This pandemic has also created stigma towards people with cold or cough, which might be symptoms of just a simple flu. Our health concerns have also increased significantly. The symptoms of flu, which were previously taken casually by people, have now become a source of extreme stress, panic and trigger for catastrophic thinking. But, we shouldn’t forget that humans are resilient and have a natural tendency to evolve and recover from difficult situations, although, some of us might need psychological help to cope with the repercussions of this pandemic.
- Is feeling exhausted, having nightmares and reduced appetite a derivative of quarantine?
- Yes. Quarantine is often an unpleasant experience for those who undergo it. Being separated from one’s family, loss of freedom, uncertainty over disease’s status, frustration and boredom because of isolation can exacerbate symptoms of stress, anxiety and depression. Inadequate healthcare facilities, fear of being infected or even infecting others can trigger emotional exhaustion. This fear may inflict nightmares and even reduce appetite, especially in people with pre-existing medical conditions, such as diabetes or asthma. In these cases, uncertainty regarding regular supply of medicines, diet compliance, thoughts like “What if I contract the infection?”or “What if my health deteriorates here at the quarantine centre?” can create a spiral of negativity in one’s mind and thus, cause psychological distress.
Q3. How can we recognize depression? Is it different from Anxiety?
- If one experiences:
- a) depressed mood most of the day, nearly every day;
- b) loss of interest or pleasure in all activities or in activities which were enjoyed previously; c) decreased energy or increased fatigue for at least two weeks, it can be called depression.
Other additional symptoms present might include:
- a) loss of confidence or self-esteem;
- b) excessive or inappropriate guilt;
- c) recurrent thoughts of death or suicide, or any suicidal behavior;
- d) diminished ability to think or concentrate which can lead to indecisiveness;
- e) sleep disturbance (insomnia or hypersomnia);
- f) change in appetite (decrease or increase) with corresponding weight change.
- Is anxiety different from depression?
- Yes, definitely anxiety is different from depression. Anxiety is a feeling of persistent worry, fear, dread, nervousness or unease about something with an uncertain outcome.
Below are some examples of the physical and mental characteristics that can be displayed by an individual experiencing either of the conditions.
Mental characteristics of anxiety
- Worry about the immediate or long-term future.
- Uncontrollable thoughts about something going wrong.
- Believing it’s better to avoid situations that could cause anxiety.
Mental characteristics of depression
- Worry that the future is hopeless.
- Not believing that positive experiences will happen in the future.
- Feelings of worthlessness and helplessness.
Physical characteristics of anxiety
- Muscle tension.
- Gastrointestinal distress (nausea, constipation, diarrhoea etc.)
- Increased heart rate.
- Shortness of breath.
- Difficulty sleeping and focusing due to racing thoughts.
Physical characteristics of depression
- Loss of appetite.
- Lack of energy.
- Disruption in sleep patterns (sleeping more or less).
- Difficulty concentrating.
- Aches and other physical pain without a cause.
Despite their differences, it’s not uncommon for the two conditions to occur simultaneously or they can happen in reaction to each other.
- What is your opinion about therapeutic foods? Are there any on our shelves we don’t yet know about?
- Although a lot of research has been done by nutritional psychologists, which suggests that there are many nutrients present in different foods that may enhance our mental health, but therapeutic foods can’t be used as a substitute for psychiatric medication or psychotherapy. Maybe, they can be used in addition to standard/evidence-based treatments.
Yes, turmeric, a spice commonly used in Kashmiri cooking has antioxidant and anti-inflammatory properties which can help lower anxiety and depressive symptoms.
- What is your take on stigma related to mental health in our society and how can we break this cycle?
- Stigma related to mental health in our society is evidently reflected in people’s attitude towards seeking mental healthcare services. Many people still prefer to visit a faith-healer aka ‘Peer sahib’ but, visiting a psychiatrist/psychologist is usually the last or may not even be an option. On many occasions, I have come across people who don’t feel comfortable in disclosing their psychological problems to their family or friends because of the fear of being judged, labelled or rejected. Others complain of having long-standing problems since their childhood but parents never consulted a mental health professional until their condition became unmanageable. It’s basically the stigma which keeps such families from acknowledging that a family member is psychologically ill. The stigma attached with a visit to a psychiatrist /psychologist is also one of the main reasons most patients shy away from treatment. It is a common notion here that anybody visiting a mental health professional is insane or crazy.
The key to breaking this stigma is to educate more and more people about the significance of mental healthcare and by creating awareness about different mental health conditions through social media, by conducting workshops for the general masses and developing self-help groups for different patient populations. Collaboration with clergymen (Imam sahib/ Molvi sahib) and traditional faith healers (Peer sahib) can greatly benefit if they timely advise people suffering from mental health conditions to visit a mental health professional even if they want to continue visiting the faith healer. We need to make people realize that mental health matters and its as important as physical health. Normalizing ‘visit to a psychiatrist or psychologist’ is the need of the hour.
- You run a therapy page: Mind Spa by Isha Malik on Facebook, and have started creating podcasts (YouTube) related to mental health too. What do you, as a professional, suggest people should rely on these days?
- I have been running this page since last year. The purpose of creating it was to build an online platform for reaching out to both, people facing mental health problems as well as general masses. I try and create awareness to educate people about various psycho-social and psychiatric problems, and how to cope with them. I also provide free online counselling as my contribution to our society during this crisis. (www.facebook.com/MindSpaByIshaMalik/).
People should rely on verified and trusted sources for COVID-19 related guidelines. It’s important to be informed but not overloaded with information. Excess media exposure regarding the current situation can trigger stress, so we need to limit our news consumption and stop spreading misinformation or fake news to avoid creating panic. It’s quite helpful to remember our collective resources – remember we, the people of Kashmir, are a strong and resilient community. We have overcome many difficult times and will defeat this pandemic as well. In Sha Allah.
In order to cope with this situation effectively, I think developing and maintaining healthy habits such as getting proper sleep, eating a balanced diet, and exercising daily is a must. I always promote self-care and believe that dedicating at least one hour daily to something you enjoy the most or anything which makes you feel positive/happy can make a big difference. Practising various mindfulness activities, relaxation exercises or maintaining a journal of your thoughts and feelings can also help. Lastly, I advise people to contact a mental health professional for additional support in case they feel extremely emotionally overwhelmed and unable to cope. People who were seeking treatment for their mental health problems prior to COVID-19 outbreak should remain in constant touch with their psychiatrist or psychologist and not stop taking their medication without consulting their concerned doctor.
Remember, your mental health should be your priority.