Impact of COVID-19 on Mental Health
By: Dr Ashish Bhat and Dr Swati Bakshi
COVID-19 has affected around 213 countries around the world with total cases around 11,965,938 as on 8th July, 2020 (source: https://www.worldometers.info/). The uncertainty of the duration of the pandemic coupled with lockdown, stress and unemployment have posed a serious threat on the mental health of the population in general and youth in particular.
Mental Illness as a Burden
Among leading non-communicable diseases in India, mental illness constitutes 26% share in the burden of diseases and it is expected that there would be a sharp increase in it in the coming years (Gururaj and Issac, 2014). There are 650 estimated cases per lakh population and it is projected to increase up to 800 cases per lakh population by the year 2015 (National Commission on Microeconomics and Health, 2005).
Mathers and Loncar (2006) in his article, Projection of Global Mortality and Burden of Diseases from 2001 to 2030, stated that unipolar depression is a kind of mental illness which is one of the three leading causes of burden of disease projected in 2030. Anxiety and homesickness are frequent problems that easily become chronic when not treated, and can present serious implications for overall psychosocial well-being, including depression and psychosomatic functional disorders such as stress related ulcers, migraines and back pain (Carballo and Mourtala, International Centre for Migration and Health, 2005).
Mental Health during COVID-19: In public health terms, the main psychological impact to date is elevated rates of stress or anxiety. But as new measures and impacts are introduced – especially quarantine and its effects on many people’s usual activities, routines or livelihoods – levels of loneliness, depression, harmful alcohol and drug use, and self-harm or suicidal behaviour are also expected to rise. As the pandemic wears on, it is likely the mental health burden will increase as measures taken to slow the spread of the virus, such as social distancing, business and school closures, and shelter-in-place orders, lead to greater isolation and potential financial distress. Though necessary to prevent loss of life due to COVID-19, these public health measures expose many people to experiencing situations that are linked to poor mental health outcomes, such as isolation and job loss. Additionally, feelings of anxiety are increasingly common, as people are fearful of themselves’ or loved ones falling ill and are uncertain of the repercussions of the pandemic.
It is pertinent to mention that according to Centre for Disease Control and Prevention (CDC), people who have chronic illnesses such as chronic lung disease, asthma, serious heart conditions, and diabetes are among those with a high risk of severe illness from COVID-19. Research shows that mental health disorders are common co-morbidities among patients with these and other chronic illnesses.
Strategies: In recognition of the mental health implications of the COVID-19 pandemic, the Ministry of Health and Family Welfare, GOI has recently released a list of considerations to address the mental well-being of the general population. Therefore, in view of the above, some of the major strategies and instructions as issued by Ministry of Health and Family Welfare are as follows:
- Handling Social isolation:
Staying at home can be quite nice for some time, but can also be boring and restricting. Here are some ways to keep positive and cheerful.
- a) Be busy. Have a regular schedule. Help in doing some of the work at home.
- b) Distract yourself from negative emotions by listening to music, reading, watching an entertaining programme on television. If you had old hobbies like painting, gardening or stitching, go back to them. Rediscover your hobbies.
- c) Eat well and drink plenty of fluids.
- d) Be physically active. Do simple indoor exercises that will keep you fit and feeling fit.
- e) Sharing is caring. Understand if someone around you needs advice, food or other essentials. Be willing to share.
- f) Elderly people may feel confused, lost and need help. Offer them help by getting them what they need, their medicines, daily needs etc.
- g) If you have children at home, keep them busy by allowing them to help in the household chores – make them feel responsible and acquire new skills.
- Focus on facts, reject rumours and theories:
- a) Knowledge is power; the more you know about a certain issue, the less fearful you may feel. Make sure to access and believe only the most reliable sources of information for self-protection.
- b) Do not follow sensational news or social media posts which may impact your mental state. Do not spread or share any unverified news or information further.
- c) Do not keep discussing all the time about who got sick and how. Instead learn about who got well and recovered.
- d) Stick to the known advice- hand hygiene and keeping a physical distance from others. It is being careful about yourself, and also about care of others.
- e) A common cold is not Corona infection. The symptoms of Corona have been well described. Follow etiquette of sneezing, coughing, avoiding spitting in public places etc.
- f) In most people, the Corona infection causes mild symptoms and the person only needs to follow social distancing till he/she stops being infective, usually 2 weeks. Mild infection does not require a person to be admitted in hospital. Only people who have breathing difficulties need to be in hospital. Most people recover.
- Handling emotional problems:
- At times of anxiety, practice breathing slowly for a few minutes. Try and distance the thoughts that are making you anxious. Think of something calm and serene, and slow down your mind.
- When feeling angry and irritated, calming your mind, counting back from 10 to 1, distracting yourself helps.
- Even when feeling afraid, deal with it by asking yourself:
- What is under my control?
- Am I unnecessarily worrying about the worst thing that can happen?
- When I have been stressed in the past, how have I managed?
- What are the things I can do to help myself stay positive?
- Feeling lonely or sad is also quite common. Stay connected with others. Communication can help you to connect with family and friends. Call up people whom you haven’t spoken to and surprise them. Discuss happy events, common interests, exchange cooking tips, share music.
- If any of these emotions persist continuously for several days, despite your trying to get out of it, talk about it with someone. If the feelings worsen, a person may feel helpless, hopeless and feel that life is not worth living. If that happens, call at helpline number (080-46110007) for advice from a mental health professional or contact your doctor / mental health professional.
- What is not advisable?
- a) Avoid tobacco, alcohol and other drugs. Use of tobacco or alcohol or other drugs to cope with emotions or boredom can worsen physical, mental health and reduce immunity. People who already have a substance use problem may require professional help, especially when they feel low in mood or stressed.
- b) Do not shun or judge people with a Covid infection. While you need to maintain a physical distance and keep yourself safe to prevent such infection, remember they need care and concern. If you know someone who might have the infection, tell them about precautions, and how to get medical assistance, if required.
- c) If you happen to get infected with Corona, remember most people get better. Do not panic. Practice self-isolation and take medications that are advised.
- Persons with mental illness:
Persons who had previous mental illness may face newer challenges during self-isolation or Covid infection:
- They would also have the same fears and stress as others which may worsen their previous mental health condition
- Social isolation may make them more withdrawn, moody and irritable
- They may not seek/get easy access to medicines and counseling.
Help and support is vital for persons with mental illness from their families and other care givers. Health helplines can provide support, in addition to regular taking of prescribed medication, a regular daily routine, keeping engaged and positive.
Stay Safe and take care!
Dr. Ashish Bhat, originally resident of Kashmir and currently staying in Delhi, is a public health professional and alumni of prestigious Tata Institute of Social Science, Mumbai. Currently, he is working as a National technical consultant in the policy and planning division of Ministry of Health and Family Welfare, GOI.
Dr. Swati Bakshi is a public health professional and currently working as a National Program Manager for ARMMAN (Developmental Organization working on Reproductive, Maternal and Child Health)