Working towards pacifying the impact of pandemics

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By: Fayaz Ahmad Paul

Since December 2019, an outbreak of a novel corona virus disease has spread from Wuhan, China and became a pandemic affecting every continent. The Covid-19 outbreak has resulted in the death of nearly 2,915,877 people worldwide by the 8th day of April 2021. Adolescents are a vulnerable group and they are experiencing a time of difficult transition. The Covid-19 outbreak and lockdown may have multiple consequences on the lives of adolescents including chronic and acute stress, worry for their families, unexpected bereavements, sudden panic attacks due to the sudden change in the ambience including closing down of institutions, lockdowns, home confinements, increased dependency on internet and social media etc.

Social relations are going through a transformation and people- no matter how much they care and love- maintain physical distance and often miss out on special functions (good or bad) not being able to participate, congratulate or even commiserate their close ones for the fear of the virus. This has suddenly created a vacuum and human psychology is such that it does not know how to adapt to new order very quickly. It is the old conditioning that is being challenged by the virus and people who had been living in a specific manner have to, know, and redraft their behavioral module. All this cannot be achieved quickly and the process is surely going to cause dilemmas and delusions.

Apart from the people with no psychiatric issues, the pandemic is also largely impacting individuals with psychiatric disorders who have an added challenge now.  In times of pandemic, Post-traumatic stress disorders, depression, and anxiety are potential impacts on adolescent mental health. There is an increased risk of Post-traumatic stress disorders symptoms after disasters, as well as epidemics. The potential traumatic effects of the Covid-19 outbreak on adolescents are unlikely to be identical to any disaster outcome. Containment measures and stress due to fear of infection are likely to be different stressful events from a violent natural disaster. Indeed, different trauma types probably have different impacts on adolescent cognition and traumatic symptoms and Post-traumatic stress disorders.

Quarantine has negative and potentially prolonged effects on the psychological health of individuals, including post-traumatic stress symptoms, confusion, and anger. In adolescents, periods without school are associated with decreased physical activity; more screen time, irregular sleep patterns, and less appropriate diets. There are reciprocal interactions between brain maturation and social environment, and isolation may have an influence on psychiatric disorder onsets during adolescence. Adolescents are experiencing a new period of insecurity: worry about the health and work of their relatives, the ubiquitous issue of death, sudden separation from friends, and school disruption.

Pandemics may be linked to increased suicide rates, stressful life events are a risk factor for adolescent suicidality. There is a potential link between several Covid-19-related experiences such as fear of physical harm and effect of social distancing. The issue of increased addictive disorders of adolescents related to disasters has also been raised. For some adolescents, the numerous deaths linked to Covid-19 are their first experience with death. This is brutal, without the patients being accompanied in their last days, and often without the possibility to visit the hospitals’ “Covid units”, followed by immediate casketing and thus deprivation of many funeral rites. Traumatic events are associated with longer grief in adolescents, particularly in the case of a violent death. Parental death is a risk factor for a major depressive disorder in adolescents. Family confinement may be a trigger for intra-familial violence during the Covid-19 pandemic.

Countries such as India, Bangladesh have reported an increase in the cases of domestic violence; children are more at risk of abuse or neglect when they live in a home where domestic violence occurs. During this period, women and girls are reportedly more exposed to gender-based violence, including sexual violence. In the context of lockdown, and school closures, adolescents escape the vigilance of professionals or other adults who would have spotted their distress in normal social conditions. Family has a role in positive and negative outcomes for adolescents in times of crisis. Some aspects of the family environment, parenting practices, and parents’ coping are likely to influence children’s post-disaster mental health.

Social media could play an even more important role during the lockdown. These enable socialization and communication and open up learning opportunities, including for adolescents’ access to information about their health. Social media use could be a positive factor in helping teenagers to maintain social interaction during lockdown. The current period of pandemic brings together several factors related to internet addiction which is characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use and internet access that leads to impairment or distress.

The Covid-19 pandemic is also resulting in an economic crisis. Economic crisis’s, it is well documented, cause an increase in suicides, depression, anxiety, and addiction disorders in adults. Adolescents reported more tensions and fights within the family and less life satisfaction. Emotional support from parents and time spent with parents may preserve adolescents from possible negative effects of an economic crisis.

To promote adolescent well-being and sense of security, it is advisable to promote reassurance, appropriate information, and stress reducing actions for adolescents. Parents are the closest and most evident help for children and adolescents. Promoting balanced life patterns, especially sleep patterns, is also recommended.  The World Health Organization has suggests recommendations addressed to adolescents to help them cope with stress: identify normal emotional reactions, engage in dialog and social exchange, maintain appropriate lifestyles and social contacts, avoid smoking, alcohol and other drugs, seek out health workers help when necessary, seek information from reliable sources, limit exposure to the media, develop strategies for emotional regulation.

The writer is Research scholar, Department of Psychiatry

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