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Addressing Mental Health During The COVID-19 Outbreak

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For the Indian population, when the lockdown was declared, it was a sort of holiday for most. Never did they understand the dearth of the situation until and unless the darker side of this lockdown started coming to surface. People had least thoughts about the issue, and even little did they do to prepare themselves. What am I talking about here is mental health.

No one had thought that this sudden lockdown would bring the suppressed emotions of peoples to the surface. On October 10, 2019, it was reported that 7.5% of the country’s population is affected by mental health, with less than 4,000 experts available. They even reported that by 2020, 20% of the Indian population would suffer from some form of mental illness.

Was it their statistics alone or the prediction of some kind, which is being evidenced today during this lock-down situation in India? While working closely with “COVID-19 SENTINEL”, a joint initiative of Pratishruti Cancer & Palliative Trust, Dibrugarh and The Superintendent of Police, Dhemaji District, Assam it was found the relevance of psychological distress among 72% quarantined in Dhemaji alone. The total number of people surveyed was 1510. The main problems faced by the people were – Anxiety disorders, Adjustment Disorders, Non-Specific physical symptoms, Mood Swings, Substance abuse, Over-whelming emotions such as fear of losing control over the situation, Depression, Suicidal thoughts, self-injury and sudden increase in substance use. (Sunday TIMES OF INDIA, April,19,2020, Assam Edition).

So we need to find the reason behind it. While a discussion with Dr Monika Sashi Maheswari an expert in mental health issues the answers we came to conclusion are what I thought is important to be discussed and to be written about.  It’s so that more people come to know about it and interpret it accordingly to seek proper medical aid instead of panicking over the situation.

Question 1) Why are apprehension, anxiety, and stress in the atmosphere?

Answer: This, COVID-19, is one of the first pandemics being faced by this generation in around 100 years. It is a kind of sudden shock for the whole population who were very busy in their own routine life. Least scientific knowledge or survival skills on this viral infection (any kind of pandemics) have been gathered till date.

Question 2)  What are the causes behind this?

Answer: The first and foremost reason among the general population and health care workers can be the lack of awareness about the conditions related to mental health issues. The second could be the acceptance of them suffering from one or other form of mental issues. The third, and most important, cause behind it is ‘Trigger Exposure’ (injurious or harmful conditions which are responsible to make oneself remember past trauma- might be smell, sound, or sight or any other factor). As quoted by Brittany Moses, “When you cannot see the future and not knowing the outcome gives you Anxiety.

Question 3) What are the common signs and symptoms?

Answer: Signs and symptoms:

  1. Irritability and sudden eruption of anger bouts.
  2. Sleepiness or Sleeplessness.
  3. Headaches.
  4. Sudden allergic reactions like- itching or hypersensitivity of the skin.
  5. Low productivity.
  6. Mental Hyper-sensitivity or Restlessness.
  7. Broken Numbness.
  8. Disappointment.
  9. Insecurities.
  10. Indifference with loved ones.
  11. Adjustment issues.

Question 4) What are the types of mental illness?

Answer: Types of Mental illness

  1. Anxiety disorders- A mental health disorder characterised by feelings of worry, anxiety or fear that are strong enough to interfere with one’s daily activities.
  2. Depression– A mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.
  3. Bipolar disorder- A disorder associated with episodes of mood swings ranging from depressive lows to manic highs.
  4. Neurodevelopmental disorders-  are a group of disorders that affect the development of nervous system, resulting to abnormal brain function which may affect emotion, learning ability, self-control, and memory. Can include:
  • Specific learning disorders like dyslexia.
  • Autism Spectrum disorder
  • Motor disorders including developmental coordination disorder.
  • Tourette’s syndrome.
  • Traumatic brain injury (alike congenital injuries) that might cause cerebral palsy.
  • Communication, speech and language disorders.
  • Genetic disorders.
  • Disorders due to medications and illegal drugs including alcoholism
  • Attention Deficit Hyperactivity Disorder (ADHD).

5. Mood disorders – emotional state or mood is distorted or inconsistent with ones circumstances and interferes with ones ability to function. One may be extremely sad, empty or irritable (depressed), or may have periods of depression alternating with being excessively happy (mania).

  • Major depressive disorder— prolonged and persistent periods of extreme sadness
  • Bipolar disorder— also called manic depression or bipolar affective disorder, depression that includes alternating times of depression and mania
  • Seasonal affective disorder (SAD)— a form of depression most often associated with fewer hours of daylight in the far northern and southern latitudes from late fall to early spring
  • Cyclothymic disorder— a disorder that causes emotional ups and downs that are less extreme than bipolar disorder
  • Premenstrual dysphoric disorder— mood changes and irritability that occur during the premenstrual phase of a woman’s cycle and go away with the onset of menses
  • Persistent depressive disorder (dysthymia)— a long-term (chronic) form of depression
  • Disruptive mood dysregulation disorder— a disorder of chronic, severe and persistent irritability in children that often includes frequent temper outbursts that are inconsistent with the child’s developmental age
  • Depression related to medical illness— a persistent depressed mood and a significant loss of pleasure in most or all activities that’s directly related to the physical effects of another medical condition
  • Depression induced by substance use or medication― depression symptoms that develop during or soon after substance use or withdrawal or after exposure to a medication

6. Schizophrenia and Psychotic disorders- A mental disorder characterized by a disconnection from reality. Psychosis may occur as a result of a psychiatric illness such as schizophrenia. In other instances, it may be caused by a health condition, medication or drug use.

Possible symptoms include delusions, hallucinations, talking incoherently and agitation.

7. Feeding and Eating Disorders- Feeding disorders are a type of eating disorder that prevents the consumption of certain foods, often based on colour, texture, or other factors. Eating disorders are mental disorders defined by abnormal eating habits, such as bingeing, purging, and/or fasting.

8. Personality disorders- A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school. Personality disorders usually begin in the teenage years or early adulthood. There are many types of personality disorders. Some types may become less obvious throughout middle age.

9. Obsessive-compulsive disorder- Obsessive-compulsive disorder is characterized by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviours.OCD often centres on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life.

10. Post Traumatic Stress Disorder (PTSD) – A disorder characterized by failure to recover after experiencing or witnessing a terrifying event. Symptoms may include nightmares or flashbacks, avoidance of situations that bring back the trauma, heightened reactivity to stimuli, anxiety or depressed mood.

Question 5) What is the possible plan of action to work through?

Answer: The possible plan of action is- Firstly Acceptance of the fact that one might be suffering from some psychiatric problem. Second is- Communicate your issues to your friends and families. Start talking about your problems and triggers. The third is to start working on the trigger. Talk to a therapist or a mental health worker if you are already under some medication or psychotherapy.

For the near and dear ones, the importance is on studying the mental health first-aid related to these issues. Thumb rule is – To understand and stand by the victim so that they don’t feel left alone (mentally), and if you notice any behavioural changes in your dear ones kindly contact the mental health specialist but only with the consent of the sufferer or victim.

Dr. Monika Sashi Maheswari further talks about the Homeopathic line of treatment and management for the acute and sudden trigger of mental health issues during this COVID-19 pandemic. She talks about a strategy of providing symptomatic medication where after understanding the trigger through proper counselling so that the root cause could be understood. Too many people think that “mental illness” is a mental stigma.

There are so many medications that can be used to treat numerous symptoms of anxiety and depression. But along it is important to understand that those symptoms are not because of another illness such as underactive thyroid, or some stomach ulcers, etc. Dr. Monika says,

You should try to combat your stress and anxiety with some creative ways also during this lockdown. Like mindful reading, colouring, to evaluate your own actions, don’t be so judgmental about your own actions. Spend more time in engaging your mind by picking up your old hobbies, even if you don’t feel like talking just try to be with your family and listen to and observe the situations. Don’t stop your apprehensions if you find talking to yourself. Try to analyze your thoughts and if you see that there is the growths of uneasiness within yourself talk with your family, or friends with whom you are with and then get in contact with the respective counsellor. There are many telemedicine centres who are doing good work by providing on-call and video conferencing help to those people who are in Quarantine or those cases who require help during this lockdown situation. Don’t force yourself for anything which was a normal thing for you in past. Since it is going to be a new normal for everyone.  We need to learn a new balance technique”.

The COVID-19 outbreak has given a push to all these mental symptoms that tend to all of a sudden have come to surface. Instead of panicking in this situation, it is better to see it in a more scientific way. Everyone is talking about the dos and don’ts to be done during the Coronavirus outbreak but least is being talked about the mental health-related issues. Because as C.S. Lewis said, “Mental pain is less dramatic than physical pain, but it is more common and also harder to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say “My heart is broken.

You must be to comment.
  1. Dibyojit Dutta

    Agreed. Many people are facing difficulties to adjust in the sudden change of environment these problem can be magnified if staying alone without emotional support. I think one phone call from friends, relatives, family members can greatly alleviate the trauma.

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Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

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The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

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Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

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As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

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Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

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