By Aashiq Hussain Andrabi
AFTER spreading its tentacles across more than 215 countries, infecting some 6.4 million people worldwide, and claiming more than 3.7 lakh lives, the COVID-19 pandemic is now posing a major risk to mental health.
Gaining control of an infectious disease outbreak requires making difficult decisions, particularly when infections are human-to-human transmissible.
Most countries have taken action to curtail the spread of COVID-19 through measures such as lockdowns, social distancing and self-isolation.
While these measures were necessary but they have rewritten almost every aspect of our lives.
With the millions of jobs having been lost, the careers spoiled and the businesses closed, the economic impact of the crisis will take a toll on the wellbeing of millions of people across the globe.
Besides many have lost their loved ones and these precautionary measures have upended the natural order of saying goodbye to the beloved fallen.
All this means a potential mental health crisis and the world might see an increase in stress levels and negative psychiatric effects.
The impact is likely to be felt by the general public, sufferers of COVID-19, their families and friends, persons with pre-existing mental health conditions and healthcare workers.
To deal with the COVID-induced mental stress, Dr Syeda Ruksheda, a Mumbai-based eminent psychiatrist and psychotherapist, is consulting at various centers in order to bridge the gap and provide quality affordable mental healthcare to all.
The ardent advocate of community well-being is also a celebrity speaker on Mental Health, with two Tedx talks to her credit.
Having received numerous international awards including a prestigious WHO Fellowship from South Korea in psycho-social rehabilitation, Dr Ruksheda specialises in adolescents, young adults, women and families.
As someone who has served on boards of local, national, and international professional bodies, the lady doctor is currently the Co-Chair of women’s mental health specialty section of Indian Psychiatric Society and Secretary of the women’s mental health committee of Indian Association of Private Psychiatry.
In an exclusive chat with Kashmir Observer, Dr Ruksheda talks about the COVID-19 impact on mental health.
INTERVIEWER: What’s the impact of Covid-19 on mood and social processes?
Dr RUKSHEDA: COVID-19 has significantly resulted in a large number of psychological and social consequences.
From increase in issues of sleep patterns, psychosomatic complaints, worry, irritability, sadness, loneliness, poor quality of life to psychiatric disorders like depression, anxiety, panic attacks, suicidality, and substance abuse related complications are being reported.
These consequences are mostly as a result of:
Fear of infection, quarantine, treatment availability and possible death of self and loved ones;
Movement restrictions leading to social isolation, physical inactivity, economic hardships;
Lockdown leading to difficulty in accessing regular health care for other pre-existing or new Medical disorders.
INTERVIEWER: How can compliance with social distancing measures and school closures impact the school going children?
Dr RUKSHEDA: Clearly, school closures and social distancing have an impact on the education of the children involved.
But the effects on the mental health and on the likelihood of children engaging in other risky behaviours if they’re left unattended at home can be potentially very large, far-reaching and long term.
The closures and social distancing measures have caused disruptions to daily routines which are important coping mechanisms.
Children can become frustrated and short-tempered when their daily routines are disrupted. As they often do not know how to put words to their feelings, they act out.
Acting out may look like excessive clinginess, tearfulness, emotional meltdowns, aggressiveness, or regression in other behaviors.
There’re many who may also feel stressed as they face bereavement and issues related to parental unemployment or loss of household income.
Children already challenged with ADHD [attention deficit hyperactivity disorder] are facing difficulties with hyperactivity, impulsivity and attention span.
For children with depression, there will be considerable difficulties adjusting back to normal life when school resumes.
INTERVIEWER: What’s your message to parents on how they can counter the impact of pandemic on their children?
Dr RUKSHEDA: First and foremost, there’s an urgent need to continuously monitor our children’s mental health status.
We as parents also need to be very calm and proactive in our conversations with the children.
As a parent, we must encourage children to express and deal with their complicated feelings in a healthy, appropriate manner.
Creativity in dealing with children’s needs right from food to studies to play will help making the new normal, pleasant and easy to embrace.
Besides our daily routines, parenting styles and adult interactions with spouses/partners and other relatives have to be more relaxed, calming and soothing.
INTERVIEWER: In these unprecedented circumstances of pandemic, young people are also either self-isolating or on lockdown in their homes. There’re concerns that this will impact their mental health and well-being. What coping strategies should youth adopt?
Dr RUKSHEDA: Studies have found that most of youth group are facing serious mental health issues during this public health emergency.
Negative coping style has been found to be one the factors that influence youth mental health.
If young people [teenagers and young adults] are living with families they must get involved in household chores which are an important coping mechanism.
It’s not just life skills training but helps them feel a sense of ownership to the house and home thereby easing them out.
While parents need to push them into this and hold them accountable too, but keeping patience while they do contribute to chores is important or they might feel rejected.
There’ve to be rules implemented like no gadgets on meal times, at least one meal the families can have together, keeping in mind some parents might have work from home and different schedules.
Encouraging engagement with their friends over video calls and not just chats also ensures their sense of isolation is lessened.
Over indulgence in social media activities can lead to further issues and digital wellness should be discussed and practiced.
Mental Illness is a medical illness
An illness needs treatment, not judgement
Those seeing a professional are stronger and smarter because they are helping themselves
A short clip by Dr Ruksheda #mentalhealth #nostigma #barriers #taketreatment #askadr #letstalk pic.twitter.com/iJAg6Rn8qF
— Ruksheda Syeda (@rukshedaMARG) August 11, 2018
INTERVIEWER: What’re the mental health consequences of Covid-19 lockdown and self-isolation for vulnerable groups and how can these be mitigated under pandemic circumstances?
Dr RUKSHEDA: People in the most vulnerable situations are hit the hardest by this crisis, and the COVID-19 crisis is exacerbating structural inequalities in society.
Women, children, people with disabilities, the marginalized and the displaced, all are exhibiting anxiety, stress, and fear about the COVID-19 virus. There needs to be an inclusive response for such groups.
Loss of access to the usual mental health and social support systems during lockdown can make people even more vulnerable than they already are.
INTERVIEWER: It’s vital that healthcare professionals support the mental health of themselves and their colleagues. How can they do that?
Dr RUKSHEDA: Healthcare workers are at the frontline of the COVID-19 outbreak response.
They’re facing burn out, depression and anxiety. They’re undoubtedly confronted with much more than what they were ever trained for.
Under these unprecedented circumstances, they can support the mental health of themselves and their colleagues by taking regular breaks, spending time with their loved ones, friends and families is important.
Besides they must optimize physical fitness including nutrition, sleep, hydration, exercise.
Mental health exercises and talking about their concerns even being able to complain in safe spaces is important – venting can be cathartic.
INTERVIEWER: What’s the effect of media consumption about Covid-19 through traditional and social media on mental health and how can wellbeing be promoted under such circumstances?
Dr RUKSHEDA: While responsible and trusted media coverage and government communication is vital during a crisis and can provide reassurance – but it can also make people more anxious and this can affect their mental health.
Everyone including healthcare workers need to limit their consumption of news and information about the pandemic.
We must understand that facts don’t change on an hourly basis in this case and as such we don’t need always to stick to news.
Creating and consuming content on health and wellbeing should be a conscious behaviour with an intention of self-care and helping other.
Media ought to be used to encourage people to act in ways that help reduce the spread of the virus and reduce levels of anxiety and other mental health issues.
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