As India’s Covid-19 lockdown ends, a mental health crisis is looming

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Those having existing issues or familial concerns have only had it harder as they’re unable to use most of their usual coping methods or get breaks.

By Ritika Aggarwal

The first onslaught of the pandemic was the physical concerns brought about by the virus, but now we need to brace for the tidal wave of mental health concerns across all segments of our population that are expected to continue increasing for the next few months at least. By May, we had already seen a 20% rise in cases of mental health according to the Indian Psychiatric Society. The mental health concerns due to the pandemic may not just be immediate, but can also cause long term effects lasting for a minimum of 1-3 years.

People across the board have been facing mental health concerns as a result of the pandemic and the lockdown, including but not limited to anxiety and a fear of the unknown as the pandemic continues but the lockdown lifts. Many are feeling unsafe every time they step out of their homes or bring something in as COVID-19 is hitting people and areas close to us without any bias. This leads to increased and constant vigilance which can be exhausting. There has also been increased social isolation leading to feelings of low mood. The lockdown has hit many financially causing a range of psychosocial issues as a result. Some people have turned to substance abuse as a form of coping which has created its own set of concerns. It is likely that those with existing mental health concerns may worsen.

While some children have really enjoyed the quality time with family, others have found it difficult to cope. Students have had to go online for studies which is in itself difficult for many in regards to access of laptops/ phones. I’ve heard increased complaints about difficulty concentrating as it feels impersonal, finding it hard to not meet friends and connect in person, missing out on the physical activities that were a daily aspect of their lives, etc. Adolescents have also been hard hit for similar reasons with many concerned about their futures and how their exams (or lack of), difficulty with internships, and inability to go abroad for their further education will affect their future employment prospects.

Many have had to defer their admissions to universities abroad. Those having existing issues or familial concerns have only had it harder as they’re unable to use most of their usual coping methods or get breaks.

Families have been thrown together for an extended period of time without the usual options of short breaks from each other, thus intensifying underlying familial issues which so far had been swept under the rug. People at home have had to deal with the sudden increase in housework and no quality time for themselves.

Work from home has led to a lot of issues of its own: role blurring, juggling office work & housework longer hours with most employees being on call all the time, zoom fatigue, additional pressure to use this time productively, being away from colleagues who act as a support system, etc. This constant stress affects the concentration levels, ability to think clearly and decisively, as well as the productivity and efficacy of the individual. All of this can lead to mental exhaustion, anxiety, depression, burnout, and poorer physical wellbeing (reduced immunity, aches & pains, etc).

Healthcare workers have also been overworked without a respite since the pandemic started leading to constant stress as well as mental and physical burnout. All essential workers and their families have all been hit with a constant fear of infection/ infecting near & dear ones, and having to make complete changes to their daily lifestyle such as staying away from families and other resources of relaxation during a time when they need it the most.

Among the elderly, there has been increased stress at being constantly reminded about being vulnerable to the virus leading to a house arrest even after the country has started opening up. This constant reminder of their concerns can be stressful in addition to their worries regarding medical aid if required, the inability to maintain good lifestyle habits such as walking in the garden, meeting up with their family and friends, nutrition, etc. The elderly that are alone at home and not comfortable with technology have found it more difficult in today’s online era as everything from buying vegetables (people preferring online payment apps) to talking to family has gone online.

Many patients that have tested positive for COVID-19 have had to face stigma or have been having flashbacks of their ordeals in the hospital with no family and friends for support. In addition, they are surrounded by doctors, nurses, and staff wearing PPEs, who try to make them as comfortable as possible, but it is difficult to form an emotional connect when you cannot see the other person’s face clearly. Those that have had to go through ICU and especially those who underwent mechanical ventilation or BiPap have been found to be at a higher risk for cognitive concerns as well as for Post Intensive-Care Syndrome (PICS).

Now that we know how the pandemic can affect us at a mental health level, let’s work on creating prevention and coping strategies for all.

Recognise that some level of anxiety is normal in this situation-it helps keep us safe. However, it should not interfere with your day to day functioning

Focus on self care-adequate sleep, good nutrition, daily exercise, deep breathing exercises, practice gratitude and mindfulness

Limit the amount of news you watch and ensure you get your news from reliable sources

Find time to recharge-do something you enjoy daily (you cannot pour from an empty cup!)

Reframe your thoughts

Don’t focus on how things are different now-instead focus on what we can control i.e. how we can move forward and create new opportunities using a solution focused approach.

at the end of the day. This can also be a family bonding exercise.

Set clear boundaries at work and home

Create a daily routine: Create a schedule and ensure you allocate some time for relaxation as well!!

Create screen free times and zones.

Find some time to do the things you enjoy-read a book, paint, listen to music, sing, play games, attend online concerts, learn something new, take online tours, etc.

Connect with family and friends virtually-solidify your support system.

Consider volunteering: this doesn’t mean you have to go out. You could do any of the following simple tasks: reach out virtually to others who are struggling, cook a meal for your neighbour who may be alone, help people who may not have access to information, teach the elderly to use the internet, etc.

Create an atmosphere of gratitude for what you have: keep a jar with some slips of paper in a central area of your home where the entire family can note down what they’re grateful for that day, and empty the jar together at the end of the day to read it as a family (for eg: somebody helping out without being asked or saying thank you, etc.)

Write a journal-get your thoughts out there

Practice mindfulness-use the 4-7-8 technique. Breathe in for 4 counts, hold your breath for 7 counts, and then release for 8 counts. Do this a few times to calm yourself and your thoughts. Remember to use abdominal breathing.

If you’re finding it difficult to cope in spite of these techniques, consult a mental health practitioner.

(The author is Consultant Psychologist, Jaslok Hospital & Research Centre. Views expressed are personal.)