Mental health impacts of COVID-19

COVID-19 pandemic related mental health issues are an evolving multi-layered phenomenon that warrants appropriate attention and necessary action. Mental health problems related to COVID-19 can be classified as mild problems resolving on its own or moderate problems affecting quality of life. A long-term trajectory of serious mental health epidemic affecting a significant population is under watch. This has been flagged by evidence-based researchers as well as by mental health experts.

We are going through an unprecedented challenging situation of our lifetime. Governments all over the world are mandated by World Health Organization to take extraordinary preventative measures to abort excessive loss of lives. These harsh preventative measures although saves lives, but surely takes its toll on overall health and economy of the nation. We are all in it together, trying to make it through to the end and hope to do the right things to reduce any negative side effects.

Anxiety, Stress and PTSD (Post Traumatic Stress Disorder), Depression, Addiction and other self-injurious behaviour, loss and grief, anger and domestic violence are some of the mental health conditions that have been skyrocketing since the pandemic started.

Anxiety is a natural consequence of living with constant fear of uncertainty, unknowns and unpredictability. Some people are experiencing it as generalised anxiety, panic disorders, phobia etc. Some are using sleep medications, alcohol, etc. to calm their nerves, which is increasing the risk of long-term dependency.

Stress is running high for many reasons like job insecurities, educational inconsistencies, economic depression etc. on top of living in a life-threatening situation. Restricted access to healthier coping mechanisms (e.g. fun social gatherings, gym, outdoor activities, etc.) is an important contributory factor in it too. This prolonged chronic stressful life situation can be a traumatic experience for many. Impact of this collective trauma could be managed better by fostering a sense of connectedness and mutual support.

 Isolation is often damaging in trauma experience whereas social isolation is a must to prevent spread of the disease. Balancing these competitive needs is unequivocally challenging for many people. Fortunately, social media and advanced technology are helpful to mitigate this risk factor to a large extent. Perhaps this is not true for people who are technologically challenged or are deprived from this essential pandemic commodity. Double trauma (personal and pandemic) could lead to PTSD in people with history of unresolved trauma. There is anecdotal evidence that humans get one "free trauma" by virtue of life as it is, but subsequent additional trauma experiences become costlier to mental health.

Depression has a fertile ground to pop up because we are living in a negative environment. Negative news is prevalent everywhere. In absence of healthy distractions, over exposure to stress etc. unleashes any underlying automatic negative thought patterns. This is more common when people have no way to do a reality check with others or listen to the brighter side of the story from others.

Addiction and self-injurious behaviours are coping mechanisms when psychological pain grows so intense that the urgency for relief at any cost becomes the only option. People who are in active addiction are prone to go downhill without proper support. Number of cases of self-injurious behaviours reporting to hospital emergency departments are rising in many countries. Some experts are calling it as the beginning of the long-term mental health disaster.

Loss and grief are rampant in pandemic. Loss of loved ones, not being able to mourn properly, inability to follow proper rituals are taking a toll on human minds. Perhaps people who are still healthy cannot even imagine what goes through the mind of severely ill people in quarantine. Family members are horrified and agonised by the fact that they cannot comfort their loved ones in terminal state. These lonely final days of life is traumatic to witness, it is a nightmare for others. There is also survivors' guilt because of how one person remains asymptomatic while another person dies from the same virus by natural selection process.

At present, loss of school-years, loss of hopes and dreams, jobs and financial securities are not getting enough attention as people are focusing mostly on loss of lives. Sympathy, empathy and compassion are drying out quickly as people are trying just to float with their heads above water. This crisis mode of operation allows the brain to remain overloaded with unresolved grief issues to finish its course in future under favourable circumstances. This pending grief work will be another challenge in letting go of the past and be able to live in the present.

Anger and domestic violence are other mental health concerns. Domestic violence is soaring as a result of all mental health crises mentioned above and many more. Domestic violence cannot be overlooked as it leaves long term imprint in the developing brain and tips the balance of the family system. Enforced social isolation helps the abusers. Abusers often systematically isolate and disconnect the victims from the outer world and create a fearful situation of shame and secrecy inside closed doors. Thus, voices of the victims remain unheeded.

Anger can be the flip side of depression or it can be a personality trait or part of grieving process or a faulty communication pattern or manifestation of other mental health problems or all these together. People having impulsive anger outbursts at wrong places with wrong people is not uncommon in this pandemic. This adds additional pain and sufferings to all.

Anger gets easily displaced on weaker people. Health care workers often become the target of uncontrolled anger in absence of proper protocol and protective measures. Nobody, let alone health care workers, deserve to be on the receiving end of this unfiltered animalistic anger. Lack of appreciation, respect and trust on health service does not help anybody.

People who used to travel abroad for world standard health care facilities are now feeling helpless, having to rely on a health system they cannot trust. On a positive note, this could be a fertile ground to initiate an open and honest dialogue between health care industry and stakeholders to make positive changes in this field.

Photo: Collected