The mental health crisis in the time of Coronavirus

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By Minal Khan

We are all too familiar with the devastating effects of the Coronavirus on our health and economy. Hospitals are filling up with patients day by day, and the lockdown is getting harder by months. The isolation from our normal worldly routine has caused a steep decline in mental health globally. Not only has it affected the citizens but also the emotional health services. According to The Lancet Psychiatry COVID-19 has severely impacted the mental health services globally, especially in lower-income and middle-income countries (LMICs), where psychological health systems are already frail.

Psychiatric illnesses linked to COVID-19 are due to many circumstances such as: isolation from friends and family, growing financial loses, shortages of resources for testing and treatments, death of a loved one, uncertainty, and the illness itself. Some people who are at risk due to pre-existing medical conditions or pre-existing mental health conditions have a bigger burden to carry. And not to mention the health care professionals who have to work longer hours and have to avoid loved ones incase of spreading the virus, are also dealing with great mental distress.

The immense pressure created by the virus has led to many people, including health care workers, developing depression, anxiety, and stress.

Anxiety is a feeling caused by specific stressors in our environment; when we feel worried or fearful this can trigger our anxiety with mild or severe symptoms. All of us have experienced some form of anxiety in our life, be it a job interview, a big exam, or giving a speech. If the feelings of anxiety don’t go away, it can lead to restless nights and impaired concentration.

Depression is classified as a mood disorder that causes a constant feeling of sadness and loss of motivation. It affects how we feel, think, and behave and can later lead to many emotional and physical problems.

Stress is your body’s reaction to something challenging or demanding. It is a feeling of emotional or physical tension that causes us to feel nervous, frustrated, or angry.

When all three of these mental illnesses are combined it can lead to troubling mental distress, where the person is unable to function emotionally and physically. As the virus developed from an epidemic to a pandemic, many were impacted mentally. According to a figure released by The World Health Organization, surveys done in 2020 revealed high psychological distress in the population during COVID-19. China shows a 35% increase, Iran shows a 60% increase and the USA shows a 45% increase in mental distress. Those who previously had less experience with distress are now facing emotional burdens and some may have already developed a mental illness. Those that previously had mental health issues are now facing a much bigger challenge dealing with their intense emotions.

As previously stated, health care professionals are also facing mental disturbances during this time. With the number of patients increasing, HCPs are left with a brutal decision to make about whose life they should save with the limited amounts of medical supplies. A study was done on HCPs in Karachi using the Depression Anxiety Stress Scale-21 (DASS-21, a 21-item self-report validated tool designed to measure the three related negative emotional states, which are: depression, anxiety, and stress). According to Cureus, the scale revealed high numbers in each category from which they concluded, “It is evident that there are a high number of healthcare workers affected by various psychological ailments such as anxiety, stress, and depression. It is important that the government take steps to ensure that HCPs’ mental health is regularly checked and that efforts are made to reduce their burdens.”

For a better understanding, imagine a car and the car is your mind. These mental health problems are the malfunctions that are taking place in your engine. Your engine is making weird sounds but you choose to ignore it and keep driving. The more you drive the louder the engine gets, to the point where your car breaks down and combusts. Similarly, with any psychological problem that we choose to ignore it only makes it worse.

There are a number of ways we can cope with these illnesses:

1) Anxiety and Stress

One of the key components to relieve symptoms is practicing breathing exercises, which helps lower blood pressure and increase energy. It is vital to identify the triggers of anxiety and stress, and a good way to start is by journaling. Writing down feelings helps locate the source of triggering thoughts and moments. It also helps to rationalize the feelings.

Another technique to use is “The Six-Step Structured Problem Solving Technique”. According to This Way Up this technique is used for anxiety, but can also be applied to stress. You write down the main problem, list down all the solutions (even the negative ones), think about each solution in practical terms, choose the most realistic solution, plan how you will conduct that solution, and act on it.

2) Depression

A small step, even if taken back, is still a step. A major key in balancing depression is by making the effort to move. Reaching out to a loved one can be the most helpful step to take; they care about you the most and are willing to help. Keeping the conversation going helps reduce any guilt or extra stress on your body, physically and emotionally. A mood booster for depression is exercise as it releases all the needed endorphins, so try to hike, jog, dance, walk, etc. to help elevate your mood, and if possible, find a workout buddy or exercises that are rhythmic.

Apart from physical effort, it is vital to focus on our internal self. A great way to start is by gratitude journaling. As depression can cause severe negative spirals, this type of journaling helps keep a strong focus on positivity and gratefulness. To start, here are a few prompts: What was one good thing that happened today? What artist or author are you grateful for? Which memory makes you smile the most? What possession are you grateful for? Who makes you smile the most? How are you able to help others?

Lastly, the most effective and promising way to cope is through counseling and therapy. Professional help gives you a safe space to discuss issues without feeling judged. Despite the taboo around therapy, there is monumental proof about its positive influence on any mental health related issues. Though it may feel unusual at first, things will get better! Reaching out for help makes us stronger and one step closer to breaking the stigma around mental health.

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