COVID-19 and pandemic of fear

World mental health day is usually celebrated on October 10 every year and the theme for 2020 is “Mental health for all, greater investment – greater access”. The pandemic of COVID-19 has brought immense suffering to the people and the greatest impact from all the social and economic difficulties will be on Mental Health. In this era of COVID-19 pandemic, awareness on COVID-19 and the impact on mental health is the need of the hour.
Fear is an emotion induced by perceived danger or threat, which causes physiological changes and ultimately behavioural changes, such as fleeing, hiding, or freezing from perceived traumatic events. Fear in human beings may occur in response to a certain stimulus occurring in the present, or in anticipation or expectation of a future threat perceived as a risk to oneself.
Novel threat like the Corona virus provoke more fear than more familiar threats resulting in anxiety, depression, panic, social withdrawal, paranoia, anger, difficulty sleeping or concentrating, hyper-vigilance to our health, overexposure to media/social media, feeling helpless or confused, stress and burnout.
Mental health issues have increased but, many patients fear to seek consultation, investigation and treatment while some may not realize the symptoms and those with pre-existing mental illness fear to go for follow up and start showing exacerbation of symptoms due to either stopping of treatment or unavailability of medicines. Reports of deliberate self harm, substance use have increased and patients with Obsessive Compulsive Disorder (OCD) have exacerbated symptoms due to the current safety protocol and people without OCD started showing excess of washing and checking rituals. Despite of the rise in the number of Mental health problems, people refrain from seeking help from professionals, because of fear to visit hospitals but the good news is that Telemedicine NEIGRIHMS and in SAN-KER can be easily accessed by people even in far flung areas.etc.
The WHO Declared coronavirus infection as a pandemic on March 12 and as of October 5 the infection has spread globally with 3,50,70,218 confirmed cases and 10,35,853 confirmed deaths. India has 66,23,815 confirmed cases and 1,02,714 deaths (MoH&FW, Government of India, 2020). Meghalaya has 6,656 confirmed cases and 54 deaths. The rapid increase in the number of COVID related cases and information on the disease through various media and social media platform has put our country in the midst of a greater fear and psychological crisis.
Stigma
One of the offshoots of this fear is ‘stigma’ which is mainly due to fear of the unknown, high infectivity of SARS nCOV2, conflicting scientific explanations, unclear modes of transmission and misinformation. The treatment protocol itself can lead to stigma. Stigma can lead people to hide illness, prevent people from seeking help immediately and discourage them from adopting healthy behaviours.
We can all help to fight stigma. Community leaders and health care workers should maintain the privacy and confidentiality of those seeking healthcare and those who may be part of any contact investigation. It can also be reduced by communicating the risk, or lack of risk, from contact with people and places, in simple language.
Negative language that can cause stigma is to be avoided. Negative behaviors and statements, including those on social media should be corrected and make sure that, whatever image which is used in communications or IEC materials does not point to a particular community.
Fear and behavioural change
Fear of getting infected or fear of infecting others has played a major role in changing behaviour. Face mask has become part of our life, and majority of people follow safety protocol like washing hands, sanitizers etc. especially by those having small children, elderly and people with other co-morbid medical ilness(es).
Those with high level of anxiety have become homebound or they come out of their home with fear.
However, when we talk of behavioural change, social distancing and face touching seems to be difficult to follow. The reason could be that socially and culturally, physical distance can be a form of non-verbal communication.
For social distancing, there must be a conscious effort on our part and it can be achieved if the motivation level is high and the locus of control is internal, in that, the behaviour is to protect ourselves and more importantly, others (altruistic behaviour).
Therefore the need of the hour is to change our behaviour for the benefit of the greater good and human behaviour, we feel, can determine the rise or fall of COVID-19.
Coping with Fear
Coping with the current situation can reduce most of the mental health problems. And the good news is that there are ways to improve our mental resilience.
* Whenever we feel anxious we should STOP and DROP whatever we are thinking about, and take several deep breaths to calm our body and stop the rush of stress hormones.
* We should stop worrying about the future.
* We can Calm our mind by taking charge of our thoughts and be tell ourselves that ‘we can handle it”
* We can reduce the fear by following the safety protocol and take responsible health measures and relax.
* We can prevent the virus from entering our homes by staying home as much as possible.
* We can prevent the virus from entering our body by wearing masks, maintain social distance, washing our hands and not touching our face.
* We can prevent the virus from entering our minds by not watching the news and social media continuously.
* We can improve our resilience by eating well-balanced meals, exercise regularly, adequate sleep, and avoid tobacco, alcohol and drugs.
* We should cultivate positivity and be creative. Creativity and enjoyment can change our mood from overwhelm and despair to happier and more hopeful.
* We maintain our social support by connecting with our loved ones and friends.
* We should spend time with children and
* We live in a time of fear which has changed the way we live, work and socialize. The importance of mental health at this crucial time cannot be ignored. As the theme of this year’s World Mental Health Day, it is time to invest attention, compassion, empathy, love and kindness to bring Mental Health for all.
By Dr Arvind Nongpiur, Dr Andreecia Mn Mawiong, Dr Naveen A., and Ms Kimberly Syiem. Department of Psychiatry, NEIGRIHMS,