As the country struggles through the novel coronavirus outbreak and the public tries to cope with the abnormal situation of being ‘locked’ inside their own homes for days, a necessary step to contain the virus, many people are likely to experience various feelings that could impact adversely on their mental health.
The Sunday Observer spoke to Counselling Psychologist Nivendra Uduman for his views on the subject and how we should deal with the situation in a positive manner.
Excerpts…
Q. The long hours spent inside one’s home due to the present curfew to prevent the spread of COVID-19 has reportedly led to a surge in mental problems in countries across the world. What is your opinion on the response to the enforced hours at home from the Lankan population in general?
A. The curfew imposed in response to the outbreak of COVID-19 is a necessary step to contain the spread of the virus. While this is an important measure taken by the authorities, it definitely does have an impact on people. Being contained in one place for an extended period of time can be difficult and frustrating which can bring about feelings of anger, sadness, helplessness and anxiety. These are all normal reactions to an abnormal situation. It is something people in general are not used to, and the experience of adjusting to this change in social rhythm and lifestyle can be different from person to person. It is difficult to conclusively say that there is an increase in mental illness or mental health problems due to the curfew, but, it can affect people in different ways.
Q. Who do you consider as persons most at risk?
A. Persons most at risk of developing psychological difficulties during this time could be those who have a pre-existing mental illness that can be exacerbated due to the current situation. There may be some people who do not have easy access to healthcare and their medication and therefore experience difficulties with their mental health. People with chronic physical health problems can also be at risk, due to the scarce availability of facilities and healthcare services. Elderly people with poor family and community support may be at risk of feeling isolated, lonely and neglected leading to mental health problems.
Q. What about young persons who are suddenly forced to change their normal routines?
A. A change of lifestyle and routine can definitely have an impact on children and adolescents. The lack of contact with peers due to physical distancing and the inability to engage in regular activities can be stressful. Inadequate information being provided to children and young people about the current situation could also cause distress. There can also be feelings of frustration that can emerge out of being in the same surroundings for a long period of time.
While engaging with your family in a positive manner, spending quality time together, doing fun activities together is a healthy and useful approach, it must be acknowledged that some young people may not be able to engage with their family members due to different family dynamics.
Some families are distant by nature, while other families are too enmeshed. Hence, it is important that young people are not pressured into spending too much time interacting with family members but are also given space to spend time by themselves.
Q. Domestic violence, incestuous behaviour, marital rape can also rise during these long periods of staying within the walls of one’s home, leading to psychological trauma besides physical scars according to recent studies. Your comments?
A. There is definitely a risk of an increase in domestic/intimate partner violence, sexual abuse and other forms of violence in family environments during a pandemic. There is naturally tension and frustration that people would feel at a time like this, and sometimes due to the inability to regulate one’s emotions, they could manifest in the form of violence against another family member or one’s partner. Curfew can also prevent people experiencing violence from getting help if there is a risk of harm to their life. There are services available to support women and children who go through violence, that can be accessed over the phone.
Q. Solution?
A. Assertive communication, regulating one’s emotions by for example, practising deep breathing, engaging in a hobby, listening to music, doing some reading, speaking to someone you trust can help prevent tension escalating into violence.
Q. Reports have said that existing mental illnesses have surged following fears of lockdown to curb the COVID spread. Do you agree?
A. There is a risk of people developing disorders on the anxiety and mood disorder spectrum and most of all, for people with a history of mental illness it can be a stressful and difficult period. Symptoms can exacerbate, feel more intense, and there may not be adequate support. People who were seeing a counsellor or a therapist may not have easy access anymore, and people who regularly saw a psychiatrist for their mental health may not have access either.
This can have its impact on disorder specific symptoms worsening and one’s general mental health deteriorating. Feelings of isolation and loneliness can also intensify for those who do not have good social support. Furthermore those who are caregivers for someone with a mental health problem can also experience stress, anxiety and practical difficulties.
Q. Depression and anxiety seem to be very much a fall out of the COVD. Your comments?
A. It is normal to feel low and anxious at a time like this. However, if one’s low mood continues for an extended period of time and anxiety begins to interfere with one’s daily functioning, it is important that one seeks help. Depressive features can be normal these days where people would feel a lack of energy and drive, a loss of motivation, sleep and appetite problems etc and it is important to note that while these are symptoms of Depression, it is not always that you would be diagnosed with Depression. The diagnosis needs to be made by a mental health professional and it depends on a lot of things. Your history, the time period in which you’ve experienced symptoms, the severity of symptoms, etc. It is important that readers are aware that symptoms can come about due to situational factors and that it does not always warrant a diagnosis. If in doubt, it is vital to speak to a mental health professional. There are services being offered online at the moment.
Q. What about young persons who are addicted to computers and computer games. Can these addictions increase at this time around?
A. Well, there is a risk of behavioural addictions increasing during this time, and this is where it is important for parents to know how to manage children and young people at home. Engaging children in activities that consist of imaginary play, art, physical activity, could reduce over usage of devices. Organizations like Mel Madura can be contacted for information and advice on helping a young person with behavioural addictions.
Q. Do you think our present health system is able to handle these new challenges effectively especially in the area of mental health? What are the gaps you see and like to be rectified?
A. The main gap I see is in terms of access to mental health care. There are inequalities in our system, and some people do not get easy access to mental health services. Most importantly we also have to find ways to bridge gaps between different communities when it comes to access to information on mental health during this time. Of course, we also need more qualified professionals in the field of mental health as a whole. However, there is a great deal of work being done by the state sector and the private sector in providing mental health services during this time.
Q. The possibility of a surge in mental illness during the COVID19 outbreak has become so acute in some countries that psychiatrists and psychologists have come together to introduce hotlines, as well as radio and Television discussions on common problems teenagers and young adults face in stressful situations at this time around. Your comments?
A. I think it is a very positive step that there are hotlines available and that mental health professionals are accessible via the media. It is much needed when face to face consultations might be difficult.
Q. Research has been found that having a positive outlook on life even in the face of unexpected crises can improve one’s physical and mental well being. Do you agree?
A. Building resilience and having an attitude of gratitude can really improve emotional health and physical health outcomes during this period. Accepting that we cannot control certain things can help.
Q. Your advice to our readers during this time?
A. Acknowledge what you are feeling and thinking, and be kind to yourself during this time