FEW will dispute that we are facing the biggest global crisis of our generation. Covid-19 has now spread to almost all countries with over a million confirmed cases. In the earlier days of the pandemic, Dr Ghebreyesus, WHO director general, had stated: “This is not just a public health crisis, it is a crisis that will touch every sector.” We are seeing the truth of his observation unfold before our eyes.
Like other pandemics, this situation is generating significant stress and anxiety, particularly in people with existing mental health problems, children, health practitioners, front-line workers, and those deemed to be at high risk of contracting the virus, like older people and those with chronic disease.
Reactions to such a crisis can include feeling overwhelmed, fearful, sad, angry, helpless. People may begin to worry about their own health and that of their loved ones. Some people may have difficulty sleeping or concentrating. Others may be fearful of having contact with others, travelling on public transport or going into public spaces, while some others may have physical symptoms, such as an increased heart rate or upset stomach. Increased use of alcohol, tobacco and other drugs have also been reported.
There is a need to keep things in perspective in these times.
A main reason for stress comes from a feeling of uncertainty, and if this has triggered anything on a global scale, it is a sense of moving into the unknown. All that we knew about the usual rhythm of life has changed and things continue to change as we speak. Schools have closed, there is an economic shutdown, restaurants, malls, theatres, parks, gyms and other avenues of socialisation are out of reach, hospitals are changing care methodologies, travel has come to a standstill and social distancing has been mandated. Life, as we knew it, is no more.
People fear losing livelihoods. Some groups, like front-line workers, are wary of being isolated because of their exposure risk. Yet others are fearful about being separated from loved ones or not being able to protect them. Several families separated by borders because of work or education are anxious for their loved ones. Common symptoms of other health problems (eg fever) are being mistaken for Covid-19. There is a general air of dread.
International reports have already started documenting an increase in domestic violence. Dystopian behaviour like hoarding of basic supplies, dry food items, hand sanitisers, masks, even toilet paper in some countries, has become a norm. There is an increase in the sale of guns in the US in anticipation of an economic crisis that may lead to a breakdown of society. While other medical specialties are seeing a decrease in outpatient visits, psychiatric visits continue or may even have increased with people reporting loneliness, anxiety, depression and helplessness.
How does one respond to these times? How does one think about responsibility to self, family, community and the world at large? And how does one contain the fear and stress – that is, to a point, adaptive – in these circumstances? It is critical that one starts taking care of their emotional self as much as one does of their physical health. As we keep ourselves hydrated, sleep well, eat healthy and get some fresh air and exercise as part of our daily regimen, there are other small steps one can take to support mental well-being.
Constantly hearing about the pandemic can be very disturbing. It is helpful to take breaks from watching, reading or listening to news stories, including social media. It is also necessary to make some time to unwind and spend time doing activities one enjoys. Reading, music, reflection, writing, meditation are just a few of those things that one may wish to rediscover. While we recharge ourselves, connection with others remains integral; talking with people, sharing concerns, and communicating our feelings and thoughts and maintaining healthy relationships prevent loneliness and despair. Social distancing, mandated with the outside world, gives us an opportunity to slow down and reconnect with close family and friends using available technology.
In this era of growing information, it is worth finding one or two trustworthy resources to watch or read for news updates. Global crises are breeding grounds for rumours, misinformation and sensationalism. It is vital to always check on sources and avoid forwarding or sharing information that does not have a dependable reference. And while we are finding our own ways of coping with this situation, there is a need to keep things in perspective. While some things are obviously beyond our control, there are guidelines we can follow, useful information we can access and share, relationships we can nurture, and memories we can create. Let’s focus on that.
The writer is an associate professor of psychiatry and dean of students at Aga Khan University.
Published in Dawn, April 4th, 2020