Whether it is home quarantine, schools shutting down, travel plans being cancelled, or the suspension of jobs, the impact of the coronavirus pandemic in the day-to-day lives of people is painfully evident. But what the news of positive cases and death counts may not capture is the stress and anxiety of living through a global pandemic, and how quickly it can spread alongside the virus. In Bengaluru, health department officials are trying to address this situation by engaging mental health professionals to counsel people who are isolated, both at home and in hospitals, and those who have tested positive for coronavirus. Dr Rajani P, Deputy Director, Mental Health, Department of Health and Family Welfare, has spoken to several of the 15 COVID-19 patients in Karnataka over the phone, and she says that anxiety is a common emotion shared by the patients. “Initially, people are anxious when they come to know that they have tested positive (for coronavirus). They have a couple of common questions: How long will we be isolated? What about the people we came in contact with?” explains Dr Rajani. “We reassure the patients that this is temporary and that they are not fighting the disease alone. We ask them to engage their mind in relaxation techniques, and to watch movies, listen to music and speak to family members. This is because increased stress levels during treatment may in turn prolong the course of the disease,” says Dr Rajani. She says that some of the patients maintained their calm during the course of their isolation and treatment while others showed improvement and were comfortable after they were counselled. The Department of Health and Family Welfare finalised plans to provide mental health counselling to people quarantined in Karnataka on March 7, two days before the first COVID-19 case was reported in the state on March 9. “Being isolated is a new experience for everyone so it can induce stress, anxiety, and panic. We issued guidelines and engaged professionals in the mental health programme across the state to ensure that the people who are in isolation are contacted at least once in three days to keep a check on their mental health status,” says Dr Rajani. Since then, as many as 3,007 people have been counselled by the team of 35 psychiatrists, 31 psychologists, 40 social workers and 61 nurses working under the District Mental Health Programme (DMHP). “We ask them if they are anxious, depressed, and whether their biological functions like sleep and appetite are affected,” says Dr Rajani. People with existing mental health issues Among the people counselled, 18 people have pre-existing mental health issues. “For people previously diagnosed with mental health issues, it is important that they continue their regular psychotherapy and that they are wary of the changes that fears over coronavirus bring,” says Dr Rajani. Mental health professionals say that people with mental health issues are more vulnerable in a time like this. “For those with anxiety issues or obsessive compulsive disorders (OCD), this concern (over coronavirus) can be overwhelming. People with OCD may increase the frequency of behaviour which is as simple as washing hands just to feel better off,” explains Dr Manoj Sharma, a clinical psychologist at the National Institute of Mental Health and Neurosciences (NIMHANS). Dr Manoj, who has over a decade’s experience in dealing with behavioural addiction, also runs the Service for Healthy Use of Technology (SHUT) Clinic which deals with digital addiction among adolescents. He says that with more people staying indoors, their online activity has increased 20-30%, and this in turn has affected their lifestyle. Online addiction “In a time like this, when we don’t have the opportunity to move out, we are observing an increase in online activities in the free time. There will be a tendency to binge watch TV shows. But we should also take breaks from continuously looking at a screen to reduce the physical effects of excessive digital use,” says Dr Manoj. He says that the sheer amount of information and warnings about coronavirus in the media could be overwhelming for some. “People have the fear of missing out on something. They want to know everything about the virus – about the preventive steps. They are forwarding what they receive online to others, either for validation or due to the feeling that others also should know it.” News coverage of the coronavirus pandemic has focused on the grim number of deaths reported worldwide and the spread of the contagious disease. “A person who was quarantined told me he is scared after watching all that is shown on television. I told him the solution was in his hand and that he can simply switch off the TV,” says Dr Rajani, adding that the person laughed at her suggestion. She notes that it is important for the news media to publish information about the spread of the virus but also urges newspapers and news channels to publish positive stories. Staying indoors and loneliness Both Dr Rajani and Dr Manoj say that one thing is inevitable – people should prepare for spending more time indoors in their home. “People should be wary of changes in their day-to-day routines. It is time to be more vigilant of our sleeping patterns, eating habits and our mental health. It is best to seek help whenever there is an issue, however small it may seem,” says Dr. Rajani. Prime Minister Narendra Modi has announced something to this effect, asking people to stay indoors as much as possible. But the mental health professionals also say that the practice of social distancing and staying indoors should not result in loneliness and a feeling of being isolated. “This could lead to loneliness and affect the mood of people staying indoors for long hours,” says Dr. Manoj. “We have to acknowledge the fact that being home is necessary at this time and then plan our day differently. Besides our occupational demands, we can do physical exercises inside our homes, increase the amount of time we sleep, read books, and connect with the people around us, even by calling them up,” he adds.
