Dr V P de Sa
The unrelenting progress of the Covid virus has spread inexorably across the globe, from Wuhan to Washington, and left devastation and complete chaos in its wake. To commemorate 'World Mental Health Day' on October 10, 2020, we are challenged to focus on this problem, which has affected society at large.
The stigma and stress associated with the corona pandemic has left no one unscathed and has impacted every stratum of society. There is a dictum that 'the health of a nation is dependent on the health of the individual citizen'.
No country or society has been spared; therefore, looking at the larger picture and avoiding the hype and hysteria around us at the micro-level the pandemic has left the individual human being scarred and completely demoralised due to changes in personality, lifestyle and overall outlook on life and existence.
It is paradoxical that during this pandemic, all that we believed in, all that we would live for and the dreams of millions of people all over the world have been shattered or kept on hold because of what has occurred globally in the space of about nine months. Currently, no one can predict what the future holds for humanity.
The fact of the matter is that there were five lockdowns in Mumbai, causing tremendous stress and insecurity in the population. Just two days ago, 4,000 eminent scientists from reputed institutions like Oxford, Stanford and Harvard have castigated the need for lockdowns, saying these are detrimental to the progress of society, cause fear and affect the mind, body and spirit.
If life has to return to normal, the health and well-being of citizens is paramount. It is imperative that the government has to provide good health care to the masses.
It is an undeniable fact that we are living in a VUCA world (Volatile, Uncertain, Complex & Ambiguous). The entire framework of progress in wealthy nations has been undermined due to the pressures and challenges faced by society at large. The end is very far from being in sight and there is no light at the end of the tunnel.
Healthcare workers are most at risk, since they work long hours in the hospital and go back to their families and are beset with fears of bringing home the virus. They work under tremendous stress and fall prey to Covid and it is not unknown that some have succumbed to the disease. Fear is the key which drives people and has a negative impact on their minds. It is important to mitigate the physical and mental impact on their psyche.
This is a matter of huge concern in society because of the fear of unemployment, loss of daily sustenance, education and so on. Therefore, in this era of Covid laws, we have to strictly follow the rules and protect our environment and health and restore sanity in the population. Post-Covid patients who go home develop prolonged symptoms of chronic fatigue, breathlessness, and post-Covid pulmonary fibrosis, which may be long-lasting or permanent.
Fear leads to stress, anxiety, depression, insomnia, outbursts of anger, changes in personality and paranoia. This ultimately spirals into alcoholism and substance abuse, affecting families, the workplace and society at large. The tremendous pressure faced by families, students and housewives has cast its shadow on the psyche and mindset of the individual, leading to various symptoms and complications, like chronic headache, forgetfulness, insomnia, apprehension, stress, myalgia of unknown aetiology, hypertension, diabetes and some elderly persons suffer strokes and develop heart disease. But above all, the greatest impact has been on the molecules of the human mind -- depression, reduced self esteem, uncontrollable stress, anxiety and a host of mental ailments.
a) You are not alone. It is important to remember that this pandemic us affecting everyone's lives, big and small, without any clear end in sight.
b) Reduce stress hormones: It is important to reduce the production of stress hormones, which is an option to achieve reduced stress levels of Covid Stress Disorder by following a few guidelines:
1. Control your exposure to the news: Avoid saturating the mind with negative news and ruminating on it for long periods.
2. Practise mindfulness: Cultivate positivity with small meditation techniques to quiet down those areas of the brain by constantly injecting positive thoughts ('mind gym' technique).
3. Exercise to strengthen the brain: Any physical exercise helps -- walking, cycling, yoga etc. The benefits of exercise are that it regulates the mood and gives a feeling of gladness.
4. Find ways to be social: Visit people where you can maintain a safe social distance, make phone calls or schedule Zoom visits.
5. Manage your mind by doing something you love: e.g. watching good movies or videos, cooking or playing the mind game 'Lumosity'
6. Get good sleep: At least seven hours every 24 hours, at a regular time.
7. Last but not the least :If symptoms persist, resort to expert counselling or treatment.
8. It is important to do a daily check of your mental health status. At least 60 per cent of middle-aged and elderly patients are affected by severe anxiety.
9. Gauge the early warning symptoms and take a daily review of our 'mental health temperature'. Strong emotions during the pandemic lead to spiralling symptoms and untoward reactions growing stronger and worse, day by day.
We need to act on a war footing to salvage the very existence and sanity of humanity. On this important day, we should promise ourselves to reach out to those people who have exhibited various symptoms and are affected with various forms of psychological instability. This is a 'call to action' for each and every member of society in our country and in the world, to identify the early warning signs of risk in our environment and society and ultimately, create a safe, equitable and sustainable healthcare ecosystem for our future generation.
The writer is Director, Medical Affairs, Clinical Compliance & Governance, Saifee Hospital.