On 15 February, a father of three, based in Andhra Pradesh’s Chittoor district, took his life after contracting flu-like symptoms. “The 50-year-old became convinced he had picked up the coronavirus, now known as Covid-19, after watching videos online," The Telegraph, UK, reported. A month later, on 19 March, a 23-year-old man, who had flown from Sydney to Delhi and had been shifted to Safdarjung Hospital on suspicion that he had the coronavirus, jumped off the hospital building. These two incidents were cited by the media as the first few deaths by suicide anywhere in the world linked to the coronavirus.

In a country where nearly 15% of adults are in need of active intervention for one or more mental health issues (according to the National Mental Health Survey, 2015-16 by Nimhans, Bengaluru), a more holistic approach is needed to deal with Covid-19, with emotional and physical well-being getting equal importance.

The effect of the pandemic on mental health is already evident. Bengaluru-based psychiatrist Brunda Amruthraj has started getting anxious calls on Covid-19—and that’s saying a lot, given that most people in India still don’t reach out for help when it comes to mental health. “It is only natural to feel anxious, depressed and tense during this time and people with existing psychological symptoms are feeling an increase in their symptoms," she says.

The reactions are following a trajectory similar to the one witnessed during the Severe Acute Respiratory Syndrome (SARS) outbreak in South-East Asia in 2003. Delhi-based consultant psychiatrist Amitabh Saha, who was working in Singapore at the time, saw people develop acute depression, with some developing OCD about washing hands.“We are basing the line of treatment for Covid-19 on those experiences," he says.

Keeping stigma at bay

Health professionals are seeing two kinds of reactions at the moment. There are those who are rushing to get tested. “Then there is the opposite effect, where people are ignoring symptoms as they are scared of home quarantine," says Laxman Jessani, consultant, infectious diseases, Apollo Hospitals, Navi Mumbai. This stems from a certain fear of ostracization. This month, for instance, four coronavirus patients ran away from a government-run hospital in Nagpur fearing they would be labelled as “people spreading the virus".

To educate people, the World Health Organization (WHO) has come up with Mental Health And Psychosocial Considerations During COVID-19 Outbreak guidelines, which state that one must not link the infection to any ethnicity or nationality. “Be empathetic to those who get affected...those with the disease have not done anything wrong. Don’t refer to people with disease as ‘Covid-19 cases’, ‘victims’, ‘Covid-19 families’ or the ‘diseased’. They are ‘people who have Covid-19’, ‘people who are being treated for Covid-19’, ‘people who are recovering from Covid-19’ and after recovering from Covid- 19 their life will go on with their jobs, families and loved ones."

Avoid ‘what-if’ scenarios

There is a need for active anxiety management programmes at home to keep emotional health intact during social distancing and a countrywide lockdown.

The first step is to recognize the root cause of one’s worries. According to Samir Parikh, director and head of mental health and behavioural sciences department, Fortis Healthcare Delhi, it is normal to feel scared. One tends to worry that this may happen to oneself or to loved ones. “People are worried about pay cuts, job losses and probable effects on finances. The most important thing is to recognize that this is an unprecedented situation for everyone and it is absolutely fine not to know how to deal with it," he says.

You can also learn a new language during this time.
You can also learn a new language during this time. (Photo: iStock)

It is important to chalk out a routine and stick to it. “When you work from home, make sure you discuss each family member’s role during the day, the importance of not being disturbed while working, and more," says Dr Amruthraj. It is also important to balance work with activities that alleviate your stress, such as catching up with friends and watching movies—something other than thinking about the pandemic.“It’s critical to stay away from what-if scenarios. Stick to what is in our control and can be focused on today," she adds.

Dr Amruthraj cites the example of a 28-year-old woman in Bengaluru who is extremely anxious about her elderly parents living in Mumbai. In addition, she has been going through a low phase following a bad break-up. “Her father has gone through a surgery and is diabetic. She doesn’t want to travel to Mumbai so as not to carry the infection to him," she says. The doctors have asked that he be isolated at home. “But she is plagued with these what-if scenarios. I have been listening to her and providing her with support to cope with the anxiety," she says.

Add to your skill set

One way of spending time constructively in lockdown is to acquire new skills. Girishchandra, senior consultant, psychiatry, Aster CMI Hospital, Bengaluru, points out that it is possible to pick up new ways of meditating and exercising from YouTube. A host of short-term online courses are on offer too. “Try to get back to skills you may have used in the past or acquire new ones, such as playing an instrument and learning a language," he says.

In fact, some people are doing just that. Gaurav Vaidya, managing partner, Sid Hospitality, in Mumbai has finally found the time to take up Sanskrit. “I always wanted to delve deeper into the language and have found an individual down south who sends me lessons via email. The course is now becoming a part of my routine," he says.

Fashion commentator Sujata Assomull has found a course on fashion and sustainability, offered by the London School of Fashion through Future Learn. “I like to do some sort of course every year. But being old school, I have always resisted going online," she says. When a friend suggested this course, however, she couldn’t resist it—not least because it helps her keep sane and away from WhatsApp and social media.

Socially distant, emotionally closer

Dr Parikh wants people to remember that this is the time for social distancing, not emotional distancing. Use social media constructively to stay connected with friends and family. “We can fight this pandemic with altruism and not individualism. You need to take care not just of yourself but of others too," he adds. Do simple things: Call someone you know who is ill and help out with groceries and medicines, leave fruits outside a neighbour’s house, distribute sanitizers in the locality.

Being socially responsible will also add a spark of positivity to your life, as Neeta Chopra, a resident of Gurugram, discovered recently. She and her husband returned from California on 12 March after visiting their daughter and immediately went into a 14-day self-quarantine. “No one asked us to do this but it was our social responsibility to do so after an overseas trip," says Chopra. Even when they go out for a walk early morning, they keep a distance of 5-6ft from others. “We watch movies at home. Both of us love singing. We cook together. We know we have to be careful so we do pranayam and gargle in the morning. This is a time of renewed positivity," she says.

Manage your digital time

Tips from Manoj Sharma, professor of clinical psychology, SHUT Clinic (Service for Healthy Use of Technology), Nimhans, Bengaluru

  • Practise media literacy: Anxiety-prone readers suffer from the “fear of missing out" and spend hours on the internet. Consume and share news responsibly and from verified sources.
  • Seek information and updates at specific times during the day, once or twice, from local health authorities.
  • Every half-an-hour, take a break from the screen. Do simple eye exercises, move your wrist clockwise and anti-clockwise.
  • To break the cycle of binge- watching shows, take a 15-minute break after every episode.

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