Coronavirus Outbreak: Taking care of your mental health during periods of self-isolation

These are difficult times. The whole situation is unprecedented. Nobody conceptualized the extent and magnitude of disruptions only a few months ago. Life in recent decades has been laden with various stressors including issues related to work, family life, cultures in a state of transitions, mass migration etc. There has been a mushrooming of mental health issues. In particular, common mental health issues like depressive illness and various anxiety-related illnesses. Let us consider depression, the causation of it is usually multifactorial and the causes can be generally divided into four categories. [caption id=“attachment_8187731” align=“alignnone” width=“1280”] Changes and uncertainty are a source of stress.[/caption] One gets depressed due to:

•  Disputes in one’s life whether it is with the loved ones or at work.
•  Loss of loved ones due to death.
•  Lots of changes and uncertainty.
• Isolation and loneliness.

Considering that changes and uncertainty are a source of stress and with the current scenario with coronavirus, we can assume that there is going to be a lot of stress around. The usual conversations end up with everybody feeling that nobody knows when this is going to end. And as a doctor, I have to answer a lot of these questions. I usually end up saying that only time will tell. For most people, relatively minor uncertainties like whether they will get a promotion or will they qualify in a competitive exam can be enough to stress them out. The current scenario brings a greater amount of uncertainty with it. The amount of misinformation out there fired by rampant forwards on social media does not help the matter. We all need to endeavour to support, educate and help each other in these difficult times, obviously depending on one’s abilities and skills.

Self-isolation

Thinking about isolation and loneliness, this has been considered as a major causative factor in depression. It was more apparent in the western context where individualism is the backbone of the culture. In recent times with mass migration and rapid urbanization in our country as well there has been increasing levels of isolation and as a consequence depression. In the current scenario where self-isolation and quarantine have become a necessity it only adds to the misery. It is an essential evil which needs to be endured. Factors that will add to the stress levels will include lack of clear and concise information, absence of clarity on the tests and clinical outcomes, a dearth of adequate facilities for quarantine, etc. Whatever we can do to mitigate these things will help people endure self-isolation days. Individually, I think that it can be an opportunity to take a pause, reflect and re-evaluate one’s life. One can read, share, watch movies with substance and share the gyaan with friends and family, digitally of course. [caption id=“attachment_8187721” align=“alignnone” width=“1280”] Isolation and loneliness are considered as a major causative factor in depression.[/caption]

Anxiety

Let us now consider anxiety-based common mental health disorders like illness anxiety disorder, obsessive-compulsive disorder (OCD) and generalized anxiety disorder. The predisposition to these illnesses again is multifactorial, it depends on one’s genes and character traits etc. Recent events are rife for adding fuel to the fire of anxiety-based disorders. Central to the pathway of suffering from these issues is a tendency to catastrophize normal bodily events. We see a lot of people these days who present with various medically unexplained symptoms wherein they are focusing excessively on their body to look for signs like discomfort in the chest or difficulties with digestion etc. and then misinterpreting these. We usually manage such experiences with appropriate and judicious use of psychotherapy and medications. If anybody is experiencing excess worries beyond the norm, they can seek professional help. [caption id=“attachment_8187711” align=“alignnone” width=“1280”] Hand washing is imperative to keep coronavirus at bay.[/caption] The obsessive-compulsive disorder manifests in the form of preoccupation with repetitive thoughts or compulsive rituals, usually, the compulsive rituals are of checking or cleaning type. In view of the need to maintain hand hygiene and cleanliness to a microscopic level in current times, we can imagine the burden placed on somebody with OCD. The mainstay of treatment for OCD involves us, training people, to not to give in these urges to wash hands or clean excessively. We have to continue with the same principle albeit in the context of the current norms. There is going to be a tsunami of stress coming our way in the coming months. We need to support each other, be appropriate in our response situations and adhere to directives from experts and the government if we are to successfully see the storm through. The author is a psychiatrist and the head of Mpower-The Centre in Bengaluru