The COVID-19 impact has germinated the seeds of another dangerous pandemic - the one of mental health. Symptoms like panic, fear, sleep problems, anxiety and depression have become very common. Psychiatrist Dr. Tulika Shukla of the Millennium Medical Centre, Dubai delves deeper into the mental health issues that have surfaced due to  the pandemic and their management.

The COVID-19 pandemic has been an unprecedented, chronic and collective stressor that has impacted the emotional and mental health of people globally. The mental health impact has not only been at multiple levels – individual, familial, community, national and global but also  longitudinal – immediate and long term. Scientists have documented that any disaster-natural or man-made- is followed by an increase in poor mental health outcomes like PTSD , pathological grief , anxiety and depression. But what is unique about the COVID-19 impact is the chronicity and prolonged nature of the stressor. We have been going through a rapid period of transitions trying to adjust to the “New  Normal”. Overall, the past 20 months have been one of significant transitions requiring a lot of adaptability and have impacted the course of our lives uniquely.

The other important thing to understand is the multifactorial nature of this stressor. Loneliness and lack of social interactions due to social distancing, lockdown and quarantine  have been associated with increase in depression, sleep difficulties and anxiety . People who lost dear ones to the pandemic and survived COVID-19 had to face untimely grief that too without the physical comforting presence of their loved ones. The frontline workers (medical, police, support services, etc.) are another group which bore the brunt of the pandemic. Burnout , risk of infection and stigma were some of the issues that impacted their mental health. Some of the HCW report feeling as if they are back from a war and experiencing PTSD like symptoms. They report having flashbacks of what they have been through. The social and economic COVID-19 impact is larger still. Loss of jobs and financial difficulties have caused severe mental health issues and impaired wellbeing.

The mental health consequences statistics recorded by the Centers for Disease Control and Prevention (CDC) between June 24–30, 2020, show that around 40% of adults in the U.S. reported at least one adverse mental health concern. Other studies have found that 40% of the people in the general population experienced anxiety and depression and almost 70% reported poor well?being and stress during the pandemic. Common symptoms reported are feeling nervous, excessive worrying, overthinking, irritability, disturbed sleep or appetite, decreased interest in activities, and decreased motivation.  We need to understand that the symptoms we are having are “normal reactions to an abnormal situation”.These studies with prevalence of mental health issues in as much as 70 % populations suggest that there is a need for expanding mental health services to everyone in the society. There is a need to “rethink” mental healthcare in the post?COVID era.

The goal in working with people experiencing these issues is to work with their resilience and strengths. We all have an inherent ability to face adversities which is known as resilience and we are all capable of what trauma psychologists call as “post traumatic growth”. In these testing times it is essential to approach problems as they are evolving systematically and with clarity. This may require one to get professional help and treatment with appropriate medications and therapy. 

Other than the mental health issues already mentioned, some people are experiencing what scientists call COVID anxiety syndrome.Countries have now softened the  protocols and as lockdowns are lifted people are going out and enjoying life as best as they can while still being mindful of safety.Yet, for some, going back out and mixing with other people is a concept filled with fear and anxiety. Covid anxiety symptoms  mimic those of other mental health conditions, including anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) and, the pandemic and related factors appear to be the cause. Profs Ana Nik?evi? from Kingston University of London and Marcantonio Spada from London South Bank University, both in the U.K.,in October 2020 had outlined the characteristic symptoms of COVID anxiety symptom syndrome.

• Compulsively checking for symptoms of COVID-19
• Trouble thinking about anything other than COVID-19
• Anxiety interfering  in daily life—going to work or grocery store even with low risk
• Isolating yourself when it isn't necessary
• Avoidance of public places due to fear of contracting COVID.
• Obsessive cleaning and sanitizing
• Health anxiety
• Practicing precautions where not needed. Eg.  wearing masks inside house

People with this syndrome also had higher risk of post-traumatic stress, general stress, anxiety,depression, health anxiety, and even suicidal ideation. Personality traits high “neuroticism” may play a role in developing covid anxiety . Additionally, people with OCD tendencies may also be more at risk.

Experts say that it's essential to identify this syndrome and find ways of treating and preventing it. Otherwise, it can lead to a more significant issue. If you feel that your symptoms of COVID anxiety syndrome are lasting longer than a couple of weeks, or have started interfering with your day-to-day life, reach out to a psychiatrist ,  therapist or counselor either in-office or online.

The first step in managing COVID- anxiety symptoms is to accept and process what has happened to us. We need to understand that the symptoms we are having are “normal reactions to an abnormal situation”.Once we are able to identify and label what we are experiencing only then we can address it.

The concerns that people have of contracting the illness, travel restrictions, and financial problems are very real. The challenge is to identify if one has developed a pattern of behaviors that are maladaptive and worsening the situation. Behavioral therapy and medications for treating anxiety , PTSD and depression can also help those experiencing significant difficulties with this unique and evolving situation.