*Central Research Laboratory, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar-751003, Odisha, **Siksha’ O’Anusandhan Deemed to be University, Bhubaneswar-751003, Odisha.
ABSTRACT
The COVID-19 (SARS-CoV-2) virus causes a respiratory disease with physical and mental health effects, ending at general morbidity and fatality from some latest coronavirus strains, at times. During the present pandemics, people stay mainly at home, contributing to some elevated stress levels. World Health Organization (WHO) contemplates that the additional steps like, quarantine and self-isolation have stimulated daily routines of peoples, leading to a rise in agitation, oppression, sleeplessness, alcohol addiction, drug-addictions and suicidal behaviors; consequently, causing increase in cases of domestic violence, even. At this stage, health service providers cannot help the poor, elderly people, children who are susceptible to pre-medical adverse conditions. This work aims to highlight the general scenario of the mental health locally in India during COVID-19 pandemic. Some lifestyles, such as yoga, meditation, Ayurvedic medication, avoiding reading on corona too much and watching TV about it, while staying with the own family with the popular healthier lifestyles are recommended to alleviate stress.
INTRODUCTION
The COVID-19 (SARS-CoV-2) emerged in Wuhan city China in December 2019.1,2 The COVID-19 virus started from and Mid-March 2020; while, the local governments declared lockdown of all activities.2,3 Outbursts of the virus and the consequential moves endured by the governments to limit the spread of the virus have maximized discomfort for an expansive pump-up the mental health ramifications.4,5 To break chain of virus transmissions, several safety measures have been implemented,viz., quarantine for travelers and avoiding direct contact with people; eventually, closing down of academic institutions, employment and platforms of relaxation were done.6 On the other hand, these preventive measures have adversely impacted the mental health of individuals allover.2 The negative
impacts of quarantine and self-isolation on mental health are due to the lack of liberty, monotony, and distrust that could produce general declination.7 Particularly, several questions emerge in each young mind lacking the social outbursts, especially in children staying away from classrooms and schoolmates; eventually, they turn to their parents to get some answer and company. Thus, through the generated frustration and helplessness arising from the lack of social activity in schools, children might have a lasting traumatic effect on their mental health as the loss of coordination and a mindful-home study. Furthermore, senior citizens might stay away from family members because of inherent clinical reasons and some typical adverse immunological response(s). Eventually, the physical family-distance could have
Corresponding author: Rabindra Nath Padhy E-mail: rnpadhy54@gmail.com
Received 25 September 2021 Revised 1 November 2021 Accepted 9 November 2021 ORCID ID: https://orcid.org/0000-0002-2522-9843 http://dx.doi.org/10.33192/Smj.2022.8
significant adversity on the mental health in the pandemic. It could not stop the generated nervousness, unhappiness and initiate devastating circumstances that can induce an erratic behaviorial pattern. Because senior citizens rely on family members for their routine ongoing requirements, covid-related self-isolation could harm the family system. Moreover, health personnel employed as the frontline force for patients could result in the mentally suffering of particular patients in the form of fear of contracting a disease; the long hours of service of health workers may result in insufficiency of ancillary protective equipment. Moreover, there could be a negative mental-health effect from the news of the mortality of fellow patients, apart from the load of the patient and unavailability of effective medicines.
Social concerns affecting mental health
A psychological-interventional medical team was formed for attending to patients affected in the pandemic. The team consisted of psychiatrists, clinical psychologists and psychiatric nurses, who formulated interventions for planning separately for different groups. Indeed, the different stages of flow of people or/and patients are picturised (Fig 1).
Health experts could understand the mental health status of various groups of the society affected by the pandemic. The timely identification of high-risk patient groups, especially those with prior mental health issues, is essential to prevent extreme suicide and other negative impulsive behaviors. Interventions should be based on a comprehensive assessment of risk factors leading to psychological problems, poor mental health before a crisis, and a previous bereavement that might injure one or family members. Moreover, the described life-
threatening circumstances, panic, separation from family and low household income may fuel the fire, at least due to the process of lockdown.
Impact on mental health
India registered the first case of COVID-19 in Kerala in January 2020; the numbers have been rising regularly. In India and several nations, the devastating pandemic lead to an alarming state of national lockdown.8,9 Preventive interventions such as social isolation and quarantine suggested by WHO affect mental health.2,10 Psychological depression is caused by abrupt changes in everyday life, leading to lockouts and extended isolation.8 Fatigue, nausea, exhaustion, insomnia, and social rejection are the principal mental health conditions associated with the COVID-19 pandemic.5 Particularly, exhaustion, anxiety, and stress go hand in glove with the pandemic.12,13 Thus, COVID-19 can contribute to an increased suicide risk; strict lockout rules, social distancing, travel limits could lead to a state of fear and anxiety, often leading to depression, which is not yet explicitly studied. However, studies into the prevalence of psychiatric morbidities by general individuals in the pandemic, health care staff and COVID-19 patients estimated that half of the population experienced psychological impacts related to pandemics.14
The most frequently recorded conditions were poor quality of sleep, depression and psychological distress. It is found that some groups of the population, such as women, infants and the elderly, are at greater risk of complications when a stressful accident occurs.15 Social encouragement and cold reactions often influence increased mental health conditions. Health personnels, older adults, and pregnant women may feel more frustrated.16 As it is,
it can be challenging for children and teenagers to stay at home permanently without personal meetings with peers that make them feel agitated and bored.17 Sudden travel bans triggered during severe pandemics have initiated panic among internal migrant workers in India. They were expected to migrate several thousand miles to reach their respective indigenous locations under this condition and be back to work. The condition for most citizens causing evident psychological trauma has been worsened by significant work reductions, unemployment, pay reduction, and the increasing economic downturn.18 Lockdown has facilitated the excessive use of social media and multimedia channels to disrupt sleep habits and negatively affect mental wellbeing from the tendency of having updated news. Notably, a 20% rise in mental illness cases since the Indian Psychiatry Society was reported in the pandemic in Lancet 2020.19 Patients with pre-existing psychological disorders such as, depression or anxiety or a history of abuse may be more at risk of discomfort during these severe times.20
Quarantine is increasingly taking a toll on people as a stringent attempt to contain the transmission of the infection; eventually, life under quarantine has an acute impact on mental health for disrupted of everyday life from the quarantine. This affected individuals to lose control of their lives, in general. Another leading factor to depression is social self-rejection from fearful persons engaging with cured or suspicious patients. Thus, acute fear and depression for a comparatively longer-term are correlated with the failure to activate social networks.
Strategies undertaken
Indeed, the frontline staff is credited for the suitable attempts to minimize the number of COVID-19 incidents.21 Hydroxychloroquine could be deliberated under strict medical monitoring for individuals with high-risk characteristics for other severe diseases.22 Another strategy of treatment practiced in India is plasma therapy. The App in smartphones, ‘Arogya Setu’, helps to inform people in their vicinity about the COVID-19 condition, and self-assessments are available to individual personal health.16 So far, the Indian Government has approved emergency usage for the Covishield of Serum Institute of India and Covaxin of Bharat Biotech. There are many ways of alleviating boredom by remaining busy with the mobile, keeping oneself occupied with daily activities and re-discovering hobbies and interests. Often the beneficial pursuits are healthy behaviors, dietary habits and suitable hobbies. Furthermore, common in Indian households, usages of ayurvedic herbs and herbal drugs such as, Ayurvedic preparations of cinnamon, Tulsi,
turmeric, daily ‘yoga and meditation’ simultaneously boost immunity, which can help ease the generated stress and anxiety.23,24 Throughout these challenging days, stress control, counselling and communication are vital for public life.
CONCLUSION
The present COVID-19 war is a challenging in testing ones emotional ability, patience and stamina. Mainly, Indians are accustomed to struggles and sacrifices from a very early age. The public must be aware of the common psychological effects of a pandemic through special TV programmes, as it can take months for the impact of COVID-19 on the slow-creeping mental wellbeing to become completely evident. To control its effects, it needs collaborative contributions from psychiatrists and the health care system, as well. India is a land of spirituality and yoga. It has a great legacy of traditional mindfulness of meditative practices and traditional medicines in the banner of Ayrvedic products; nonetheless, each country has own developments of age-old traditional medicines. Such practices have been known to reduce psychiatric disorders; those will prove too beneficial significantly and support integrating meditation for improved mental and physical wellbeing into our everyday regimen. Maintaining a constructive mindset, coping methods and recognizing the issue-point would help solve the mental health challenges in this hour of crisis.
Additionally, the stress due could ramify other related problems, family responsibilities, personal health concens therefrom, health problems affecting other family members and the overall family economy. The struggle when becomes related to economy in most countries gets involved with males, indeed.
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