Mind your head

We explore how we can prepare ourselves better not only to cope with the current crisis, but also to deal with challenges in a post-pandemic world.

When we first heard the word Coronavirus (and then Covid-19) in February, we were not sure what it would mean to us. We did not have the faintest idea of how it would change the world and our lives.

When my colleagues and I decided to close our office and shift work to our homes in mid-March, we told each other we shall meet in a fortnight’s time. But then, on March 22, a lot changed in the way we started looking at the pandemic. In the time since then, if there’s one word that I am constantly hearing in most conversations, it is ‘uncertainty’.

Not trained for uncertainty

And uncertainty or lack of predictability about our future is not something we are trained to handle or cope with. Any sudden change can have an adverse impact on our mental health, if we do not have an effective coping mechanism to deal with the change.

In a webinar conducted by our Foundation, Dr Shekhar Saxena, Professor of the Practice of Global Mental Health, Department of Global Health and Population, Harvard T H Chan School of Public Health, said: “Fear is a strong emotion, along with apprehension. And then, the lack of control on the future and our circumstances. These are strong stressors.” And, when we live with these stressors for a period of time, it can potentially lead to mental health issues, he added.

What’s your coping mechanism?

We all have our own coping mechanisms to deal with adverse and challenging situations. These coping mechanisms have been put to one of the toughest tests today. Aparna Joshi, practising psychotherapist and Assistant Professor at the School of Human Ecology, Tata Institute of Social Sciences, explains: “Most of us have had coping mechanisms to deal with normal stressors. A lot of these coping mechanisms were about going out or externalising ourselves. Taking a walk in the park, meeting friends, shopping, going on vacations and so on. During the lockdown (and post that), many of these options are not available. And we don’t know how to adapt ourselves to suit the new reality or develop a new coping mechanism. That is one possible reason why people are reaching out to helplines (for their emotional distress).”

It is, therefore, not surprising that many mental health professionals have reported a spurt in mental health issues immediately after the lockdown was announced. The emotional distress faced by people have manifested in a range of issues. Anxiety, perhaps, has been the most commonly reported.

Relationship issues

It has also been noticed that relationship issues in the family have increased. Aparna points out that iCALL has received a number of calls from people saying that it was becoming difficult for them to stay with their family members. “While they are drawing energy from the place they call home, they are also being forced to negotiate their space from this very place. Old issues of fear and anxiety within the household are suddenly being triggered,” she adds. This is also leading to a lot of cases of domestic violence. There are also cases of alcohol and substance use connected with the current situation. While we don’t know if suicidality has increased due to these situations, several deaths due to suicide across the country have been attributed to the pandemic and the subsequent lockdown. Though I must hasten to add that mental health issues may not always be a factor in deaths due to suicide.

Looking ahead

Various studies point out that during large-scale adversities such as natural calamities or war, the prevalence of mental health issues can increase by as much as five times. We must know that by the time the pandemic is behind us, a far greater number of people would be emotionally affected by the pandemic and the drastically changing situations than those of us who will eventually be hit by the virus. Moreover, its impact on the mental health of several of us will be felt for a much longer time.

Therefore, there’s a need to work towards ensuring that we, as individuals and collectively as a community, are resilient to the challenges that lay ahead of us.

At an individual level, each one of us must prioritise our mental health and take steps to stay emotionally resilient. We must also actively create a supportive environment for those among us who may be more vulnerable.

The first step to addressing the problems relating to mental health issues is to acknowledge its presence, or, if we are more aware, its triggers. We must accept that we are living in difficult times and they could lead us to emotionally stressful situations.

The next step is to be preventive in our approach. As a preventive step for our physiological health, several of us have learnt newer methods of boosting our immunity in the last two-three months.

Only because, we have been told that good immunity can help us combat the virus better. Similarly, we must learn to take preventive steps to ensure that we build emotional resilience.

In a recent discussion with me, Dr Prabha Chandra, Professor, Department of Psychiatry at NIMHANS, pointed out how having a purpose in our lives can help us build emotional resilience. “If people have a sense of purpose ⁠— if they are helping someone, reaching out to someone ⁠— then, even in a crisis, that purpose gives them a lot of meaning,” she explained.

We have our own stress triggers and we need to identify them. And we must stay away from those triggers or reduce our exposure to them, if possible. For instance, the daily dose of data on the spread of Covid-19 can be a trigger to some of us. So, consuming less of such ‘news’ can be helpful.

We must acknowledge that we are a social animal. Our social skills have been a strong coping mechanism for most of us. The pandemic and the lockdown have severely restricted our socialising activities. Even as we maintain physical distancing, we must not create social distancing. Mental health experts point out to the greater need for us to maintain our social connectedness and build newer ones in times like these.

No shame in reaching out

Despite all our efforts, if we see the worsening of our mental health, we must reach out to someone to seek help. The earlier the better. We must accept the need for help and seek professional help, if needed.

Similarly, if we find someone around us who may seem to need help for their emotional distress, let us encourage them to reach out to a mental health professional. It is the delay in our decision to reach out for help that makes the matter worse. No symptoms or stress are too small to seek professional help.

Clearly, there would be some among us who may be more vulnerable to the stressors of the environment. We must identify them and reach out to them and help them. People with a history of mental health issues are facing grave situations. Children, many of whom have been exposed to much longer periods of screen time and reduced socialising opportunities, can find themselves facing the risk of emotional distress. The geriatric population, those who have lost their jobs or earnings, women, whose rights have been curtailed due to the lockdown ⁠— there are several sections of our society who are vulnerable to severe emotional distress. We must reach out to them and help them seek professional help.

As much as we as individuals must take appropriate steps to prioritise our mental health, there’s a strong need for the country’s leadership to rise to the occasion as well. We must create greater awareness among people and educate them to become emotionally resilient.

It was heartening to see how several states set up helplines to address issues of mental health immediately after the lockdown was announced. This has not only helped those who need assistance, but also mainstreamed mental healthcare in a big way.

Workplaces, local communities, social service organisations and healthcare professionals — all must include mental healthcare in their plans to address the anxiety of the population at large.

Take charge of your emotions

Dr Prabha Chandra, Professor of Psychiatry at NIMHANS, points out that people are not born emotionally resilient. However, it is possible to develop skills to successfully emerge out of tough situations. Here are her tips on how to control our emotions better to help us stay mentally healthy:

Manage your emotions in a socially acceptable manner.

Look at solutions rather than focussing only on problems.

Manage conflicts through discussions.

Be flexible with your environment, needs and expectations.

Look back and think how you resolved problems in the past — this will also give you a sense of control.

Reach out for support, whenever necessary.

Simple coping tips

Bring a sense of purpose in your life.

Use your internal resources, including your previously-tested coping methods.

Pick a way to divert your mind off the triggers; by packing in activities, for instance.

Maintain your social connections; build newer social contacts, if possible. Ensure the connections you build are not toxic.

Take pride and confidence in what you are able to do.

These are difficult times and if you are coping, you ought to give yourself a pat.

Follow a routine and stay as disciplined as possible.

Ensure you are getting good sleep.

Maintain good nutrition, improve your food habits and eat a balanced diet.

Get sunlight.

Try and help others.

Do not hesitate to seek help for your emotional health when required; there’s no shame in asking for help.

Seek help here

Here’s a mental health helplines’ ready reckoner:

NIMHANS (also GOI helpline): 080-46110007

HelpAge India (for the elderly): 1800-180-1253

National Commission for Women helpline for women experiencing domestic violence during Covid-19: [phone]

iCAll helpline (specifically for Covid-19-related issues): + 91 9152987820

Covid Saathi: [phone]

Swaasthi (by iCall for healthcare providers): [phone]

The author is the CEO of White Swan Foundation For Mental Health, a non-profit knowledge service organisation.