A looming mental health crisis in times of Corona

A day after Delhi is under total lockdown, 25-year-old, Saima Rehman called upon her counsellor to learn ways to cope with her anxiety and depression with social distancing and quarantine becoming the norm amid large scale Corona fears gripping the world. 

“It has just been two days of being at home and not meeting many people; my anxiety and panic attacks have already shot up. As an extrovert, this self-isolation, social-distancing, quarantine is taking a toll on my mental health. It is bad. The longer I am in quarantine, the worse my mental health gets, and the way the situation in our country is escalating, I don’t know what’s ahead for people grappling with mental health issues,” Saima told this correspondent. 

“As advised by my counsellor, I am trying to distract myself by offering prayers, sharing jokes, cooking, reading, and watching stuff on Netflix. But at the end of the day, I am still scared, angry, and my anxiety is through the roof,” she added. Rahman is one among millions of Indians living with mental health conditions in the country. 

As the Corona pandemic expands, experts believe that social distancing and isolation of people living with depression and mental health issues might aggravate their illnesses further. More so, anxiety and panic, combined with social distancing and loneliness could be lethal and further complicate mental health cases among Indians who are already vulnerable to it.

A National Mental Health Survey report commissioned by the Indian government and executed by Mental Health and Neurosciences (Nimhans), had pointed out that in 2016, 150 million Indians (10.6 per cent of adults) were suffering from a mental health disorder. Subsequently, a report by World Health Organisation in 2017 highlighted those mental illnesses comprise one-sixth of all health-related problems, and India accounted for nearly 15 per cent of the global psychiatric, neurological, and substance abuse disorder burden.

The report also predicted that by the end of 2020, 20 per cent of Indians would be living with some form of mental illness. The organisation estimates that between 2012-30, India’s mental health emergency will cost the economy as much $1 trillion. With the outbreak of current pandemic, experts fear that the situation can worsen. 

Dr Sanchari Mukhopadhyay, mental health professional and Ex-senior resident of Lady Harding Medical College, New Delhi, believes that even though in people not predisposed to have a mental illness, it is unlikely they will have extended time life-changing experience. However, fear, anxiety and distancing may cause adjustment issues, and that is trauma-related and stress reactions for a vast population. 

It is pertinent to mention that a surge in such health condition might make things even tricky for India that does not have the necessary infrastructure to deal with it. The 2017 WHO report had pointed out that there were fewer than two mental health professionals for every 1,00,000 people.

“Social distancing and isolation can aggravate things for people already living with depression, and it is valid for quite a lot of other psychiatric illnesses like psychoses, mood disorders. Fear and distancing may cause adjustment issues, anxiety, trauma-related and stress reactions,” Sanchari explained. 

“However, in people otherwise not predisposed to having mental illnesses, it’s doubtful that they’ll have a long-term life-changing experience. If at a mild to moderate level, trauma-focused therapies or behavioural activation scheduling or developing healthy coping strategies should be sufficient to deal with it,” she added. 

For patients like Gurmehar (name changed), 28, a fellow with Delhi government, suffering from Obsessive Compulsion Disorder along with anxiety, social distancing can complicate things further both in terms of health and productivity. 

“I would too often put myself to isolation due to interest in life; quarantine has made that mandatory. I do not feel the change as of, but I anticipate long term consequences quite well, and that this could exacerbate my health conditions,” Gurmehar said. 

“I could feel my condition improving ever since I took up a full-time job last year, but with the isolation and not being able to move out of the house, I fear my symptoms will rebound, and visa vis will impact my productivity,” She added.

A senior doctor at the Department of Physiatry, All India Institute of Medical Sciences anticipates that coronavirus pandemic will be flooding mental health cases all over the country. And that even big hospitals, including AIIMS, is inefficient in dealing with such a surge in numbers. 

The medical journal, The Lancet, published a study on the psychological impacts of quarantine that suggests several negative consequences such as post-traumatic stress, confusion and anger. 

The study also highlights that the reason for stressors will include fears of infection, a longer quarantine duration, frustration, boredom, inadequate information, lack of supplies, financial loss and stigma.

Meanwhile, two deaths by suicide, allegedly linked to the pandemic, have been reported. In what is most likely as the first death by suicide anywhere in the world related to the epidemic, a 50-year-old man died by committing suicide after becoming convinced that he had contracted the virus. According to the deceased’s son, the man would continuously watch coronavirus-related videos circulating online. On March 18, a 35-year-old man, suspected to be a coronavirus patient, committed suicide at Safdarjung Hospital.