At a time when India is being warned about an impending third wave of coronavirus, mental health experts warn about the long-standing affect the ongoing pandemic has on our sanity.

As Dr Vasanth Renganathan, Consultant Psychiatrist in Chennai, says, ‘Mental health issues today are a pandemic within a pandemic.’ There is a similarity between covid and mental health, no one is immune and safe, everyone is vulnerable. While in 2020 at the start of the pandemic the geriatric were reaching out for help worried about being vulnerable to the infection, high mortality rate and the concerns over the vaccine. However, this year, children, teens and those in their mid-life are vastly hit. The second wave left Indians in a lurch as the health system collapsed overnight. There was shortage of vaccines, hospital beds, oxygen and for factual information. In short, it was a humanitarian crisis which came with no warning. The scars this leaves behind is far too deep.

Not child’s play
For the first time, fear of losing someone has gripped children this early in life to the extent that they cry refusing to let parents step out for grocery shopping. The pandemic has also caused a lot of potential risk for child’s development.

Dr M Selvi, a Clinical Psychologist at M S Chellamuthu Trust and Research Foundation and at Ahana Hospitals, Madurai, said, ‘Confinement is to protect a child from getting infected.

But at the same time, it is becoming a risk for child development.’

From the age of three to 15, the social and emotional development of a child happens in school. Their peer relationship with neighbourhood children too is vital. With movement being restricted and the lack of a regular routine has aggravated the situation. There is no outdoor activity, their sleep pattern is erratic, some take the liberty to order unhealthy food online and they are also witnessing the stress level in parents rising, she said.

With a lot of negative news around, psychiatrists are also seeing rising cases of post- traumatic stress disorder (PTSD) in children. One incident Dr Selvi narrates is of how a teenager experienced PTSD after losing her father to Covid.

‘It was at 3 am they were informed of it and none of the relatives could come to the hospital to offer support. As per covid protocol, they could not see him one last time, bid a final good-bye or have time to express grief’, she said. The family has not come to terms with the loss. They have not grieved. They have not got closure to what has unfolded.

‘In India if there is a death, there are rituals, prayer meetings and relatives coming in to stand with you. In a way it helps navigate through the sadness. Now, it is completely missing. Here the wife has not yet grieved her husband’s demise, days after losing her father the daughter was diagnosed with mood disorder and depression. The youngest child is still unaware of her father’s death’, she explains.

A child and Adolescent Psychologist, Selvi is treating the elder daughter. ‘The teenager developed pain in her body. Somatic pain is part of grief. She had crying spells and could not slept for 72 hours straight. She also tried to self-harm’, she said. The daughter says she is guilty of getting her father admitted to the hospital when he did not want it. There are others who are traumatised from near-death experiences and engulfed with thoughts: If they would come back home to their loved ones, if they would still have jobs, if they have saved enough finances for their family and so on. And many others suffer from post covid depression. One of the symptoms being that they do not enjoy many things they did in the recent past, such as reading the newspaper or spending time with children.

Reaching for help
According to a report, the economic recession cost India 41 lakh jobs resulting in a volatile job market. The job insecurity is so high that the between a sick family member and a day at work, work was prioritised by employees. There is a statistical spike in the burnout rates among employees with salary cuts and many sectors resorting to grossly underpaying staff. When a salaried person is hit financially, a family bears the impacts of it. Here arises the need for counselling. Sample this, in the year 2020, nearly 11,528 persons reached out for help through the Tamilnadu State government’s tele-counselling centre in Chennai and in 2021, until June, the number stands at 18,903.

Dr Vasanth said, ‘The pandemic has changed the way we lived and has affected our social life. If it has hit in a good or bad way only time can tell. But definitely we are not what we were in the pre-pandemic phase.’ There is a spike in the number of cases of anxiety disorder, depressive disorder, mood disorder and adjustment issues.

Stop Scrolling on the gram!
Tik-Tokers and Instagram influencers push the message on hustling and imbibing only positive vibes. Many reaching out to medical experts say they are flooded with information from social media causing anxiety. Being exposed to false information, toxic positivity and a flurry of fake news can undoubtedly affect a person’s well-being.

If you feel vulnerable, it is best to skip watching or reading distressing news from some other part of India. The excess of information can be overbearing. Dr Vasanth said about one such patient of his: The patient had a diagnosis of obsessive-compulsive disorder. His major complaint was repeated hand washing. Over years the patient’s condition had stabilised with medication and therapy and was doing well and the pandemic began. With a tsunami of covid news, hygiene protocols and caution over touching surfaces, the patient became confused and relapsed.

‘The patient could not tell if the hand washing was because of a protocol or if the mind was telling as part of the spectrum of disorder. The anxiety caused the patient to spending an hour or two washing hands. This was a setback’, he said.

The indicators
Seek help when you feel your day-to-day life is getting affected by your emotional or mental state. Dr Vasanth said, ‘Suppose you wake up in the morning and you do not feel good or happy about it, pay attention. A new morning must make you feel emotionally neutral, if not happy because you have not experienced anything for the day. If you wake up and think this is another day you have to push through or you cannot give 100 per cent to household work or office work and if you are in constant rumination or if your substance use has increased over the years, seek help.’ Dr Selvi concludes, one thing everyone can follow is: ‘With the pandemic being unpredictable, it helps if you have a predictable routine. To some extent in your family, eat a meal together or meet friends virtually. You are expected to maintain only physical distancing and not emotional distancing.’