Sleep Disorders, Anger, Burnout: Lockdown to Have Prolonged Impact

Mitigation measures taken at the right time can save the country from a psychological and psychosocial crisis.

6 min read
A large percentage of India's 1.35 billion population will face mental health related issues during and after the lockdown, experts warn.

The ramifications of coronavirus are not limited to physical health, flag experts. We are perhaps making a mistake by not weighing the potentials benefits of COVID-19 lockdown against its long-term psychological impact. Most of us are not going to come out of this pandemic the same people as we entered it.

"Mental health epidemic to follow", says Harish Shetty, a well-know Psychiatrist based out of Mumbai. Recovery will be difficult, he hints.

A reference can be taken from history in this regard as every time a disaster such as an epidemic or war took place, some people developed toxic symptoms such as irritability, frustration, anger, sleep disorder, anxiety, post-traumatic stress, depression, absenteeism, panic attacks, paranoia and even violence in some cases. A review published on The Lancet explores it in detail.

"Just when we need all able bodies to repair the economy, we can expect a sharp spike in absenteeism and burnout", says a report published on World Economic Forum by Dr Elke Van Hoof, Professor, health psychology and primary care psychology, Vrije Universiteit Brussel.

Restriction in the movement and isolation - the very foundations of a lockdown - are likely to make a large percentage of India's 1.35 billion population experience a secondary public health crisis, experts worry as the number of mental health cases is already prevalent in the country.

Glimpses of Life in Lockdown

Pulkit, a 28-year-old, working in Bangalore has been living on his own during this lockdown - over 1900 kms away from his family. He tells FIT he will continue to fear public gathering and travel for the next three months at least while the stress of being away from home and not being able to contribute in any way builds-up.

"I could be a carrier of coronavirus for my parents and little kids at home. And the thought of not being able to visit them because of this fear brings irritability", he adds.

Experts have said that paranoia will be prevalent across the population.

Amidst all the chaos, Pulkit takes out time for his work, hobby and little bit of cooking. "More appreciative of readily available food back at home now", he says.
Amidst all the chaos, Pulkit takes out time for his work, hobby and little bit of cooking. "More appreciative of readily available food back at home now", he says.
(Photo: Accessed by FIT)

For 26-year-old , Jahnvi life meant big achievements and constant hustle - Sitting alone with the self without doing anything "productive or significant" was never an option. But the COVID-19 lockdown gave her a new outlook. For the first time in recent years, she has been getting time for herself which has begun to make her too comfortable, unexpectedly. However, she fears one thing.

“Deep-rooted idea of success and constant productivity keep creeping in and leave me irritated and anxious for not being able to work like before. I love the idea of conscious life but I also fear for my professional goals which have taken a hit due to the market slowdown and don’t seem to have a certain recovery timeline.”
Jahnvi is working from her home amid lockdown. She has set up a little workstation for herself.
Jahnvi is working from her home amid lockdown. She has set up a little workstation for herself.
(Photo: Accessed by FIT)

Like Pulkit and Jahnvi, every individual feels differently about the unprecedented pandemic and how it will change their lives. People who already have an underlying mental health-related issue may face the impact more acutely.

Sramona, who has been living with OCD for a few years now, is observing some of her symptoms reflecting again due to added paranoia.

"I am stuck at home, cleaning the house 10 times, washing my hands endlessly and sanitizing all groceries. This paranoia is too much to take. It is exhausting. These things will indeed take a lot of time to normalise after lockdown ends", she tells FIT.

As a lot of people on social media have been advocating a productive use of the lockdown period for activities and new hobbies, some feel unnecessary pressure looking at this competition of a kind when they can't practice it on their own. It can work as added pressure on the mind of those who are not instinctively proactive.

"I feel both envious and jealous seeing people being able to use this time for creative activities", says Harshit, a media producer who mostly spends time tracking news updates.

As many cling to hope and refuse to see any personal implication of this quarantine period, Dr Achal Bhagat, Senior Consultant Psychiatrist and Psychotherapist warns,

“Most people are waiting for the game to be reset but that is not how it is likely to play out, this is not a game nor a war. It does not end and restart afresh in the same way. It will require rebuilding one’s goals and way of living life.”

Can't Sleep, Restlessness...

According to experts, sleep and body's circadian system contribute to regulating moods, hunger and immunity. With people spending most time alone at their home, the sleep cycles are likely to get disrupted. While some are spending the night catching up on shows, some sleep a little too much. This can have a long-term impact on sleep cycles, further resulting in stress and irritation.

Sleep, however, is not the only thing to worry about. Poor concentration and indecisiveness will most likely contribute into making work-life tougher than before.

"Mental Health difficulties will be dynamic in nature and keep on changing over the weeks. As the virus spreads and there is more mortality, the mental health issues are likely to exponentially grow", says Dr Achal Bhagat, Senior Consultant Psychiatrist and Psychotherapist.

He further adds,

“The psycho-social realities of loss, helplessness, hopelessness, risks related to children, violence, unemployment, malnourishment, and poverty are all likely to increase morbidity and mortality related to mental health problems.”

He also notes that an important factor that is not being recognized right now is that there will be a bi-directional relationship between mental health and the epidemic.

A report in The Conversation by clinical psychological scientists at the University of Washington’s Center for the Science of Social Connection says, "While the COVID-19 crisis increases risk for depression, depression will make recovery from the crisis harder across a spectrum of needs."

It further adds, since depression has impact on problem-solving and motivation, when economy recovers, depressed people will have a tough time engaging in a new goal and finding work. They will also have a tough time re-engaging in meaningful social activity when isolation ends.

Double the Crisis for COVID-19 Patients & Healthcare Workers

The psychological manifestation in health workers would be unimaginable, say experts. A study has confirmed that healthcare workers treating patients in China have shown symptoms of insomnia, depression and anxiety.

Stressing on the need for more studies and mitigation measures, a recent journal published by Lancet Psychiatry notes,

"An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19."

The study also highlights the neurological impact of virus on the brain, it says,

“Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, might infect the brain or trigger immune responses that have additional adverse effects on brain function and mental health in patients with COVID-19.”

Experts also believe that the stigma and guilt are going to take a huge toll on the minds of COVID-19 patients. Further, therapists and psychiatrists treating these cases will also experience pressure as more number of cases will start to emerge soon.

As the week's lockdown turning into month's, Harish Shetty, tells FIT, "Mental health is invisible so there is no support available to fight the psychological impact of the lockdown."

He questions why there is no screening being done for mental health like there is one for COVID-19? Why PM Modi has not spoken about this next epidemic yet? Are we only trying to provide a kind of help that is visible?

"Mental health intervention is required in any kind of disaster", he adds.

"Mental health screening is needed as much as COVID-19 screening otherwise we will not be able to control the mental health epidemic."
Harish Shetty, Psychiatrist

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