“The mental state sparks from the stark reality that the COVID patient, put in hospitalised isolation, never gets to see another human.. for weeks.”
15 days after he was hospitalised for COVID-19, legendary actor Amitabh Bachchan penned down an emotional, heartfelt note detailing the psychological toll that the diagnosis and the resulting isolation can take on patients infected by the contagious virus.
“There is one note of matter that seems trivial but it is a factor - the mental conditions and the effects of the disease. Very little is known (of) that (which) remains hidden, unseen and not visible .. and matters of the mind often are not ..”Amitabh Bachchan
His blog extended the conversation beyond COVID-19’s physical effects, to uncover the psychological manifestations of a disease that binds you to a single room and disallows any physical interactions with the outside world - barring the ‘robotic’ visits by doctors and healthcare workers - all covered up from top to bottom in their protective shields.
“It Really Messed Up My Mind”
FIT spoke to patients who were home-quarantined or hospitalised to learn how they coped with the isolation.
To one of them, being ‘locked up’ in the room for 14 days almost felt like her world was ‘shrinking’ to the four walls around her. The consistently contracting circle of social interaction, which starts from relegating you to your city and home, and eventually restricts you to one single room - explains this ‘shrinking’ experience.
“It can really get to you. If your symptoms are mild, it’s the isolation and not so much the illness that messes with your head. Even for a person as sorted as I like to think I am, it had gotten too much. The day I finally came out of the room, I lost my cool on everyone in my family for no fault of theirs. It was days of stress manifesting itself.”A self-quarantined patient
Psychologist Kamna Chhibber, Head, Mental Health and Behavioural Sciences, Fortis Gurugram, explains, “Research has consistently shown that isolation can impact people’s moods. They could feel low or less interested in things they usually like. On top of that, there is the uncertainty that surrounds the disease and its outcomes. All this, together, may create anxiety in the mind of the patient.”
“When you are regularly meeting people and interacting with them, the conversations you have can mediate the negative thoughts and difficult emotions developing inside you. But when you are in a state of isolation, you do not have these breaks available to overcome the negativity.”Kamna Chhibber
“This lack of reassurance could fuel irrational and illogical thoughts, making it seem like you are going into a downward spiral,” she adds.
‘Remote’ and ‘Impersonal’ Treatment
The nature of the disease and the fear of contamination does not permit doctors and healthcare workers to interact and engage with patients beyond the bare minimum, or over and above what is necessary.
Bachchan writes in his blog, “There are the nurses and the doctors on visit and medicine care .. but they ever appear in PPE units .. you never get to know who they are, what are their features, expressions because they are forever covered in the units for protection .. all white beings about .. almost robotic in their presence .. they deliver what is prescribed and leave .. leave because longer stay has the fear of contamination.”
“The doctor under whose guidance the care and mapping and reports are governed by never ever comes near you to give a hand of assurance .. a personal detail of the treatment in the close proximity of an assurance .. they are on the communication vehicle of FaceTime .. it’s the best under the circumstances .. but it is still impersonal, it cannot physically be possible otherwise .. we are in remote treatment.”Amitabh Bachchan
Elaborating the need for facial cues in everyday interactions, which make up about 70-80% of our communication, Kamna Chhibber explains, “When you are not able to see the face, you are unable to derive your regular social cues. Human beings infer a lot of things from people’s facial expressions, besides the words they use.”
“Now when doctors are just coming in and going out, you can’t see the expressions, can’t make out what they are thinking. This, in itself, can be triggering. Thoughts like “Am I getting all the information?”, “Are they telling me everything?” can crop up in a person’s mind.”Kamna Chhibber
Guilt, Stigma, and Coping
Nikita Sulay, a clinical psychologist at a COVID hospital, is responsible for counselling suspected and positive patients to ensure they don’t suffer mentally. From her experience, she says, “After being diagnosed with the disease, a person experiences a range of emotions. There is anxiety and there may be fearful reactions. Extreme thoughts about life and death could also cloud their minds.”
Sulay shares how she counselled a person who passed on the virus to his family and experienced immense guilt afterwards.
Then there is also the fear of social stigma. The apprehension of being treated differently can plague the minds of these patients. As Bachchan puts it, “They are afraid to be in public for fear or apprehension of being treated differently .. treated as one that has carried the disease .. a pariah syndrome .. driving them into deeper depression and in the loneliness that they have just come out of.”
The contagiousness of the disease, however, makes isolation extremely crucial and indispensable. For patients with more severe illness, the physical effects of the virus on the body are bigger and of more immediate concern. But the mental health impact can be felt all across the board.
Being in constant touch with your family and friends through phone conversations and video calls could help the most. In Chhibber’s words, “Stay connected as far as possible with your social network.”
This is precisely what helped Vaibhav, a COVID-19 patient who was admitted to Fortis, Vasant Kunj. “Living in the hospital for 12-13 days does impact you mentally. I was in contact with my family throughout. I spoke to them once or twice a day. They kept me motivated and going.”
Chhibber advises that the key to maintaining psychological wellbeing is to intentionally ‘break’ the negative thought processes. This can be done in several ways: by being in touch with your loved ones, by engaging in activities that your body allows you to (just listening to music can also help), and by being your own source of assurance. Remind yourself that you are being taken care of and you will be fine.
And of course, do not hesitate in getting professional help.
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