Calming the Covid mind

Renu Sud Sinha & Chandni S Chandel

The lockdown, the restrictions, the confinement, the paranoia — Covid-19 spawned situations that had no precedence. The virus not only tested immunity, but also the elasticity of human ties. As a vaccine shot becomes a reality, lifting the pandemic’s occupation of the mindscape is the big challenge.

In the initial weeks, an unsuspecting populace treated it more like a holiday — not going to work, no school, spending time with family. The pause provided the much-needed break everyone had yearned for at some point of time. However, reality soon set in that the pandemic and the ‘pause’ is here to stay and no one knows for how long.

A palpable fatigue set in because of the restrictions. Families were now living and colliding in each other’s personal space 24/7 within the four walls called home.

Infecting the mind

The rising number of cases brought in a corresponding increase in anxiety and fear. The virus with unknown long-term effects not only claimed lives, it played havoc with minds too. There was a huge rise in the number of mental health patients. The condition of those already affected worsened in absence of therapy or treatment.

From toddlers to the elderly, everyone has been affected, some more than others.

All of three, Chandigarh-based Shubham, otherwise a bright and active child, has had difficulty in learning new words. The lack of interaction with other kids and adults has led to a decline in communicative and expressing skills, says his paediatrician, Dr Mahesh Hiranandani.

On the other side of the spectrum is Anand (40), a Ludhiana-based teacher at a coaching centre. Already under psychiatric care, his anxiety and phobia intensified. As his institution closed, he shut himself inside his room in April. When he eventually stopped eating altogether, his family had to forcibly admit him to a local mental health clinic.

“There has been a 40-50 per cent rise in mental health issues as compared to the pre-Covid days,” says Delhi-based Dr Deepali Batra, a clinical psychologist.

The most worrying aspect has been the reported rise in the number of suicide cases. “At least two to three have been reported per day in Himachal Pradesh since May. For one death by suicide, there were 20 attempted suicide cases, including by teenagers, women and those in the middle-age groups,” says Dr Sanjay Pathak, CEO, Himachal Pradesh State Mental Health Authority.

Burdened beyond years

The pandemic has been especially trying for children and adolescents, particularly those in the age group of 13-19 years. “An under-pressure family unit is unknowingly transferring anxiety to children,” says Dr Batra. As a result, many kids, particularly those under 10, have become clingy, adding to the pressures of an already stressed homemaker.

Teenagers, on the other hand, fear the proximity of parents more than the virus itself. On the threshold of adulthood, the loss of independence and privacy, and the lack of interaction with friends have turned many a home into a conflict zone, says Dr Rajeev Gupta, a Ludhiana-based psychiatrist.

For the energetic group of students appearing for Class XII boards and gruelling competitive exams, looking forward to the outside world, the year has been one of ‘parental surveillance’ instead.

The common refrain among teens has been of parents preaching and judging more and listening less. “During a counselling session with a teenager, she asked me to tell her parents to cut down on the speaking part,” shares Dr Batra.

An overdose of negative attention has created an atmosphere of constant suffocation and resultant rebellion. That has resulted in an increasing number of cases of domestic violence and child abuse, adds Dr Gupta.

A prolonged admission process and uncertainty over admissions abroad have only added to the stress of this vulnerable group, already facing anxiety, says Dr Hiranandani.

Of those already affected

Delhi-based Shanaya (18) suffers from obsessive-compulsive disorder (OCD). Her condition worsened in the face of a virus that could exist on any surface for an unknown period and needed increased hygiene practises. She locked herself in her room and was constantly sanitising herself and everything around. Crying continuously, she was barely sleeping and eventually stopped eating. Uncertainty and lack of information only fuelled her fears, that included the world ending due to pandemic. Even counselling, that had gone digital now, was not of much help initially, says her therapist, Ashita Mahendru, a clinical psychologist.

The condition of one of her other patients, Kritika (19), already under therapy for anxiety, had worsened in this constant state of uncertainty. It didn’t help when both her parents acquired the dreaded infection. Her worst nightmare had come true. With parents under isolation and grandparents at home, the teenager had no time for self-care. However, a support group of friends, video calls with her ‘cool and composed’ mom and calming exercises from earlier therapy sessions kept her grounded.

Even those teens who had never suffered an anxious moment besides the usual exam stress could not cope. For a sports lover being cooped inside without any physical activity can be extremely frustrating. A few weeks into the lockdown, Anshul (17) started exhibiting symptoms like extreme irritability, mood swings, argumentativeness, etc. The realisation that this situation may well extend into next year made things worse. His mother was able to persuade him to go for therapy.

“Adolescents with adequate and constructive coping mechanism have been able to keep a modicum of composure but those with vulnerability, or having other traits like a tendency to be low and apprehensive, are finding it difficult,” says Dr Adarsh Kohli, Professor, Clinical Psychology, PGIMER, Chandigarh.

Too close for comfort

Forced proximity made many parents aware of the problems being faced by kids, signs of being dysfunctional and unsettling discoveries like the use of drugs or addiction to pornography or social media.

Conflicts increased as a result, but in the end, these harmful revelations also led them to face some bitter home truths about themselves and their kids and eventually seek help.

Life, as we knew in pre-Covid times, has changed forever. However, survival strategies, coping mechanisms, rules for parenting or for that matter any relationship have remained the same. Only their re-learning is needed. “More than adolescents, we had to counsel the parents,” says Mahendru. “The problem lies majorly with parents. Most are critical, often compare their kids with siblings or peers, are judgmental, do not listen but order or preach. Even when they bring their kids to us, they seek validation for their own point of view,” she rues.

Rules for new normal

Kritika’s mom, a homemaker, has a simple solution, validated by experts. “Listen to them. They are not kids anymore but young adults and they can be right at times. Don’t impose your thinking; let them make their own mistakes and learn from them.”

Dr Priyanka Kalra, a Ludhiana-based psychiatrist, has been holding training sessions for parents to help them deal with Covid-induced behavioural problems such as restlessness, aggression and even deception among kids as young as six. She cites the case of a 10-year-old boy, who along with his five-year-old sister, would log in for his class, and then watch cartoons on the other phone that he would ostensibly ask for to use the hotspot.

She advocates unintrusive and patient monitoring, more family activities and reinforcement of positive behaviour by parents as some key solutions.

For adolescents, Dr Sandeep Grover, HoD, Psychiatry, PGI, Chandigarh, suggests parents involving them in decision making, daily activities, helping around the house, teaching them basic life skills, and taking up some common activities or hobbies together to strengthen familial bonds.

In short, continue doing what we all did during the initial phase of lockdown, but with a better understanding and a positive perspective.

It was never meant to be easy, but why make it more difficult.

(Some names have been changed to protect identity)

Symptoms to watch out for

• Disturbed sleep
• Irritability
• Extreme mood swings
• Aggressive, argumentative behaviour
• Frequent headaches
• Poor appetite
• Indifference towards self-care
• Self-isolation, less or no social interaction

Strategies to help cope

• Listen without judging or preaching
• Unconditional acceptance
• Give physical, emotional and mental space
• Provide a positive, conducive atmosphere
• Create a schedule or time table
• Have more all-inclusive family activities
• Encourage connecting with friends, cousins, family members
• Set time for exercise, walks, yoga
• Take up new hobbies together

Helpline services

• Chandigarh Administration’s 24X7 toll-free helpline no. 1800-180-2063
• The Ministry of Health and Family Welfare provides a pan-India toll-free helpline no. 08046110007
• Paramarsh toll-free helpline no. 08047192224 (9 to 9) by Indian Association of Clinical Psychologists
• Rehabilitation Council of India provides free services by 640 certified professionals across India. Check its website for more info