Managing your mental health and wellness during Covid 19

(This is a guest post by Dr Kiran Manduv)

People around the world are experiencing a pandemic for the first time in 2 or 3 generations. In addition to the rapid spread of the virus, the daily increasing numbers of deaths has triggered anxiety among a lot of people worried about their own safety and that of their families. That is doubly so, if any of their loved ones are under quarantine, or worse develop a medical problem.

Access to medical care is becoming difficult as most hospitals have stopped non emergency medical care. The risk of picking up the virus if people visit a hospital is stopping many from seeking urgent medical care unless it becomes unavoidable due to the severity. Add to this, the exponential spread and relative ease with which the virus is affecting large number of people in the community, has led to large scale panic. The critical shortage of masks and hand sanitizers is a problem faced not only by the general public but also the medical community.

The virus can spread between people even before they start showing symptoms and this has led to a degree of uncertainty among all, as no one can be sure whether they are already infected and might start showing symptoms in the next few days. The huge numbers of the toll taken by the virus many advanced countries is having a numbing effect on people who wonder what they will do if the same thing happens in their neighbourhood or the local community.

Whole cities and countries are under lockdown. Being unable to travel and worrying about loved ones stuck in distant places obviously leads to anxiety.  Loss of earning capabilities for daily wage labourers and for private ventures are the other consequences that we are seeing.  Disruption of supply chains, global economies coming to a standstill and crashing of the markets have led many prominent economists to declare the advent of recession that is supposed to be worse than the 2008 global financial crisis. So feeling helpless is natural in the face of it all.

Here I will list down a few of the things that people can do to in their homes to try to proactively cope with the unprecedented situation. One of the most important things one could do is to cut down on the smart phone usage. This will benefit the person who manages to do this admittedly difficult task. It allows us to stay away from the barrage of bad news coming from all over the world, most of which we cannot do anything to help. This advice is particularly relevant to the children, who out of boredom, might take to excessive usage of the smart phone, which will have a deleterious impact on their future psychological development.

At the same time, one must make sure to be updated with the basic recommendations to stay protected and also keep track of the progression of the virus in ones locality, as regular updates are being released by the government in this regard. Here are three activities that would be helpful

  • Physical exercise is one of the most important things to do. It can elevate the mood, relieve anxiety and fatigue and lift a person out of the morose feeling that many are experiencing stuck in their houses. Any exercise is good but aerobic exercise is especially advised, if possible. Using a treadmill, jogging in the house are some of the options. Most importantly, physical exercise also acts as an immune booster and we need all the immunity we can get in these dangerous times.
  • Anxiety and depression can be staved off by simple home based activities. Yoga and meditation is highly recommended but may be difficult for the uninitiated. Such people can start with simple postures like the Surya Namaskaar etc.
  • Breathing exercises are particularly effective. Even short periods of practice of breathing exercises will have disproportionate benefits. The most effective types are such simple practices including Anulom-Vilom, Bhastrika and Kapalbhati. More patient practitioners can try mindfulness based meditations. These are widely available on platforms like YouTube etc. It is pertinent to note that, just like with physical exercise, breathing exercises and relief from anxiety also have a positive impact on the immunity. Getting adequate sunlight has well proven benefits too, in this regard.

There are also unexpected benefits from the lockdown. People can now spend more time with their families and can give quality time to their spouses and their children. Catching up on old TV classics like the Ramayana, Mahabharata and Chanakya can be an enjoyable together- time for the family and essential cultural education for the millennials. Interpersonal interaction with family and friends has its own intrinsic therapeutic potential and catching up with relatives and friends by phone can help in re establishing old neglected ties and also lead to a sense of oneness in the extended family and the local community that we’re all in this together and can get courage and reassurance from each other.

One should also try to make the best use of the time to catch up on long neglected hobbies, practice of the arts and intellectual pursuits like reading, writing and any special projects like that we all have planned but never find the time to do. One can enrol oneself in online courses that have been made free by many MOOC providers and upskill themselves and be job-market-ready once the lockdown is over. Gardening is an especially rewarding activity as it promotes both physical and psychological well being.

Some people are also disturbed because of the sudden lack of access to cigarettes and alcohol. This is a valid concern for people used to daily consumption of these substances.  Instead of worrying about availability and going out to find these substances, this lockdown can be viewed as a good opportunity to quit these harmful substances.  Having some anxiety and sleep disturbances after quitting alcohol is common and can be dealt with by taking mild sedatives (which are prescription drugs and can be obtained only on the advice of a doctor).

More severe withdrawal symptoms will result in withdrawal seizures and delirium which cannot be managed at home and will need the attention of a medical doctor, preferably a psychiatrist.  Intense craving for nicotine after running out of cigarettes is common. Paradoxically, accepting that there is no availability of cigarettes and deciding to quit smoking itself will result in a significant reduction of craving. Craving can also be reduced by taking tobacco chewing gums that are available in pharmacies over the counter.

Taking a counter viewpoint, it is a God-send opportunity for many who want to quit smoking, but the intense craving for cigarettes and the easy availability in daily life (when there is no lockdown) prevents them from quitting as they befool themselves that they will smoke ‘for just one more day and quit the next day’. The lockdown and the close monitoring of their loved ones in the family, who re also restricted to their homes during the lockdown can enable a person to make a serious attempt at quitting smoking.

Finally, one should realize that there are many whose livelihoods and the usual sources of income are disrupted badly due to the lockdown. The domestic help, the daily wage laborer could do with a bit of a helping hand. Giving them their complete monthly salary for the period of the lockdown is something that a lot of us can afford to do. Participating in the local residential committee’s meetings to take care of the small things to ensure the continuity of basic services and the protection of the community will ensure that one has a sense of purpose and oneness during these days. With patience, courage, and togetherness, we can tide over this crisis.

About the author

Dr Kiran Manduva did his MBBS in 2001 and studied Psychiatry from NIMHANS in 2005. He is interested in deaddiction, psychotherapy for victims of sexual abuse and neuroscience. He is especially interested in novel public health approaches to make psychiatric care accessible to all.

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