Mental health and COVID-19: The questions that haunt

 

As a psychiatrist, I have been seeing more and more cases of covid related mental health issues of late. I could observe various themes in these clients. There were various reasons why someone got psychologically affected during this pandemic. The insight grew deeper and clearer when I got infected, along with my family a few weeks ago. Here in this blog, I have tried to identify and address some common concerns or questions (based on my experiences as a psychiatrist and also as an individual) that haunt us during these testing times. For the sake of clarity, I have discussed these themes under sections, each corresponding to a time zone.

When someone is not infected

During this period the major concern is “what if I get infected?”, “How safe am I and my family” “Is it safe to step outside”. What we should understand that stepping outside to get the essential stuff is inevitable, and the risk of infection can be reduced to a bare minimum if we follow safety protocols strictly, there is no need to panic. You can also go for a walk or jog in non-crowdy areas if the local COVID protocols permit you to do so. I have also seen some clients developing too much concern for sanitization and display behavior almost similar to what we call obsessive-compulsive disorder (excessive cleaning and sanitization), such individuals need to understand that too much concern will not give any additional protection to you, rather you will be prone for various physical and psychological issues like sanitizer induced skin problems, phobia, depression, etc. If you have noticed that your overcautious behavior is disturbing yourself and your loved ones, you should seek professional help.

When someone is tested positive

I think this is the most difficult phase. The usual questions that haunt are “will I infect my family?”, “will I recover?” and most importantly “Am I going to die?”. It is advisable to separate yourself as early as possible once you have symptoms (even before testing) to avoid infecting others. If you have failed to do so, don’t panic, isolate yourself first, use masks while moving around common areas of the house, avoid touching doorknobs, handles as much as possible, if sharing the bathroom with others ask them to sanitize it every time you use. There are many such examples where only one member of the family is infected and others are safe.

Understand that COVID-19 infection is mild and self-limiting in a large majority of people. Only a few people need hospitalization and oxygen support. The recovery rate is above 90%, and only 1-2% of people die due to COVID. This suggests that you have a high chance of recovering successfully from COVID.

If you are asymptomatic or mildly symptomatic, indulge in yoga, breathing exercises, engage in your hobbies like reading, painting, music for some part of the day at least. Make a video call to your friends and family for a casual chit chat.

After recovering from COVID-19 infection:

This is the phase where many still feel anxious about various issues, mainly "is it safe to mix up with family?", "am I completely out of danger?", "what if symptoms surge again?", "what if I land up in some complications?". I have seen people who continue to isolate themselves for months together from their family, and even I faced the same problem, I was not very confident of eating along with my family, sleeping beside them, and removing my mask even when home.

Usually, the virus stops replicating on the 10^th day in most cases, and the person stops infecting others within 12-13 days. So, two weeks of isolation is sufficient in most uncomplicated cases. If you want to be a little more cautious, you can extend partial isolation for one more week, during which, you can use common areas of the house with a mask on and interact with family with the other person also wearing a mask. Prolongation of isolation beyond three weeks is not only unnecessary but also will affect your mental health negatively. In most cases, once symptoms completely subside, the person is out of danger after 14 days. No need to worry. To the best of my knowledge, no complications should trouble you unless you had moderate to severe illness and had been hospitalized. Chances of re-infection within 2-3 months are also extremely low. Hence relax and get back to routine as early as possible. Start mingling with your family without fear, start exercising you have stopped, of course in a graded manner.

Parting words:

Apart from what has been discussed, irrespective of your COVID status, invest in your mental health. Adopt a healthy lifestyle, avoid negative triggers like news and social media posts. Spend time with your family. Remember, no health without mental health. 

Dr.Bheemsain Tekkalaki

Consultant Psychiatrist

Sumana Psychiatry center

Belgaum