Risks to mental health:
Those who have no mental health problems but have predisposition, may break down emotionally.
Those who have existing mental health issues may relapse.
Both can affect overall mental wellbeing of the community
Why?
Because the pandemic is a potent stressor:
It is a potent stressor by following the pandemic epidemiology itself, and also the indirect effect of illness. No clear evidence of direct psychopathologic effects yet, but research is ongoing.
Many past epidemics had this.
The COVID-19 pandemic can affect mental wellbeing through the following ways:
Pandemic related:
Why and How?
Mass panic or anxiety over contagion, being infected and coming down with illness. Fuelled by misinformation, misconceptions and media. May instigate preventive measures that are extreme or not evidence-based e.g. pepper soup in Lagos, bathing with hand sanitizer
↑ Anxiety & fear over uncertainties (job, health, income/business, etc)
↑ bereavement
Threat to earning a daily living
Possible effects/manifestation
Emerging or worsening OCD symptoms, with excessive preoccupation with germ contamination, excessive handwashing or sanitizing
↑ Sleep changes
↑ Hypochondriasis or illness anxieties
Family conflict, mediated by limited resources.
Isolation-related
Why and How?
For some physical social support network is crucial in wellbeing, and may lie outside the home. Being cut off can affect coping with anxiety, etc
For some the change in routine may be too sudden and extreme. Going to work may be what feeds their self-worth or self-esteem.
Stigma of being infected may prevent declaration and help-seeking. This may lead to despair and catastrophizing, and thus risk of suicide or self-harm
Being unable to access mental and physical health care follow-up; this can be quite significant because for many patients visiting the doctor is itself therapeutic, and keeps providing them with hope, structure and purpose
Increased sexual activity
Possible effects/manifestation
↑ Worsening isolation in already asocial/isolated at-risk people
Less distraction from distressing thoughts
Difficult grief and/or abnormal grief if someone close dies during this period either from covid-19 or other reasons, due to lack of usual social support that would have been available. Grieving is culturally-mediated in many African societies. Some may not be able to perform the usual customary rites as they would have. The funerals may have to be postponed, or held with fewer people. This may affect ability to achieve closure.
Disruption of exercise regime (may not be able to go to gym, etc)
Potential ↑ in exposure to domestic violence by being forced to stay home with abuser
↑ Online exposure risks from going online more (increased online traffic) to deal with ‘stay at home’ rule This can result in:
- Vulnerability to online exploitation and cybercrime, more ‘phishing’
- ↑ time spent by kids online and so risk of grooming for sexual abuse, etc
- Worsening of online or social media addiction → comparisons, etc
- ↑ Online buying → over-spending → depletion of funds → guilt feelings → ‘depression’
↑ Depressive symptoms (helplessness/hopelessness/pathological guilt/selective abstraction/catastrophic thinking, etc) due to being alone at home or unable to visit counselor/therapist face to face
Worsening mental health symptoms in general such as binge-eating.
In utero cohort may have unfavourable future outcomes which themselves can predispose to mental health issues
Maladaptive Coping
- Denial
- ↑ Substance abuse as a coping strategy among at risk groups
- Transfer of aggression
- Binge eating
- Self-injury
WHAT CAN HELP?
- Explore remote/virtual communication with therapist
- Have hotline services at hand
- Try music as therapy
- Modify exercise routine
- Explore home treatment options with precautions
- Talk to someone/ share your difficulties
- The gains of covid-19 stay at home restriction
- Opportunity to build broken/strengthen weak relationships → talk to each other
- Opportunity to bond with and get to know children, esp for very busy parents → find out their interests and how they are dealing with the situation and other aspects
TIPS
Teach a family member a skill
Play family games
Watch movies together
Call your elderly family member who may be living or feeling aloneCC
Call a person a day just to share experiences (not social media messaging. Actual call!!!)
Try indoor exercise
Manage your diet & do not turn to food as a coping strategy