Image by Julián Amé from Pixabay 

The novel coronavirus or covid 19 is a highly contagious disease with the possibility of causing severe respiratory disease. It is now a public health emergency of national and international concern. Millions of lives have been significantly altered, and a global, multi-level, and demanding stress-coping-adjustment process is ongoing.

The disease has now achieved pandemic status. The World Health Organization has issued guidelines for managing the problem from both biomedical and psychological points of view. While preventive and medical action is the most important at this stage, emergency psychological crisis interventions for people affected by COVID-19 are also critical. Whether it is COVID-19 or a series of other physical and psychological conditions, the burden on global healthcare systems at the moment means that staying well is far from a certainty. This experience of ongoing fear of the pandemic can be physically and mentally exhausting due to the competing demands that it places on our bodies and minds. The coronavirus pandemic is an epidemiological and psychological crisis. The enormity of living in isolation, changes in our daily lives, job loss, financial hardship, and grief over the death of loved ones have the potential to affect the mental health and well-being of many. We must recognise that we are all either current or potential users of mental health services. The usual responses to threat and uncertainty (fight-or-flight) sit on a continuum with more distressing thoughts, behaviours, and emotional states associated with mental health conditions. This is particularly true of mild to moderate mental health conditions relating to depression and anxiety, such as panic disorder, a single depressive episode, or generalised anxiety disorder.

Obsessive Compulsive Disorder, for instance, is characterised by ritualistic behaviours or compulsions (e.g. checking or washing) that neutralise the threat of unwanted intrusive images, ideas, or fears. Some of the compulsive behaviours seen in individuals with OCD sit at the extreme end of a continuum of adaptive responses to threats. Sadness, anger, and panic are three completely appropriate emotional reactions to the uncertainty and exposure to threats that we are currently experiencing. These are unpleasant states that we may wish to avoid. For some of us, however, they are intensely terrifying states that are embodied reminders of unsafe experiences or memories. This can be for a range of reasons, including previously upsetting or traumatic events. People managing emotional difficulties and mental health conditions may face additional challenges and complexity Other people may experience emotions that are harder to cope with or bring back previous negative experiences Post-traumatic stress is particularly topical during a challenging time such as COVID-19. Those affected can include, people who have had coronavirus, frontline key workers, people who have had Post Traumatic Stress Disorder (PTSD), families, carers, and colleagues of affected groups and individuals.

People with such conditions may be affected by COVID-19 in different ways to the rest of the population. Lockdown and the continual news feed of traumatic events are more likely to impact those who have experienced trauma before. We also need to consider how higher levels of fear can impact those who struggle with paranoia, a core symptom of schizophrenia. These individuals may be more digitally excluded or highly reliant on reduced services to provide social connectedness. At least 40% of people with severe mental illness smoke, almost three times the general population. This health risk is increased during COVID-19. Other health behaviours such as physical activity, diet and seeking healthcare are challenging for this group, even more so during COVID-19. More specific examples include ensuring that medications are adhered to and blood tests undertaken, and support that may require extra thought and care. There is by no means a direct causal relationship between early life events and experiences in later life. However, some habits, templates and behaviours in adulthood can be influenced in our earlier lives. We know, for instance, that adverse childhood experiences can predispose physical and psychological difficulties later in life, including during the current COVID-19 pandemic. These could be loss, neglect, abuse and trauma, although people’s perception of these is also highly important.

Even in this time of physical distancing, it’s critical to seek social support and connection with others. It’s also important to know the signs of anxiety, panic attacks, depression, and suicide so you can easily identify them, not just among your family, friends, and neighbors, but for yourself.

Signs of anxiety include persistent worry or feeling overwhelmed by emotions, excessive worry about a number of concerns, such as health problems or finances, and a general sense that something bad is going to happen.

Signs of a panic attack are Sweating, trembling, shortness of breath or a feeling of choking, pounding heart or rapid heart rate, and feelings of dread. Such attacks often happen suddenly, without warning. People who experience panic attacks often become fearful about when the next episode will occur, which can cause them to change or restrict their normal activities.

Signs of depression can be, a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy or an inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide.

Risk factors for suicide are talking about dying or harming oneself, recent loss through death, divorce, separation, or even loss of interest in friends, hobbies, and activities previously enjoyed, besides, changes in personality like sadness, withdrawal, irritability, or anxiety, changes in behavior, sleep patterns and eating habits erratic behavior, harming self or others, low self-esteem including feelings of worthlessness, guilt or self-hatred. Stress during an infectious disease outbreak can include, fear and worry about your own health and the health of your loved ones. changes in sleep or eating patterns, difficulty sleeping or concentrating, worsening of chronic health problems, worsening of mental health conditions, and increased use of alcohol, tobacco, or drugs.

As regards ways to cope with stress, Dr. Vijay Dahiya said that we must take breaks from watching, reading, or listening to news stories, including social media regarding covid 19. Hearing about the pandemic repeatedly can be upsetting. We should take care of our bodies. Try to eat healthy and well-balanced meals, make it a habit to exercise regularly, and get plenty of sound sleep. Make time to unwind. Try to do some other activities you enjoy. Connect with others, and talk with people you trust about your concerns and how you are feeling. People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Call your healthcare provider if stress gets in the way of your daily activities for several days in a row. 

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