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Ask The Doctor: How To Manage Your Pre-Existing Mental Health Issues During COVID-19 Infection

Dr Neerja Agarwal chalked out ten steps for COVID-19 patients to deal with mental health issues.

Dr Neerja Agarwal chalked out ten steps for COVID-19 patients to deal with mental health issues.

In today's column, the doctor explains how the families of those struggling with mental health issues should help them during a COVID-19 infection.

A year and a half after the Coronavirus pandemic wrecked our collective lives, our society has been grappling with fear and insecurity. As a result, we have seen misinformation spread like wildfire, and many resorting to bizarre and incorrect methods of dealing with the virus. With this column, which will be published every Sunday, we aim to address any health or vaccine-related question our readers might have about the coronavirus pandemic.

In this week’s column, Dr. Neerja Agarwal, A Rehabilitation Psychologist and expert in mental health issues like anxiety, depression, and Adolescent issues, talks about how those suffering from mental health problems should manage those issues during a COVID-19 infection

If someone already has a pre-existing mental health condition, how can they protect/ promote their well-being if they get Covid?

Covid-19 infection can worsen a pre-existing mental health condition. It can escalate anxiety and reduces immunity. A person with a pre-existing mental health condition should try the following: Get in touch with your mental health provider to receive complete information about Covid-19 disease. Knowing everything in advance about the symptoms and the treatment can mentally prepare such persons better, and make them feel more in control of the situation.

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Therefore, family members or counsellors should also inform the patient about how anxiety or depression can worsen the situation and how they can deal with it effectively. It is also important to chart out a plan in detail in advance. At times, families refrain from sharing the information with the patients for the fear of heightened anxiety but prior knowledge will only empower them.

Secondly, as such individuals struggle with the infection, they have to reminded that this is a global phenomenon, and they are not alone in this. Watching or showing video clipping on the need for Covid Appropriate Behaviour during quarantine or isolation helps understand why it is necessary for the patient as well as for the family to follow such protocols thoroughly.

They should keep in touch with your mental health provider as regular counseling and medication is important. Keeping a record of sleep and mood is also helpful. The family should also remain tolerant and empathetic in case of occasional anger outbursts or withdrawn behavior of the patient. If they live alone, then it is important for relatives and friends to stay connected with them through video calls so that they does not feel helpless and alone during this condition.

Such individuals should limit negative news intake as it can escalate anxiety. Reading and watching positive stories of recovery can make them feel hopeful. They should continue to follow a routine daily like bathing, grooming, steaming, gargling, organizing the room, etc or indulge in some hobbies such as reading, writing, painting (if condition allows).

Exercise is the best anxiolytic as it produces oxytocin. So, one can do some light breathing exercises such as Makara (Om chanting with stress on M) and Bharmri Pranayam produces indigenous nitric oxide, which prevents blockages in the heart and the lungs; Anulom Vilom, alternate nostril breathing, which balances the left and right brain activities, calming your mind. Progressive muscle relaxation and grounding techniques (5-4-3-2-1 technique), and mindfulness also help reduce anxiety and keep them in present. Practicing these on a regular basis allows the person to use these techniques when anxious.

A simple balanced diet is very important as 90 % of serotonin, which helps deal with depression and anxiety, is produced in our gut area. So, it is very important to eat well to feel well. Family members should remain calm and display problem-solving behavior. It is important that they handle their own anxieties through breathing exercises, by taking some ‘Me’ time out.

Encouraging such individuals to see the silver lining in this crisis situation, tell him or her that this will make him/her more resilient, and how he/she can be a role model for others with similar conditions can also inspire them to cope better.

The family can make a gratitude list of small things before bedtime to give the patient some positive perspective of life. Serenity prayer helps a lot during this stressful time. Paste ‘Serenity prayer’ in that person’s room in advance, and encourage his/her to repeat the prayer every morning and evening with you through video calls.

Does Covid -19 cause mental health issues?

The uncertainty, restrictions, unemployment, lack of social interactions, monotonous routine due to the Covid-19 pandemic have increased the level of anxiety and depression. Baseline data of a Pennsylvania State University teen anxiety study indicated that anxiety severity among participants increased by 29% compared to pre- Covid-19 time. Heightened anxiety can cause several mental health issues such as generalized anxiety disorder, Obsessive Compulsive Disorder, eating disorders, alcohol abuse, mood disorders, and psychosis.

Screen time has increased during the pandemic which is affecting our attention span, and concentration. Video game addiction cases have been reported among teenagers.

People have lost many loved ones to the disease, which has complicated their grief. There has been an increase in cases of complicated grief and suicide. Complicated grief mimics the symptoms of depression and PTSD but requires a different strategy of Grief Resolving.

What can one do to cope with the effects of Covid-19 Quarantine?

Quarantine can make one feel lonely and irksome. And if the family members are scared of catching an infection and show extra unnecessary precautions, it can make the patient nervous. So, it is important for the family to be empathetic towards the patient.

Focus on what you can control and tolerate rather than on what you can’t control. Accepting reality helps us in dealing with the distress situation effectively and does not let us go into the ‘why me’ scenario. You can try and follow the tips I have shared above. Besides, some sleep rituals before going to bed like warm shower, reading some spiritual text, sleep meditation, or Yoga Nidra can help get you sound sleep. If you are still unable to sleep, come out of your bed, read something you li,ght and try to sleep after some time. Use your bed for sleep only.

Make the best use of quarantine, try to do things you were postponing for long such as reading an interesting book or pursue an online course (at your own pace) or connect with your old friends, relatives. Enjoy your solitude, connect with yourself through meditation.

How can mental health be promoted during Covid?

Whether you are vaccinated or not, your immunity helps you in fighting infection and good mental health is an indicator and as well a booster of our immunity. It should be promoted through webinars, social media, and the print media. Our celebrities, sports persons should come forward and talk about these issues so that taboo can be removed. We should join hands with the government in promoting mental health. Online counseling and suicide helplines should be made easily accessible.

How can you help others with mental health illnesses during covid?

We can do so by adopting an empathetic, nonjudgmental, and problem-solving attitude towards them; by attentively listening to and addressing their concerns, reassuring them, sending them motivational videos, quotes, messages. We should try and address their negative thoughts and reframe them into more realistic thoughts. Equally important is to chart out a plan for the emergency in advance.

What are the coping strategies to ease mental health issues during Covid?

If you are someone who struggle with issues of mental health, the first step is to build a resilience mindset, and thereby tolerate uncertainty and focus on what you can change, plan, prepare and practice. Staying positive, connected, and active is also important.

Acronym IMPROVE gives us many strategies to use as coping mechanisms. The acronym stands for the following:

I: Imagination- safe place visualization and mindfulness exercise

M: Meaning, Prayers- serenity prayer

R: Relaxation through self-soothing activities& hobbies

O: One thing at a time

V: Mental vacation by getting ‘Me time’, or going out in nature

E: Encouragement and practicing opposite emotions like standing tall if you are feeling depressed, watching funny movies if you are sad.

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first published:July 18, 2021, 17:26 IST