Dr. Madhu Bhatia, a psychiatrist in Washington D.C., finished setting up her home office a few days ago, two weeks after the Metro area began to sit up and take notice of COVID 19.
“I’ve already seen an uptick in anxiety among my patients,” she says, “and now, more than ever, I need to stay in touch. I’m expecting an increase in cases, and more Post Traumatic Stress Disorder (PTSD) type symptoms.”
“This is the first time I’m practicing telepsychiatry on this scale,” she adds wryly. “It’s going to be a new experience for me and many of my colleagues – but it may be the future, for a long time.”
The suddenness and speed of COVID19’s onslaught has sent our health care and our social systems into shock. Equally important, (but in danger of being underplayed as all our attention focuses on the battle with the virus), it has been a massive, invisible shock to our collective psyche.
As we live this in real time, health professionals all over the world are getting more concerned about the long-term emotional fallout from the pandemic. The complete cessation of normal activity in lockdown, a constant ticker tape of rising numbers of those infected and dying on TV, and economic insecurity associated with the shutdown is the perfect formula for creating a sense of suppressed panic and helplessness, which, in turn, is a perfect breeding ground for anxiety disorders and depression.
We can look to China, which was ahead of the curve, for the trajectory of anxiety and anxiety related disorders. Early studies on the effect of the pandemic indicate an enormous, lingering impact on mental health. In the first few weeks of the lock down in China, there was mostly worry about contracting the virus and the safety of loved ones. As more time passed in quarantine, financial strain and more stress with family relations piled onto the general worry for safety.
In an ITV report, Dr. Peng Kaiping, the head of Psychology at Tsinghua University in Hubei province (where the epicenter, Wuhan is located), says they are now increasingly seeing symptoms of PTSD among the population.
“It’s important to remember,” says Dr. Bhatia, “that even something as innocuous as more enforced time at home with the family can become a source of great anxiety, if it isn’t handled correctly. There can be something like too much togetherness. Time has to be managed carefully, especially in families which already have underlying stresses in relationships.”
She advises setting up strict daily routines, especially if there are children at home.
“Children need the security a routine provides. However, they also need social interaction with their peers and a sudden cessation of contact with friends creates anxiety. If they are young, set up facetime playdates for them.”
“For teenagers, try to give each individual enough time on their own and permission to retreat into their own space if they want to, but designate a family time where you come together, especially for meals. Make that a pandemic free space, where things like homework or activities are discussed and optimism about the future is restored.”
“South Asian families are often not very good at expressing their feelings, and there is a sense of shame, specifically in the older generation, in admitting that they are fearful. This is a time when parents should reassure their children (and sometimes their own parents), that it’s important to talk frankly about one’s fears and be supportive of each other.”
Therapists and providers are increasingly adapting their practices to technology to get their message out.
Pallavi Surana, a resident of Herndon, Virginia, and a meditation therapist, has guided a group meditation session every Friday for the past 10 years.
With Virginia’s COVID restrictions, she has now taken it to Facetime (the group dials in from home and meditates together) and increased its frequency to an hour every day.
“Daily Meditation is more important than ever during this crisis,” she says. “We are locked in at home, with our fight or flight responses highly aroused. Calming our minds has an enormous impact on our immune systems, and doing it collectively is even more beneficial. Even a short 20-minute session has an impact.”
Alice Walton in a recent Forbes article suggested important ways to preserve sanity and maintain optimism during these trying times.
Gratitude is a therapeutic emotion. Take time to be grateful for family and friends, and for all the things which are working for you in life. In a Harvard health study, it was found that writing down even 5 things you were grateful for, just once a week, had an enormous positive effect on emotional well-being.
Exercise and meditate daily. Treat these activities as necessary, medicinal doses of stress relief and give them priority. There are several online sites offering free exercise routines and meditation. Mindfulness based stress reduction (MBSR), developed by Jon Kabat Zinnat at UMass, has been shown, through many studies, to be very effective. Several organizations now offer this online. Meditation is a proven stress buster and is especially good for our immune systems.
If you aren’t into meditation, studies have shown that just calming your breathing – taking a few minutes a day to sit quietly and breathe deeply – can greatly reduce daily stress. Simple breathing exercises, like those taught in Yoga, (check out these top rated apps), are also great at soothing the mind and producing a sense of well-being.
Your daily exercise routine should be supplemented by “quality time” outdoors. The Japanese concept of “forest bathing,” which means spending as much time in nature as possible and mentally “bathing” in its beauty, is now backed by science. Being around greenery doesn’t just calm the mind – it has a proven effect on our immune system and lowers the levels of the stress hormone, cortisol. Consider positioning your home office where you have a view of the greenery outside.
And last, but not the least, connect to friends and family daily through whatever means available. Social isolation is like a punishment for our species, because we are wired with a strong need to interact. A recent article in the Washington Post by social scientist, Arthur C. Brooks, emphasizes the importance of social interactions which allow eye contact. Looking directly into a person’s eyes while talking releases oxytocin, the pleasure hormone, and is the most beneficial for our social needs. So, choose a medium like Skype or Zoom or Face Time where you can see your friend or family.
Stay safe, dear reader, and remember to hug your family often! Human touch is a proven therapy for anxiety.
Edited by Meera Kymal, contributing editor at India Currents.