Covid-19: Coping with mental health challenges

Edith* was recently diagnosed with an anxiety disorder. In her case, it is triggered by excessive worry about death. She says since February, her mind has been dwelling on thoughts coming from Covid-19, to a point where it frightens her. “I was really scared. I felt like mankind was going down a hill so fast. Since the whole pandemic issue, death has been all I think of.”

Hoping that she could escape her torturous reality, she took to the use of substances. “I tried weed and it seemed to work for a while. I slept like a baby for over a month till one day when I took some with friends and it caused havoc. I spent six hours just trying to snap myself back to reality,” she says.
Edith had arrived at a point where her emotions were raw, and so she caved in. “I just kept having that feeling that I was going to die. I could not breathe, my heart was racing, I had chest pain; you know, the stabbing kind of pain, it was horrible. I tried taking a cold shower but I felt like the water was suffocating me. Like I was drowning.”

Fortunately, her anxiety attacks stopped. The presidential announcement on closure of schools however, meant that she had to return home where she constantly kept tabs on the global death toll which was rising fast and “so it started again.” She resorted to prayer but it still did not help much. Her worries stirred up insomnia and so for several nights, she went without sleep.
After a month of helplessness, Edith sought clinical relief. She visited a hospital, was diagnosed, is being treated and has been recovering steadily ever since.

Vulnerability
According to Dr Yvonne Zabu, a clinical psychologist with Wellness Psychological Services, susceptibility to mental illness depends on “our capacity to cope with environmental challenges through adaptive internal coping strategies and a strong support network. The less able one is, the more stress they will feel, and the more likely it is that they will develop a mental health challenge.”

She highlights the fact that the Covid-19 crisis has increased financial stress, reactive anxiety, fear of bereavement, insecurity, confusion, emotional isolation, and stigma. Owing to the lockdown measures still, individuals’ support networks have been limited and this cripples their ability to cope with the challenges.
It is believed that many are likely to face mental health challenges in the wake of this crisis such as depression, irritability, insomnia and anxiety. The key emotions at play here are fear, confusion, anger, frustration, boredom, and the stigma faced in association with Covid-19 infection.
All this is worrisome because stress and anxiety can severely affect one’s ability to carry out routine activities. Also, the prevalence of depression and anxiety may rapidly increase, yet “depression is already one of the leading causes of the global burden of disease,” Dr Zabu says.

Life after Covid-19
In response to worries of a ripple effect after the crisis, Dr Zabu says the anticipated challenges to mental health shall indeed surface, especially among those with neurological/developmental disorders and pre-existing mental illnesses if there is prolonged increase in environmental stress. She emphasises that some groups might be more vulnerable than others for instance, those with substance use problems.
However, she adds: “Conversations about Covid-19 already refer to this time as a transition to the ‘new normal’.

Ensuring mental stability

Dr Innocent Guma, a psychiatrist with Makerere University Department of psychiatry, says aside from those developing new mental health challenges, there is also a possibility of relapse for individuals already battling with mental illness which is why it is important to look out for what will make an individual feel better.
● It is advised that a person increases contact with loved ones through social media and other technological tools. Also, determine the things that are within your control and those that are not. Cooking, cleaning and washing hands are within our control and can be done once we decide to do them. Curfew, on the other hand, is not and as such, we must first understand its rationale, then adhere to it.

● Structuring the day and executing a routine also helps since it encourages consistency. Continuity as well, for instance, watching the same TV shows as before the lockdown and creativity, taking up challenges and fun activities should also be looked into.
● Compassion cannot be overstated. Treating yourself to good meals and sharing with others helps improve self-appreciation and also relieves the mind of stress. Dr Guma also advises that we extend care and well thought out explanations to children who are particularly confused by these times and might also be worried.

● Friends and loved ones too can be of assistance to those afflicted by providing a safe space for them to share their experiences and concerns. Edith, for example, shares that she copes and is relieved by speaking to her best friend, reading novels and watching movies. She is however cautious to stay away from sad news and sad movies since these trigger her episodes.
● In cases like Edith’s where the challenges are overwhelming, Dr Zabu instructs that professional support be sought.

*Names have been changed to protect the identity of the person