From the onset of the coronavirus pandemic, the world has focused on the harm caused by the
global emergency in the areas of physical health, the economy, and education, almost to the
exclusion of an equally grave area of harm – the psychological well-being of people. To redress this
obvious gap, various scientists and thought leaders in the relevant fields have been engaged in
finding solutions to the most obvious problems arising that are rooted in psychology. Take for
instance, the wearing of masks, social distancing, social isolation or even accepting vaccines, all
functions of psychology, mindset, and social behavior. Ignoring mental well-being will certainly
impact the speed with which the present pandemic can be put behind us.
No group is immune from any of this, as it affects all age groups, from children who can no longer go out to play to the elderly who are socially isolated without human contact. According to the National
Institute of Mental Health (N.I.M.H)., corona phobia is a newly emerging global fear related to the
manifestation and evolving nature of the COVID-19 pandemic. Corona phobia is the fear, anxiety,
panic, social avoidance, or stress associated with the uncertainties and ever-changing reality of social
isolation, fear of dying, fear of infection with the COVID-19 virus, loneliness, changes in people’s
socio-economic realities and the breakdown of health infrastructure. These are truly uncharted
waters for world superpower and developing country alike, never mind the helpless individual.
Quite apart from its known lethality, a multiplicity of side effects attributed to the raging COVID-19
pandemic is being recognized in recent times. The enormous stress of enforced confinement within
the various lockdown regimes has generated a discernible increase in people presenting with mental health symptoms such as anxiety, depression and fear, enough to affect their ability to function optimally at home and in the workplace. This has led to difficulty in domestic relationships as well as work performance.
Unfortunately, the continuing acute pressure on health systems, coupled with the stigma attached to acknowledging mental health affliction amongst many Africans has meant that many go undiagnosed and thus untreated. A recourse to alcohol as a coping mechanism adds yet another complication – an already fraught brew. Yet, the direct correlation between our mental health and our quality of life is inescapable.
It is easy to forget that the brain is an organ in the body, just like the liver, kidney or heart, for
example. Under certain conditions such as stress, abnormal physiology, infection, drug and alcohol
abuse, domestic violence and other forms of abuse, the brain can malfunction. According to the
NMH, (what do these letters stand for?) about a third of adults in the US will experience anxiety of
varying severity at some time in their life. This malfunction can affect the way we feel, act or think.
Data from neuroimaging studies of brain activity reveal abnormalities in the limbic part of the brain
that is common with most people with anxiety disorders.
Clinically, certain types of medication are able to balance neurotransmitters that can help alleviate
anxiety. This is common for other mental health disorders, where it is possible to observe in a clinical setting, brain abnormalities under neuroimaging procedures and correct them by alerting the neurotransmitters; yet, thanks to mental health being treated as a taboo subject, many Africans fail to take advantage of these in knowledge and treatment, continuing to suffer in silence. Often, the outcome of these failures is sadly manifest in the notification of suicide, a reputation for not being able to keep one’s job, alcoholism or drug abuse. Mental illness can be caused by genetic factors, head injuries, infections, developmental anomalies, a stressful childhood, social and financial stress, or isolation, all underpinned by poor coping skills.
Many, in particular people of African extraction, tend to underestimate the role of culture and
religion when seeking help for health complaints. This is especially so with mental health issues.
When the option avails itself, it is best to seek help from practitioners with an understanding of the
cultural and religious views underpinning the patient’s make-up and who are open-minded enough to learn about and appreciation of the patient’s perspective in respect of mental health issues.
This is not an admonition to seek help exclusively from practitioners with a shared cultural
background to the patient. On the contrary, the advice is to seek help from one who is sufficiently
competent, having regard to the cultural and religious background of the patient. Often in the field of mental health practice, what may be perfectly normal in one culture and religion, may have a
thoroughly different interpretation and be classified as a disorder, due to a failure of understanding
by the treating physician.
Where a patient ascribes all their symptoms to the spiritual or oppression or possession, there is
little relief to be had from the psychiatrist. So spiritual or physical help? Without in anyway seeking
to dismiss the notion that many disorders have their genesis in the religious or spiritual, any
consultation with a physician should primarily be about seeking relief for the physical manifestations or symptoms.In these environments, minority individuals need to be clear in their expectations and set appropriate boundaries, bearing in mind that a psychiatrist is not interchangeable with a pastor. In any interaction with the patient, the psychiatrist wears a scientific hat and unless a prior agreement has been sought between patient and practitioner to include the patient’s spirituality in the treatment plan, this must always remain the case.
As a Christian Psychiatrist and Addiction Specialist, one’s not averse for instance, to sharing scriptures with patients that will alleviate their suffering, if requested; however, I will nonetheless run laboratory tests and be guided by the results thereof. Thus, an assertion that an evil step-mother somewhere conjured up your positive blood screen, is unlikely to be persuasive with my treatment of your condition. In short, one remains ever cognizant of the fact that as a practitioner, my primary role is that of a physician-scientist, when consulting with patients.
In that regard, patients are entreated to remember that when visiting their designated psychiatrist,
their consultation should be based on symptoms and science, as a psychiatrist may not be attuned to the meaning of the expression “the people in my village are after me” and might think the patient is delusional. If you come from a culture with high expressed emotions and drama, the clinician might simply think you are insane.
So be careful to represent and express yourself clearly, coherently and manage your expectation of
your psychiatrist, so that the appropriate help needed may be forthcoming. Second opinions are
always a good fallback position and should be embraced wherever the patient feels misunderstood.
Being human, there are clinicians with biases and stereotypical views of people that might stand in
the way of a successful consultation, diagnosis and treatment and this must always be in
contemplation when there is doubt.
Prior to the advent of the COVID-19 pandemic, it was well known that many people with mental
illness fail to seek help for reasons rooted in the cultural, religious, stigma or accessibility. In recent
times, however, there has been a marked increase in people seeking help for mental illness due to
worsening of pre-existing mental conditions, recent socio-economic loss, grief from death of loved
ones, mental health afflictions occasioned by the effects of the COVID-19 viral infection of the brain
or just the emotional toll of the pandemic on the human mind.
There has been a steady increase in the number of patients seeking help for mental illness during
this pandemic. They can be grouped into 3 different sets. The first group are those who have
pre-existing mental health issues that were worsened by the isolation and the lack of access to
healthcare services during the pandemic. People with known diagnoses, such as anxiety disorders,
psychotic disorders, additive disorders, and depressive disorders might not have access to their
regular support systems and might decide not to attend with their regular psychiatrist.The second group are those who developed symptoms and meet criteria for mental illness directly
because of COVID-19 but had no prior issue of mental illness. People in this group typically start off with coronaphobia, which is extreme fear of contracting COVID-19. Eventually, the stress becomes too much and they start to present with symptoms of mental illness. These include disorders such as generalized anxiety disorder, panic disorder, grief, major depression, alcoholism, pornography addiction, and post-traumatic stress disorder.
The third group are those that have post-COVID-19 mental illness that developed after contracting
COVID-19; they are sometimes referred to as “long-haulers”. This group presents with mental illness as a direct effect of inflammation in the brain caused by the virus. Their symptoms include brain fog, memory loss, poor concentration, irritability, and depression, and can last for over 9 months.
The Lockdown Generation, who have had to contend with uncertainty as to when life will return to
normal, have been reported to have over 25% increase in incidents of mental illness. For the
Lockdown Generation, going to school is much more than acquiring information and learning; going to school is part of their social development, where they develop skills such as setting boundaries, sharing, conflict resolution, coping with peer pressure and playing. Many have missed celebrating special events such as birthdays, graduations, and special holidays with their peers. Some have missed extracurricular activities, and others have had to go without proper nutrients since they have no access to meals provided in school. Some of the youth have even become victims of rape or abuse, so it is no wonder that there has been a significant increase in the presentation of mental illness in this generation. The predominant symptoms they present with include anxiety, panic attacks, depression, irritability, bed-wetting, anger, alcohol and drug use, grief, and post-traumatic stress disorder. Parents of the Lockdown Generation also have mental illnesses to contend with. Due to the uncertainty of COVID-19, financial
stresses, job insecurity, loss of friends and family, problematic relationships with their children and
their spouse, and isolation; many have presented with symptoms of mental illness similar to the
Lockdown Generation. In addition, many of them have reported an increase in domestic violence,
hence there has been an increase in symptoms of trauma. In addition, there have been increases in
divorces and separations in this group.
The older group, which comprises grandparents and retirees, has not been spared. As a result of
their vulnerability to COVID19 infection. Many have been left in isolation due to lack of exposure, and many have lost their loved ones and friends. They present with symptoms of anxiety, depression, trauma, social withdrawal, grief, and an increase in body aches and pain.
Here are tips to actively manage your mental health:
- Stay informed. Get your information from a reliable source regularly to stay aware of the
developments, changes in policies, and recommendations regarding COVID-19. Do not
overconsume information. - Accept the new normal and be flexible with yourself. Nobody has been on this road before,
and we’re all observers. - Sleep well.
- Create a regular schedule, even if you work or school from home.
- Exercise regularly.6. Take your multivitamins and eat food that can boost your immunity.
- If you have preexisting mental or physical illnesses, take your medication regularly to avoid
being ill and needing hospitalization. - Wear your mask, maintain social distancing, avoid crowds, wash your hands regularly to
prevent getting COVID-19. When you have the opportunity to get the vaccine, I would
suggest you strongly consider taking the vaccine. - Listen to your children and check in with them regularly to see how they are feeling. Give
them some time to hang out with their friends safely on the internet. Make accommodation
for them such as allowing them to spend more time using the internet to socialize. - Support your spouse, your children, your parents, and your friends regularly as they too are
going through their struggles. - Try and work on enhancing your relationship with your family members.
- Connect with people by social media or Zoom and check in with your friends and family
regularly. - Accept your situation and adjust accordingly. You might have to cut back on some activities
or spending. It’s best to save as much you as can because you don’t know how long this
pandemic will last. - Practice relaxation techniques when stressed.
- Try and organize a movie night with your family members when possible. Netflix, Hulu,
YouTube and other streaming services have brought the cinema to your home. - Be understanding of your children. Some might struggle with online instruction and might
need some intervention and support. - Use this opportunity to observe your children and strengthen your relationship with them.
- Encourage your children to acquire new skills, and consider acquiring new skills yourself.
- Seek out new opportunities during this pandemic. While many companies have been
destroyed, many more have blossomed as new services such as grocery delivery, food
delivery, deep cleaning services, tutoring, and video conferencing have done very well. - Keep a thankfulness journal and rely on your faith and spirituality for strength. Remember,
things could be worse, so count your blessings.
Finally, anxiety, depression, and fear are quite commonplace during this period. If the symptoms
become worse and affect the following:
● Your ability to function
● Your relationships
● Your sleep
● Your sex life
● Your appetite
● Your weight
● Alcohol use
● Suicidality
● Irritability
● Crying spells
● Social withdrawal
it is time to seek help from your primary care doctor. Hang in there; things will get better soon! Do not forget to take care of yourself so that you can outlive this pandemic.*The contents of this article reflect the writer’s personal opinion. No doctor-patient relationship is
assumed or intended. If you have any queries of a personal nature, please reach out to your
personal physician