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The psychology of uncertainty: promoting mental health during CoVID 19

-Shristi Rana 

In the present context, world is facing a great challenge with novel corona virus disease (COVID-19). The first case of COVID-19 was diagnosed in December 2019 in Wuhan, the capital of China's Hubei. According to WHO, more than 3,02059people have died and over 4 425 485 have been infected by the coronavirus worldwide (latest update 16th May, 2020).

The pandemic COVID-19, sweeping rapidly across the world, is causing widespread concern with fear and stress. All of this is natural and normal reaction, to the changing and uncertain situation that everyone is facing. In an effort to minimize the morbidity and mortality, a practice of physical distancing (also known as social distancing) and lockdown has been adopted all over the world. Most of the countries are putting their citizens on various forms of lockdown. This has brought changes in national behavioral patterns and shutdowns of usual day-to-day functioning. All the schools & colleges, non-essential businesses and the transport system are closed. Due to this, people are facing new challenges in their day-to-day life like working from home, online classes, business/factories shutdowns, temporary unemployment, harsh realities of inability to join hands & mouth in lower income families and so on. People are also facing a totally unique situation of lack of physical contact with other family members, friends and colleagues.

Although this social distancing and lockdown is helping to mitigate the spread of disease, we cannot say that this hasn’t affected mental health of people. It has been the reason for increased anxiety and depression, substance use, loneliness, and domestic violence.  Physical signs like increased heartbeat or butterflies in the stomach, changes in sleep pattern, loss of appetite or energy are common during this time. Additionally, people are often feeling unable to cope or handle such situation with ease. They are feeling scared, restless or stressed now and then. Many people are experiencing some of these symptoms at present even in the absence of any mental illness. The current condition has affected mental health of people directly and indirectly as well.

Normal people are becoming over conscious as they started to worry even with minor cough and cold. Those who are in quarantine have additional anxiety because of their symptoms which might make them sick and more importantly, fear of losing life. Social distancing itself is having the greatest impact in some people who are in low-paid or insecure occupations leading toloss of income.Some are struggling to balance working from home with children. Homeless people are suffering from hunger and lack of shelter. 

Lockdown itself is having the greatest impact in some people who are in low-paid or insecure occupations leading to loss of income. Some are struggling to balance working from home with children. Homeless people are suffering from hunger and lack of shelter. With the announcement of lockdown, only the essential sectors like health centres, telecommunication, electricity, gasoline/petroleum product, food and water supplies etc are running. Import and export of items and supplies has been disturbed as transportation is not allowed. Likewise, national production is disrupted in a same way with closure of factories and industries. Stores and markets are opened only for limited hours in order to minimize the crowd. Hence, at this critical time, due to the shortage of different essential supplies, public have to pay higher price.

Healthcare personnelare the front-line workers involved directly in handling the affected patients are at greater risk than others. Excessive workload/work hours, inadequate personal protective equipment, over-enthusiastic media news, feeling inadequately supported has adversely affected their psychology. Another important reason for such psychological impact is the infection rate among medical staff. They also have been suffering from social stigma because people are afraid to interact with them in public. Landlords are hesitating in letting in their health worker tenants so they have to manage elsewhere to stay which is absolutely not fair and an unwanted stress for the moment of crisis.

Talking about education sectors, in order to push ahead with the academic calendar, most of the educational institution of Nepal has initiated the online classes through different apps to beat the Covid-19 lockdown. However, this is a challenge for every students and teachers, because internet facility might not be accessible and affordable to everyone. Dropout rates of the students is common due to lack of proper devices like laptop or smartphones and poor internet (wifi) connectivity. Telecommunication internet services like 3G and 4G has been provided with special package for students but still it may be expensive for those who cannot afford it. So due to this factor students are worried about their studies and career.

Another, big stressors for people is the fact they do not know how long the lockdown will last. Because people are getting fed up from monotonous life as they are staying inside for too long time period. Their income generating occupations are at halt. When these human demands are not fulfilled, people become unsatisfied and undergo stressful events. Many other stressful factors associated with CoVID-19 exist which are undoubtedly having consequences for mental health and well-being in both the short and long term.

In order to minimize the consequences, immediate efforts on prevention must be focused and direct intervention are needed to address the impact of the outbreak in mental health at individual, community and national level. 

Stress reduction is one of the most important technique to maintain mental health. It can be done through different ways. Self-care strategies which include getting enough sleep, regular physical exercise, eating balanced diet, drinking plenty of fluids, avoiding junk foods, caffeine, alcohol and tobacco products are very beneficial. Relaxation techniques such as yoga, meditation, music therapy, prayers help to relax and divert mind. Virtual communication with loved ones through online services, phone calls and texts can help people feel less lonely and isolated. Different activities such as gyms, yoga etc. can be conducted through online on a schedule similar to what was in place prior to social distancing. Constant news about COVID-19 from all types of media can heighten fears about the disease. So, limit reading, hearing or watching other news, but keep up to date on national and local recommendations. Mind should be kept busy now and then in order to keep negative thoughts away. Enjoy hobbies i.e. cooking, gardening, watching movies, playing online games, creative art and craft works, etc. that can be done at home. Schedule daily activities like regular bedtime routine, consistent times for meals, bathing and getting dressed, work or study schedules, and exercise. Immense social support must be provided to the infected/isolated person which help to uplift their self-esteem. Most important, every person must adopt preventive measures against the pandemic disease.

The Government plays a vital role in uplifting the mental health of the citizens. There should be strict control on movement of people from most prevalent areas. Every health organization must be provided with maximum rapid diagnostic test kit so that isolation with adequate treatment of positive cases can be done through early detection. Personal protective equipment must be provided to every health workers to ensure their safety. Everyone must appreciate their dedication during this critical phase of life. In order to address problem in education sector, internet facilities with strong range must be made accessible under minimum cost. All of these actions ultimately help to reduce the stressful burden of present context.

Additionally, people need to understand that they are not facing this crisis alone, the whole world is going through the same challenges physically, psychologically, emotionally, and economically. We are all facing the same problems. According to WHO, coronavirus disease cases deaths are 21% and recovered are 79%. So, let's motivate each other by spreading message that we can fight with COVID-19 and win over it by breaking the chain of coronavirus disease. So, maintain self-quarantine and stay safe.

With the announcement of lockdown, only the most needed sectors like health centres, telecommunication, electricity, gasoline/petroleum product, food and water supply etc are running. Import and export of items and supplies has been disturbed as transportation is not allowed. Likewise, national production is disrupted in a same way with closure of factories and industries. Stores and markets are opened only for limited hours in order to minimize the crowd. Hence, at this critical time, due to the shortage of different essential supplies, public have to pay higher price.

Healthcare personnel are the front-line workers involved directly in handling the affected patients are at greater risk than others. Excessive workload/work hours, inadequate personal protective equipment, over-enthusiastic media news, feeling inadequately supported has adversely affected their psychology.Another important reason for such psychological impact is the infection rate among medical staffs. They also have been suffering from social stigma because people are afraid to interact with them in public. Houseowner are hesitating in letting in their health worker tenants so they have to manage elsewhere to stay which is absolutely not fair.

Talking about education sector, in order to push ahead with the academic calendar, most of the educational institution of Nepal has initiated the online classes through different apps to beat the Covid-19 lockdown. However, this is a challenge for every students and teachers, because internet facility might not be accessible and affordable to everyone. Dropout rates of the students is common due to lack of proper devices like laptop or smartphones and poor internet (wifi) connectivity. Telecommunication internet services like 3G and 4G has been provided with special package for students but still it may be expensive for those who cannot afford it. So due to this factor students are worried about their studies and career.

Another, big stressors for people is the fact they do not know how long the lockdown will last. Because people are getting fed up from monotonous life as they are staying inside for too long time period. When these human demands are not fulfilled, people become unsatisfied and undergo stressful events. Many other stressful factors associated with CoVID19 exists which are undoubtedly having consequences for mental health and well-being in both the short and long term. 

In order to minimize the consequences, immediate efforts on prevention must be focused and direct intervention are needed to address the impact of the outbreak in mental health at individual, community and national level. Stress reduction is one of the most important technique to maintain mental health. It can be done through different ways. Self-care strategies which include getting enough sleep, regular physical exercise, eating balanced diet, drinking plenty of fluids, avoiding junk foods, caffeine, alcohol and tobacco products are very beneficial. Relaxation techniques such as yoga, meditation, music therapy, prayers help to relax and divert mind. Virtual communication with loved ones through online services, phone calls and texts can help people feel less lonely and isolated. Different activities such as gyms, yoga etc. can be conducted through online on a schedule similar to what was in place prior to social distancing. Constant news about COVID-19 from all types of media can heighten fears about the disease. So, limit reading, hearing or watching other news, but keep up to date on national and local recommendations.Mind should be kept busy in order to keepnegative thoughts away. Enjoy hobbies i.e. cooking, gardening, watching movies, creative art and craft works, etc. that can be done at home. Schedule daily activities like regular bedtime routine, consistent times for meals, bathing and getting dressed, work or study schedules, and exercise. Immense social support must be provided to the infected/isolated person which help to uplift their self-esteem.Most important, every person must adopt preventive measures against corona virus disease.

Government play a vital role in uplifting the mental health of citizens. There should be strict control on movement of people from most prevalent areas. Every health organization must be provided with maximum rapid diagnostic test kit so that isolation with adequate treatment of positive cases can be done through early detection. Personal protective equipment must be provided to every health workers to ensure their safety. Everyone must appreciate their dedication during this critical phase of life. In order to address problem in education sector, internet facilities with strong range must be made accessible under minimum cost. All of theseactions ultimately help to reduce the stressful burden of present context.

Additionally, people need to understand that they are not facing this crisis alone, the whole world is going through the same challenges physically, psychologically, emotionally, and economically. We are all facing the same problems. According to Worldometer latest update (16th May, 2020), globally, coronavirus disease cases deaths are 15% and recovered are 85%.So, let's motivate each other by spreading message that we can fight with COVID-19 and win over it by breaking the chain of coronavirus disease. So, maintain self-quarantine and stay safe. 

 

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