When the pandemic struck last year, the messaging was such that people thought that this was going to be a 100-metre dash. But little did they know that it was going to be a marathon, says Soumitra Pathare, Director, Centre for Mental Health Law & Policy. Now, people don’t have the energy to run anymore. They weren’t prepared for a long haul. Had people known earlier, they’d pace themselves very differently, he says.
The World Health Organisation declared the novel coronavirus to be a pandemic on 11 March 2020. India announced a nationwide lockdown on 24 March 2020. But things seemed to be on the mend since October, as cases started coming down and eventually even reached an eight-month low of 8,635 cases on 2 February 2021.
But after we as a nation abandoned all precautions, and hundreds of thousands of people mingled at election rallies and religious events, a deadly second wave infected and killed in record numbers. As the public health system collapsed, sick people and their families were reduced to a pitiful state, begging and pleading for beds, oxygen, and medicines. As the crisis deepened, people died without accessing medical help. Several parts of the country imposed lockdowns as a last resort.
Just when people had started looking forward to getting vaccinated, stepping out and resuming a normal life, not only did things get worse, the untold suffering exacerbated by the complete failure of the state, is one of the darkest times in our nation’s history.
India Ahead spoke to experts to understand how mental health concerns in 2021 are different from 2020.
Prolonged peak stress
Our bodies are equipped and designed to deal with short periods of peak stress. They are also capable of dealing with low stress for longer periods, says Pathare. However, if peak stress persists for longer periods, bodies aren’t prepared for that, and no matter what one’s coping skills are, a person will get overwhelmed.
“People who were doing okay in the first wave, are now complaining of being tired and stressed out. An exposure to peak stress over long periods of time can have physical effects like hypertension and diabetes,” says Pathare.
An exposure to peak stress over long periods of time can have physical effects like hypertension and diabetes.
Prolonged stress leads to chronic systemic problems. The physical systems break down under so much stress. The relations between high levels of stress and blood sugar is well known, and not new, says Pathare.
There are professions like air traffic controllers, or the police, who have been documented to have hypertension as their professions bring with them high levels of stress over long periods of time, says Pathare. “These were occupations that were prone, but now, everyone is being exposed to peak stress,” he says.
However, Pathare says that no amount of counselling can help unless people’s practical problems, which lead to stress and anxiety, are solved.
“Job losses, or not having enough money to buy essentials, in such cases no amount of counselling can make a difference. This is where state policies come into the picture. People’s difficult practical problems need to be solved. State policies need to take away stress from some of these practical real-life problems otherwise mental health practitioners cannot do much,” he says
Cases of unresolved grief have gone up during this wave, says Pathare. Last year, there wasn’t so much of a crisis about finding beds or oxygen.
“Normal patterns of grieving have been disrupted. Earlier you would see the body, the hearse, last rites are conducted, and ceremonies performed. Covid has disrupted all of that. These rituals sometimes have some value, in terms of achieving closure. That’s not being dealt with,” said Pathare.
READ: Covid-19 Trauma: How People Are Coping With The Incredibly Hard Reality Of Grieving Alone
Pathare says that we are going to see the fallout of that in the coming years. Unresolved grief can have a long-lasting impact on individuals alone, and on societies as a whole as well.
For individuals, it may manifest itself with physical symptoms as well as psychological effects like depression and anxiety. Unresolved grief can even lead to destructive behaviour, like excessive alcohol or tobacco consumption, said Pathare.
“The effects will be particularly worse and will have long term implications for young children who have lost one or both parents. They’ll carry this for a long time in their lives. They will require long-term support,” he said.
On how unresolved grief affects society, Parashar points to places like Palestine and Kashmir, which have witnessed traumatic events. For years, there has been so much unresolved grief that it results in a cycle of violence that keeps on perpetuating itself.
Helplessness and lack of hope
Neha Parashar, Clinical Psychologist and PhD scholar, says there was a slight glimmer of hope in 2020, especially when things started getting back to normal. Despite the lockdown that was in place, people held onto the hope that things would eventually get better. However, with the advent of the second wave, a sense of doom and helplessness has become more prominent.
“Immense personal losses of family members, friends or even people in extended circles coupled with financial losses such as loss of jobs, educational opportunities hindered the scope of any hope,” she said. “There has been a heightened fear of uncertainty, in regard to how life will shape up in the future, which leads to increased helplessness.”
There has been a heightened fear of uncertainty, in regard to how life will shape up, which leads to increased helplessness.
These conditions often have physical implications, says Parashar.
“We are certainly receiving more cases of psychosomatic complaints such as headaches and backaches. Many clients are complaining of loss of concentration and motivation in their jobs and studies. Mood swings are becoming frequent in younger clients,” said Parashar. She said that many also report foul moods and when that becomes persistent, they turn into diagnosable cases of depression and anxiety.
Awareness and acceptance
Jyoti Singh, a Consultant Clinical Psychologist at Fortis Hospital, observed more awareness and acceptance, as compared to the initial shock and confusion that impacted people in 2020. This year, she says, people have accepted an isolated life and made peace with it.
“The sudden loss of routine or a structure to life caused anxiety for many in 2020. Now, they’ve accepted that and become more compliant. They also identify symptoms of mental health problems and reach out because they are more aware,” said Singh.
Singh initially has witnessed a lot of hesitancy in people regarding online communication or telecommunication. Patients were worried about confidentiality and not being able to open up freely. In the second wave, that has changed. “Clients are more forthcoming now and are embracing video calls and other online communication methods. They’ve realised that this method of consulting is working well too,” she said.
This time around, Parashar, the clinical psychologist, also noticed an increase in how much people cherish human relationships and quality time with family. Having adjusted to this new routine, they’ve built virtual communities to support each other.
Pro bono services
Singh said that she has seen an increase in the number of people who are reaching out for help this time. She offers her services pro bono for an online portal, which has a toll free number for those dealing with mental health issues, and says that this has helped people of poorer economic backgrounds to also reach out for help.
Parashar, the clinical psychologist, said organisations like Rehabilitation Council of India and One Future Collective, were reaching out to people in towns through volunteers who provide counselling services either pro-bono or for a very minimal fee.
If you or someone you know needs help, please call 1800-599-0019, India’s 24/7 toll-free national mental health helpline or 08047192224, a free helpline number being run by the Indian Association of Clinical Psychologists.