Nearly 17.50 million around the world have contracted coronavirus, and almost 800,000 have died. In Bangladesh, so far around 300,000 have been infected by the virus and the deaths total nearly 4000.
We see these cases and deaths being updated every day in numbers. The higher the number, the more our anxiety. We try to comfort ourselves if the numbers dip. But tucked away behind the numbers is the sorrow of those who have lost their loved ones, mental sufferings and depression.
Numbers give a picture of the state of coronavirus, but can numbers actually tell the enormity of the situation? Mental anguish, frustration, alarm and sorrow can hardly be measured in numbers. That is why along with discussions on preventive measures and vaccines for coronavirus, there is need to discuss the global issue of deteriorating mental health during the pandemic.
Mental health is mounting due to the fear of contracting coronavirus, the fear of death, the looming economic crisis, unemployment, adjusting to changing social behavior, the social taboos and discrimination attached to coronavirus.
Those who have been suffering from coronavirus, those who have not and those who are at the frontline tacking the virus, are all under varying degrees of mental pressure. Researchers foresee that mental health problems will increase in the post-Covid world too. In Bangladesh, mental pressure continues to rise during the pandemic. There may not have been any extensive research on the issue, by certain unpublished studies as well as media reports indicate the rising phenomenon of deteriorating mental health.
When people sink to the nadir of depression, they have an increased propensity towards suicide. It is as if contracting coronavirus is a crime, a matter of shame. This creates frustration and depression. Sometimes it generates panic, leading to suicide.
Suicides and coronavirus
In the last week of March, the body of Thomas Schafer, finance minister of a German province, was recovered in the town Hofheim. According to media reports, he was under great mental stress about managing the economic pressure created by coronavirus.
It is not just in the West, but in Bangladesh too that there have been such instances. Towards the end of March, a 36 year-old-man young man committed suicide after facing the ‘stigma’ of contracting coronavirus. He had gone home from Dhaka as there was no scope for work in the city. The people in the village suspected he had come back home because he had coronavirus and began castigating him.
In the third week of June, a middle-aged man in Dhaka was admitted to a government hospital, having tested positive for coronavirus. He later ran away from the hospital and came home where he committed suicide.
When people sink to the nadir of depression, they have an increased propensity towards suicide. It is as if contracting coronavirus is a crime, a matter of shame. This creates frustration and depression. Sometimes it generates panic, leading to suicide.
In the second week of April, a 10-year-old child in Sirajganj committed suicide, distressed by his father’s unemployment. His father used to work in a factory but was laid off when the factory shut down.
Depression, alarm and anxiety on the rise
Towards the end of March a physician called me about a boy who was admitted to a hospital in Dhaka with coronavirus. He was behaving abnormally. I was given a phone number to call him and treat him over the phone. I tried a few times and in the evening managed to speak to the boy. I felt he was suffering from conversion disorder, what was termed as hysteria before. I gave him the necessary advice and spoke to the physician.
In the last week of April, as member of a government medical board for an ICU patient in a government hospital, I visited the hospital to see the patient. He had overcome Covid complications, but was facing a mental breakdown. He was later given the necessary treatment.
Various studies around the world have shown that mental stress, anxiety, depression and panic attacks had increased much more during the pandemic than in normal times, among Covid patients, persons having to remain at home due to the lockdown and also among health workers.
A study conducted in China shows that 28 per cent of the health workers suffered from mental stress and there was indications that 43 per cent of them would probably suffer from post traumatic stress disorder.
In Bangladesh there have been some small scale studies on COVID-19 and mental health. A research paper of Bangladesh was published in the August 2020 issue of Journal of Affective Disorder.
This study was conducted online in April this year, after the general holiday was declared, on 505 students of university and college. It was seen that 33 per cent had symptoms of anxiety, 47 of depression and around 29 per cent of extreme mental stress. This was multiple times more than in normal times.
Of the 1,427 adult respondents of Patuakhali University of Science and Technology, around 60 per cent showed symptoms of extreme mental stress.
Another online study conducted jointly by Begum Rokeya University in Rangpur and Western Sydney University, Australia, showed that 72 per cent of the 11,000 respondents had sleep problems during the coronavirus pandemic.
Mental stress and various mental diseases are increasing during coronavirus times. Mood swings, forgetfulness, attention disorders, losing interest is matters of interest, irritation, losing one’s temper, aggressive behavior, impatience and lack of sleep are some of the symptoms noted in these times of the pandemic.
Depression, alarm and anxiety on the rise
Towards the end of March a physician called me about a boy who was admitted to a hospital in Dhaka with coronavirus. He was behaving abnormally. I was given a phone number to call him and treat him over the phone. I tried a few times and in the evening managed to speak to the boy. I felt he was suffering from conversion disorder, what was termed as hysteria before. I gave him the necessary advice and spoke to the physician.
In the last week of April, as member of a government medical board for an ICU patient in a government hospital, I visited the hospital to see the patient. He had overcome Covid complications, but was facing a mental breakdown. He was later given the necessary treatment.
Various studies around the world have shown that mental stress, anxiety, depression and panic attacks had increased much more during the pandemic than in normal times, among Covid patients, persons having to remain at home due to the lockdown and also among health workers.
A study conducted in China shows that 28 per cent of the health workers suffered from mental stress and there was indications that 43 per cent of them would probably suffer from post traumatic stress disorder.
In Bangladesh there have been some small scale studies on COVID-19 and mental health. A research paper of Bangladesh was published in the August 2020 issue of Journal of Affective Disorder.
This study was conducted online in April this year, after the general holiday was declared, on 505 students of university and college. It was seen that 33 per cent had symptoms of anxiety, 47 of depression and around 29 per cent of extreme mental stress. This was multiple times more than in normal times.
Of the 1,427 adult respondents of Patuakhali University of Science and Technology, around 60 per cent showed symptoms of extreme mental stress.
In Peru, around 915 women went missing after the outbreak of coronavirus, from mid-March to the end of June. It is thought that most of them have been killed in incidents of domestic violence.
Another online study conducted jointly by Begum Rokeya University in Rangpur and Western Sydney University, Australia, showed that 72 per cent of the 11,000 respondents had sleep problems during the coronavirus pandemic.
Mental stress and various mental diseases are increasing during coronavirus times. Mood swings, forgetfulness, attention disorders, losing interest is matters of interest, irritableness, losing one’s temper, aggressive behavior, impatience and lack of sleep are some of the symptoms noted in these times of the pandemic.
Domestic violence and divorce
In Peru, around 915 women went missing after the outbreak of coronavirus, from mid-March to the end of June. It is thought that most of them have been killed in incidents of domestic violence. These disappearances have increased by about one and a half per cent since the pandemic began.
In Spain, domestic violence went up by 18 per cent in the first two weeks of lockdown.
A UN publication states that in Singapore, domestic violence went up by 33 per cent and in France, by 30 per cent.
Divorce rates have increased in China, Britain, the US and several other countries after the lockdown began. According to the legal firm, Co-opt Legal Services, in Britain there had been a 42 per cent increase in divorce applications. In the US, a survey points to a 32 per cent increase.
In a study conducted by Manusher Jonno Foundation in 27 districts of Bangladesh, in April this year 4,249 women and 456 children were victims of domestic violence. Women are mostly being abused by their husbands. Interestingly, 1,672 of the women respondents and 423 of the children were subject to domestic violence for the first time during the pandemic.
Vicious cycle
When the gap grows between what a person wants and what a person gets, when plans go awry, frustration and uncertainty grows in the mind. From this arises anger. Anger leads to aggressive behavior. In scientific terms, this is called the ‘frustration-aggression hypothesis’. In anger, one loses rational thinking and takes wrong decisions. This increases the gap between wanting and receiving. This is a vicious cycle.
Coronavirus has turned everything topsy-turvy, from personal live plans to overall plans. Things have to be though anew. Studies, lifestyles, professions, economy and even politics are all changing in keeping with the pandemic. This is forced change, leading to more frustration, anger and aggression. And that is reflected in interpersonal relations. Domestic violence is increasing. Added to that is the fear of coronavirus transmission, death, loss of loved ones and economic uncertainty. All this has had a devastating effect on mental health worldwide.
The way ahead
‘When will I face mental problems?’ ‘When will I face depression?’ ‘When will I become suicidal?’ ‘Will I wait till then and then go to a psychiatrist?’ Such planning is dangerous.
Mental health must be given importance from a personal level to an institutional and even state level. There was been some perfunctory campaigns for mental health in our country during coronavirus, some guidebooks carelessly placed, unnoticed on the health directorate’s website. There is a limited amount of training in mental health for physicians and health workers. The issue is discussed on TV and the social media. But that is not at all enough.
Just as we all have eyes, noses, lungs and hearts, we also have minds. If we forget to take care of our minds in this disaster period, then our lungs, hearts and other organs will fail. The entire social system will disintegrate.
Rather than examples of developed countries like Britain or Japan, we can turn to Thailand. There is a separate directorate there for mental health, a separate directorate general for mental health. Thailand’s mental health department has taken up all sorts of programmes for mental health. One such programme is called ‘family vaccine’, where families, right down to the grassroots, are provided with mental healthcare.
The three basic features of ‘family vaccine’ are Power of Optimism, Power of Flexibility and Power of Cooperation. This has proven to be a very effective programme.
In our country too there is need to ensure mental health for everyone, from families to health workers at the grassroots. And this cannot just be restricted to programmes on paper.
It must be kept in mind that today or tomorrow a vaccine against coronavirus will be discovered, but a vaccine for mental distress won’t be made in any laboratory. The mental health problems that arise during coronavirus times and that will emerge later, must be addressed now.
Just as we all have eyes, noses, lungs and hearts, we also have minds. If we forget to take care of our minds in this disaster period, then our lungs, hearts and other organs will fail. The entire social system will disintegrate. This will be as serious a disaster as the pandemic. Mental health must be included as a part of disaster management and planning when tackling coronavirus.
The mind must be given due attention at home and at the workplace. Mental health is not only an issue to be dealt with by mental health specialists. It is the responsibility of the state’s leaders, public health experts, media persons, and every conscious citizen.
* Dr Ahmed Helal is associate professor, National Institute of Mental Health, Dhaka. This report appeared in the print and online edition of Prothom Alo and has been rewritten in English by Ayesha Kabir