What are the expected behavioural, mental and psychological health responses and consequences of the corona virus infection and the Covid-19 pandemic due to the quarantine, loneliness, physical and social distancing associated with the C19?
Causes of the behavioural, mental and psychological health conditions due to the pandemic.
The pandemic has brough about loneliness which can be looked as a form of loss of freedom, loss or decrease in income, loss of job, employment and livelihoods, closure of all schools including the tertiary institutions, affectations of the four dimensions of health, the physical, mental, social and spiritual wellbeing health. There is an increase in domestic violence because spouses are spending more time with one another and finding faults with each other.
Even before the onset of the C19 pandemic, the degrees of mental health conditions such as generalised anxiety, depression, psychotic conditions such as bipolar illness and substance use; therefore it stands to reason that there would have been some remarkable increase in the mental health issues during this pandemic lockdown period and definitely after the pandemic era.
What are the mental health conditions that we are likely to encounter during the pandemic lockdown?
The total lockdown will bring about mental health conditions in various forms of severity from mild, to moderate and severe conditions. These conditions include
- Loneliness especially for the elderly, which has a high correlation for mental health disorders
- Fear of the unknown, fear of catching the illness and fear of dying
- Anxiety, panic, phobia, which can manifest and restlessness, agitation, sweating, racing heart beats, sleep disturbances, chest constriction
- Symptoms of depression – low moods, fatigue, loss of interest in activities that hitherto brought joy and happiness, sleep disturbances, gloomy feelings, restlessness,
- Domestic violence, spouse abuse, child abuse, verbal and physical aggression
- Suicidal thoughts, ideas, and outright suicide
- Obsessive-compulsive symptoms – repeated temperature checks, washing of hands, and overtly use of hand sanitisers.
- On societal angle, armed robberies, abductions for ransom will be on the increase
- Civil disobedience which we can observed in many cities in Nigeria
- Loss of jobs, high rates of unemployment as many people won’t even be able to pay salary, governors may also find it difficult to continue to pay salaries due to heavy drop in the price of crude oil, all these will lead to increased poverty and poverty has been highly linked to the development of various types of mental illness.
Those with previous psychological distress and mental health illnesses
Nigerians that have been diagnosed as having mental health illnesses previously before the pandemic, most likely, their illnesses may get worse and may experience relapses of their mental health conditions. Due to the lockdown, they may not have access to their hospitals or attend their outpatients’ clinics. Since they could non access their hospitals and clinics, they may also not be able to get their prescription drugs. In this regard, these patients may continue to experience severity of their conditions
The middle-aged and elderly in the society
We also need to consider the middle-aged and elderly within the age bracket 60 years and above who already had been diagnosed and also experiencing chronic physical illnesses such as hypertension, diabetes, heart disease and cancers who need regular monthly follow-up at their outpatients’ clinics but have not been able to access their clinics and hospitals due to the pandemic. They may also have difficulties in procuring their medications. This will also lead to diminished physical and mental wellbeing of the populace which can also exacerbates psychological distress and mental health disorders. The elderly above the age of 65 years need to be very careful because they have been found to be vulnerable and could easily contract the Covid-19 illness. We are advised to protect them and keep them safe in their rooms.
Bereavement and grief reactions from family members who lost their loved ones
We all know one or two people that have died during this period, their family members and friends will also experience symptoms of grief such as – Denial, Anger, Depression, Acute stress disorders some day after the loss of the family member, Posttraumatic Stress Disorder may occur some week or months after the loss of the loved member of the family that can manifests as flash backs, re-living the traumatic experience, sleep problems, and avoidance of places where the death occurred.
Those that have contacted the virus, received treatment and discharged from the isolation centres
Patients who had contracted the infection, treated at the isolation centre will face the issues of posttraumatic stress disorder, discrimination and social stigma and may also be avoided by family members and friends. We therefore need to carry out mass public education and information to prevent stigmatisation and discrimination of previously infected people.
Other Illnesses Similar to the COVID-19
The rainy season is here with us in Nigeria, therefore there will an increase in other viral infections that affect the nose and throat such as the common cold, the flu caused by influenza fever, that have similar signs and symptoms such as cough, fever, running nose, weakness, sneezing, chest pain and fatigue such as those of the Covid-19 illness. When we experience these symptoms, we should not panic, we should take of the counter medications such as pain relievers, cough mixtures, multivitamins and herbal teas and get plenty of rest for three days. If the symptoms do not subside after three days that is when to call your doctor for an appointment. On listening to you and after examining you, the doctor will decide whether you need to go for the coronavirus test.
Prevention of Getting Infected by the Corona Virus
Apart from the perfect personal hygiene of using your mask in crowded areas, washing your hands frequently, and social and physical distancing advertised by the NCDC, we also need to consider other self-care strategies such as:
Knowing that the virus cannot be transmitted through the use of ATMs, or eating food bought from restaurants, or through your shoes when you go out.
You can’t be protected from the virus by taking vinegar, garlic, ginger, turmeric and other herbal concoctions: these herbal drugs can only increase your immunity but will not cure the viral infection. You need to also get out of your house to get some sunshine. Vitamin D is good for the prevention of the infection.
Prevention and Management of Psychological Distress During and After the Pandemic
What are the mental health preventive measures, that we can all adopt to boost our mental health during this pandemic period? Here are 10 tips to improve your mental health during this pandemic period.
- Get sound sleep for about 8 hours of sleep daily.
- Connect socially with close family members through social media means
- Avoid unnecessary frightening information from the social medical, depend only on information from government
- Keep physically fit, workout in any form for at least 30 minutes thrice weekly if possible, inside the sun
- Go back to our hobbies that you have passion for especially while in secondary and tertiary institutions; learn a new skill such as dancing, singing, new language or musical instruments.
- Read books motivational and inspirational books, and if possible, write your own book too.
- Avoid excessive intake of alcohol, sugar, salt and fat.
- Learn how to use positive emotional strategy of smiling and laughing. Laughter has been said to be the medicine for all ailments. When we smile, it shows that we happy and the psychological trick, is that we cannot be happy and sad at the same time. This is why we need to learn to watch comedy and funny movies to further boost ore emotions.
- Learn to meditate to increase your resilience for physical and mental stress to also increase your frustration tolerance level.
- Connect directly with the supernatural power of God through meditation, praying and fasting.
Mental health care post pandemic era
The Covis-19 infection will not go away soon, it will remain with us for some months therefore, it is expected that the rates of mental illness will also rise exponentially, the local, state and federal governments need to also put in place mental health surveillance and routine screening for common mental health conditions such as anxiety, depression and drug abuse at the primary and secondary health care levels. Because of the very few mental health personnel available in Nigeria, we need to quickly train, engage and involve allied mental health workers such as the nurses, social workers and community health workers, religious leaders, mental health non-governmental organisations, volunteers, and life coaches in brief evidence-based counselling methods to assist to the mental health experts to manage the expected increase in mental health conditions.
We also need to as matter of urgency advice the public and mental health policy makers to integrate mental healthcare into primary and secondary health care as soon as possible.
My final parting words, we should however, realise that 80% of those that get infected may be asymptomatic, that means, that they are without signs and symptoms of the COVID-19 illness. Only 20% of those who develop the illness will have mild symptoms to moderate symptoms that will need to be admitted and treated at the Isolation Centres, while 5% may end up at the Intensive Care Unit and less just about 1% of the population will eventually die from the illness.
Dr. Ayodele Olurotimi Coker, a Clinical Psychologist, and Associate Professor of Psychiatry and Behavioural Health Scientist is based in Lagos, Nigeria.