Panic, paranoia and anxiety: Doctors report a worrying rise in mental health patientsIncreased exposure to distressing news, uncertainty and increased stressors due to the Covid-19 lockdown are prompting numerous mental health issues.
Last week, Bimala from Sano Bharyang was taken to the Nepal Mental Hospital in Lalitpur by her in-laws after she started showing unusual behaviour. She was constantly washing her and her children’s hands, and locking the children inside their room.
“Her in-laws said that she was extremely worried about a possible coronavirus infection,” Dr Ananta Prasad Adhikari, a psychiatric consultant at Nepal Mental Hospital, told the Post.
Bimala, 31, displayed symptoms of obsessive-compulsive disorder, triggered by the ongoing Covid-19 pandemic, said Adhikari. Obsessive-compulsive disorder is when patients have unwanted and repeated thoughts, feelings and obsessions.
According to doctors at the Nepal Mental Hospital, the pandemic and the lockdown enforced to contain its spread have led to increased feelings of stress and anxiety, which can trigger latent issues, like with Bimala. Already, more patients with anxiety are visiting the hospital, said doctors.
Forty-two-year-old Anil from Sanothimi in Bhaktapur visited the Nepal Mental Hospital after not being able to sleep due to overwhelming fears of a possible infection.
“The patient was wearing several masks at once and told us that he had also put several on his children.” said Adhikari. “He was obsessed with Covid-19 news and complained about difficulties sleeping and concentrating.”
Anil too exhibited symptoms of obsessive-compulsive disorder along with clinical anxiety, according to doctors.
The Post is identifying both Bimala and Anil only by their first names in the interest of privacy.
The World Health Organization has acknowledged mental health as a very real concern during the pandemic and has suggested that people minimise watching, reading or listening to news about Covid-19 that cause feelings of anxiety or distress.
“The sudden and near-constant stream of news reports about an outbreak can cause anyone to feel worried,” reads the WHO statement. “Get the facts, not rumors and misinformation.”
The UN health agency has urged people to seek information only from trusted sources and at specific times during the day, once or twice.
Last week, the Epidemiology and Disease Control Division held a video conference with clinical psychologists and psychiatrists from major hospitals across the country, where participants reported a sudden surge in the number of patients and disruptions in the supply of medicines. They warned that if the ongoing lockdown continues, and if the mental health problems caused by the coronavirus are ignored, more issues in many more people, including persistent depression, anxiety, and panic attacks, could arise.
Even for those not prone to anxiety over the pandemic, the severe measures countries around the world have instituted to limit its spread have led to increased stresses, as many have lost their jobs or are unable to provide for their families.
Nepal has so far reported a relatively small number of Covid-19 cases—eight live cases with one recovery, but in the absence of widespread testing, there are fears that the number could be higher.
According to Dr Mita Rana, a clinical psychologist at Tribhuvan University Teaching Hospital, being fired or sent on unpaid leave has created new stressors that could manifest in a disorder.
“Rising levels of stress and uncertainty are fuelling anxiety disorders,” she said.
In order to deal with the current situation, Rana suggests that the people try to avoid stressors, refrain from engaging in unnecessary arguments with family members, and try to sort problems together.
Those already diagnosed with mental health problems are highly vulnerable to relapse and for their conditions to worsen, said doctors, especially as they are unable to engage in social activities to release stress or visit their doctors and therapists due to the lockdown.
A number of clinical psychologists as well as psychiatrists from around the country have offered online and telephone counselling. But at times, patients need in-person counseling and that is often not possible during the lockdown. In some cases, the supply of critical psychiatric drugs has even been disrupted.
Dr Phanindra Prasad Baral, chief of the Mental Health Section at the Epidemiology and Disease Control Division, conceded that patients in remote villages might have been deprived of medication due to the ongoing lockdown but that they were working to ensure supply.
“Long-term problems could arise if patients do not get their medication on time and they relapse,” said Baral.
(If you or someone you know has some concerns, please contact the following helplines.)
Dr Abhash Niraula (Birtamod): 9852064922
Dr Neekesh Rajbhandari (Biratnagar): 9851131321
Dr Madhur Basnet (Dharan): 9852056415
Dr Sirish Aryal (Janakpur): 9812073900
Dr Sailendra Raj Adhikri (Chitwan): 9855061744
Dr Neena Rai (Kathmandu): 9841335998
Dr Sagun Ballav Panta (Kathmandu): 9841444410
Dr Sandeep Subedi (Bhairahawa): 9847020023
Dr Rajan Sharma (Pokhara): 9856034600
Dr Tanveer Ahmed Khan (Nepalgunj): 9858023672
Frequently asked questions about the coronavirus outbreak
UPDATED as of June 2, 2020
What is Covid-19?
Covid-19, short for coronavirus disease, is an illness caused by the coronavirus SARS-CoV-2, short for severe acute respiratory syndrome coronavirus 2. Common symptoms of the disease include fever, dry cough, fatigue, shortness of breath and breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
How contagious is Covid-19?
Covid-19 can spread easily from person to person, especially in enclosed spaces. The virus can travel through the air in respiratory droplets produced when a sick person breathes, talks, coughs or sneezes. As the virus can also survive on plastic and steel surfaces for up to 72 hours and on cardboard for up to 24 hours, any contact with such surfaces can also spread the virus. Symptoms take between two to 14 days to appear, during which time the carrier is believed to be contagious.
Where did the virus come from?
The virus was first identified in Wuhan, China in late December. The coronavirus is a large family of viruses that is responsible for everything from the common cold to Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). After an initial outbreak in Wuhan that spread across Hubei province, eventually infecting over 80,000 and killing more than 3,000, new infection rates in mainland China have dropped. However, the disease has since spread across the world at an alarming rate.
What is the current status of Covid-19?
The World Health Organisation has called the ongoing outbreak a “pandemic” and urged countries across the world to take precautionary measures. Covid-19 had spread to 213 countries and infected more than 6,321,836 people with 375,657 deaths. In South Asia, India has reported the highest number of infections at 198,140 with 5,608 deaths. While Pakistan has reported 72,460 confirmed cases with 1,543 deaths. Nepal has so far reported 1,811 cases with eight deaths.
How dangerous is the disease?
The mortality rate for Covid-19 is estimated to be 3.6 percent, but new studies have put the rate slightly higher at 5.7 percent. Although Covid-19 is not too dangerous to young healthy people, older individuals and those with immune-compromised systems are at greater risk of death. People with chronic medical conditions like heart disease, diabetes and lung disease, or those who’ve recently undergone serious medical procedures, are also at risk.
How do I keep myself safe?
The WHO advises that the most important thing you can do is wash your hands frequently with soap and water for at least 20 seconds or use hand sanitizers with at least 60 percent alcohol content. Avoid touching your eyes, nose and mouth with unclean hands. Clean and disinfect frequently used surfaces like your computers and phones. Avoid large crowds of people. Seek medical attention if symptoms persist for longer than a few days.
Is it time to panic?
No. The government has imposed a lockdown to limit the spread of the virus. There is no need to begin stockpiling food, cooking gas or hand sanitizers. However, it is always prudent to take sensible precautions like the ones identified above.