Rajesh was excited to meet his friends when his college started in-person classes after months of lockdown last year. However, restrictions imposed by the government following the surge of Covid-19 cases across the country has forced the 22-year-old undergraduate student to stay at home again.

“I spend my days surfing the internet on my phone. However, I am already fed up,” said Rajesh, who wished to be identified by only his first name. “I am scared of seeing social media posts. I have recently read news that there are no hospital beds available for Covid-19 patients and many people are dying in lack of treatment.”

The second wave of Covid-19 has turned out to be more virulent and lethal, infecting more people and taking more lives.

According to the Ministry of Health and Population, Nepal in the last 24 hours reported 7,587 new coronavirus infections, the highest number recorded on a single day since the pandemic began. During this period, 55 lost their lives to the virus, the highest death toll in one day.

There have been 351,005 cases so far with 59,798 active cases, and the death toll stands at 3, 417.

Besides causing financial and physical problems, the second wave of the pandemic has also affected people mentally, creating panic among people, especially the youth.

“I can’t sleep properly thinking about my future. This Covid-19 has delayed my second year BSW [bachelor of social work] exam once again. I have already lost one year and I don't want to lose another,” said Rajesh. “I don’t think the situation will become normal anytime soon and thinking about it gives me anxiety.”

With the number of cases rising each day in the country, many people are having difficulty finding hospital beds, plasma and oxygen for the treatment of Covid-19 patients. People have turned to social media to get support and many are receiving the help too.

However, for others witnessing such a scenario all over their social media feeds has triggered their mental health.

“The uncertainty about their present and future, restricted to stay at home, seeing panic posts on social media and fear about new variants is all exacerbating mental illness,” Dr Prabhakar Pokharel, a consultant psychiatrist, told the Post. “The second wave could be more severe for mental health because it came suddenly when everything seemed to be returning to normal.”

When the government announced that the country’s health system is unable to cope as coronavirus infections continue to soar, people panicked more which led to more stress, fear, anxiety and other mental health related problems, Pokharel added.

According to the World Health Organisation’s Nepal office, the prevalence of mental disorders, such as depression and anxiety, is expected to rise with the soaring number of cases every day in Nepal.

“Certain groups such as persons with existing mental health conditions and psychosocial disabilities were more vulnerable to acquiring Covid-19 and stress and needed continuous care. Moreover, not everyone had access to mental health services when they required it,” states its report.

The World Health Organisation, Country Office for Nepal, has been assisting the Ministry of Health and Population in developing a Covid-19 Mental Health & Psychological Support intervention framework to draw adequate attention to mental health and psychosocial support services in the national emergency response and to continue delivering essential mental health services, according to the report.

Mental Hospital in Patan has been receiving calls from patients having problems like stress, anxiety and not being able to sleep as their close ones are infected, according to the Hospital.

“Social support is the key–share and keep talking to people,” said Dr Basudev Karki, a psychiatrist at the hospital. “One needs to keep a healthy lifestyle, have regular sleep, exercise, do yoga, read, listen to music and take multiple breaks.”

The only way to manage stress in these times is to focus on living in the present, he added.

For Anita Dhital of Kathmandu, who has just finished her undergraduate studies and was looking forward to internship opportunities, the restrictions have come hard.

“I am having difficulty dealing with my emotions,” said Dhital, 22. “I now sometimes completely lose my appetite. Neither can I sleep properly.”

For Dhital, fears of contracting the novel coronavirus and lack of medical facilities to get treatment in the event of getting infected has compounded her mental state.

“This really triggers me. What if me and my family contracted the virus, there would be no hospital beds and oxygen in government hospitals while the private hospital will charge a huge amount after being admitted,” she added. “I used to go out to meet my friends, or go to relatives’ homes. All that has stopped and I started feeling being caged.”

Mental health related problem has been a challenge for Nepal even before the Covid-19 pandemic with thousands of people committing suicide every year.

According to a 2015 report of the World Health Organisation, Nepal ranked 126th by suicide rate globally and records an estimated 6,840 suicides annually—8.2 suicides per 100,000 people.

More and more suicide deaths are being reported across the country every year, according to police data. A total of 5,124 people committed suicide in the fiscal year 2016-17. The number rose to 5,317 in 2017-18 and to 5,785 in 2018-19.

According to the data provided by Nepal Police, during the lockdown period last year a total of 2, 218 people committed suicide.

The government though has not refrained from using the term “lockdown”, the prohibitory orders that have been in place are going to be made stricter, at least in Kathmandu Valley, starting Thursday. According to chief district officers of Kathmandu, Bhaktapur and Lalitpur, shops that were allowed to operate between 5pm to 7pm will remain shut. People can buy their daily essentials only in the morning until 9am.

The stricter provisions are being implemented to break the chain of virus transmission. This, however, will mean, people will be spending even more hours at home.

Experts suggest people should try to engage themselves in some creative fields rather than spending much time on social media.

“Rather than being panicked, people should take proper precautions and not look at social media sites much,” said Pokharel, the consultant psychiatrist, “as social media is often filled with negative news which spreads rapidly and causes panic and stress among people.”

Here is what doctors suggest

- Avoid focusing on statistics that serve no purpose for the common man. All one needs to do is focus on their own self which means the same old stringent measures of wearing a mask and staying indoors.

- Follow a disciplined routine. Discipline helps the brain to focus on the task at hand and not stray away into unnecessary negative thoughts.

- Pursue a creative activity.

- Exercise releases endorphins which are natural painkillers. It also gives a sense of accomplishment while keeping us physically fit and improving immunity.

- Adequate sleep and sleep-wake patterns allow for the balance of neurochemicals to be restored so the emotional exhaustion and burnout is low.

- Healthy diet is always important to improve physical and psychological stress tolerance.

- Connect with family and friends.

If you or someone you know has some concerns, contact the following helplines.

The Tribhuvan University Teaching Hospital suicide hotline: 9840021600 (24 hours)

Patan Hospital crisis helpline for suicide prevention: 9813476123 (24 hours)

The Transcultural Psychosocial Organization: 16600102005 (Monday to Friday from 9:30am to 4:30pm)