The Effects Of COVID 19 On Mental Health
A walk down memory lane
In the beginning of 2020 amidst the threat of a third world war, emerged a strain of virus that was unknown even to the greatest of scientists worldwide. First discovered in the city of Wuhan, China, this virus soon spread at a rapid pace and within just three months, it was declared as a worldwide pandemic by the World Health Organization (WHO). It was named coronavirus since ‘corona’ means a crown and the virus looks like one due to the spike proteins sticking out of it. It was then shortened to COVID-19 so that it did not refer to any particular animal, geographical location, person or a group of people and was easy to pronounce.
Initially, the virus appeared only in China. However, by April 2020, over 210 countries and territories were affected by it, with Europe, USA and Iran forming new clusters. The United States had the highest number of confirmed COVID-19 cases while India and China, despite being among the most population-dense countries in the world, had managed to constrain the infection rate by the implementation of a complete lockdown with arrangements in place to manage the confirmed cases. Similarly, the UK also managed to maintain a low curve of the graph by implementing similar measures, though these were not strictly enforced.
Spread by droplet transmission, the virus is not only highly contagious but also has different strains or strands, which made it extremely challenging to control it especially in the beginning. Hence, it led to a dramatic loss of human life worldwide and presented an unprecedented challenge to public health, food systems and the entire society on the whole.
The consequences were brutal on the economy and most of the world went under a mandatory lockdown with schools and offices functioning virtually and many businesses even shutting down.
With a direct impact on revenue due to early fatalities, decreased productivity and workplace absenteeism, COVID-19 also created a negative supply shock, with manufacturing activity slowing down as a result of supply chain disruptions around the world and factory closures. For instance, the Chinese output index fell more than 54 per cent from the previous month’s value in February.
Consumers often changed their buying habits in addition to the effects on productive economic activities, primarily as a result of decreased income and household finances as well as the fear and terror brought on by the outbreak. Due to the decline in travel, service sectors like tourism, hospitality, and transportation saw major losses. According to the International Air Transport Association, airline passenger revenues dropped by $314 billion by April 2020, due to severe travel restrictions and of course, the spread of the virus.
The COVID-19 quarantine procedures had an adverse impact on various industries in the United States like sensitive manufacturing, travel and transportation, restaurants and bars, and travel and entertainment.
The COVID-19 outbreak continues to have an impact on various segments of the society — those living in poverty, the elderly, people with disabilities, children and indigenous peoples. Early data suggests that the poor are disproportionately bearing the costs of the virus’ effects on their health and economy. For instance, homeless individuals are more vulnerable to the threat of the virus since they don’t have a secure place to stay at and may not have taken the vaccination owing to lack of money and awareness. It’s also hard for them to find a job after the pandemic and they may be the victims of xenophobia.
For the elderly and those with comorbidities, the virus continue to pose a threat as it can severely impact their health.
Mental health and COVID-19
The pandemic had a huge impact on the mental health of the society too. With everyone being instructed to stay at home or in quarantine to stop the spread of the virus. This led to despair, tension, and frustration.
There were primarily two ways in which the virus had an impact on a person’s mental health — direct and indirect.
In the beginning, certain characteristics of the disease such as the lack of a vaccine to treat it or the knowledge about how it spreads, evolves or affects a person, made people extremely fearful. In addition to the high rates of new cases and deaths every day, the bombardment of information to which citizens were subjected by the social media influenced the development of mood disorders. Thus, from the early stages of the pandemic, Chinese researchers found moderate and severe symptoms of anxiety, stress, and depression in the Chinese population.
These were the various rules and regulations to contain the spread of the virus like isolation and quarantine.
Every individual, whether infected or not, was asked to stay at home to prevent the spread of the virus. This led to the emergence of several psychological disorders like anxiety and panic, obsessive compulsive disorders, insomnia, digestive problems, as well as depression and post-traumatic stress. Prolonged social isolation, that is the lack of interaction with others, can adversely affect the physical and emotional health of a person and even alter sleep, movement and nutritional rhythms.
Social isolation has been associated with cognitive decline, lowered immunity, elevated risk of cardiovascular diseases and eventually, mortality. Spending a lot of time with just a few people in a confined space impacts the mood and well-being of a person as well as increases the risk of conflicts and domestic violence. For instance, China experienced a significant rise in separations and divorces during the pandemic.
On the other hand, those who live alone and are unable to rely on a sufficient social network experience deep detachment and are therefore more likely to experience depressive symptoms.
As many people lost their lives thanks to the virus, there was a severe impact on the mental and physical health of the people near and dear to them. The one emotion experienced by all these people was grief. A common reaction to the death of a person as well as the abrupt changes in habits and ways of life that typically give us solace and a sense of security, grief can be classified into different types like ambiguous, latent and anticipatory.
Ambiguous grief is a loss that occurs without closure or clear understanding and often results in unresolved feelings and a sense of uneasiness. The losses that are part of ambiguous grief are not typically acknowledged as losses by our friends and families — loss of confidence, security or even feelings of control over our own lives. All of these are losses that we may grieve over but have no rituals or even a language to acknowledge.
Latent (hidden) grief is often associated with caregivers of individuals with dementia. It attributes caregiver burden to the hidden grief that comes with losses associated with dementia, such as loss of memory, loss of relationships as they once were, or loss of mobility. Each time the patients suffering from dementia change, those around them grieve those changes. The thought is that addressing the hidden feelings of grief can diminish the burden. Similarly, losses, both big and small, can build up and lead to overwhelming feelings of sadness, powerlessness, anxiety and depression.
Anticipatory grief refers to our feelings of grief even before a loss occurs. For example, we may be worried about an extremely ill family member and already feel that we are grieving them. Or we may be anticipating a loss of income and financial insecurity. Even though our worst fears may not come to pass, anticipating them can lead to legitimate feelings of grief.
The restriction of movement during the pandemic was also an indirect reason which hampered the mental health of individuals in certain ways. Longer durations of quarantine were associated with poorer mental health specifically, post-traumatic stress symptoms, avoidance behaviors and anger.
Confinement, loss of routine and reduced social and physical contact with others were frequently shown to cause boredom, frustration, and a sense of isolation from the rest of the world, which was distressing. This frustration was exacerbated by not being able to take part in the usual day-to-day activities, such as shopping for basic necessities or taking part in social networking activities via the telephone or internet.
In a nutshell
There have been several viral epidemics in the past and COVID-19 has been no different as can be seen by its effects on the mental and physical health of the society, especially on patients and frontline healthcare workers. However, the persistence and uncertainty of the virus along with its size and impact, have created an impact like never before on the society. Its effect on the world economy demonstrates how intricately interconnected and interdependent the human race is through its many communities, continents, institutions and infrastructure.
Rayyan is a 2nd year undergrad pursuing MBBS from HBTMC, Mumbai. He is an avid writer and almost always finds himself on the other side of the screen typing away or tweeting. Deeply passionate about football, academia, medicine and teaching, not necessarily in the same order.