by Fayaz Ahmad Paul
The current pandemic, technically known as COVID-19 is an infectious disease caused by a
newly discovered coronavirus. The people infected mostly experience mild to moderate respiratory illness. Recoveries occur without requiring special treatment. However, elderly and those with underlying medical conditions like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.
The best way to prevent and slow down transmission is to be well informed about the COVID-19
virus, the disease it causes and how it spreads. Protection lies in preventive measures.
Beyond affecting the people, the epidemic is causing increased stress and anxiety, particularly in people with existing mental health problems. According to the experts, reactions to the crisis can include feeling overwhelmed, fearful, sad, angry and helpless. Some people may have difficulty sleeping or concentrating. Fear of contact with others, travelling on public transport or going into public spaces may increase, and some people will have physical symptoms, such as an increased heart rate or upset stomach.
The World Health Organization has acknowledged that the crisis is generating stress, and has advised people to avoid watching, reading or listening to news that causes feelings of anxiety or distress. Quarantine or self-isolation is likely to have a negative impact on mental wellbeing. Separation from loved ones, the loss of freedom, uncertainty over disease status, and boredom can, on occasion, create dramatic effects. Substantial anger generated, Suicide has been reported and lawsuits brought following the imposition of quarantine in previous outbreaks. We anticipate the effects of infectious disease threats to manifest as sheer anxiety and panic: worry about getting an infection, worry about loved ones getting ill, and worry when related symptoms even minor are present. The absence of definitive treatment for the disease easily exacerbates anxiety. In most cases, these anxiety symptoms do not reach diagnostic thresholds for a DSM-5 diagnosis; however, patients will benefit from reassurance and education.
Contamination obsessions, unwanted, intrusive worry that one is dirty and in need of washing,
cleaning, or sterilizing are very common in patients with OCD. Perceptual experiences (e.g., feeling dirt on the skin) understandably would amplify obsessions. Sensory experiences (but not necessarily full tactile hallucinations) have been found in up to 75 % of patients with OCD patients. More intense sensory experiences (pseudo-hallucinations) are related to worsened control over compulsions and poorer insight. Biased information processing is associated with a tendency to overestimate threat in individuals with OCD. This may increase sensitivity to the panic associated with pandemic threats and further destabilize patients and increase functional impairment.
Cleaning and washing compulsions, also a core feature of OCD can easily be exacerbated by the threat of infectious pandemics. Complications of excessive cleaning include dry, chapped skin (which can lead to super-imposed infections). And contact and atopic dermatitis; similarly, overuse of toxic cleaning supplies can lead to inhalational injuries. Fear of acquiring a new, sensationalized disease may worsen negative behaviours. Clinicians in psychiatry, psycho-dermatology, and primary care practices should be alert to potential issues in patients with OCD.
The current COVID-19 outbreak is spurring fear on a societal level. On an individual level, it may differentially exacerbate anxiety and psychosis-like symptoms as well as lead to non-specific mental issues (e.g., mood problems, sleep issues, phobia-like behaviours, and panic-like symptoms).
(Author is a research scholar, Psychiatric Social Work, Department of Psychiatry, Government
Medical College and Hospital, Sector-32, Chandigarh. Ideas Expresses are personal)