Good days, bad days

There is a mixed impact on those with mental health problems


Sayanora D. from Mumbai says she can sometimes see bacteria and viruses on surfaces. The 35-year-old has had to deal with obsessive-compulsive disorder (OCD) since childhood but the symptoms were always under control. The Covid-19 pandemic, though, aggravated her OCD. She would wash her hands up to fifty times a day and became non-functional. “My family members had a tough time dealing with my obsession with sanitation,” said Sayanora. “I restricted myself to my room and reduced interactions with people, including my own family. I feared that if I stepped out, I would get Covid.”

For many people with mental health problems, the pandemic has made things worse. Prolonged social isolation aggravated anxiety disorders and fears. And, with limited access to therapists and medicines, some tried solutions like tele-counselling, pet therapy or simply spending time with family.

“Many of them who needed medication were not able to get refills and had relapses,” said Dr Prabha Chandra, head of psychiatry, National Institute of Mental Health and Neuro-Sciences, Bengaluru. “They reached out to their doctors and therapists for tele-consultations. People with severe mental illnesses suffered the most. I found that those with common mental health disorders used self-help techniques and mental health apps which kept them going.”

Debolina Ray from Bengaluru has anxiety disorder. During the lockdown, the 26-year-old was alone. She experienced anxiety, panic and insomnia, but was able to reach out to Sakra World Hospital, Bengaluru, through online consultation. “She also adopted a pet which helped her to cope better,” said Dr Naveen Jayaram, a consultant psychiatrist at Sakra.

For some patients with a diagnosis of schizophrenia, it has been much easier to stay indoors. “As we have dealt with being in ‘lockdown’ for years, this feels no [different],” said 40-year-old Reshma Valliappan from Pune, who was diagnosed with schizophrenia at 22. “In comparison, many of my friends could not even handle one month of being indoors and needed to keep taking breaks by stepping out.”

Sufia Khatoon from Kolkata sought refuge in art as the pandemic hit her hard emotionally. “I really missed hugs, the warmth of conversations and seeing people around me,” she said.

“We are all bubbles of love,” wrote Khatoon, 32, in a poem. Of late, this cofounder of the Rhythm Divine Poets community often finds herself thinking about the transience and futility of life. “I suffer from anxiety and panic attacks,” she said. “I feel unloved, lonely and abandoned when I go through these phases. It takes a lot of courage to smile or hold on to self-love. The pandemic has been like war for me. I am very rooted to nature and travel. I have a garden. It is the only place where I feel genuinely happy.”

There is a pomegranate tree in Khatoon’s garden. “It is the same age as I,” she said. “It bloomed when the lockdown started. This tree does not fruit so well, so I identify with it as a rebel.”

On the other hand, some have emerged with better coping skills, especially those with alcohol and drug problems, said Dr Jyoti Kapoor Madan, a psychiatrist in the National Capital Region. “Sometimes, the inability to break from a long-standing pattern of daily living acts as a deterrent to better outcomes despite clinical management. This is especially true for lifestyle diseases.”

Shawn Peter, one of her clients, had avoidant personality disorder and would indulge in alcohol to deal with stress. Counselling did not help. “The lockdown forced him to find alternative means to manage without alcohol,” said Madan. “Through tele-consultation, we were able to enforce detoxification and development of better stress-coping strategies. After eight months, he does not feel the need to drink, and is more compliant with treatment and therapy.”

Dr Kedar Tilwe, a consultant psychiatrist at Fortis Hospital Mulund and Hiranandani Hospital, Mumbai, says the pandemic has been a blessing in disguise for some. “The [inaccessibility] of liquor as well as the shutting of local smoking joints forced many to give up these habits,” he said. “Work from home and the extra time available allowed some to implement relaxation, yoga and mindfulness techniques in their routines.”

The lockdown, indeed, has been a much-needed break for many. Rohit Das from Delhi was suffering from anxiety disorder with secondary depression. Before the lockdown, he had a worsening of his autoimmune neurological condition because of work pressure. “During lockdown, he did not have to travel to office and because of the slow pace of work, he was able to make adjustments to his sleep routine, diet and exercise,” said Madan. “The family time helped him acknowledge the need for stability and [enjoy] the simple pleasures of being with children and spouse. This inspired him to carry on with a slower pace of work. He is now planning to start a private consultancy.”

The lockdown also saw grownups return to their nest. Sreehari Ramesh, 42, from Bengaluru, who had recurrent depression, coped better during the pandemic as he returned to his hometown. People like him are reportedly feeling better after they moved in back with their parents. The warmth of the nest heals many.

(Some names have been changed.)