The Mental Battle During Global Crisis

By Shrey Siddharth

For the past year and a half, the dreadful corona virus outbreak in India has brought everything to a standstill, especially after the second wave. The doctors, healthcare workers and frontline workers have been working relentlessly putting their life on the line. But, it isn’t just the virus and its deadly effects that is taking lives. The fear, risk of isolation, stigma and abuse that comes with it simply adds to the misery of the ones affected. Several people have committed suicides after discovering that they are tested positive for covid. On the other hand, many doctors from all over the country have been facing mental trauma and have shared their experiences on social media.

Dr. Bikash Das, who is an Assistant Professor, Psychology, Shailabala College, Cuttack threw some light on the raising issue of innocent people commiting suicide after testing positive for covid in recent times. He said,”With reference to ‘The dual pandemic’ of suicide and COVID-19: A biopsychosocial narrative of risks and prevention, a study by Debanjan Banerjee, Jagannatha Rao Kosagisharaf, and T.S. Sathyanarayana Rao, the impact of covid on psychosocial wellbeing in countries like India highlighted the increased sleep disturbances, generalized anxiety, substance use, depression and self-harm behaviour. Increased stigma, lack of medical protective equipment and inadequate access to health care are amongst other attributing factors that urge an individual to commit suicide in the pandemic situation.”

Dr. Bikash Das went on to explain about the ‘Separation theory’ by Robert Firestone, that identifies the split within a person as the ‘real self’ and the ‘anti self’, where the real self is the life affirming side of an individual whereas anti self represents self destructive elements of the personality. The negative thoughts run in a continuum, from mild self criticism to extreme self hatred do direct a person to commit suicide. He talked about a well known suicidologist Dr. Israel Orbach who suggested that people with suicidal tendencies have high tolerance to physical trauma, physical pain through the disassociation,and low tolerance to mental pain.

He further said,”The factors which could lead to suicidal tendencies during this pandemic include biological factors, environmental factors and genetic factors. The interaction of genetic factors and environmental factors gives rise to suicidal tendencies. Some environmental factors include unemployment, demoralization and social rejection are considered major reasons for suicide in this pandemic situation. Many psychological distresses such as anxiety and agitation, outburst of rage and frustration, major depression and hazardous drinking, which are associated with greater suicidal risk. From a recent study ‘Social and biological parameters involved in suicide ideation during Covid 19 pandemic: A narrative study’, it was observed that The alterations in glutamatergic and GABAergic neurotransmitters had upregulated the GABARB3, GABARA4, GABARA3, GABARR1, GABARG2, and GAD2 gene expressions in suicidal victims.”

Dr. Bikash Das also stressed on the hyperactivity of the hypothalamic-pituitary-adrenal axis (HPA axis) as a major reason for suicidal behavior in the pandemic period. The HPA axis helps in regulating the affective behaviors and it’s hyperactivity leads to anxiety disorders causing suicidal behavior.

The ongoing pandemic situation has had a mental toll on the doctors. There had been several instances of doctors spreading awareness about the disease and urging their fellow countrymen to stay home and follow the precautions. Dr. Bikash Das said,”In the initial days of pandemic, doctors were giving the treatment of coryza to the covid patients and they had moral strength. But in today’s date, due to the apathetic issue of the government or lack of oxygen cylinders and healthcare resources, a doctor is meeting with a helpless state of seeing his patients die right before his eyes. A doctor never wants that and he wants to help his patient recover. So if a doctor meets with these sort of situations for about one year, it develops into a traumatic situation. Yes they could be doctors, but they’re human beings first. Their duty is to save lives, not extend lives. This agony and strain of losing whether their near and dear ones or their patients leaves a lasting mental impact.”

Explaining the situation further, he said,”The moral support and strength of a doctor deteriorates when they face the situation of losing their patients over a period of time. Yet they face the situation boldly and do their duty, otherwise they’ll be held responsible. Hence, they record videos to make people and the administration aware about the deadly situation. They’ve got family at home and they see about 30 out of 100 patients die in front of their eyes.”

Speaking of the mental health of people in the pandemic situation, he said,”Mental health takes time to restore and doesn’t happen overnight. When we talk about an individual suffering through a traumatic situation, we often suggest that instead of staying in complete isolation in a room, they should get close to nature and have positive conversations with people like they always did just to bring some change.”

“Let’s say if a girl who faced physical abuse is kept within the house and her situation is not disclosed to anyone. After the traumatic experience she underwent, if she’s not given enough care and exposure to natural circumstances, it grows into anxiety and eventually post traumatic stress disorder (PTSD). She’ll have to go medication in order to recover. But if her situation is addressed immediately, and she’s taken for outings and has normal conversations with people close to her, she slowly recovers.”, he further said.

Staying home, making sure about the safety measures and precautions and taking the initiatives to help could act as a moral support to the doctors. Cooperating with the system and the protocols would give a fitting tribute and support to the doctors along with all the frontline and the healthcare workers