The global climate changes of our planet, the air connectivity & the international exchange have gifted us the COVID 19. It is cutting across the countries to pandemic proportions leading to anxiety, acute stress to real or impending threat of virus, and widespread panic attacks apart from medical morbidity and death. Though we are not new to these threats as we have defeated flu like illness psychologically earlier, but media coverage has highlighted COVID 19 as a literal death threat. This has led to hoarding of masks, hand sanitizers and virtual absence of related medical equipments from the market inclusive of on line availability as well.
Resilience, not panic is the psychological remedy. The fear pendulum of COVID is swinging gradually from denial to crisis and what is required at this time is sensible health policy to avoid spreading of this highly contagious disease. Everyone is focusing on quarantine and rightly so, but that itself from mental health point of view would cause short term fall outs like irritability, frustration, anxiety and fear psychosis which would need a psychiatrist’s intervention and if isolation is prolonged to a long term phenomenon called post traumatic stress disorder (PTSD) with likely substance abuse as well. The disease has started crossing continents from China to Iran, Italy, Middle East, India and now our valley as well. As a mental health professional I must emphasise that it’s high time we should be geared up to tackle panic attacks, hysteria and anxiety. I believe in our set up the old proverb “a lie has no legs but a scandal has wings” really holds. These common mental health conditions will travel, I am afraid, more quickly than the idea of resilience and hope. When any treatment is still awaited there will be a downhill course to despair with far reaching consequences, unless positive mental health is promoted by our doctors to augment psychological support system. This can be best achieved by people working together, and promoting mutual trust. Washing hands thoroughly, not touching face, keeping a good distance from a sick, are reasonable measures, but quarantining whole community is certainly not advisable and as psychiatrists we must offer these days counseling for parallel social greetings viz a viz to hand shaking and act as a resource to community and religious heads as well..
Once again I will focus on resilience as it is most important tool which gives people the psychological strength to cope with stress. It carries people through trauma and prevents them to fall apart. Fortunately our society is resilient to a good extent but it can be learnt by many ways as well, like we should avoid trying to solve problems with same thinking that created it, By staying tough, keep growing and by staying prepared. A simple, but one of the best ways to be resilient is to be aware of what’s happening. By remaining aware a resilient person can control an awkward situation and think of new strategies to tackle issues. A typical person is not only aware of his emotions but also the behavior of his people around him. Here the internet and media I am afraid may act as a double edged sword. With its instant, indiscriminate reductive messages will spread panic, anxiety and hopelessness very fast. What is expected of a psychiatrist and mental health professional at this stage is to provide psychological support through its support teams, promote correct knowledge and spread it as quickly as possible. The electronic counseling and mental health screening directly as well as by referral for depression, anxiety, panic and suicidality has to be taken up as soon as possible. With the availability of competent psychiatrists in all district hospitals of our valley and promotion of DMHP units by Director health surely the mental health crisis if any would be taken care of.
To conclude, ponder over the quote of World Health Organization Director General, Dr. Tedross: “It’s easy to blame, easy to politicize, but it’s harder to tackle a problem together and find solutions together”. Let’s be mentally tough to counter COVID 19 in our part of the world.
Dr Imtiyaz Mansur MD is Sr. Consultant Psychiatry & Nodal Officer Mental Health, Directorate Of Health Services Kashmir