Invisible scars: COVID takes a heavy toll on mental health

Rashed Hasan may have recovered from COVID-19 but his battle with the disease has left deep-seated psychological scars. He now has frequent bouts of depression and his morale is easily deflated by any negative event.

Anxiety is also an issue for Rashed, a Khilgaon resident, as even the slightest hint of illness makes him think he is suffering from COVID-19 again. Medical treatment has ensured his recovery from the illness but Rashed can no longer sleep peacefully at night.

“I now react badly to mundane things or if something goes against my will. But then, I simply forget about it after a while. I have become quite forgetful,” he said.

Tonni, 14, returned to her classes after a long, pandemic-enforced break. But now, the pandemic's toll on her mental health has become apparent as she has been having difficulties socialising with others.

She was confined to her home for more than a year due to the pandemic and that has affected Tonni’s personality, turning her into an introvert, according to her mother Farzana Islam.

“I hope she’ll go back to being her usual self once she meets everyone,” she said, adding the family are giving her some time to adjust.

Meherunnesa finds herself getting irritated at the most trivial issues these days. She is yet to see a doctor in person but she is soliciting advice online.

“I used to go out but I stopped after the coronavirus pandemic broke out. Also, I need to do a lot of household chores as I asked my domestic helper not to come anymore. I don't get much time for rest or entertainment anymore,” Meherunnesa, a homemaker, living in Niketan.

Besides upending the daily lives and livelihoods of people across the globe, the coronavirus pandemic has left a lasting impact on their mental health, psychologists warn. It has led to an upturn in new patients while aggravating the complications of those who are already suffering from mental health issues.

According to an estimate by a research team at the University of Australia, there would have been 193 million cases of major depressive disorder worldwide if the pandemic had not happened. But now, the figure is 246 million cases, which is a 28 percent increase.

Anxiety disorders have jumped 26 percent during the pandemic, with around 374 million actual cases compared to the pre-pandemic estimate of 298 million.

More patients with a history of mental health issues are now seeking medical help, according to Prof Nilufer Akhter Jahan of the National Institute of Mental Health and Hospital.

“There's been a deterioration in the condition of those who had already been suffering from mental health problems and were on medication. They are taking longer to recover,” she said. She believes the pandemic has had negative repercussions for all patients.

“When I try to figure out their problems, I see that there’s nothing noteworthy. There aren't many cases of family problems or financial constraints. Even then, the patients are taking time to recover. In particular, the number of patients suffering from depression has gone up.”

Highlighting ‘stress’ as a major reason behind mental health issues, Prof Nilufer said people's worries have only increased due to COVID.

“Students are affected as schools and colleges are shut. For professionals, many of them had their earnings halved. Some of them lost their jobs and ended up coming to us. All these are the indirect consequences of the pandemic.”

Many of her patients are struggling with their mental health after recovering from COVID-19.

“People are relieved to a certain extent as the coronavirus infection rate, as well as the death rate, is trending down. We had a surge in the number of patients when the death toll began surging in Bangladesh due to the prevalence of the Delta variant.”

Educational institutions across Bangladesh were shut for more than a year following the outbreak of the pandemic. Schools and colleges only resumed in-person classes in September, that too on a limited scale. But many universities are yet to open their doors to students.

Consequently, students are increasingly seeking help for depression, anxiety and other mental illnesses, the psychiatrist said.

Most people are stressed out as they try to evade the fast-spreading pathogen. Mental stress shoots up when someone contracts the disease, believes Dr Mahmudur Rahman, president of Bangladesh Clinical Psychology Society.

Explaining the pandemic's mental health fallout, he said, “When people face uncertainty and anxiety, they suffer from mental problems. Many people have lost their livelihoods. It’s obvious that the more they struggle to make ends meet, the worse their mental health gets. And that is what has happened.”

In a bid to curb the spread of the virus, the government had to impose a series of lockdowns at various times. Also, many companies allowed their employees to work from home.

Dr Rahman believes this hampered the daily routine at home for many, and in turn, affected their mental health.

Children are going to bed at unusual hours and are also waking up late. Their mealtimes and study habits have been disrupted as a result. Students are now more susceptible to depression, according to Dr Rahman.

The number of people suffering from depression and anxiety doubled amid the pandemic, he said.

“Once they encounter a mental health problem, it changes their thought pattern and behaviour. Often, it becomes hard to overcome it without proper treatment.”

A woman shows photos of birds from a book to a toddler girl next to the lake of Suhrawardy Udyan in Dhaka on Wednesday, Aug 25, 2021. Residents of the capital are getting out for fresh air after the lifting of the coronavirus lockdown. Photo: Kazi Salahuddin Razu

HOW TO PROTECT MENTAL HEALTH

In Bangladesh, most people do not consider mental distress as an issue that warrants medical attention, while the fear of social stigma leaves many reluctant to seek treatment. That is why they suffer more in the long run, according to mental health expert Mahmudur Rahman.

Many people are unhappy with their lives at home as domestic squabbles, pent-up anger and fights are complicating relationships. It is also driving more people towards divorce and suicide, he said.

He stressed the need to identify the reasons behind mental distress at its outset in order to effectively address the issue. “A person with mental distress needs treatment. But most people never seek help as they think they’ll be called insane. People consider mental health problems as an isolated issue and fail to figure out its cause.”

Mahmudur also pointed out that the state has a responsibility to protect the mental health of the poor and vulnerable while highlighting the widening wealth disparity in the country. “The country is developing, but is it the same for the mental health of its people? Poor people are turning poorer while the rich are getting richer.”

“The earning disparity must be eliminated and the basic rights ensured for all citizens. Eliminating unemployment and ensuring a good life for people should be prioritised.”

To curb crimes, people must be engaged in constructive activities, according to him. That way, they will not be thinking of dying by suicide and the state must focus on this issue, the mental health expert said.

“People should have a happy life. We need separate programmes for different age groups. Anyone suffering from a mental illness must be treated quickly.”

In order to maintain their mental wellbeing, people should ponder on solutions rather than fixating on the problem. They should try to create a happy environment by listening to songs, watching movies, reading or gardening, he suggested.

Empathy, positive thoughts and a healthy attitude towards others are the keys to reducing stress and anxiety, he said.

“These, however, may not be effective in all cases. Then we have to see how complicated the problem is,” said Mahmudur Rahman.

The lack of timely intervention has led to the increase in mental health problems in Bangladesh, according to Prof Nilufer.

“Those who are not suffering from mental illness should take measures to improve their mental health. And those who are already suffering from it must get treatment.”

“But the condition of some patients worsened after receiving treatment. They need to be rehabilitated. They should engage in social work and economic endeavours.”

In some cases, children have a chance to inherit mental illnesses from their parents. It is imperative to keep them in a friendly environment, she said.

Emphasising a healthy lifestyle, the psychologist said a person’s daily routine should include at least 7-8 hours of sleep, 7-8 hours of work, rest, entertainment and social engagement.

“We encourage families to spend some time together every day. It will protect them from mental illness.”

[Written in English by Sabrina Karim Murshed and edited by Turaj Ahmad]