Fear, anxiety and stress: Covid-19 wreaks havoc on mental health

Farhad Hossain (not his real name) went to the National Institute of Mental Health and Hospital after suffering a severe panic attack. For the last 20 days, he has been unable to rid himself of the fear of death as he thinks he will contract the coronavirus. His condition worsened so much over the last week that he could not sleep at night. 

"I am trying hard to get rid of thanatophobia (death anxiety), but I cannot," said the 31-year-old Farhad who lives alone in Savar, and works as a medical assistant for a private clinic and diagnostic centre. 

He said the fear of death is chasing him all the time. He feels like he will contract coronavirus at any moment, everyone in his family will then also be infected and ultimately all of them will die.

"Sometimes, I feel a pain in the chest," said Farhad. 

The fear mounts when he thinks about his past. He donated one of his kidneys to his mother some two years back. 

Doctors at the National Institute of Mental Health and Hospital counselled him for 25 minutes. They also gave him some medicine, and asked him to come to the hospital again if his condition deteriorates.  

Like Farhad, many people from all walks of life are experiencing stress and panic attacks in the midst of the pandemic. Some are going to hospital, but many are not. Doctors are advising people not to think too much about the negative sides of the pandemic all the time. 

Dr Golam Mostofa, assistant registrar at the National Institute of Mental Health and Hospital, told The Business Standard that 200 patients come to the outpatient section on average every day. 

"Of them, 20 are coming after suffering a panic attack due to the pandemic," he said, adding that the number is increasing gradually.

Outpatient section doctors said patients fear death and contracting coronavirus, and are also worried about their family members. 

"Suddenly, they become restless, have breathing problems and feel chest pain," said Dr Mostofa. "These patients are failing to concentrate on their work. As a result, they are suffering from depression."

For people who have been suffering from depression for a long time, their anxiety has increased. Also, some have begun to suffer from anxiety, depression, and fear of death for the first time after the outbreak of the virus. Many are also worried about the future. 

What doctors are doing
 
Doctors are providing counselling as well as medicine to reduce anxiety of patients. They are also recommending not using social media like Facebook for as long as the pandemic continues. 

According to physicians, people should avoid watching negative news – such as deaths of people, bed crisis in hospital, and other coronavirus reports – and should instead watch reports on how to take precautionary measures during the pandemic.    

Dr Bidhan Ranjan Roy Podder, director of the National Institute of Mental Health and Hospital, told The Business Standard he believes that only a few people are coming to hospital for treatment. 

"Our assumption is that many people are suffering from mental illness because of the pandemic, but most of them are not going to hospital," he said.

"More than 50 percent of people in our community are suffering from stress due to the pandemic," said Dr Bidhan. 

People who think they cannot take it anymore and are getting impatient should seek immediate treatment, said doctors. 

This is because some people who are under severe stress will permanently suffer from the stress if they do not receive treatment, they said.  

They also said the media should publish positive reports on how people are coping after contracting the virus and this will give everyone some courage. 

Professor Dr Mahjabeen Haque, chairperson of the department of educational and counselling psychology at the University of Dhaka, said that students of the department and trained professionals have provided free counselling to more than 1,000 people from different age groups in the last three months over phone and social media.

She said there are many people who are suffering from depression, obsessive compulsive disorder, and pre-marital and marital relationship problems. "These problems intensified following the pandemic." 

Her department received around 1,000 phone calls in the last three months, and some 150 of those were exclusively about coronavirus-related anxiety. 

"Because of restrictions on going out, people are now staying home for 24 hours. As a result, the situation worsened," said Dr Mahjabeen. 

She believes that many people who are suffering from severe mental health problems are not going to hospital or seeking counselling as they put less emphasis on it, thinking they will recover naturally.  

Also, people sometimes suffer from mental health problems, but other members of the family do not realise that. 

"I have seen several patients who were hospitalised with coronavirus symptoms, but their test reports were negative. They are actually suffering from anxiety, which is psychological," said Dr Mahjabeen. 

"They will suffer for long if they do not seek treatment. They will have to take proper treatment as soon as possible," she added. 

Moner Bondhu, a platform providing mental health care and well-being services, has received more than 2,500 phone calls since March 27. Its CEO Tawhida Shiropa said most of the calls were from college and university students. 

"In the first month of the shutdown, students were somewhat fine. But as time went by, they became bored and were experiencing monotony," she said, adding that the situation could have serious impacts on pupils.

Long-term mental health issues ahead 

No comprehensive study has been done on the impact of Covid-19 on people's mental health in Bangladesh. Experts in this field said that many people become mentally ill during disasters and thereafter. They believe many will suffer from a variety of problems, including sleeplessness and depression, for a long time in Bangladesh.  

Dr Waziul Alam Chowdhury, president of Bangladesh Association of Psychiatrists, told The Business Standard that the Vietnam War ended 50 years back but nearly three lakh American war veterans are still suffering from post-traumatic stress disorder. 

It is natural that people will fear Covid-19 as many are getting infected and dying every day, he said.     

The doctor said that people who are not suffering from serious mental illness are at least experiencing "negative wellbeing". 

"Around 99 percent of people are experiencing it. Negative wellbeing means we have lost good feelings about everything, and nobody is feeling well," said Dr Waziul.

He said children are experiencing restlessness as schools are closed.

According to Dr Waziul, the ultimate result will be that a significant number of people will suffer from post-traumatic stress disorder in the whole world as nobody knows how long the pandemic will continue.      

He said that 11 psychiatrists are working in different hospitals in Dhaka designated for Covid-19 patients. These psychiatrists are regularly providing counselling to health workers, including doctors, and relatives of patients who are going through stress.

But the number of psychiatrists is insufficient, said mental health experts. They said at least 10,000 psychiatrists are needed now though the country has only around 250. 

"Not all districts have psychiatrists. We are trying to take initiatives to train junior doctors from those districts," said Dr Waziul.  

Habibur Rahman, line director of the Non-Communicable Disease Control under the Directorate General of Health Services, and head of the directorate's committee on Covid-19-related mental health, told The Business Standard that they want to boost mental strength of health workers treating coronavirus patients. 

"The committee will draw up guidelines and manuals to create awareness among the patients and their relatives through counselling. It will work to support those who have lost jobs and are suffering from stress. The children who have long been at home will be provided support too," he said.    

Health minister blames it on TV

Health Minister Zahid Maleque told The Business Standard he believes that the number of people with mental illness is increasing in the country due to the pandemic. 

He said television news is playing a role in intensifying such problems. 

"People are going out less now. They are staying home most of the time, and what they do is watch television. When channels report deaths, people become scared," he said.  

Zahid said negative news creates a negative impact on the audience. "For this reason, more people are suffering from mental problems." 

He believes that television channels should not report Covid-19 deaths and death figures all the time. 

"Do channels always report on people dying from heart attack, kidney failure, cancer or stroke? If not, then why are they doing it in case of Covid-19?"