Mental Health in the Time Of Corona

In the current situations of this pandemic, the word that is looming in the minds of every individual is “UNCERTAINTY”.  Understandably many of us are anxious about the global situation, the challenge remains: how we could navigate through our lives without significant compromise in social and occupational functioning.

How to protect your Mental Health during a Quarantine ?

Mental Health issues can arrive at any phase of our lives and the current environment poses a greater risk at triggering it. This instability is one of the main sources for the perceived stress, anxiety and other forms of psychological disturbances in today’s world. It might be a relapse of an existing mental illness or might be the first time when you are not feeling well psychologically. It depends primarily on our anticipation of the post-pandemic society, of what exactly it might have in store for us. It could also lead to the comparison of the current times with the beautiful days of the past. In a nutshell, we can experience a wide range of emotions thus leading to a feeling of helplessness and unanswerable “uncertainty”.

How this pandemic is triggering OCD or Obsessive Compulsive Disorder?

In recent studies by the World Health Organisation (WHO), experts have issued a warning that this current situation can lead to anxiety and especially, OCD. This disorder affects our social functioning and contains two parts primarily. One, the obsession – it includes those repetitive intrusive irrational thoughts which we want to get rid off but are not able to. The contamination of germs is one of the most common obsessive thoughts. Two, the behaviour -- these obsessive thoughts can lead to some form of ritualistic behaviour. Here, for example, washing hands repeatedly, touching objects symmetrically.

Now in the coronavirus pandemic, it is crucial to understand the boundary between rational, understandable preoccupation for prevention and irrational intense preoccupation, which is beyond the range of an understandable reaction. This habit of repeatedly washing hands can become 50-60 times a day and here it becomes pathological. It brings us to a halt, slows our performances in both personal and professional fields. So the anxiety arising from the coronavirus situation can precipitate a relapse of OCD or just aid to the vulnerability of a person to develop it for the first time.

 How do we manage our anxiety level?

The first step is to identify if something feels ‘wrong’. Sleep deprivation, being in a constant state of anxiety, disturbances in your daily performance levels are some of the common features.  There are several approaches but the first approach recommended by Dr Arghya Sarkhel, Consultant Psychiatrist from Living Mind is the simplest one – sharing your thoughts with friends and family even before we think about taking professional help. To talk to someone whom you trust is a life-changing step. Confiding in someone would inevitably release some stress from our shoulders. If someone is already having a pre-existing history, then they could opt for some top-up sessions with their therapists, counsellors, psychologists or psychotherapists.

In cognitive-behavioural theory, one is taught to identify our catastrophic thinking and how to challenge those thoughts by keeping a “THOUGHT DIARY”, or using another method called the “flashcard technique”, where one writes down some of the facts that will challenge the catastrophic thoughts. Flashing those written cards repeatedly to ourselves would help reduce the intensity and frequency of our ‘thinking errors’ and of course thus leading to improve our functioning and quality of life.

One area of the front of the brain known as the orbitofrontal cortex is affected significantly in OCD and medications play a vital role along with talking therapy in restoring the function of this part of the cortex. One shouldn’t hesitate to talk to the GPs (if one is in the UK) or psychiatrists in NHS or private psychiatrist. It is important to find out if there is a necessity to simply tweak the medications. Many of us are quite anxious to go out of our homes to seek professional help, so fortunately some GPs and family physicians are providing remote consultations i.e. online consultations. Dr Sarkhel requests each and everyone to not ignore any symptoms of mental illness. Just like the occurrence of sudden cough and cold could be symptoms of COVID-19, similarly, the occurrence of unusual and different behaviours and thoughts should be taken seriously too. Help is available for all.

How should one deal with this intense and constant FEAR?

Fear is a natural response when our mind perceives that we are threatened, it might be internal or external. The constant flashing numbers of COVID deaths on our televisions screens, mobile phones, etc, creates this fear of losing our loved ones, especially, our elder relatives. It is important to recognise if our fear is crossing the level that is normally expected. If we are not performing well at work, if we have slowed down in our lives and if we start avoiding things are the major tell-tale signs.

In this context, Dr Sarkhel at Living Mind advises on an integrated approach to help everyone struggling in the current situations—MINDFULNESS  is one of the key aspects Dr Sarkhel explains.

It is an extremely powerful and yet under-used method, whose concept initially came from Zen of Buddhism. The idea that encompasses mindfulness is that it gives us the skill to embrace both good and bad emotions. The fear we feel is an emotional response, whereas doing some regular mindfulness exercise, will teach us the skill to accept our feelings just the way it is, and not have the impulse to react to it. Mindfulness often uses simple breathing exercise, that facilitates the recognition of physical and emotional experiences in detail. It is well researched now by neuroimaging studies that mindfulness improves the functioning of our frontal lobe of the brain which deals with many higher cognitive functions.

There are various books and online exercise sessions where one could find it. Also one could try the mindfulness audio sessions created by Living Mind’s own Dr Arghya Sarkhel, available in Spotify, Google Play, Youtube and many other digital platforms. The album “MINDFUL LIVING” contains 10 separate tracks for different conditions, one of them being ‘managing anxiety’. These easy-to-do guided meditations are amazing ways to relax and take care of ourselves.

How to approach mental illness without taking medications?

Living Mind believes in the integrated approach to helping mental issues. Dr Arghya Sarkhel is one of the few psychiatrists who are advocating the method of rTMS. It is known now by extensive research that brain circuits have a huge role to play as it is their functions, the increase or decrease of which, results in depression, anxiety, OCD, etc.  ‘Medication’ is involved in modulating the chemical imbalance of the brain and ‘Talking Therapy’ is involved in modifying our thoughts and behaviours. Now rTMS is involved in the electrical modulation of our brain circuits.

 In our brain, the nerves are connected through electric energy, which is seen to be slightly loosely connected in the frontal lobe in patients of depression. In the TRANSCRANIAL MAGNETIC STIMULATION, a magnetic coil sits on the frontal part of the head and emits magnetic pulses and this is what distinguishes it from ECT (ELECTROCONVULSIVE THERAPY), where electricity is directly given and produces side-effects such as headaches and memory loss. But in rTMS, all these side-effects are absent as it is a much-focused treatment using a fundamental law of physics that talks about the conversion of magnetic energy into electrical energy. Repeated sessions of rTMS help to re-enforce and strengthen that loose circuit. Patients can relax during the treatment by reading a book, watching a video, talk, etc. People who do not want to take the drug route to fight depression, rTMS is the true saviour. Apart from Depression, Anxiety and OCD are also treated by this method. It is also seen that when a patient is under medication or talking therapy, rTMS can improve the outcome of pharmacological and psychological interventions. Patients get more involved in therapy, their information processing skill gets better with rTMS.

Finally, last but not the least, as Dr Sarkhel explains, we as a global society need to realise that even in this difficult situation of COVID-19, we have a CHOICE. It is extremely empowering to think that we are in control, we have the choice to decide that if we want o feel miserable and keep worrying always or we can adapt our lives around it by embracing these difficult emotions. As soon as we realise this power of choice, the world with its million opportunities opens up. We become aware and get ready to adapt to this new world to this “NEW NORMAL” and make the best use of it. 

Living Mind

www.livingmind.co.uk

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