Managing Mental health in Lockdown!

Whenever a living organism is faced with a new situation, the brain and body gear up to adapt to this novelty which is understood clinically as a stress response. There are physiological changes causing the release of chemicals which make us physically and psychologically feel or respond. If the change is considered positive, it feels pleasant and if it is perceived negatively, it causes tension and anxiety. Physiologically, even pleasant feelings cause a build up of stress or strain which majority of us we feel in our skeletal muscles and smooth muscles of the stomach, intestine,, ureters etc. leading to stiffness in muscles, fatigue, restlessness, stomach issues like gas/indigestion/hyperacidity/increased frequency of urination etc. That’s the reason why we feel similar physiological sensation whether we are excited or nervous and if the stakes are high participants end up crying after a intensely fought competition whether they win or lose!

Therefore, the current grave situation arising as a result of COVID-19 pandemic and the consequent lockdown is likely to affect the majority of us both physically and mentally, during and after the control of the situation.

Following are few tips for general health and wellbeing of all people:

1. Accept the change, fight creates a stressful situation in our nervous system putting us physically and mentally in a flight or fight mode causing anger, frustration and anxiety.
2. Establish a routine, doing something with a regularity makes mind adapt easily and gradually the change becomes a new state of normalcy.
3. Exercise helps physically as well as mentally by releasing endorphins and engaging us in a useful activity. Incorporate exercise in your routine that you can follow through even after the lockdown gets over.
4. Healthy home-made diet with incorporation of foods rich in Vitamin B12, Vitamin C, antioxidants and omega 3 fatty acids has always been encouraged to reduce the impact of stress hormones. Now we have the option to cook it up ourselves. Again, use the time to create a menu which can be incorporated easily in all situations.
5. Be aware of the stress in the system, denying it does not help us deal with it. Whether it is a conflict of opinions with in laws or grudges against the spouse, it is always a good idea to address the issue rather than hide in office to avoid addressing the issue.

People with mental health issues need to be as careful about the building of tension in times of uncertainty because all health conditions tend to worsen with increase in levels of stress chemicals.

1. Continue medicines that have been prescribed for regular use and do not alter the time of medicines. While adjusting to a personal or social change, regular medicines should not be stopped unless advised by your doctor.
2. A proper sleep wake routine is very important in management of mood disorders. Therefore don’t go on binge watching at night because you don’t need to wake up in morning to go to office.
3. In case of any escalation of problem, do get in touch with your doctor. Even though it is normal to get anxious, lonely or sad, there is a way to handle it and your doctor can help you better in these times of vulnerability.
4. In case medicines are not available, avoid stopping them abruptly. Your doctor will be able to guide you.
5. Psychotic conditions as well as other mood issues tend to worsen if family members/care givers become over involved or start nagging the patient over every little thing. In psychiatry, its called high expressed emotions and with stress and frustration rising in lockdown period, caregivers are likely to become more critical of a patients not following a routine or not taking a bath. Be patient and discuss with the treating psychiatrist of issues become difficult to control.
6. Drug and Alcohol Withdrawals may get precipitated due to non-availability of drugs in situations of lockdown and may be confused with new physical or psychiatric symptoms. If you have been using alcohol or any other drugs, do inform the health care practitioner you have been seeking help from. Severe alcohol/drug withdrawal may require emergency management or hospital admission.
7. Avoid excessive smoking or drinking because there is more leisure time, it can worsen anxiety or mood symptoms. Use leisure time for creative activities or learning new skills. Those suffering from work place exhaustion or burn out can use this time to set priorities straight instead of worrying about the very job that has caused job related psychological issues.
8. Don’t use lockdown as an excuse to stop medicines against advise. Most of the patients once stabilized want to withdraw medicines as soon as possible and end up having relapse or recurrence of symptoms. If the doctor has asked to continue, please continue and if withdrawal was planned during this period, it may be still be done a little while later.
9. Last but not the least, mental health conditions are not just similar to physical health conditions, they may also worsen physical health and lower immunity if not managed properly. Therefore, do not ignore your and your near and dear one’s psychological state.

Tele medicine services are being widely available for online consultation.

Stay home, Stay Safe!