There has already been much research and discussion related to the psychological effects of the pandemic and I don’t wish to add to the growing burden of statistics. In lay language, the ever-needed awareness related to mental health, the importance of social connectedness, the need for self-care and the traditional neglect of public health have been uncovered by the Covid-19 outbreak. I humbly want to point out one of the most prevalent and harmful misconceptions among people.
Staying ‘psychologically healthy’ cannot be equated either with ‘absence of psychiatric disorders’ or ‘a state of perpetual happiness’. For every person suffering from a diagnosed mental health condition, be it depression, anxiety disorder, schizophrenia, acute psychosis, dementia, autism spectrum disorder, post-traumatic stress disorder, etc., there are thousands more who might not tick the cut-off standards for any diagnostic category, but are under immense stress, tension, facing a low mood, or afflicted by guilt or sleep disturbances, which affect their quality of life in personal and professional spheres.
Let’s take the example of diabetes, a common chronic medical condition. If we say that someone can be diagnosed with diabetes only if their fasting blood sugar crosses a particular value, there might be many with high blood sugar levels that have not yet crossed the ‘prescribed’ threshold. They are considered to be at-risk for diabetes, technically known as ‘impaired glucose tolerance’. Similarly, a mere absence of a diagnosable mental disorder does not confer you good mental health.
On another note, many of my clients and friends ask me if they need to avail counselling to stay happy. Being happy, sad, angry or frustrated, all are emotions that we face in daily life. Psychological well-being depends on whether we are able to balance them adequately and whether they are affecting our daily roles. We all feel distressed after a stressful day at office, we grieve when we lose our loved ones, we feel angry when our expectations are not met, we are heartbroken when our dreams falter; but none of these are unhealthy.
These are normal emotional reactions that are expected out of any individual. However, if after a traumatic incident, someone feels ‘so deeply sad’ that he/she continues to avoid work or home for days, starts losing weight due to loss of appetite, doesn’t sleep for weeks altogether or contemplates dying, that’s the time when help needs to be sought. Basically, without going into the details of any disease, staying mentally fit is about knowing, balancing and appreciating your emotions with adequate self-care and empathy for others.
Idealistic as it might sound, it also involves knowing what is good for your mental health. It is high time we start considering the need to stay psychologically healthy as an integral part of public health. For the real change: Like every year, this year too the World Health Organization (WHO) commemorates October 10 as World Mental Health Day. Considering the devastating and unprecedented circumstances of the pandemic, this day might have a special relevance this year. As a mental health professional, while I respect this, I am also quite sceptical about the permanence of this relevance in the aftermath of the pandemic.
The viral outbreak will eventually cease, but the lessons learnt in terms of mental health behaviour need to live beyond the outbreak. Human lives have been restructured in more ways than one since the beginning of this year. Days have become digitised, socialisation has become virtual, ‘masking’ has become the new norm and hand sanitisers the new essential commodities. Were we really prepared for all these changes? It’s hard to tell; however, how we decide to imbibe them in the upcoming days will dictate our public health behaviour, which includes our psychological well-being.
Covid-19 has become a household term now and a quick glance at the surroundings reveals that the public fear towards the infection has faded, giving way to callousness and carelessness about oneself and others. While it is indeed necessary to maintain a fine line between complacency and paranoia, it is important to understand that mental well-being determines the success of any public health intervention. In that way, the numerous rich discourses, the scientifically robust articles and the ongoing talk about mental health might not move beyond preaching to practicing.
Like the role of diet, exercise, sleep, smoking habits and other lifestyle changes, mental health also begins at home. Removal of the stigma behind mental illness, increased help-seeking, acknowledging the role of mental health professionals, fighting misinformation and disinformation, and cessation of fantasised and opinionated portrayal of psychological problems in popular media might go a long way to preserve its importance beyond the limits of a particular day.
This is a collective responsibility at all levels and this can foster humane understanding, empathy and hope. The WHO’s theme for this year’s World Mental Health Day as “increased investment in mental health”. Besides the administrative understanding of the term, an emotional and social investment is the ultimate necessity. Over-emphasising or alarmist approaches will not help. As we traverse the difficult path of the pandemic, taking care of our mental peace is needed for our physical safety, immunity and general public health measures. Only once we understand this can discourse related to mental health transcend the pandemic and prepare us better for such crises in the future.
Debanjan Banerjee
Psychiatrist, NIMHANS, Bengaluru
(dr.djan88@gmail.com)