COVID-19 and Mental Health

COVID-19 and Mental Health
Fatemeh Haghaniat | Mahla Mohamadnia

The COVID-19 has affected our mental health in many aspect and making many people feel lonely, depressed, anxious and even distressed. More than 210 million people have been infected since the eleventh of March, 2020 when the World Health Organization declared COVID-19 global pandemic. Investigation has shown that COVID-19 should not probably be considered just as a respiratory disease because it affects brain tissue and arteries and it has serious impact on mental health. This issue will be discussed in one of the specialized panels of the International Conference on Education and Interventions Social Work at the time of COVID-19 Pandemic. For this reason, we have talked to mental health professionals about the impact of COVID-19 and its consequences on the mental health of the general public, as well as people with psychiatric disorders.

pandemic crisis and public mental health
The Statistics show a significant prevalence of psychiatric disorders before the COVID-19 in our country, so that one in four Iranians has experienced some level of psychiatric disorders during their lifetime. Mrs. Barkhordari, the headmaster of social worker at Razi Psychiatric Hospital, considered social crises as one of the causes of psychiatric disorders said: « When human encounter a new and unpredictable event such as COVID-19, they will experience a wide range of disorders due to extreme anxiety and fear of death. »

The COVID-19 has serious repercussion on dimensions of mental health. Dr. Mihan, a psychiatrist, said about this: « Consequences of COVID-19 Pandemic on mental health, like the anxiety of being infected, quarantined and isolated, the traumatic experiences of losing some one in families are very conspicuous today. The current prevalence of COVID-19 has led to social fears that exacerbate disorders such as depression, anxiety, phobia, panic attacks, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, suicide, alcohol and drug usage. »

In reply to the question of which groups have the greatest psychological repercussions of COVID-19, she added: « While these worries and stresses affect the entire population, exceptional vulnerable groups, COVID-19 patients and their families, health care providers, people with psychiatric disorders or underlying physical illnesses, the elderly, people detained or living in long-term care centers, informal or daily rate laborers, immigrants and refugees, women and children who are vulnerable to abuse or violence need psychosocial attention and support. »
Coping strategies to maintain physical health or threaten mental health?

The mechanism by which the COVID-19 affects people’s mental health can be examined from several dimensions. “Confusion over hearing contradictory news and information about COVID-19, lifestyle changes, reduced individual-family and social interactions, job loss and consequent economic hardship, hearing the news of death, and the death of friends and loved ones and not going through the stages of mourning that evoke the image and expectation of death in people’s minds are all among the factors that undermine people’s mental health.” Ms. Barkhodari said.

Strategies to deal with this pandemic, are mainly based on social distancing and lockdown, have also had a serious impact on aggravating psychological consequences. Mrs. Zabihi, an expert of psychiatric social worker, said: « The strategies that used to deal with COVID-19 have played significant role in demonstration of psychological problems. One of these strategies is social distancing and quarantine, which has left negative psychological consequences in Iranian society. minimize communication and family interactions have led to limited social networking.»

COVID-19 and people with severe mental disorders
Mental health experts considered the effect of COVID-19 on people with psychiatric disorders as an important factor that needs attention of planners and policy makers. People with psychiatric disorders are the most vulnerable groups in society who are more likely to be deprived of their basic rights in pandemic. Mrs. Zabihi pointed out that: «In general, one of the problems of people with psychiatric disorders is lack of access to appropriate treatment in exact time, which exert an influence on relapse of the disease and exacerbation of symptoms in subsequent episodes. With occurring COVID-19, most of the hospital’s capacity and treatment centers has been dedicated to treatment of COVID-19 and even psychiatric hospitals have been forced to reduce their admission capacity due to patient safety. In these circumstances, the access of these people to treatment has become much more difficult.»

On the other hand, Dr. Mihan considered that these people have higher chance of getting COVID-19 and said: « People with intensive psychiatric illnesses such as schizophrenia, bipolar disorder, and major depressive disorder are more susceptible to COVID-19 and death. Fear, weak coping mechanisms, feelings of insecurity and uncertainty in infectious disease pandemic are stronger in these people. »

Mental health in people with COVID-19
Dr. Mihan pointed out the impact of disease on temperament of people who suffered from COVID-19 during these two years and added: «Anxiety and depression are significantly higher in patients with COVID-19 than in the general population. These people are more impressed by psychological effects and need additional support and psychological care. In patients with infection have fear of severe consequences of the disease, fear of transmission to others, isolation, loss of trust in health services and fear of death. They may experience feelings of loneliness, denial, anxiety, depression, insomnia, and hopelessness that reduce adherence to treatment. »

In the end, Dr. Mihan explained ways to prevent and reduce mental problems that caused by COVID-19. Conventional approaches to mental health services that rely on face-to-face therapy are problematic in context of COVID-19 and not completed for reduction of pandemic needs. But proper education about the disease and preventive measures, giving right news and no contradictions in media, education and warnings about psychiatric consequences of pandemic, teaching how to access and facilitate mental health services can reduce fears and complications of pandemic.

Active screening of high-risk individuals for COVID-19 psychiatric complications is required by telephone or online. Empathy and attention to people’s concerns, increasing the sense of care and strengthening coping mechanisms are the main dimensions of mental health care. simple but helpful guidelines such as maintaining well sleep, proper nutrition, humor, music, and regular exercise should be encouraged. High-risk groups, especially patients with coronary artery disease, bereaved families, medical staff, services such as individual or group psychotherapy, and regular follow-up are recommended.