In the pandemic, anxiety is the new normal

The uncertainty, isolation and complete disruption of life as we knew it has unsurprisingly brought with it untold anxiety and sadness for almost everyone. BusinessLine spoke to psychiatrist Alok Sarin, a consultant psychiatrist with the Sitaram Bhartia Institute of Science and Research, New Delhi, about mental well-being in the midst of the coronavirus pandemic. Excerpts:

The fact that the situation is stressful is clear. But there is no one way that people will handle it. While what has become known as social distancing is required for slowing down the spread of the virus and is necessary for flattening the curve, social, or rather physical distancing is actually the exact antithesis of what is needed for dealing with mental health issues. And so, while we make sure that there is social distancing, we need to make sure we find ways to create social connectedness. This would be the most important way to deal with the current situation.

While being able to chat on video is very necessary for a certain segment of the population that has access to the internet, is involved in work-from-home and is technology-savvy, it is not necessarily true for a very, very large number of people. So, the way that the social determinants of mental health will play out is very different for different groups of people. We need to think not only of how the virus has an impact (on us), but also of how the intervention has an impact (on us) as well, because anxiety convinces us to think and act in ways that seem as if there is no alternative. Anxiety is its own slippery slope.

The boundaries between the earlier situation and the now become blurred. Look, for instance, at the person who has for all his life feared contamination and contagion and battled obsessive thoughts about them while still realising that they are irrational and has found them extremely difficult to control. Today, because of the virus pandemic that person with an obsessive disorder is suddenly being told that those fears are justified and that not only does he have to wash his hands, but so also the rest of the world. Having learnt in some way to deal with the symptoms and fear for a lifetime, this person finds a waking nightmare where he is mentally unwell in a world that has gone crazy. But, of course, for everybody today, the fault lines have deepened: personal, societal, and community-based. Vulnerabilities ― individual, economic, and communal ― have broadened and deepened, giving rise to anxiety. Anxieties tend to leech onto themselves. Economic anxiety, for example, will attach itself to other fears and dread and seek expression finding its own pathway.

If one were to pick up a common thread, it would be uncertainty; the acceptance of vulnerability and fragility, the understanding that it can happen to me. Everyone who has had a scratchy throat on waking up and found it gone by mid-day, now panics and wonders whether this is the dreaded virus, and if so, will I be quarantined, will I have to be admitted to hospital, what would it mean for my family... those fears are very real and are with everybody, the privileged and the non-privileged. The virus has actually made anxiety the new normal. Being able to talk about it without being ashamed, embarrassed or guilty is essential, both as an individual and as a society. In all of this, one impact of anxiety is the stigmatisation of those who are quarantined or of healthcare workers or (those) putting up posters on peoples’ doors ― (this) is where we have lost the plot.

There is obviously no simple or single answer to this question. It will be different depending on each individual and each scenario that we are talking about. The fact that we need to talk to each other, find a routine, find distractions, get involved in work and definitely exercise, is common sense. These are simple and obvious things to do but that doesn’t mean that these are any less important. But remember that the anxiety for someone who is from the middle class and working from home at this time and who is worrying about milk and vegetables will worry about how to obtain these rather than someone from a less privileged class who will worry about how to pay for these things. Obviously, there can be no formulaic answer, but social connectedness has to keep in mind concepts of social equity. What extreme anxiety in such situations does is to make us think small, within a limited domain: my family, my home, my work, my financial resources... while actually what is needed is larger thinking. Anxiety prevents us from thinking large and extending sensitivity and compassion to others. Those are the things I believe are needed at this time.

Of course, both natural and man-made disasters have many parallels. This is not the first disaster to happen to the world and it won’t be the last either. The way technology has now become so widely used, both the news and the impact will have wider ramifications. That, and the fact that travel is much more and there is so much more of an interchange of people mean that there is a greater spread of the virus. At the same time, it has also created many truths and turned many an argument on its head. Traditionally, we’ve always thought of illness as a vulnerability of the socially-disadvantaged who would be easier prey to diseases. But here it turns out that those who are travelling abroad are the ones who have fallen prey much faster. Every disaster gives us both the scope for new learnings and in many ways repeating the same mistakes. But we are a global village.

There’s non-stop barrage of news at the moment and definitely getting a stimulus overload is not helpful. Checking the news hour after hour will only fuel the stress. Instead, recognising the anxiety and trying to curtail it, finding time to switch off, making sure there’s leisure time, are ways to navigate this period. At the same time, thinking larger, beyond yourself and the immediate community, is important. There are organisations working with migrant labour, to help provide personal protective equipment to healthcare workers, those who are feeding people in need, or assisting vulnerable groups... all of those are there and it is our responsibility to be participative in whatever way we can, even if we are not able to go there. This is the kind of social connectedness that is also necessary — my contributing to the society I live in is not doing anyone else a favour because I am doing good to myself. And altruism is a great contributor to feeling good.

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