These are difficult times, and the world around us seems headed towards a dystopia of sorts. As discussed in our earlier interview with Dr Kalyanasundaram, Bengaluru-based Consultant Psychiatrist and an Honorary Adviser to the Bengaluru Branch of Richmond Fellowship Society, the risk of mental health issues has increased sharply.

Dr Kalyanasundaram S

Indeed, we are already beginning to see signs among people caught in the situations created by the outbreak of coronavirus – corporate professionals struggling to get all work done from home, parents trying to keep their kids occupied and entertained all day, caregivers trying to explain the situation to the most vulnerable senior citizens and keep them safe… and of course, not to forget the many many key workers – doctors, nurses, paramedical staff whose life has become one unending work day!

How can people cope with these peculiar circumstances that have become the order of the day? More insight from Dr Kalyanasundaram:

There are people who are saying ‘I am very stressed now.’, ‘Markets have crashed…’, ‘Work from home is happening with little clarity on things’, ‘My children are at home and they and I don’t know what to do.’, and so on. How does one cope with such situations?

Dr KS: It is but natural for most to have such thoughts. Let me though first talk about how the current pandemic is having an impact on several areas.

For many people, home has become the work space. Having to deal with stress related to work and home at the same time can add up to a disproportionate level of distress which many may find tough to cope with.

For example, those working from home may not be able to do so without interference / disturbance from people at home: children may be running around, breaking things, not knowing how to channelize their energy because they are not allowed to go out, and not knowing what to do at home. Parents may have the TV on, or may want to talk about some issue while the person is trying to work. In such a scenario, there is bound to be frequent clash of wills.

The mother (especially a career woman) has multiple roles now – when she was at office, she could do office related work without any interference from family members, and with minimal thought of work to be done at home / for family. Now this (WFH) can become doubly troubling and stressful for the mother, and single parents.

Do you think being together with family members for extended periods can cause stress?

Dr KS: Families that have never been in the same premises during the day time are now all cooped up on the same premises/space. This enforced state can and does result in each person entering into the other’s psychological and mental space very frequently.

In such scenarios, people tend to enter into spaces where they had no business to, and they never did, because they were never home to do that in the first place.

For example, some men may tend to interfere (find fault with the way things are being done at home),  where earlier, they had very little idea about what was happening when they went out to work; their major expectation would be that food and other comforts be made available to them when they returned home at the end of the day.

Let alone the children, elderly people are not allowed to / do not want to go out for a walk – something they used to do earlier; their social circles are starting to shrink, and suddenly, they do not have as many opportunities to ventilate – something they would do when they met their friends in a park, or while walking, for example, or chat about things of their choice – be it politics, weather, family… The physical space now available to them is also constrained. It is almost like taking away one’s freedom.

Everybody is getting quarantined at home fearing infection – this is something they are not used to. It brings in its own problems and stresses.

Having said that, now is the time when family members are starting to ‘discover’ some aspects of the others that they had not seen before, or had forgotten, thanks to the daily grind of life. While there are bound to be some ‘negative’ qualities that are immediately visible, this enforced staying together is also an opportunity to recognise the good in people.

One can find people with resilience, people with tenacity, or those with compassion. People with different view points and outlooks are starting to make a conscious effort to bond and overlook some quirks in others – be it adults or children or seniors. Hopefully, one of the positive impacts, if one can call it that, of the virus could be the family bonding as a unit and learning to appreciate each other.

How does one deal with this kind of stress, especially when one has to also work from home?

Dr KS: I recommend that, if one has to work from home, one finds a designated space to work from, and has a clear understanding with family members that he/she would like to work for some period without any interference or disturbance. Each person at home should in turn understand that the other person’s work space should not be interfered with, since, even though a person is being asked to work from home, he/she has to put in the requisite 7-9 work hours. This is all the more necessary when people do not have the luxury of a separate room or work space at home.

Another thing to do while working from home is to take some time off (maybe 15 -20 minutes every few hours) from work, and spend quality time with children / senior citizens so they feel wanted and cared for. This can improve the chances of the latter not interfering with one’s work schedule or disturbing them while they work from home.

People must have a clear understanding with the family that when one parent (say mother) is working, the other parent (father) takes care of household tasks and children and vice versa. It is not the mother’s responsibility alone to take care of the children – it is everyone’s responsibility.

Children must be given specific tasks that they enjoy doing / can do, rather than merely telling them to ‘Go, do something useful.’ Let them colour, make paper aeroplanes, help in the kitchen, paint and do anything at all that will keep them occupied and challenging. During such time, the parents too should keep in mind that if the children mess the place, it doesn’t matter much. Instead, get them to clean or, if possible, join them and make cleaning a fun activity.

What about the people in the medical profession? Most of them have not been given any leave, and they cannot work from home either…

Dr KS: We (doctors, nurses, and others in this profession) are a very different kind of a breed. No matter what happens, where, we go to work. And we are exposed and vulnerable.  We however have a responsibility towards our patients and those who work with us, be it the nurses, admin staff, fellow doctors or other support staff. We should ensure that we do not pass on any infection to them, and for that matter we should do our best to ensure that we do not get any infection in the first place.

Every doctor should take responsibility for such a situation today in the best manner possible. Doctors today are in a position where they have to sacrifice their personal interest for the benefit of the larger cause.

How does the medical staff deal with stress at work?

Dr KS: Being a doctor is in itself is a stressful job at times! Each of us will have to find some coping mechanisms ourselves.

If someone has a personal problem, I am sure they will talk to a colleague, and, if necessary, to a mental health colleague. Doctors are generally supportive of one another whenever required. Under these circumstances, I am sure they will go an extra mile to help / support their colleagues in distress.  I think these things are very essential. But, having said that, unfortunately, many doctors, ignore this dictum “Physician heal thyself.“

Any suggestions on how we can deal with the current crisis?

Dr KS: I think we should not over react – not go into a panic mode. For example, almost everyone is walking around with a mask – this is needless (unless the person has an infection). Try not to spread panic, use the media judiciously. Watch out for fake news and messages.

Looking at the countries that have been infected (through newspaper and media), India has done a great job of protecting its borders and taking care of its citizens. Numbers are considerably small as compared to the population of the country.

The spread of the disease is happening largely because some people are being irresponsible and in the process infecting many others they come in contact with. This is a time, an occasion, where our mettle is getting tested.  Each person must take responsibility for oneself, one’s family and the community at large.

Also read: COVID-19: “Community spread could lead to proportional rise in mental illness cases”

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