#IsolationStruggles

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Mental Health: Pandemic Time - Part 1

These past three years have been unlike any others in recent history. The world has grappled with the overwhelming impact of the COVID-19 pandemic. As a doctor, I've witnessed firsthand the toll it has taken on the mental health of countless individuals. The isolation, uncertainty, anxiety, and depression that many have faced during this time are topics that demand our attention and support.

As of this moment, 6,926,045 people died because of COVID, and the number keeps on increasing. The sudden emergence of this virus shocked the world and paralyzed life as we know it. Everything changed, but in the beginning, it was hard to cope due to the uncomfortable situation I was put in. Everyone I knew expected answers from me regarding the virus, but I didn't know more than what they did. The international medical society didn't know more. Every effort was being put into understanding the virus and aiming to build a vaccine to protect the whole global population.

The chaos that spread suddenly left many people in a tremendous amount of mental distress. The whole world population had to adapt to a new way of living.

Mental Health Deterioration:

The isolation brought about by lockdowns and social distancing measures has left many individuals feeling profoundly lonely. The isolation and prolonged periods of confinement that many of us have experienced during the pandemic are in stark contrast to the natural human state. Humans are inherently active creatures and our physiology is designed for movement.

For centuries, our ancestors were hunters, gatherers, and explorers. Our bodies are programmed to expend energy, burn calories, and engage in physical activity. A sedentary lifestyle due to confinement and remote working can disrupt this natural balance, affecting both our physical and mental health. This disconnection from our innate need to move has contributed to feelings of restlessness, laziness, and even mental health issues that individuals face. It reminds us of the importance of finding ways to incorporate physical activity into our daily routine, even in difficult circumstances.

Taken independently from the context of the pandemic, isolation or confinement can lead to a range of profound psychological implications. General consequences include the transformation of this isolation into loneliness. The loneliness results from the absence of social interactions with other people, and that often leads to depression or anxiety. In many people, as long as the coping mechanisms are fit enough, these perturbated states do not develop into a pathological disorder. On the other hand, many other individuals had been diagnosed with major depressive disorder or generalized anxiety disorder years before the pandemic started. These patients relapse into acute episodes despite being compliant with their medication.

Every living being thrives for freedom. It is evident that staying inside a cage harms the psych slowly and sometimes irreversibly. The feeling of being trapped and powerless can lead to high levels of stress. Any bird who spends its life in a cage might never be able to fly again when set free.

Cognitive decline, particularly in older adults, is another potential outcome of prolonged isolation, brought on by a lack of mental stimulation and social interaction. Many people started spending hours on social media trying to be as involved as possible. Every like or view on any social media platform brought little accumulative rewards to the addicted users. Using those applications became the trend in coping with the situation of isolation.

Furthermore, irritability and agitation can arise in those settings, along with restlessness and frustration. It was well known that anger spawned violence at some point during the lockdowns. The incidence of domestic abuse increased and victims coped in different ways to their unfortunate situation.

In the context of the pandemic, there are specific aspects that have been magnified. Pandemic-related anxiety has surged due to the fear of contracting the virus. That was the first concern. Ultimately, that extended to concerns about the health of loved ones, and the general uncertainty about the future. The doctors didn't know much about the situation, so the rest of the population suffered from a lack of information that eventually became a state of paranoia.

Grief and loss became prevalent, with many individuals experiencing the loss of their loved ones. The virus killed people randomly. Young healthy men and women lost their lives unexpectedly, while some others suffered for months after recovery due to the scarring of their lung tissues by the virus. For many people, it didn't make sense that they couldn't be by the side of their loved ones when they passed away. The pandemic prevented the contact of patients under strict isolation. People were dying all alone in those beds and many countries buried the dead in mass numbers.

Pandemic fatigue has set in as the prolonged nature of the crisis has led to exhaustion and that in return transformed into more vulnerable states.

As time passed, individuals were exposed to a relentless stream of pandemic-related news, from rising case numbers to new safety measures. All they could see were numbers daily and everywhere on the news. People even could get live updates on the internet. The constant barrage of information led to a sense of apathy, where individuals became desensitized to alarming events. For example, the daily reporting of infection rates, hospitalizations, and death tolls lost its initial impact as people became accustomed to these numbers. It was not uncommon for individuals to react less strongly to alarming news than they did earlier in the pandemic, which was a sign of psychological adaptation to the ongoing crisis.

One of the other consequences of pandemic fatigue was the decline in adherence to safety measures. This included wearing masks, practicing social distancing, and maintaining rigorous hand hygiene. As the pandemic persisted, some individuals grew suspicious of these precautions and began to let their guard down. For instance, people became less attentive about wearing masks in public spaces or attending gatherings with others outside their households. They chose the solutions with short-term relief rather than avoiding the serious complications that could come in the long run. This decreased adherence posed health risks, as it left individuals more vulnerable to potential exposure to the virus.

The Adults of the Future:

Children and adolescents have faced unique challenges, including disruptions in education, social connections, and extracurricular activities, which have contributed to their mental health concerns. I think the future generation that was born around the time of the pandemic is going to be very different from all the generations that came before. The intense exposure of children to social media in the time of the pandemic installed numerous random ideologies into their heads - especially when their parents weren't around to supervise them. Students became more lazy and their attention span decreased tremendously with online classes. Discussing the consequences with kids can take a whole different essay to decently talk about it.

Frontline Superheroes:

Frontline workers, a category encompassing healthcare professionals, first responders, and essential workers, have been at the forefront of the battle against the pandemic. Their experiences have been marked by immense stress, including moral distress and burnout. This aspect of the pandemic is particularly poignant and sensitive, and it strikes a personal chord for me as well. I vividly recall a pivotal moment during this crisis when the reality of my work as a healthcare professional hit home.

In the emergency department, we are accustomed to life-and-death situations, but the pandemic brought a unique set of challenges. The fear of suddenly losing one's life due to exposure to a patient carrying the virus was an ever-present concern. It was a stark reminder of our vulnerability and the sacrifices frontline workers were making to save lives.

One memory that still haunts my thoughts is the day a patient arrived in the emergency room with no pulse. Time was of the essence, and every second counted. However, the protocol required us to put on the full protective gowns before approaching the patient, a process that took precious minutes. In that brief span, a life hung in the balance, and the urgency was palpable. It didn't make sense to our human minds that we couldn't immediately perform life-saving interventions. The ethical and moral dilemma was heart-wrenching.

The term "moral distress" captures the emotions and ethical conflicts that healthcare professionals face during these situations. It is the anguish of knowing the right course of action but being impeded by external factors, such as guidelines, protocols, or limited resources. In those critical moments, as we hurriedly donned our protective gear, the weight of moral distress bore down on us. The patient's life was on the line, and we grappled with the haunting question of whether those few minutes spent dressing in protective gear could have made the difference between life and death.

Frontline workers endured not only the physical strain of their duties but also the emotional and psychological toll of making life-altering decisions in the face of extreme circumstances. The burden of knowing that we did all we could, yet still confronted such limitations, was emotionally draining. Burnout loomed large as we tried to navigate the delicate balance between providing care and safeguarding our own well-being.

In conclusion:

In the shadow of these extraordinary years, I've witnessed a world transformed by the relentless waves of the COVID-19 pandemic. The toll it's taken on mental health is a stark reality, with isolation, uncertainty, and anxiety leaving indelible imprints on our collective psyche. Our confinement and the innate need for movement clash in a silent battle, while isolation's profound psychological implications and the weight of pandemic fatigue become apparent. As we draw the curtains on this chapter, it's time to pen new stories, tales of resilience, and the unwavering human spirit. Let's remember that even in these challenging times, the strength of humanity shines through. Those who have recovered and the heroes who've stepped up for vaccination offer beacons of hope. Together, we find hope for a brighter tomorrow.