A worrisome fallout of Covid-19
Stressors are piling up, and the Novel Coronavirus infection itself seems to have neuropsychiatric repercussions. Both patients and doctors need support
Recently, William
Lynes, MD, author of the award-winning medical novel Luger Rounds, who had a flourishing medical practice, spoke at the virtual American Psychiatric Association (APA) 2021 Annual Meeting about the challenges of dealing with depression while managing the stresses of a career in medicine. He revealed that he had first attempted suicide in 1999 at the age of 45.
As the continued spread of COVID-19 adds to the occupational stress of healthcare personnel, ways to support the mental health of frontline workers are being discussed.
And not just doctors – COVID-19 patients themselves are reporting neuropsychiatric issues. Neurology and psychiatry experts are seeing worrisome reports of healthcare workers developing psychotic symptoms even when they have no prior history of mental illness. While rare, the condition can be severe enough to require hospitalization.
A COCKTAIL OF CRISES
Healthcare workers are trained to manage the intensity of a medical crisis. But a few are equally comfortable managing the mental health aftermath, in themselves or in others. The emotional challenge of getting through the pandemic is weighing on the mental health of many health care workers.
“Cases of neuropsychiatric symptoms in COVID patients without any prior history are being referred to us. I have personally treated several patients who recovered from COVID and later developed psychotic or manic symptoms, and also elderly patients with mild COVID symptoms who developed unexplained delirium states,” says Dr Jyoti Kapoor, Senior Psychiatrist and Founder of
Manasthali.
Symptoms may include hallucinations, unusual agitation, restlessness, preoccupation, paranoid beliefs, decreased need for sleep and impulsive behaviour.
“According to available literature, delirium and confusion can be a direct result of the inflammatory response of the nervous system to the Coronavirus infection,” explains Dr Jyothi.
INCREASED VULNERABILITY
Global studies show 28.8% of trainee doctors show signs of depression. A few studies had previously indicated that suicide rates are higher among doctors as compared to the general population. This pandemic is only thrusting mental health issues into the forefront faster and in bigger numbers.
A recent study by the University of Utah Health published in the Journal of Psychiatric Research suggested more than half of frontline health care workers involved in COVID-19 care could be at risk for one or more mental health problems.
In India, a doctor at a private hospital in Delhi committed suicide, apparently unable to bear the severe stress of the deadly second wave of the COVID-19 pandemic. “He was a brilliant doctor from Gorakhpur and helped to save hundreds of lives during the pandemic,” former Indian Medical Association (IMA) chief Dr Ravi Wankhedkar tweeted.
WHY ARE HEALTHCARE WORKERS COMMITTING SUICIDE?
“Many personal and systemic factors contribute,” explains Padma Shri-awardee Dr Manjula Anagani, Chief Gynaecologist and Laparoscopic Surgeon at Maxcure Hospitals. “At different stages of their careers healthcare workers face different challenges. Sleep deprivation, poor living conditions, a lot of misery and death around — a feeling of helplessness, triggering the existing depression can push them to suicide,” she says. Other factors can be violence against doctors, toxic work conditions, long working hours, financial stress, separation from families, unhygienic quarantine facilities and the fear of getting the disease,” Dr Manjula adds.
WANTED – A SUPPORT SYSTEM
The pandemic has created a VUCA – volatile, uncertain, complex and ambiguous world.
“Multiple stressors can foster increased worry, despair, anxiety. These include fear of getting an infection, getting hospitalized, inability to find adequate medical facilities, losing relatives, friends and colleagues, financial insecurities, and handling work in the changed environment. This will have both short and long-term impact on mental health,” says Dr Namita Singh, Consultant
The direct effect of the virus, steroids and other drugs being used to treat the disease, and the psychological aspects of isolation, fear and uncertainty can all culminate to manifest as serious mental illnesses
Psychologist, Apollo Hospitals.
Those who have lost loved ones are likely to be affected by traumarelated disorders, anxiety, depression, increase in substance abuse, a growing tendency to violence, and suicide,” she stresses.
—Dr Jyoti Kapoor, Senior Psychiatrist