Hi,
My mother is convinced that she will never get to see me, my wife, and our little son again. My parents live in a town 1,300 km from our home in Delhi. Although the government has eased the terms of the lockdown and flights have resumed, there is still widespread fear and confusion. Many families like mine have decided to give travel a wide berth for at least the rest of 2020.
The number of confirmed coronavirus infections and deaths is galloping in India, with Delhi doing particularly badly. Last week, recoveries in India eclipsed the number of active cases, though that means little by itself.
These are hard times for all manner of people. For elderly people, constantly threatened by the tag of ‘most vulnerable’, the desperation to reunite with their children and grandchildren is a source of exquisite pain.
When my mother cries on the phone, riven by sheer anxiety, I don’t know how to console her without lying. Three months ago, when India’s lockdown started, I’d still manage to paint a picture of vague optimism. Now, all I can offer are tired lines about the whole world being in the same boat.
Which is not such a good thing to say to an anxious person. I know this from my own experience: being told that the whole world is suffering doesn’t help alleviate my anxiety. It can actually feel like gaslighting.
How to soothe people without guilting them
Then there is the other kind of anxiety: that the virus has lodged itself in your body. I remember how in the early days of the pandemic, one phrase which cropped up frequently in news reports - "shedding virus" - gave me nightmares. I constantly pictured my body shedding virus everywhere, like dandruff.
Mandar Kubal, a physician in India specialising in infectious diseases recently tweeted: "Covid phobia now seems to be peaking. Many patients with distressing anxiety mimicking Covid symptoms. palpitations, dry throat, lump in throat, choking sensations, heaviness in chest, sighs while breathing, feeling exhausted. Fever notably absent. Pulse, sats (oxygen saturation), CBC (complete blood count), CXR (chest X-ray), ECG normal."
How do healthcare professionals help such people? Specifically, what language do they adopt to talk them out of their fear, and is there something in it that we too can learn as an emergency measure if corona panic hits home?
Milan Balakrishnan, a psychiatrist, says counselling is critical for immediate relief. The internet has resources that help differentiate between anxiety and Covid infection. "Normal pulse oximetry helps many relieve stress, but it’s challenging," Balakrishnan says. "We need mental health experts [to tackle Covid-related anxiety] on a large scale.
As a doctor, Balakrishnan relies on giving his patients "reassurance, lots of it, and helping them differentiate [between Covid and a panic attack] without guilting them. What I usually do is make them realise that bodily symptoms of anxiety are something they have experienced before, like when they went for an interview or an exam or tried to speak to a girl they had a crush on. Palpitations, rapid breathing, sweaty palms dizziness - we now interpret these as life threatening, but these are how the body responds to any stressful situation. The more we analyse them, the more they come back. Otherwise they are self limiting."
Balakrishnan’s advice is that we should all learn some psychological first-aid, but he’s quick to add that breathing difficulties are a symptom of Covid too. Misinterpreting them can lead to more anxiety and more symptoms.
I took away three things from what the doctor said:
- We have to accept the fact that the world will be an uncertain, anxiety-inducing place for a long time to come. So we need to arm ourselves with the right knowledge and skills. For instance, I am taking this online course on psychological first-aid by Johns Hopkins University.
- A big part of helping others through this time is learning non-violent communication. We can only give an anxious person succour and relieve them of guilt by practising deep listening and compassion.
- Ultimately, home remedies may not help with anxiety. You may need to talk to an expert. Many therapists and counsellors are offering help online, some even pro-bono.
And of course, do see a doctor immediately if you feel that symptoms indicate an infection. (I have to deal with my own guilt while recommending this, because I know healthcare systems all across the world are crumbling, leaving thousands with nowhere to go.)
What other techniques have you found useful to cope with corona panic? Let me know in the comments section below this newsletter.
Stay safe. See you next week.
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