Usman Khan

PESHAWAR: The coronavirus pandemic has changed the life of 55-year-old Jahanrez Khan, a resident of Rashid Garhi area of Peshawar, who is associated with medicine business, but now he mostly remains inside his house along with his family.

Jahanrez Khan’s niece Robina Khan says her uncle is so scared of coronavirus because he believes that it can easily attack him as he is a heart patient.

“My uncle even don’t come to inquire after my ailing father and instead talks to him on telephone daily,” she told TNN.

Psychiatrists say the problem like that of Jahanraiz khan happens due to stress or tension.

Coronavirus has so far killed over 562,000 people with over 12 million infections in 216 countries, according to latest data.

Dr Hans Henri P. Kluge, WHO Regional Director for Europe, says problems of stress, tension and fear of coronavirus are quite natural. He says every individual has undergone some kind of internal change after the pandemic situation. However, he says, it is crucial for everyone to handle the pressure and maintain discipline amid the uncertain situation.

Dr Aizaz Jamal, who is serving at Mardan Medical Complex (MMC), says stress-related issues confront everyone at some stage, but the real thing is that how the people deal with the situation.

The young psychiatrist told TNN that importance must also be given to mental health besides physical heath. “If we did not do this, then our problems will compound further.”

Dr Aizaz Jamal says there are many reasons behind increase in stress-related problems after the outbreak of coronavirus. He says some people are worrying too much about the pandemic and think about it all the time, which creates stress. He says there is no doubt that corona is a dangerous disease and there is no recognised cure for it, but majority of patients are recovering from it.

“Elderly patients and those will heart condition or kidney disease or diabetes must be extra careful about their activities.”

Dr Aizaz says the outcome of the pandemic is affecting different people differently.

Impact of lockdown and work from home

A fresh survey of Gallup Pakistan has revealed that 54 percent salaried class has been affected due to coronavirus, 27 percent people have lost their jobs and 27 percent have witnessed cut in their salaries.

Dr Aizaz Jamal says most of men were not mentally prepared for working from home. He says those who have lost jobs are confronting stress of being unemployed, while those working from home are facing problems as they could not find office environment at home. He says many such people are facing problems of stress, depression, emotional sensitivity, guilty feelings etc due to which domestic quarrels have witnessed increase.

Impact on children

The education of children has virtually come to a halt since the closure of schools, they can’t meet friends, can’t go out of home for entertainment or recreational activities, and the result is stress.

A report of UNICEF says violence on children and women has increased during the lockdowns as families spend all the time together in locked houses.

The report, which was published in May, says ever eight in 10 children aged from one to 14 years faced physical or mental torture during the previous month’s lockdown. Moreover, it says, three-fourth children aged between two to four years faced corporal punishment inside their home.  It further mentions that 19 percent married women also faced physical or sexual violence from partner and the proportion of such incidents is likely to increase if lockdown continued.

Dr Aizaz says violence on children reduces their creativity and puts negative impact on their behaviour. He says same is the case with women who face violence.

Psychological problems with expectant mothers

Arshi Arbab, who works as Clinical Psychologist in Dogra Hospital of Khyber tribal district, says observation and surveys show that women are facing more stress-related problems than men after the outbreak of the pandemic. She says it is unfortunate that expectant women, who are even more exposed to psychological problems, are being ignored during this critical time.

Dr Arshi told TNN that hormones change in an expectant woman’s body impacts her psychological condition and if there is some kind of fear or uncertainty, then it can also impact the health of the mother and child.

Dr Arshi says rumours about the pandemic have further complicated the situation. To cite an example, she says women nowadays in tribal districts are not going to hospitals for delivery as rumours are rife that patients are administered poisonous injections at hospitals.

The clinical psychologist says miscarriage ratio is increasing as expectant women are increasingly confronting psychological issues. Premature births have also increased and deaths during delivery are also happening with alarming ratio.

“Some women, some of them well-educated, also come to my clinic seeking advice that they want abortion as they can’t give birth to another child amid stressful situation.”

Impact of rumours on mental health

Like other parts of the world, rumours also spread in Pakistan within no time. The main rumour is about poisonous injection to patients and others are exaggeration of corona deaths by the government; counting the dead from other disease into corona deaths for financial aid; and denying the existence of coronavirus altogether.

Dr Arshi says all these rumours are putting negative impact on mental health.

“A 16-year-old boy, who was infected by coronavirus, was brought to isolation ward in tehsil Bara and he had no sleep for 24 hours after coming to know about his disease. The boy feared that he might be administered poisonous injection by doctors if he went to sleep. His condition was deteriorating and we were called to help him. We put in a lot of effort to convince the boy that there is no danger as such and he must sleep without any tension,” Dr Arshi recalled.

Dr Arshi says Peshawar’s Jahanrez Khan is also probably facing psychological problems due to these rumours. Jahanrez Khan’s niece says her uncle is extra careful due to his heart condition.

“My uncle quarantined himself inside a room few days ago as he thought he has contracted coronavirus despite the fact that he did not undergo any test, nor he went out of home, and he didn’t show any symptoms either. It was a case of deception or may be delusion,” she told TNN.

She says her uncle used to spend most of the time watching TV or reading newspaper. She says they tried to convince him that too much media is causing bad impact on him. She said her uncle’s condition improved considerably when he reduced the use of media.

Too much media

Psychologist Dr Aizaz Jamal believes that too much media has created an atmosphere of fear about coronavirus in our society.

“TV channels and newspapers as well as social media are full of news about corona. When a healthy person spends too much time inquiring about the corona situation then he eventually feels that he has also contracted coronavirus. This is exactly what happened with Jahanrez Khan,” Dr Aizaz says.

He says many people have gone into depression due to such news on media.

Considering corona a social stigma

It is a common practice around the world that corona patients either go to hospital or quarantine them inside their houses. However, many people in Pakistan, particularly in KP, have also reportedly concealed their illness due to fear of social stigma.

In Peshawar, a female broadcaster recently accused the staff of Police Services Hospital, dedicated for corona patients, of misbehaviour. The hospital administration then issued a clarification that the broadcaster had contracted coronavirus, but she instead of going into self-isolation, came to hospital along with her family members and violated all the SOPs, hereby putting the health of other people in danger. The hospital administration said the broadcaster was not going into quarantine due to social stigma and endangering the health of other people.

Prof Dr Zafar Khan of Sociology Department of the University of Peshawar says some factors and collective behaviour of society has made corona a cause of social stigma like AIDS and some other diseases.

Dr Zafar says presenting corona as a monster by the media; method of shifting of corona patients to hospital by the government officials; misery for whole street or neighbourhood due to carelessness of a single patient, these are such factors which have created the existing problems. However, he considers the factors of social distancing and very limited funeral of corona victims as the main reasons behind social stigma.

How to avoid psychological problems

All doctors agree on the recommendations of the World Health Organisation (WHO) for avoiding psychological problems.

The WHO says:

  • Reliable media outlets like the national media must be subscribed for authentic and balanced news.
  • All routine activities must be continued as far as possible.
  • Proper sleep must be taken and healthy food must be consumed.
  • Timings must be set for work and rest.
  • Time must be spared for recreational activities.
  • News feeds must be kept reduced and that news, which may create tension, must be avoided. If required, then fresh news must be seen once or twice a day at specific times.
  • Social distancing is a must. If there is restriction on movement, then contacts can be established through online channels.
    Keep track of exposure to screen. Make sure that rest time is taken from on-screen activities.
  • Social media accounts encouraging positive activities must be subscribed.
  • Proper times must be set for learning activities at home. Time must also be spared for sports activities.
  • Children must be helped for discovering positive ways of anger management. Parents must help the children in positive learning activities like sports, drawing etc.
  • Stories must be written, poems must be read, and singing and dancing may also help. Gardening is also a good habit.
  • Children must not give too much time to video games.
  • Loved ones must be kept in touch through telephone, email, social media, video-conference etc.
  • Activities like food, sleep and recreational activities must be fully enjoyed.
  • Easy physical exercises must be done regularly to maintain physical activity.