Lockdown breakdown

“I’m tired,” Anita Seth (name changed) said. “I don’t know how long I can keep doing this. Not for a second does anyone at home let me sit. Where do I go?” Then she broke down.

For Rachana Awatramani, the person on the other end of the phone call, this wasn’t the first such incident. A counselling psychologist, she has been helping many of her clients cope with a city in lockdown. For Ms. Seth, looking after her two-room Andheri apartment, where she lives with ailing elders, plus the regular demands of her job in the unfamiliar work-from-home situation, had pushed her to the edge. Ms. Awatramani advised her to take a five-minute walk on her building’s terrace. “It’s mainly about space,” says Ms. Awatramani. “They live in small houses and when someone is ailing at home, it’s even more challenging. In such situations, they don’t know if they will keep their jobs.”

In an already congested city, the lockdown is making people feel even more boxed in. “There are fewer distractions,” says psychologist and regression therapist Namita Shetty. “They just don’t know what to do; they are trapped in a space, and have to deal with their emotions.”

Project Mumbai, which started a countrywide counselling service for the lockdown, received calls from people in Mumbai who were whispering; when counsellors asked them to speak up, they said they couldn’t, people at home would hear. “Can I have a text call?” one asked.

The service also heard from healthcare professionals at Kasturba Hospital — which initiated COVID-19 testing in the city — who expressed a ‘Doomsday’ feeling. “We’re seeing a layer of worry among doctors,” says Shishir Joshi, CEO and founder, Project Mumbai. “They are getting little to no sleep, nurses are away from their children for long periods of time, and they can’t even talk to each other because there’s no time. Everybody is stretched, and nobody knows what’s next.”

The Brihanmumbai Municipal Corporation’s 24x7 mental health helpline, Hitguj, or ‘communication for well-being’, has been receiving 15 to 18 calls a day from people feeling the stress of being indoors, ever since the lockdown was announced.

“Everyone has one persistent question: ‘When will this end’?” says Dr. Shubhangi Parkar, psychiatrist and former dean of KEM Hospital, who started the helpline in May 2013. “It’s a tough question to answer, but we prepare them for the long haul, telling them it will end sooner if we follow the rules,” she says.

Lockdown breakdown

Inner demons unleashed

Psychiatrist Dr. Sanjay Kumavat, who is part of a charity helpline, says calls are generally about depression, anxiety, phobias, uncertainty, and paranoia.

The deluge of information — and misinformation — leads to panic: a cough or sneeze, which could be due to allergens, he says, makes people around panic. One Mumbai caller said she couldn’t stop washing her hands after she saw her building’s security guard coughing near the elevator. Another caller, who had ‘escaped’ to his hometown Benaras from Mumbai, felt guilty as he was staying with senior citizens.

Fears are surfacing, causing family friction. Children are demanding attention from parents, who, having relied on carers for the kids, don’t know how to cope. Ms. Awatramani says even expectations on domestic chores cause friction. Stocks of everyday items are hard to get, and homemakers are feeling emotionally overwhelmed. “They are absorbing anxiety from husbands with job uncertainty. I don’t know how many marriages will survive this, how many suicides there will be,” says Ms. Shetty.

Add financial insecurity to the mix: loan instalments to pay, salaries coming late, companies paying less, job losses looming.

Everybody hurts

Addicts are dealing with the unavailability of substances. Senior citizens, especially those living alone, have it particularly rough. “Deprived of contact with people on their morning and evening walks, they are feeling suffocated,” says Dr. Kumavat.

Extroverts feeling constricted isn’t hard to understand, but, Ms. Awatramani says, introverts are chafing too: with cohabitants always home, they’re deprived of quiet time.

Those living alone are reporting depression and isolation too, Ms. Shetty says: “They just want to talk to someone; suddenly, it’s very quiet outside. People call me at all hours, just to talk. They need the assurance that there is someone for them.”

Even among the better-off, some feel guilt about the privilege they have that daily wage earners and migrant labourers don’t, says psychotherapist Lamia Bagasrawala.

The anxiety, survival fears, frustration, and a deep sense of futility are bringing out the savage side of people, especially in corporate settings, Ms. Shetty says. “‘Either I survive, or you do.’ That’s the level of competition at a time when sales are practically nil, and workplaces are short-staffed,” she says.

More worrying: these are just the people seeking counselling or therapy. Most people don’t.

Lockdown breakdown

Future tense

“How people are responding to isolation tells us what they’re doing with their fears,” Ms. Shetty says. “People will begin to lose the very ground they’re standing on. The economy will take a while to recover, and competition is going to get worse. It’s going to take people very long to feel safe and secure around others.” Without a visible timeline for recovery, people will fear uncertainty, she says. “We need to give them the desire and hope that they can rebuild their life, even if it’s breaking down now.”

Ms. Awatramani says, “If the stress and anxiety are not addressed now, there are high chances of post-traumatic stress disorder.”

Mental health professionals worry that the country is not prepared for such a scenario, and desperately needs to think ahead. “Efforts at helping people need to be coordinated,” Ms. Shetty says. “We need a central agency. Counselling needs to be integrated into the existing health infrastructure.”

Helplines that have sprung up need to be sustained, Ms. Bagasrawala says. “We need to prepare people for another transition soon. When they go back to their offices, do we have a plan to help them adapt to their experiences?” She and psychotherapist Anjali Nair have created an online ‘safe space,’ one they hope continues long past the pandemic, for people to share their distress and experiences. They have also created a shared learning space where people can discuss what has helped them cope using a story-based approach (as against one where people are told what to do), and building an e-resource of shared experiences.

Evolving the techniques

Ms. Bagasrawala says the COVID-19 crisis has helped people see that mental health concerns aren’t things that happen to other people, thereby “normalising therapy and the way it is perceived.”

In this unprecedented situation, the field is adapting: counsellors refer patients to therapy resources and activities online, psychiatrists send e-prescriptions. But more fundamental change is needed, she says. Many psychotherapeutic frameworks are short-term, focusing on individual behaviour, and “not designed keeping in mind larger crises and disasters, or the larger context.” Therapy must be intersectional, including gender, class, caste and sexuality within the mental health conversation.

Above all, psychotherapists need to take care of their own stability. Ms. Bagasrawala says, “What’s helping me is my own therapist, and rituals and routines I have in place.” Support groups for therapists are crucial, she says. “A lot of us are unprepared.” They are also affected by the situation themselves, yet must strive to be objective with clients. “We are the first respondents, as with any other situation right now. We need to stand up as a community, reach out to each other,” she says.

Mr. Joshi says, “This is 26/11, 100 times over, for Mumbai. One needs to look at the city in a holistic way. Are we ready, once the pandemic subsides? Do we have a healthcare plan? Everyone is stretched right now, but do our authorities know which organisation is involved with what aspect of relief? Have the gaps been plugged?”

Crisis calling

Around 450 Number of callers per day

Issues: Anxiety, phobias, depression, loneliness, sleeplessness, relationship rifts

Average age of callers: Mid-20s, early 30s

“We hardly have any senior citizens calling. Most of our callers are worried about parents who are away from them,” says Parveen Shaikh, psychologist & head — Outreach & Collaborations at Mpower.

Peak call time: 3 p.m. to 11 p.m. shift gets the maximum number calls.

No. of therapists

Mpower has one helpline number, connected to over 30 therapists’ cell phones

Source: ‘BMC-Mpower 1on1’ helpline

Help on the radio

The helplines offer callers support and suggestions, in addition to immediate ‘first aid’. The Navi Mumbai Municipal Corporation (NMMC), however, has taken this a step further.

From 12 noon to 12.30 p.m., psychiatrist Dr. Shubhangi Parkar speaks on mental health issues for 15 minutes each day on the Navi Mumbai Municipal Corporation’s internet radio (‘NMMC Swacch Radio Navi Mumbai’,

The NMMC is also reaching out to people through its ‘virtual calling’ service with a set of questions on their mental well-being. The NMMC reaches out to people based on its online health survey, and at 4 p.m., people can also call back with the concerns they have.

“Our staffers are calling them through an automated call system, and if we find that they are not in a good mood, we transfer the line to clinical psychologists and psychiatrists on our calling service,” says Deputy Municipal Commissioner Amrish Patnigire.

Emotional Toolkit

Psychiatrist Dr. Sanjay Kumavat’s tips for those unaccustomed to working from home.

• Reconnect with family; talk, include everyone, play with the kids, help with chores.

• When something bothers you, speak up, tell your family, friends.

• Limit consumption of news on social media; only take in a few headlines for the day. Watch non-news TV channels.

• Exercise and do a simple 10-minute meditation each day.

• Read books, listen to music. Take that afternoon nap you could never take in office.

• Call relatives and friends, but chat about topics other than the virus

• Don’t venture far for things like groceries. Take precautions you need to. If you must step out, take help from the police.

• Look at the positives: you have work and a salary, you’re saving on commuting, and you get quality time with your family.

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Printable version | Nov 30, 2021 4:07:19 AM |

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