A psychological pandemic brews

Aditi Tandon

Covid-19-induced lockdowns and fears have triggered a full blown psychological pandemic across the country pushing people into spaces and situations they have never seen before.

With cases still peaking, the incidence of suicides due to fear of contracting the virus or succumbing to it, besides social stigma and sense of entrapment during lockdowns is witnessing a slow but progressive surge.

Conservative estimates by researchers attribute more than 100 recent deaths in India to Covid-related trauma, a trend that has led the Ministry of Health to issue detailed guidelines on mental health during the pandemic.

Most of these deaths have, tragically, been by suicide, the latest involving a Madhya Pradesh resident Rajmani Sattar, who hanged himself in the washroom of AIIMS Trauma Centre this Thursday. Sattar was not a Covid patient but had been under prolonged hospitalisation for a chronic condition. He was away from his family and friends due to Covid-related restrictions.

Not too long before Sattar’s demise, a 37-year-old journalist Tarun Sisodia on Covid management at AIIMS died of suicide after jumping off the fourth floor of the hospital. Sisodia’s death sent shockwaves across the media world leading to demands for a judicial probe into the circumstances of his death. An internal AIIMS enquiry ruled out malafide but Health Minister Harsh Vardhan nevertheless ordered the replacement of hospital trauma centre in charge.

With deaths by suicides rising amid the exploding pandemic, experts are grappling with causative factors that are pushing people into extreme situations.

Some studies have shown the virus not only damages the lungs, it also impacts the brain adversely, besides harming other organs.

“Researchers have now found that Covid-19 could trigger changes in the central and peripheral nervous system of those infected. Preliminary evidence suggests the disease can cause serious brain damage, even in mild patients. Psychiatric manifestations of Covid-19 involve hallucinations and delirium among others. It’s an evolving field because the disease is only six months old,” leading psychiatrist Ashish Pakhre says.

Pakhre also warns of a condition mental health experts call Werther Effect that has set in since actor Sushant Singh Rajput died of suicide in his Mumbai home.

“Werther Effect exemplifies the contagious nature of suicide. When a celebrity passes away by suicide, he can trigger similar episodes in local communities pushing people, who are on the brink, to take their lives. We have seen many suicides after Rajput’s death and need to watch out for signs of depression in youngsters. Changes in moods and behaviour patterns that last over two weeks should constitute alarming signs for anyone. People must remember that depression is not in the head. It is a medical condition which needs treatment,” Pakhre said.

At least eight youngsters across India, most of them fans of Rajput, died by suicide after the actor passed away.

Covid-induced suicides also continue unabated. In mid-June an IRS officer in Delhi killed himself fearing he might infect his family with Covid. The officer turned out to be Covid-19 negative.

Earlier this March, a young Covid-19 suspect jumped off the seventh floor of Delhi’s Safdarjung Hospital and died.

India’s first Covid-related suicide was reported much earlier on February 12 from South India where a 50-year-old man mistook seasonal flu symptoms to be Covid-19 and committed suicide.

The psychological pandemic triggered by Sars-Cov2 virus is not specific to any one nation. It is global.

Such has been its impact that the WHO had to, on July 2, call upon countries to pay greater attention to mental health and suicide prevention.

“Hitting lives and livelihoods, the pandemic is causing fear, anxiety, depression and stress among people. Social distancing, isolation and coping with perpetually evolving and changing information about the virus has both triggered and aggravated existing and pre-existing mental health conditions, which need urgent attention,” WHO Southeast Asia Regional Director Poonam Khetarpal says.

The WHO acknowledged that stigma related to Covid-19 infection might lead to feelings of isolation and depression, impacting mental health.

Another precipitating factor the world health body recently flagged to member nations is the rising cases of domestic violence during the pandemic.

Domestic violence is reported to have increased during lockdowns imposed by almost all countries in the Southeast Asia Region of the WHO, Khetarpal says urging early identification of mental health conditions, recognition of suicidal behaviours and appropriate management through a multi-sectoral approach even as the world continues to focus on arresting further spread of the pandemic.

Suicide claims almost 8,00,000 lives every year globally and is the leading cause of death among young people aged 15-29 years of age, global health statistics show.

There is also evidence to suggest that for each adult who dies of suicide, there are more than 20 others attempting suicide.

The WHO South-East Asia Region of 11 nations, including India, accounts for 39 per cent of the global suicide mortality and is among the most vulnerable to mental health pressures Covid-19 is exerting.

India alone, on an average, accounts for around a third of global suicides, among women and a fourth of suicides among men.

Covid-19-related suicides, however, remain a global marker. The most high-profile suicide linked to the pandemic has involved Thomas Schaefer, the finance minister of Germany’s Hesse state, who killed himself amid worries over coping with the economic fallout of the Covid crisis.

WERTHER EFFECT

At least eight youngsters across India, most of them fans of Rajput, died by suicide after the actor passed away. This was in stark reminiscence of the 1974 phenomena noted sociologist David Phillips documented in his studies on the infectious nature of suicides. Phillips found that when British and American newspapers ran a front page story about a suicide, the number of such deaths in the neighbourhoods increased immediately afterwards. He called the phenomenon Werther Effect, which led to the WHO issuing guidelines on responsible reporting of suicides.