Ambiguous loss (Covid-19 & mental health) -DAWN

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WE are required to do it constantly now … make decisions that could determine whether we or our loved ones live or die. It is a debate and a conversation that will go on. Is that friend to be trusted? How careful is she? Does she don a mask and has she been vaccinated multiple times? Has she limited her social interactions? Is she part of the crowd that has decided that vaccines are important so that the Covid-19 pandemic can become a thing of the past? Or is she an anti-vaxxer, and someone who believes that since Covid-19 will infect everyone at some point, it is no use taking any precautions?

The burden is the worst for the considerate ones. These are the people who do not want to put at risk older relatives, the immune-compromised or simply anyone. For them, the daily stress of our constant and unyielding crisis is almost unbearable. Some call this ‘Covid fatigue’ but that too is an erroneous term because if you care about other people, about your own health you cannot afford ‘fatigue’; you remain stuck in a state of constant vigilance and tirelessly monitor the surroundings for coughs, conversations for mentions of a cold, and any public space for the possibility of it becoming too crowded.

The two years that have passed since the pandemic emerged and spread across the world have allowed researchers to understand what Covid-19 is doing to our mental health. In the United States, children most of whom are now lagging academically owing to interruptions in the school year and isolation from school friends, are making many more visits to the emergency room with issues related to their mental health. In fact, according to reports, there has been an increase in suicide atte­mpts by children (those under 18 years), who now regularly experience anxiety and depression owing to the seemingly unending uncertainty that the pandemic has imposed on everyone alive at this moment.

If that is the case in the richest country in the world, then the rest of the world is suffering even more.

The two years that have passed since the pandemic emerged have allowed researchers to understand what Covid-19 is doing to our mental health.

According to the health journal Lancet, even prior to the onset of Covid-19 mental health issues were already a leading cause of the global health-related burden, with depression and anxiety disorders among the most prevalent. Naturally, the pandemic has exacerbated these conditions — someone with relatively mild anxiety issues is likely to become almost non-functional in an environment where you have no idea what tomorrow will bring. The constant threat of disease or lockdowns or travel bans cumulatively exacerbate mental health conditions that may have previously been managed by medications. The Lancet study noted that women were likely to be more affected by severe depression than men and that younger people were more affected than the older ones. Those parts of the world with the most restrictions and strictest lockdowns were believed to have the greatest increase in the number of episodes of depression.

In Pakistan, where most cases of mental illness go undiagnosed, the situation is dire. Those with issues related to anxiety and depression already suffer from the lack of available mental health treatment; and those who have developed these issues during the pandemic have no chance whatsoever to avail them. When those suffering from such disorders commit suicide, families hide the true cause of their death and there is no reliable case count of how many people have taken their own lives since the beginning of the pandemic. Ironically, Covid-19 itself can serve as a cover-up cause of the deaths of individuals who have perished owing to suicide.

In India, a charity named Muktha Foundation asked nearly 5,000 elderly citizens about their mental health and found that 65 per cent of them reported symptoms of depression. This was a 50pc increase from the days before the pandemic. Those who already suffered from psychiatric ailments like schizophrenia, obsessive compulsive disorder, depression, etc were in much worse shape than they had been before.

Then there is a toll on the healthcare workers themselves. Doctors and nurses who have borne the brunt of the pandemic are reportedly seeing high rates of burnout and suicide. As the thousands of messages posted on social media attest, repeated infection surges have made it impossible for medical staff to adequately take care of patients. Others report frustration at unvaccinated patients who had the ability to take the vaccine and avoid the virus but simply chose not to do so. It’s an important question; what are the ethics of providing care to those patients who chose to remain unvaccinated and took no safety measures to protect themselves?

In Pakistan, the joint family system has also become a sort of powder keg. Family members who could barely tolerate each other before Covid are now forced into unwilling companionship that is likely imposing its own traumas on them. If you are a daughter-in-law who must now work from home, good luck explaining this to a meddlesome mother-in-law who thinks that her son’s wife is just whiling away the time. If you’re part of a large family and must stream online classes from your college, good luck trying to get others off the internet so you can have the streaming capacity.

Experts suggest that one way of dealing with Covid-related stress, from the loss of loved ones to the loss of relationships and friendships, is to acknowledge the trauma of what we are all facing and are incredibly tired of facing. Experts call our current condition ‘ambiguous loss’, which is the loss of someone or some world that has slipped away but not quite and not definitively. Such is the state of the world and its population of perpetual mourners; suspended in crisis, their despair hidden behind their masks.