Interview With Dr Sana Kausar on Mental Heath and the Global Pandemic

We are all concerned about our physical health and the growing worry of coronavirus but there is another pandemic quietly affecting those all around the globe.

Mental health issues affect one in four people around the globe. From anxiety and stress to more serious conditions such as depression or experiencing suicidal thoughts. With the drastic change in lifestyle that we are currently experiencing, there is no surprise that the current crisis is starting to take its toll on the mental health of many around the world.

Many of the privileges or distractions that we take for granted in life have been taken away due to self-isolation, while the constant worry about catching the virus is a huge concern for many. So it’s more important than ever to consider our mental health during this time. Here to discuss the impact the coronavirus crisis could be having and how to find ways to keep yours and your family’s minds positive and active during this time is Dr Sana Kausar, Family Medicine Consultant at King’s College Hospital London, Dubai.

How can being in self-isolation affect our mental health?

Isolation in itself is a physical separation from other people and as such, it is not a bad thing in many ways. In the current climate though, with a worldwide pandemic, which will no doubt have a dark place in history, it has many more implications. The way it has been dictated to us, in the name of social integrity and protection, it is more than just a phrase. It is a public policy, or a commandment, with the threat of punishment if not duly adhered to. On top of this, the uncertainty and danger that come with this need for ‘social isolation’ can lead to a unique state of mind, as it comes with complex and multi-faceted emotional experiences. This can all lead to worrying and loneliness, which can be a consequence of emotional isolation. This is apart from the impressive impact COVID-19 has had socially, economically and from a public health perspective.

The mental health significance was therefore recognised early in the process, and clinical terms were used from the beginning in the media and social networks to describe attitudes, reactions and behaviours in different scenarios – fear, cynicism, denial, lies, panic and even hysteria. The need for psychological counselling and other measures is well recognised, which goes in line with the expected emotional impact.

Loneliness can generate many clinical conditions, such as depression and anxiety. In itself, the feelings of loneliness can lead to reflections about what is going on at the present time. The uncertainties of “worst-case scenarios’ may give place later to reflections about one’s own life: hopes and expectations, accomplishments and failures, self-criticism and self-condemnation. The apparently quiet mind has a lot of material to contend with when loneliness or solitude are encountered. These times, in essence, can provide an opportunity for self-examination, which can lead to a path of healing.

When feeling anxious what techniques can we use to calm our minds?

Meditation is a great way to calm the mind and feel in touch with yourself, but it does take practice and patience. Focusing on your breathing can help reduce your heart rate, and blood pressure, so the physical aspects are enough of a reason to persist in trying. This is more about a journey within, and just observing spiritual people from every walk of life can make you realise that they seem to have tapped into inner peace. This is universal and within us all, and what better time to take the opportunity to try and connect!

There are many helpful apps available that can help guide the process, and talk you through the techniques. The one I recommend to patients is called Headspace, and this is a very effective and user-friendly way to get started. There are also many other guided meditations on YouTube and you can find something that resonates with you easily.

Practising yoga, again, at home, is a great way to combine exercise and mindfulness, and even doing a few yoga poses can help calm feelings of stress by causing an immediate change in your emotional state.

It is also well recognised that connecting with something greater than yourself through prayer and spirituality is a way to draw strength when you need it most. It is a good time to realise how interconnected we are, and how unimaginable though it may be, we have all been affected collectively.

Are there any techniques you can suggest to keep the mind busy when not being able to leave the house?

The basics are always the same.

Take care of your body – eat healthily, do a few exercises and stretching routines throughout the day.
Take care of your mind – read books that you have not had time to read, mindfully engage in daily activities such as cooking or cleaning.
Maintain social connections – call a loved one, check on friends and relatives. Use the best of digital communication – get on the apps where you can have face to face time – you may even find your personal connections are deepening!

What advice can you give to those who are already suffering from mental health issues like depression and anxiety to keep positive during this time?

This is a great opportunity to try different mindfulness techniques, which are often guided. You can also speak to a psychologist who can assess which tool would be more helpful, with so much

knowledge available. It is very important to keep in touch with your healthcare provider, even if it is through telemedicine, to monitor your medication and your illness, and to inform them in case you feel there is any deterioration.

How can we keep our minds busy when we are at home all day?

It is a great idea to set a good routine, or you run the risk of lounging around in pyjamas all day. To be productive, you can set a morning routine involving exercise, meditation and setting yourself up for your day of working from home.

How do we keep our children positive when we may not necessarily be positive ourselves and as parents, what can we do for time out?

Choose an activity with your child/children, that will engage everyone. This is an ideal opportunity to spend time with and actually get to know your kids. Seeing the way they deal with winning or losing, and how they relate to others in the team are all ways of bonding with them, and lead to more open conversations about how they are feeling. Asking them to describe how they feel is important, as it is for us too. We cannot assume that they are feeling stressed about the same things as us.

Also, depending on their age, engage them in doing chores and helping with cooking. You may notice that they are loving the opportunity of having more time with their parents. These opportunities don’t come very often and the memories you can make now will not be forgotten once life goes back to being busy.

Kids take a lot of their cues from adults. If you appear stressed and irritated, they will feel that there is a problem. Again, if we can reframe the situation and remind ourselves, that we are lucky to be able to stay home, in a comfortable place, with enough food, then we are all using the incredible tool of gratefulness.

Now is not the time to worry about regressing in school- it is not the time to have high hopes of them doing hours of learning, activities, science experiments and book reports. Their teachers will meet them where they are once they get back to school. Every child is in the same situation, and chances are they are scared, just as we are. The summer break isn’t going to be a usual summer break and it will be very limited. For now, if there is one thing they need, it is to feel comforted and loved. Bake cookies, watch movies under a blanket, play board games. Read together. What you will find is, they can teach you something about living in the moment.

What about those who are still having to continue working or have a loved one that is working – how can they stop their minds from worrying?

As many of us remain glued to our devices, watching the stream of terrible news and images come through, one way to protect your mental health is to focus on facts … so you’re not getting carried away with rumours and opinions. We should also actively take a break from those images by turning off the news an hour before sleep, focusing on meditation, spending time with loved ones or reading a physical book.

Besides avoiding the news when it gets too much to bear, I would also recommend “reframing” the images we see. The pictures of hospital workers show commendable heroism, and all the disturbing images of people wearing masks show how diligent the world has become in taking care of each other. Just that act of cognitively reframing the image in a positive way can be helpful.

While psychologists often worry about excessive screen time, technology like Zoom, Skype and Google Hangouts are now helping people stay connected despite physical isolation. it’s such a breath of fresh air to be able to see people and laugh with them and to plan a “family Zoom date” with relatives around the world. Many have been blown away by how social distancing can make a community come together.

How do we find a work/life balance?

The biggest difference between working from home and working in the office is that you are in charge of your environment and have to treat yourself like an employee. This means holding yourself accountable, but also recognizing when enough is enough, just as a good manager might.

If you feel yourself extending your work hours because you aren’t doing anything in the evening…tell yourself it’s time to put work away, recharge, and start tomorrow with a fresh mind. The work will be there in the morning.

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