Financial uncertainty, health concerns and boredom: What's on India's mind

Many people are complaining of relapse of mental health conditions, financial uncertainties; experts fear this could be a crisis in the making

Financial uncertainty, health concerns and boredom. These are some of the issues Indians are sharing with their therapists. 

Psychologists tell Business Standard that more people with mental health issues have been forced to restart psychotherapy since the coronavirus-induced lockdown came into force.

With poor internet connectivity and a lack of infrastructure (power cuts, unavailability of a device) to support video calls for long duration, people are forced to participate in sessions over a phone call.

“People’s assumptions are getting challenged. Earlier they felt even if they were disturbed internally, the outside — their job, their ability to freely move around the city, their physical health — was under their control. Now they are feeling as if the inside and the outside are both stressed. The boundary has ceased to exist,” says Meghna Mukherjee, a Delhi-based clinical psychologist.

Tens of thousands of people across cities are experiencing what doctors call empathetic stress. Watching the condition of migrant labourers or the free fall in the economy is becoming the cause of panic attacks.

It is grim for those who are forced out of their safe spaces and made to live with families that are at best negligent or at worst physically and mentally abusive.

Many have either not told their families that they are undergoing therapy or are trying to save themselves from their perpetrators living under the same roof. They now have no option but to chat with therapists over messaging apps to maintain the veil of secrecy.

“At this time we are not doing much therapeutic work. It is more of supportive care for now,” says Medha Gupta, a Hyderabad-based clinical psychologist, whose clients include young professionals, who she says are facing sleep disorders.

The hardest hit are women, shows the data released by the National Commission for Women. The NCW said they received 587 complaints between March 23 and April 16, twice the number compared to the previous period. Of this, 239 related to instances of domestic violence. Along with work from home, many women are also forced to work at home, sans any help.

“This difference in work structure has had a major impact on women’s productivity,” says Aakriti Astha, a counselling psychologist from New Delhi. She says lack of resources discourages women from seeking help outside their families. While many reach out, most don’t want to file a complaint.

Experts argue that boys and girls need to be made comfortable expressing their emotions. Boys should be taught to deal with their feelings in a healthy way, as the violence — mental or physical — they unleash has been normalised, say experts.

“Girls need to be more expressive of their anger. The fear of being reprimanded makes girls deny their anger,” says Shweta Dharamdasani, a psychotherapist.

Invisible amidst the lockdown

With schools closed, and no clarity on pending exams, children are facing an unprecedented amount of uncertainty. The curbs on physical movement adversely impact their mind-body continuum and it is much harder for children to focus on e-learning classes when they find their family members moving around the house. Yet there is hardly any conversation about how children are coping with these times.

“Children have been invisible in this lockdown,” says Nupur Dhingra Paiva, a chartered clinical psychologist, whose clients include young adults and teenagers. She says her work with many kids has stopped as they require concrete physical presence.

There is another worrying trend. The Childline India helpline, run by the Indian government, received 92,000 SOS calls on child abuse and violence in the first 11 days of the lockdown. This might be due to the sense of helplessness people are feeling, other than some mental health conditions. In times of crisis, we get in touch with our dark side, experts say. 

To counter child abuse, Paiva says she is trying to ensure that at least one parent is a protective ally, as filing complaints would not help due to the lockdown.

Challenging the assumptions

How do you ask a person with obsessive compulsive disorder (OCD) for cleaning, to stay calm? Especially when the world is ravaged by a virus that can spread from touching contaminated surfaces. This is one of the many vexed questions psychotherapists are grappling with. Experts say that therapy is based on certain assumptions. Under normal circumstances, a person with OCD is made to understand how there is good dirt and bad dirt, and that touching anything is not going to automatically harm them. These assumptions stand challenged today. 

“Now we help people understand that the need to wash hands is the reality. But the urge to doubt it and wash your hands again after say 20 seconds is an obsession,” says Dr Geeta Singh, a clinical psychologist.

Multiple therapists and counsellors Business Standard spoke to, say these times are making them dig deep into what they had learned during their training. They admit experiencing a sense of powerlessness as their caseload has ballooned. The timings have been stretched with therapy sessions starting as early as 6-7 am in the morning, rather than the usual 10-11 am. This as Indians battle work-life disbalance and uncooperative family members.

Gupta says having a morning routine of exercising and wearing fresh clothes may help. She also suggests switching off electronic devices at least 45 minutes before going to sleep.

There is an upside though. Many people who were earlier not comfortable with going out to meet a mental health practitioner are now having a change of mind. “Some people have general anxiety associated with meeting people in person. Now they have a feeling that their therapist is just a video call away,” says Astha.

Gratitude, being more involved in our day-to-day activities, and setting boundaries in our work and personal life are a few steps most experts enumerate.
 

Mukherjee adds that there should be no stigma attached to mental health, especially in these times. “Now is the time you can say that I am anxious just like everyone else, and so I am going to therapy,” she says.