Two M’s during COVID-19

The COVID-19 outbreak earlier in China and worldwide has led to an extraordinary threat to peoples’ physiological and psychological health and wellbeing. By the end of month June 2020 cases all over the globe have crossed the mark of 10 Million and majority of survey worldwide show the increased amount of mental stress in people.

Coronavirus global map https://coronavirus.jhu.edu/map.html

People also have a great need for information from the media to make sense of the situation, and to protect their health. Information-seeking behaviors may reduce anxiety caused by uncertainty during a disease outbreak or disaster (Heath & Gay, 1997; Lachlan, Spence, & Seeger, 2009). However, while helpful, media exposure may also create new problems. Large volumes of information may amplify the perception of risk, and fear-based messages by the media may have negative effects on media consumers who cannot discern real versus fake news, or view more balanced media coverage of the event (Kasperson et al., 1988). This “infodemic” has the potential to affect population mental health and wellbeing.

Exposure to potentially distressing media content may negatively impact those who see it (Miao Chao et al., 2020). Media usage in previous similar scenarios has been associated with negative psychological outcomes in multiple disasters. For example, increased frequency of viewing newscasts during war was associated with greater anxiety among the Jewish population in Israel (Bodas, Siman-Tov, Peleg, & Solomon, 2015). After the 911 terrorist attack in the United States, those who watched television images frequently are reported to be more likely to have post-traumatic stress disorder (PTSD) and depression compared with those who did not (Ahern et al., 2002).

The two M’s: Mental Health and Media

Aaliya, a 20 year old student who is in lockdown has been continuously struggling with reduced hours of sleep. She stays awake the entire night binging on Netflix. Every ten minutes she keeps checking on the statistics of Covid-19 cases and keeps reading the news.

Her mother complains that she has become very irritable and gets annoyed even on little things. She doesn’t talk to anyone at home and keeps herself engrossed in phone from the time she wakes up. Aaliya has complained of regular headaches and sometimes feels shortness of breath. One day Aaliya’s mother saw her staring at the ceiling and asked what is troubling her, she broke down and started crying. Then she told her mother that with the ongoing pandemic and seeing the increase in numbers of cases every day, her worry about the future and career has increased too much.  She has a constant fear regarding her family and friends’ health. Sometimes she feels hopeless regarding the future and everything looks very blurred. She also experiences chest pain and dizziness. She doesn’t get hungry and sometimes doesn’t eat anything at all.

Sounds familiar? We all can relate to Aaliya on some level. Just a look at our mobile’s screen time reveals the entire story. Increased social media consumption during the lockdown has led to increased mental health problems. Unknowingly majority of us are suffering with vicarious mental trauma or secondary traumatic stress of varying degrees.

Source:https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/coronavirus-who-retracts-statement-within-a-day-that-said-asymptomatic-covid-19-carriers-cannot-spread-infection-here-is-an-explainer/photostory/76299600.cms

Vicarious traumatization is a term coined by clinical psychologists Saakvitneand Pearlman (1995). The term initially referred to the phenomenon where professional psychotherapists are involuntarily affected by the bidirectional interactions of the relationship between consultation and interview due to long-term contact with patients suffering from mental diseases. In other words, psychotherapists or health care givers experienced symptoms similar to psychological trauma. But with increasing research in this field, it has been found that excessive usage of media which gives an account of peoples’ sufferings and disasters have detrimental effect on mental health leading to psychological abnormalities. This form of indirect trauma happens due to direct exposure to disturbing images and stories. These psychological abnormalities are derived from sympathy for survivors of a trauma, which causes serious physical and mental distress, even mental breakdown (Sinclair and Hamil, 2007).

Symptoms:

Beliefs, expectations, and assumptions about the world are central to many current notions about the effects of victimization (McCain & Pearlman, 1990). In their book Transforming the Pain, Saakvitne and Pearlman (1996) have given three broad categories of symptoms

1. Physical
2. Behavioural
3. Emotional/ Psychological

1. Physical

Symptoms include:

• Exhaustion
• Insomnia
• Headaches
• Increased susceptibility to illness
• Sore back and neck
• Irritable bowel, Gastro-intestinal distress
• Rashes, breakouts
• Grinding your teeth at night
• Heart palpitations
• Hypochondria

2. Behavioral

Symptoms include:

• Increased use of alcohol and drugs
• Anger and Irritability at home and/ or at work
• Watching excessive amounts of TV/ Netflix at night
• Consuming high trauma media as entertainment
• Not returning phone calls at work and/ or at home
• Avoiding colleagues and staff gatherings
• Avoiding social events
• Impaired ability to make decisions
• Impostor syndrome – feeling unskilled in your job
• Problems in personal relationships
• Difficulty with sex and intimacy due to trauma exposure at work
• Thinking about quitting your job
• Impaired appetite or binge eating

3. Emotional/ Psychological

Symptoms include:

• Emotional exhaustion
• Negative self-image
• Depression
• Increased anxiety
• Difficulty sleeping
• Impaired appetite or binge eating
• Feelings of hopelessness
• Guilt
• Reduced ability to feel sympathy and empathy towards family or friends
• Resentment of demands being put on you at work and/or at home
• Diminished sense of enjoyment/ career (i.e., low compassion satisfaction)
• Depersonalization
• Disruption of world view/ heightened anxiety or irrational fears
• Intrusive imagery
• Hypersensitivity to emotionally charged stimuli
• Insensitivity to emotional material/ numbing
• Difficulty separating personal and professional lives
• Failure to nurture and develop non-work related aspects of life
• Suicidal thoughts

Ways to cope-up in the current scenario

Everyone is battling with their own struggles right now and due to the lockdown access to therapists and counselors is also not very much feasible. Reports of Chinese researchers show that health professional are suffering from secondary trauma along with the general public. During times of such difficulty, we can opt for some basic self help activities.

• Balance the amount of media consumption: Set limits for all your media apps. Being informed about what is happening in our world is important, but being overwhelmed takes away our ability to act constructively.
• Refine the information content: Develop knowledge about the disease, read about preventive measures. A study by Miao Chao et al., 2020 reveals that viewing heroic acts, speeches from experts, and knowledge of the disease and prevention are associated with more positive affect and less depressive symptoms.
• At times of excessive anxiety, try the Grounding technique.

Source: https://terrisamuels.com/a-grounding-techniques-with-five-senses-moving-on-from-trauma/

- 5 things you can see

- 4 things you can feel

- 3 things you can hear

- 2 things you can smell

- 1 thing you can taste

• To further relieve anxiety and help a person sleep, 4-7-8 breathing technique has been found effective. Before starting the breathing pattern, adopt a comfortable sitting position and place the tip of the tongue on the tissue right behind the top front teeth.

Source: https://www.thedeepsleepco.com/4-7-8-breathing/

To use the 4-7-8 technique, focus on the following breathing pattern:

- Empty the lungs of air

- Breathe in quietly through the nose for 4 seconds

- Hold the breath for a count of 7 seconds

- Exhale forcefully through the mouth, pursing the lips and making a “whoosh” sound, for 8 seconds

- Empty the lungs of air

- Breathe in quietly through the nose for 4 seconds

- Hold the breath for a count of 7 seconds

- Exhale forcefully through the mouth, pursing the lips and making a “whoosh” sound, for 8 seconds

(Repeat the cycle up to 4 times)

• Share your feelings and experience: F. Mathieu through his The Compassion Fatigue Workbookemphasizes on the importance of sharing the emotions. Holding the emotions within can make a person sick but when those feelings are shared with the trusted ones they break down the bigger chunk of emotions and a person feels relieved. 

Source:https://restless.co.uk/leisure-and-lifestyle/staying-productive/6-tips-to-boost-your-motivation-during-lockdown/

• Connect with friends and family: Take out time to sit with them, connect with the ones living far away and share a few laughter. Several researches have proven the role of facial expressions in emotion regulation. 

These are few suggestive techniques tested over time through various researches but it is highly possible that some of them might not be effective for many people. In case of severe or extreme conditions, seeking professional help is the best option.

Summing up with words of Viktor Frankl, “Suffering is an ineradicable part of life like fate and death. Without suffering and death, human life cannot be complete”.

Written by:

Juweria Baig

B.A. Hons Psychology, Jamia Millia Islamia

Intern, Brain Behaviour Research Foundation of India (www.bbrfi.org)

References:

• McCann, I.L., Pearlman, L.A. Vicarious traumatization: A framework for understanding the psychological effects of working with victims. J Trauma Stress 3, 131–149 (1990). https://doi.org/10.1007/BF00975140

• Williams, M.B. A systems view of psychological trauma: Developing post-traumatic stress response paradigms. J ContempPsychother 22, 89–105 (1992).https://doi.org/10.1007/BF00945997

• Miao Chao, Dini Xue, Tour Liu, Haibo Yang, Brian J. Hall Media use and acute psychological outcomes during COVID-19 outbreak in China. J Anxiety Disorders ANXDIS 102248 (2020)

• Zhenyu Li, et al., Brain, Behavior, and Immunity, https://doi.org/10.1016/j.bbi.2020.03.007

• Comstock, Casey, Judith Platania. 2017. "The Role of Media-Induced Secondary Traumatic Stress on Perceptions of Distress." American International Journal of Social Science 16 (1).

• Mathieu,F. (2011) The Compassion Fatigue Workbook: Creative tools for transforming compassion fatigue and vicarious traumatization. New York, New York: Routledge.  

• https://www.tendacademy.ca/tools-to-reduce-vicarious-trauma-secondary-trauma-and-compassion-fatigue/

• https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html