Is India facing a fear of stepping out?

Najooka Javier
Monday, 7 September 2020

The lockdown forced all of us to shut doors to the outside world and stay indoors. Suddenly, everything had changed. The initial days of transition reminded many of the announcement of demonetisation. The uncertainty, the confusion and the hustle. 

Sudhir was only 18 when he first felt it. 

He was late for a class-test, and that's when the feeling took over. He felt scared to step out of the house. Palpitations and tremoring fingers forced him to rest at home. Slowly, the feeling of being scared became a regular companion. On some days, Sudhir would fight the feeling and carry on with his work, but on some, it became too hard. 

Soon he was scared to go for class, talk in class or ride on a bus. The feeling that was till then only a fear soon turned into erratic bouts of fears and attacks. He felt like he couldn't move and breath. His body felt ice-cold, and like needles pricked him from inside. 

What was worse, he did not know when he would start feeling this way. As a professional, he would do his bit to calm himself, but the lockdown would only make things worse.

As the announcement of the lockdown came, Sudhir's condition took a turn for the worse. Though at first, it was comforting - not having to go to the office, travel and attend meetings - soon became a vice. As the process of unlocking began, he could not imagine gathering the courage to go back to face the world.

The fear of contracting the virus made it worse.

Sudhir is just one of the many. 

***

The lockdown forced all of us to shut doors to the outside world and stay indoors. Suddenly, everything had changed. The initial days of transition reminded many of the announcement of demonetisation. The uncertainty, the confusion and the hustle. 

The announcement of the lockdown came in a similar form - sudden, unexpected. But this one has a lasting impact. 

Suddenly every aspect of our daily lives changed. The stress and anxiety caused by the uncertainty and confusion affected the majority of the population. 

According to the World Health Organisation, over 90 million Indians, suffer from some form of mental disorder. Most of them do not get any help. The findings of a countrywide 2015-2016 study by India's National Institute of Mental Health & Neurosciences (NIMHANS) - an autonomous institution under the Ministry of Health and Family Welfare - revealed that nearly 150 million Indians needed active intervention while fewer than 30 million were getting it.

According to another study, in 2017, 197 million Indians (14.3 per cent of the total population) were suffering from mental disorders, of whom 46 million had depression and 45 million anxiety disorders.

It has been almost six months, and people are not yet ready to embrace the outside world again. While the government has been easing out the re-opening of the country, many still fear stepping out of their homes. 

Sakal Times spoke to Dr Rahul Khemani Consultant Psychiatrist in Wockhardt Hospital, Mira Road to discuss the impact of the lockdown on people and effective ways to deal with anxiety. 

Discussing anxiety as a disorder, Dr Khemani says, "Anxiety is faced in a normal situation as well. When the event you're facing becomes distressful, anxiety seems to go out of control. This is what is exactly happening in the lockdown period. Situations are uncertain because of COVID, which gives rise to anxiety. On usual days, when we go out of our house, we don't feel anxious, but now at every step, we feel anxious as we don't know the outcome of going out. And also, people have faced such a pandemic once in their lifetime, which has initiated the fear in them." 

While most of us may experience anxiety regularly, for some anxiety could be escalated because of the situation. Currently, people may be anxious about two things - protecting oneself against the disease and the uncertainty in the outside world. 

Treating anxiety in a situation like this becomes very important, but the most essential part is to identify symptoms. 

Dr Khemani elaborates on the occurrence and symptoms of anxiety, "Anxiety disorder is a random occurrence. It is not that only a specific person would get it always. Anyone and everyone can get it. It is a biological illness which involves depletion of serotonin. That hormone is responsible for maintaining our mood and our stress level. When it reduces, the first thing that happens is anxiety, leading to extreme worry and restlessness."

"Usually, anxiety occurs in episodic form. Also, one of the important symptoms is that the victim might feel that he may die," he added. 

During the lockdown, the uncertainty is what triggered anxiety for most people. Talking about the lockdown's link to increased anxiety among people, Dr Khemani says, "The lockdown became the new normal for us, which also gave relief from the everyday hard work. Quite a lot of people had time to take care of their mental health. However, many faced anxieties because they have no answers to certain questions concerning the COVID situation."

Health is a major concern for many people, and any compromise on it may cause people to become worried. "For example: will it be easy to adjust? How can we ensure we'll be safe? Each person became comfortable at their own homes and stepping out of the comfort zone leads to a form of anxiety. Several things are coming across the internet that as well is responsible for making people anxious," says the doctor. 

But, as we enter the process of Unlock, routines are soon expected to be back to normal. With public transport resuming and we will soon have to move out of our houses and return to our everyday lives. 

Dr Khemani talks about dealing with the stress and anxiety of stepping out. 

"First and the most important thing is one needs to ease back to their previous normal routine. Start connecting or visiting places of your comfort zone - it could be a shop or catching up with a friend you're comfortable in. First, familiarise yourself with a task. We need a gradual progressive exposure. We call this a 'Method of desensitisation," says the psychologist. 

The mental health expert also said, "We need to plan ahead. Another important advice is to focus on important information. Third, start focussing on positives. Take pleasure from little things. Stop focussing on the negative part that you think you can't do. Break your ideas into two parts - 1) the things you can control, which includes your emotions, your reaction to things. 2) things you can't control like the lockdown, the unlock the active COVID cases, and the past that changed or the future that might change."

Talking about extreme conditions, such as agoraphobic and claustrophobic people, Dr Khemani said, "The first advice is to recognise the situation. They might say either way that they are scared of stepping out or scared of staying at home. They don't understand what they are scared of. "Becoming aware of the situation and what the situation is making you feel is the first step towards getting better."

"Secondly, recognise the reason behind the anxiety you are facing. Both claustrophobic and agoraphobic need to understand which situation is making them feel scared and what happens to them body wise and mind wise. Once the awareness stage is crossed, the next stage allows the body to accept those feelings. During the present situation, both kinds of people have made themselves comfortable in their own space," he added. 

Suggesting desensitisation as a means of acclimatisation post-lockdown. Desensitisation is the process through which a person is gradually made used to a certain concept. When it comes to dealing with post-lockdown anxiety, it is important to deal with the utmost sensitivity. 

"Step out of your home but don't go too far; this helps reduce the basic sensitivity to anxiety. Lastly, mindfulness, meaning being aware of your present scenario. One needs to become aware of your anxiety and then accept your anxiety. Focus on your body - focus what is in front of you rather than focussing on what is going to happen," suggests the doctor. 

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