Last week, a 62-year-old patient under investigation for Covid-19 was found dead in Serdang Hospital. Initial investigations suggest that the patient killed himself. He was suspected of suffering from depression.
This incident, and many others, has highlighted the issue of mental health, which has long been stigmatised and not really talked about. With the Movement Control Order (MCO) now extended to April 14, the medical fraternity has called on the public to focus on their mental and emotional well-being as reports of cabin fever and other mental conditions triggered by the current crisis are on the rise.
“We live in unprecedented circumstances where there is an overarching sense of ambiguity and lack of control. It is understandable that everyone is confronting their own challenges and may not fully recognise or understand their internal and external responses to this environment,” says Ivy Tan, head of counselling at ThoughtFull Hub PLT.
ThoughtFull is a mission-led start-up working to improve access to mental health services by making it more accessible and cost-effective.
Tan points out that fear and anxiety are possible and common reactions during a crisis. “As humans, we are hardwired for the fight-or-flight response. Some can persevere through such challenging situations to build resilience. If we have proactively engaged ourselves to practise some form of self-care during such times, these emotions do fade over time as we get back into our routines.”
However, if not properly dealt with, these emotions can become excessive and disruptive. “They start interfering with your daily activities. And if left untreated, they can lower our quality of life because it may lead to decreased productivity at work or school, social isolation or even mental health disorders.”
According to suicide prevention and support group Befrienders, there has been an increase in the number of calls to its hotline, with people expressing anxiety over financial issues due to their inability to work and restlessness over movement restrictions. News portal Free Malaysia Today reported that the centre receives an average of 60 calls a day, two-thirds of which are related to the MCO.
When faced with such situations, it is important to be honest about our emotions and to be aware of our emotional state, says Tan. “It is highly recommended that you seek professional help and support should you encounter or know of someone who is experiencing such persistent distress,” she tells Enterprise.
In times of prolonged alarm and stress, mixed emotions are common and it can manifest itself in what may seem like “unusual behaviour”, says Tan. Everyone responds in their own unique ways to adapt to the current shift and ambiguity, she points out, adding that it is important to pay attention to a loved one’s moods, instead of taking the behaviour at face value.
“If we do notice a shift in moods or behaviour, try to refrain from blaming and shaming as that will only intensify the distress and create a relationship setback in the long term. Rather, look out for their strengths and practise gratitude towards each other. It could be as simple as saying ‘please’ and ‘thank you’,” says Tan.
It is important to communicate how one feels to people who understand and accept their feelings, she adds. “Talk to a trusted family member or friend about your concerns. Staying connected helps you build a healthy relationship and strong support system. In times of extraordinary circumstances, however, our usual support systems may not be enough, so do not be afraid to ask for extra support.
“If you are still feeling distress and it is affecting your daily life, reach out to professionals. Psychologists and counsellors can provide supportive coaching at such times, even if it is as simple as giving a third-party perspective or keeping you accountable. In the light of the situation, telehealth services, such as ThoughtFullChat and others, are accessible through phone, mobile apps and online platforms.”
She also advises people to engage in healthy activities that will bring them comfort and stability at this time. “For example, getting restful sleep, eating a well-balanced meal or exploring some indoor exercises and activities. Body movements help release the build-up of extra stress hormones. A good starting point is to exercise once a day or in small amounts throughout the day.
“For those who do not normally exercise, it could be as simple as starting with deep breathing or body stretches. We could also engage in activities that have mental and emotional healing impact such as journaling, making art, cooking, meditating, listening to music or carrying out religious and spiritual practices. In times of duress, anything that goes under the umbrella of ‘self-care’ is essential.”
Tan says it is pivotal to develop a routine to adapt to the “new normal” as the grounding effects of having a structure is powerful and restores our sense of normality. For personal routines, it could be creating an exercise schedule, setting aside time for podcasts or audiobooks, committing to specific hours of work and taking breaks in between, she adds.
For family routines, it could be planning meal times, play and home-schooling time with children. For couples, setting up alone time, communicating and honouring the need for space is important, especially when creating space is more difficult than before.
“It could be retreating to a separate room or corner in your home for an hour or two each day to ensure a healthy balance between time spent together and time spent apart,” says Tan.
Recognising the stress caused by the MCO and fear of the pandemic, the World Health Organisation (WHO), in its “Mental Health and Psychosocial Considerations During Covid-19 Outbreak” statement, advises people to minimise watching, reading or listening to news about it.
While Tan reiterates WHO’s recommendation, saying that the sudden and near-constant stream of news reports on the pandemic can cause anyone to feel anxious and worried, she appeals to the public to be mindful of the source of the information to avoid being overwhelmed.
“Keeping ourselves informed of the latest news about the situation can ease our nervousness and stress or anxiety that results from uncertainty. However, before we start reading, take a moment to look at the credibility of the information. What is the source? Is this information evidence-based?
“There are many helpful resources available on social media, but there are also unregulated news sources that may lead to more distress and chaos if we are not making informed choices of the knowledge that we pick up. So, always look for facts versus opinion. Under duress, we tend not to filter the information accurately.
“Prolonged exposure to crisis news may cause duress. So, to avoid excessive exposure, set a time to watch, listen or read the updates from official websites.”
ThoughtFull is responding to this situation by extending its services to the public, says founder and CEO Joan Low. ThoughtFullChat, which is in its testing phase, is now open to all so they can access affordable emotional support and daily bite-sized coaching through the mobile chat platform from the safety of their homes.
ThoughtFull has also launched an ‘Ask Me Anything’ campaign on Instagram and Facebook so that individuals can ask their certified mental health professionals any questions or air their concerns for free.
“From this campaign, we have received a wide range of questions, mostly surrounding the following topics: 1) management of stress, anxiety and transitions on a personal level; 2) management of stress, anxiety and transitions on a family level; 3) adapting and navigating these changes in their professional setting,” says Low.
For more insights, she invites readers to look out for professional responses on ThoughtFull’s Instagram Story highlights via @athoughtfullworld or access www.thoughtfull.world for more information.
Alternatively, if you are lonely, distressed or having negative thoughts, Befrienders offers free and confidential support 24 hours a day. Contact Befrienders KL at (03) 7956 8145, or (04) 281 5161/1108 in Penang, or (05) 547 7933/7955 in Ipoh, or email [email protected].