The subject I am going to write about today demands attention and it is so vast, that I cannot write everything I know in one post. So for my readers to have an easier time in reading it, I will divide it into parts.
In the first part, I just want to introduce my readers to the idea of Postpartum Depression (PPD) and how it affects mothers. The second part will focus on the increased risk of PPD for mothers who are expecting now during a pandemic and what they can do to minimise their distress.
I had plans to deviate from the topic of coronavirus and talk about other things in mental health. But there was such a popular demand for this topic that I had to address it in my next post.
As a Clinical Psychologist working with children and having two of my own, I was asked a lot about parenting young kids and toddlers in a semi-war like situation. The topics and advice discussed in this post will be partly scientific knowledge and partly knowledge I have acquired on my own as a mother.
My aim through this article, is to give general tips for coping with children of all ages. Not all the points may apply to families with older children, but I am hoping that some of the points can be improvised to fit each family’s needs.
I am not a professional writer. I have never written much except for school essays and writing competitions. So when I decided to pursue a Masters in Clinical Psychology, I had no idea that writing would become my main form of communication.
Through the course of our education, we were made to read hundreds of scientific journals, articles and books on how to write a research paper. I spent nights in front of my laptop staring at the blinking curser, not knowing what to write or where to start. But slowly, my fondness for writing started to develop and I realized that it was a very soothing experience for me to sit with my thoughts deep into the night and pen them down whenever and wherever I wanted.
So when the novel Coronavirus or SARS-CoV-2 virus broke out into a global pandemic forcing millions into a lockdown, I decided to turn to my trusted friend, Microsoft Word.
But once again, I was blank. I didn't have the flow of my university days where I spent hours turning images in my mind into a word scramble.
What should I write? Where should I write? Should I write at all? I shut the laptop and gave up.
In the next few days, instead of writing, I started online counselling sessions and decided to work on creating a name for myself as a therapist. Nowadays, everything works on Instagram and Facebook. Being born in the 1980's, I was obviously a bit handicapped at these new media tools.
Hence, I roped in the help of a trusted cousin to help me through this maze of social media marketing. Once the pages were uploaded, some friends wrote to me asking about a possible website and blog. Now, mind you, I have thought about going down the blogging road before. But I lack the confidence for it.
You see; there are wonderful blogs out there run by talented writers. They are almost artists in the way they convey their messages and their websites look beautiful.
Who would want to read a blog by me? What if it is a big mistake and I make a fool of myself? What if I get attacked by trolls who hate my writing and send me disturbing messages? Would my fragile ego handle this all? These thoughts kept me away from the blogging world for a long time.
But now at the age of 34, I realized that I had seen enough of the world to know that life would never be perfect. We can never be perfect. I can never be perfect. And my writing will certainly, never be perfect. But what did I have to lose? I was sitting at home with nothing to do but speak my mind, even if only to a limited audience of my mother, father, husband and a couple of others who will read my articles.
And that's how this blog was born.
Now the next step was to ask people what they wanted to read about. Guess what most people asked for? Yup, you got it. The pandemic. There were varying thoughts like, "How to survive with kids in a lockdown?", or "Motivation during quarantine." Stuff like that. So I decided to write an opening post of how this blog came about in the middle of the biggest global shutdown the world has ever seen.
Now moving on to the pandemic stuff. CNN called it the biggest hit to the economy since World War 2. The European Union said something similar; that this was the most significant distress the region had experienced since the last two world wars. India has initiated the biggest lockdown known to mankind by quarantining 1.3 billion people in their homes. So, what is really going on? There is a lot of confusion about it.
There seems to be an almost mass hysteria of sorts around this virus. There is obviously a lot of panic, fear, anxiety, stress and a host of other negative emotions surrounding the situation. But let us put things into a little bit of perspective here.
Pandemics are more common than we think. As per some official statistics, there have been four major pandemics in the last 40 years. The deadliest one being the HIV/AIDS pandemic that started in 1981. As per data from the World Health Organisation, 37.9 million people worldwide were living with the HIV infection at the end of 2018 and it had caused more than 500,000 deaths globally (WHO, Global Health Observatory Data).
According to Chapter 17 (Pandemics: Risks, Impacts and Mitigation) from a book called "Disease Control Priorities: Improving Health and Reducing Poverty"; 2017, influenza pandemics occur on average every 25-30 years and cause 250,000 pneumonia related deaths annually. In line with this data, is also data showing that seasonal influenza causes about 250,000 deaths a year. The thing to keep in mind here is, that seasonal influenza occurs every year whereas, influenza pandemics occur less frequently but cause higher spikes in death rates (Jamison et al., 2017).
Other eye-opening data shows that; in any given year, all low income countries combined have a 3 percent probability of experiencing at least 140,000 deaths attributable to an influenza pandemic and a 0.1 percent chance of experiencing at least 8.3 million deaths (Jamison et al., 2017).
Okay, I won't bore you anymore with numbers. The point to take away from all this scientific data, is that the threat of pandemics is one known to mankind and they are mostly expected to occur every few decades. There are even scientists trained to catch, identify and stop new viruses and bacteria from causing pandemics.
If the threat from contagious diseases is so well known to us, then why is this particular pandemic causing mayhem like never seen before? Now, I can't really speak as a medical doctor or an infectious diseases expert. But there is one area where I have some expertise: Human Behaviour. And I do suspect that a lot of this mass panic has been a result of the misinformation and rumours spreading via digital communication. We even have a phrase for it, "psychological contagion" (Perrin et al., 2009).
As quoted in an article on Mental health and pandemics by Perrin et al., (2009), "Psychological Contagion" was a phrase coined by French Sociologist, Gustav Le Bon. He referred to it as a "collective mind" of emotionally charged people in a crowd. Psychological contagion of emotions and behaviours can cause mass evacuation panic, resistance to public health measures, overburdening of hospitals and clinicians, blaming of the government, and abandoning responsibilities to families and jobs (Perrin et al., 2009). Sounds familiar, eh? Add in to the mix the world of social media and minute by minute news reporting, and you have yourself a worldwide psychological contagion fueled by our exposure to the internet.
And this isn't the only psychological effect to think about. What about the individual response? We are different as people and we react differently to a global crisis. According to a paper by Manderscheid (2007), all of us can generally be divided into three categories of psychological response: one-third of the population unaffected, one-third hyper vigilant; one- third immobilized.
I don't really need to discuss the unaffected lot. You all know who you are. The ones still going out shopping for gourmet foods in a worldwide lockdown thinking this won't affect you. The hyper vigilant ones can experience permanent arousal of their sympathetic nervous system causing excessive fear, insomnia and anxiety (Perrin et al., 2009). The immobilized category are the interesting ones. They are the ones who feel "stuck", "helpless" and "unable to move." Their response is generally linked to a deep feeling of rejection, Post Traumatic Stress Disorder and depression (Perrin et al, 2009).
So you see, there are three things to take away from all of this:
1. Pandemics are unavoidable, serious and life threatening. But they are manageable. We have always managed them and we will continue to do so.
2. There is a group level psychological response that might cause people to do things they shouldn't be doing. For example, reading symptoms online and on chat groups and thinking you have all of those symptoms. Or rushing to get to your parent's country home when you have been asked to stay where you are. Or the best one of late, mass buying of toilet paper.
3. There is an individual response that is specific to each person's genetic and environmental background. We all will react differently. Respect the differences. Don't judge someone else's response simply because yours was different.
So folks, that's it from me for now. I hope this article gives you some relief from reading only the negative news coming forward these days. I tried to put a little bit of a positive spin on things. That being said, this is a serious situation. Don't be the one third unaffected lot and go out shopping. Take the advice of the medical experts seriously. They are "experts" for a reason. Keep the social distancing going for now! If any of you are interested in reading more from these articles I have mentioned, all of them will be cited below each blog post.
Take care and stay safe.
• Jamison, D. T., Gelband, H., Horton, S., Jha, P., Laxminarayan, R., Mock, C. N., & Nugent, R. (Eds.). (2017). Chapter 17, Disease Control Priorities, Third Edition (Volume 9): Improving Health and Reducing Poverty. The World Bank. https://doi.org/10.1596/978-1-4648-0527-1
• Manderscheid, R. W. (2007). Preparing for Pandemic Avian Influenza: Ensuring Mental Health Services and Mitigating Panic. Archives of Psychiatric Nursing, 21(1), 64–67. https://doi.org/10.1016/j.apnu.2006.10.003
• Perrin, P. C., McCabe, O. L., Everly, G. S., & Links, J. M. (2009). Preparing for an Influenza Pandemic: Mental Health Considerations. Prehospital and Disaster Medicine, 24(3), 223–230. https://doi.org/10.1017/S1049023X00006853