COVID 19 and Myriad of Psychological Problems in Indian Context

*Ganapathy Sankar Umaiorubagam, Monisha Ravikumar and Santhana Rajam Sankara Eswaran*

#### **Abstract**

Corona Virus 2019 (COVID 19) is impacting every family financially as well as emotionally. There is a panic situation existed throughout the world. Due to the presence of Novel Corona Virus, there are innumerous defects and changes existed in everybody's routine activities of daily living and other recreational tasks. As the pandemic outbreak in India was on-going, the Government of India took stringent measures to limit the cases by far in that stage only, by initiating a major lockdown pan-India and also by shifting the immigrants to the special quarantine facilities prepared by the Indian Military directly from the airports and seaports for a minimum of 14 days. The lives of people were drastically affected with lock-down and fear related to the disease's potential effects and transmission. The fear due to the contraction of COVID -19 is on the rise because of the death tolls and global spread. For low income country like India, financial crisis had troubled the lives of everybody. For older adults, there is a fear of death as well as fear of saving the lives of their loved one. Adapting to this new normal life is a real challenge for older adults in middle and low economic zone like India. Indian people are going through a myriad of psychological problems in adjusting to the current lifestyles and fear of the disease.

**Keywords:** Anxiety, Depression, Poor economy, Life impact, Indian context, new normal lifestyle

#### **1. Introduction**

The continuing pandemic COVID-19 (Coronavirus Disease 2019) has twist out to be a menace to mental wellbeing as preceding investigation mechanism exposed intense as well as extensive assortment of psychosocial crash on personality, community and international echelon throughout precedent eruption of contagious ailment. Throughout preceding spate, the psychosomatic crash on non-infected community exposed momentous psychiatric morbidities, pessimistic emotion, and unfortunate psychosocial and coping response in the direction of the occurrence of infectious diseases and unswerving fret concerning contracting the Virus. At present, there is a scarcity of information on the psychosomatic crash of the general public, confirmed and suspected cases, medical staff and law enforcement agents during the flare-up of COVID-19 pandemic, particularly in the background of mental health crash. This has turn out to be still more pertinently prearranged with

indecision and impulsiveness rotating roughly through the outbreak of coronavirus pandemic of such supreme extent and strength [1].

The research finding showed that in 2017, the prevalence rate of psychiatric illness is 1 in 7 individuals, the severity of illness from mild range to severe range. The relative involvement of psychiatric illness to the whole illness encumber in India approximately twice from 1990 to 2017. Amid Psychiatric illness, that obvious mainly throughout middle age, the maximum illness encumber in India was rooted in dejection and nervousness, followed by schizophrenia and Manic Depressive turmoil. Amid the psychological illness that comprises their commencement mainly throughout the early days and teenage years [2].

The high occurrence of dejection and nervousness turmoil in south India might be connected to the high echelon of refurbishment and urban sprawl in south India and to numerous causes that are not so far well unstated. Researchers identified a linear, but unassuming, association amid dejection and self-murder in south India, with self-murder number also being more in south India than in north India. This association has also been accounted for in preceding findings. It is also significant to a reminder that the higher occurrence of dejection amongst elder people has considerable insinuation since the populace in India is aged speedily [3].

Gender discrepancy was pragmatic in the sharing of psychological illness in India. The experiential high occurrence of dejection and nervousness turmoil in women than in men has also been accounted before, which might be connected to sex prejudice, brutality, sexual cruelty, antenatal and postnatal stress, and unfavorable sociocultural norms. Distinguishing the significance of psychiatric illness in tumbling the whole illness encumber, India commenced its primary nationwide psychological wellbeing strategy in 2014 and a modified Mental Healthcare Act in 2017, amid the objectives of given that impartial, reasonably priced, and worldwide admittance to psychological wellbeing. India has a national system in which wellbeing be mainly a liability of the federation. The socio-cultural and demographic assortment crossways the parts of India requires that the strategies and interference have the encumber of psychological turmoil live healthy suitable to confined circumstance [4].

plot theory, spurious allege, propaganda plus disinformation (primarily call out corona virus as indestructible, inexorable, and invincible) are merely aggravating the mental self-possession of common public. a lot of the research works associated to the COVID-19 outbreak spotlight on recognizing the epidemiology, scientific characteristics, genomic description of the disease, systematic features, data on technique of transmit and its itinerary, reservoir, incubation epoch, warning sign and quantifiable outcomes, counting survival and death rates; neutralizing the multiplication of the virus; and supervision of universal health ascendancy [5].

The persuasive crisis is craft for the wide-ranging research work on psychosomatic health and psychological well-being of the society in the countenance of COVID-19.At present there was a pragmatic neuropsychiatric relationship connecting severe acute respiratory syndrome and psychological health tribulations by means of ruthless psychiatric co-morbidities like melancholy, dread attacks, nervousness attacks, psychomotor exhilaration, suicidal deaths, hallucination and psychotic indication [6].

Also the lives exaggerated via COVID-19 are at further stake due to the perpetuated potential adverse effects. For instance, during travel restrictions and postponement and cancelation of religious, sports, cultural and entertainment events, people in quarantine may experience anger, loneliness, boredom and anxiety, and symptoms of cough, fervor, myalgia and exhaustion may grounds emotional suffering and stance of fright of constricting COVID-19 [7].

Whereas scientists, clinicians, confined and global health organizations and establishment, epidemiologists and virologists are functioning on top of numerous unreciprocated questions of this novel outbreak, general community, international media and opinion-makers are responding in the direction of this vagueness based on an inadequate deep-rooted/unverified knowledge. This has additionally elevated the ramification in the life of citizens in the rouse of COVID-19 and calls for the novel catalog of investigation on mental health. However, the collision of broadcast of viral infection on mental health has not been recognized within their entireties, which confront the patients and the universal inhabitants [8].

#### **2. Mental health of general population**

The ailment itself fashioned a sagacity of fright and nervousness in people's minds. Low levels of consciousness concerning the ailment, its shifting symptomatology and its novel temperament, cause additional apprehension amongst community; Particularly throughout the preliminary stages. Callers report understanding fret towards probable signs and symptoms of COVID-19 with themselves and their cherished ones. They had quite a few uncertainty associated to signs and symptoms of the virus spread, and deterrence trials to be undertaken. The media theater a momentous responsibility throughout emergencies as well as epidemics through communicating the populace connecting to the situation as well as maintaining them restructured on events in use through governments to enclose the increase of the virus spread. Investigation reports demonstrate with the intention of exposing that to a great deal of media revelation be able to turn detrimental to psychological health; with social media rising nervousness additionally than the customary media. Brawny lay down of emotion enthused up by the media, could guide populace to arbitrator jeopardy by these emotions relatively than truth along with facts. Individuals who encompass admission to audio-visual, digital and public media were bombard by capital of information, which recurrently commune ill-founded plus contrasting communication. Sturdy disclosure to astuteness of escalating numeral of thrashing of individual possessions and deaths, ostentatious people's psyches, generating an atmosphere of anxiety as well as threat. Persons were alarmed not simply relating to their personal safety, but as well of their loved ones [9].

Adequate as well as credible corporeal stipulation system be competent to slot in an momentous position in addressing as well as assuage a number of these apprehension faced by the broad-spectrum community. These comprise events such as hoisting responsiveness and given that steadfast information concerning menace in addition to possible health penalty of the disease as well as development of a pandemic, and deterrence as well as intrusion events; ensuring sufficiency of difficulty estimation as well as medical amenities; construction of obtainable health workers plus protection tools; endorsing stepladder to diminish the multiplication of the virus in the society and in health-care amenities; background of tele outreach programmes to tackle uncertainty and to present telehealth assembly; defend plus hold up health-care workers throughout a pandemic etc. nevertheless, throughout the COVID-19 deadly disease in India, the health organization did not execute satisfactorily to attend the pandemic efficiently along with instigate self-confidence in people [10].

The broad-spectrum community had throbbing, unsatisfactory and apprehension infuriating experiences of shortage of difficult amenities plus of believable physical condition services, late intelligence, as well as abandon at the hands of the physical condition scheme. They uttered their aggravation in excess be short of accessibility of beds and physical condition amenities. Some also protest concerning being taken advantage of medicinal amenities, test and hospital stay. The public

health system in India, is recognized to be riddle with quite a few inadequacies counting persons connected to deprived financing, shortage of available and inexpensive health care services, insufficient human resources and poor responsibility. The pandemic additionally loaded the stressed health system, ensuing in distraction of its capital to the conduct as well as avoidance of COVID-19, and in formation of typical health services unreachable to ordinary public. Changes such as mobility limitations and be short of haulage principal to compromise right of entry to healthcare, insufficient provisions of medicine, transfer to telemedicine and online practice, further supplementary to the dilemma of the individuals [11].

#### **3. Standard of living**

Owing to the lockdown and boundaries on mobility, citizens were enforced to hunt for support for sensible apprehension allied to provisions, medicines, haulage, health and indispensable services. They had numerous distress interrelated to source of revenue and employment. They report apprehension plus improbability concerning a real or probable job hammering, pay cut, awaiting bills, incapability to purchase food, incapability to disburse EMIs etc. The illness and consequent lockdown dislocate life plans that were in use for granted by many persons; particularly by student, employer, workers etc. [12].

The unexpected transformation inside school as well as university agenda and predominantly in examination schedule, fashioned a tremendous sagacity of indecision as well as fright amongst student. Persons who were scheduling for prospect vocation, have in the direction of revolutionization or relinquish their existence tactics. There were countless others who have intended imperative time proceedings such as wedding, job transport, exchange a new house, journey, surgeries etc.; all of which have to be considerably distorted. This fashioned an enormous intelligence of commotion and a thrashing of organize. Employees functioning in prearranged division reported encompass to fetch their office into their homes. Originally, 'employment from home' come into sight as a positive panorama, particularly to persons who survive in metro cities, as it provide the essential interval from extended travel in addition to frenzied employment hours. Workers come across at this as a break for augmented efficiency [12].

Nevertheless, as the lockdown get comprehensive, person's testimony shows conflicting understanding of low efficiency as well as lack of enthusiasm. They were on track belligerent concerning exhaustion caused by protracted television interface, be deficient in demarcation flanked by individual plus professional lives, shortage of human communications with contemporaries, long-lasting statement loops to acquire straightforward tasks done etc. individuals who well thought-out their specialized lives as vital to their distinctiveness, institute it mainly hard to recognize probable wounded, qualms and failure. Women were twice as exaggerated as they lost their own jobs and/or those of their partners who were the primary bread winners. Rival home as well as work burden expose women to additional risks of pay-cuts or lay-offs [11].

Journalism institute that citizens boast innumerable pessimistic emotions such as sensation of fretfulness, depressing, uninterested, feeling alone, a sense of loss and anguish, annoyance, aggravation etc. a lot of journals provided testimony over a feeling of numbness and a disengagement from everyday reality. a number of protest concerning the fright of trailing daily life skills during the lockdown. Regardless of the talk of the 'new normal', the realism of the usual linger lively and deceptive, parting a lot of sense of loss of control over their own lives. Citizens protest concerning their diminish internal and external cope possessions as the

#### *COVID 19 and Myriad of Psychological Problems in Indian Context DOI: http://dx.doi.org/10.5772/intechopen.98768*

lockdown got frequently comprehensive. The grown-up habits of coping with suffering, which were often associated by means of contribution in the exterior world were out-of-the-way due the lockdown. at the same time as some rapidly tailored to, and urbanized newer conduct of coping with the distorted realism, others struggled to do so. For some, this also guide to existentialist quizzical regarding the connotation of life and death [12].

#### **4. Family dynamics**

Murray Bowen's family systems theory is solitary of primary wide-ranging conjecture of family systems implementation which recommend with the intention of families endeavor to equilibrium two life forces—family togetherness plus personage autonomy- that one of the recognized basis of disagreement in cherished associations is be short of equilibrium flanked by togetherness and separateness [13]. This axis divergence reflects in the COVID 19 disaster that bounded issues of cherished associations, wicker about both ends: 'annoyance owing to obligatory togetherness' plus 'segregation owing to severance from the loved ones'. loads of persons had building the familiarity of exasperating and difficulty owing to trapped within the identical family amid their associates for months collectively devoid of an break out. a lot of them reported that the old disagreement and clash, which were allegedly obscured underneath the carpet tiles, re-emerged throughout the lockdown; a observable fact portrayed as the 'return of the repressed'. The customary domestic decisions approximately foodstuff, schedule, labor, expenses, behavior etc. become foundation designed for contestation. Citizens in addition provided testimony those newer activate for divergence contiguous to issues such as quarantine, preventive measures, testing, stepping out of the house, traveling or appealing guests at home. Individuals criticize that their former strategy of disagreement decree in intimate relationships, botched in these state of affairs, frequently parting them injure, annoyed as well as heartrending. at the same time as a few description enforced allocation and familiarity as a foundation of conflicts, others in addition reported that segregation as well as social distancing from associates and relations member, produced negative cost for their mental well-being [14].

The relationship disagreement be informed by persons crossways diverse age group in addition to numerous sort of affairs counting parent–child, cherished, conjugal, protracted, peer relationships etc. Indian families, frequently explain plus boast for collectivistic character, when enforced to hang about collectively for comprehensive periods, institute it tricky to steer from side to side this enforced togetherness. The lockdown dislocate each day beat of relations implementation, plus robbed populace of the much-needed interruption endowed by work, schools and outside life. The lockdown bring 'hierarchical and lopsided nature' of the relations systems in India, to the forefront. Adolescents and young people found it restricting and exasperating to be oversee by their parents as well as elders, in addition to be sermonized on top of issue pertaining to monitor occasion, digital reliance in addition to family responsibilities. Parents on the supplementary hand accomplish out in the direction to search for instructions used for maintenance of their offspring betrothed at dwelling, and for organization of resentment outbursts and conflict in their young people. Journalism demonstrate with the intention of the adaptable belongings of the pandemic encompass been exacerbate in favor of women and girls. Specified the customary gender role prospect of caregiving from women, and unavailability of residence help throughout the lockdown, women felt entirely unconfirmed by the relatives as they demeanor the family household tasks [15].

Women criticize concerning the exponential augment during amateur care employment by means of school shutting and sensitive concern requirements of family members on residence. They also uttered their aggravation and annoyance concerning the imbalanced and inequitable splitting up of manual labor at home. Literature also demonstrate with the intention of events such as societal hostility might encompass serious penalty for the mental health of the aged, parting numerous elderly in a circumstances of segregation and melancholy in addition it adds as a causative to a probable augment in elderly suicides throughout the pandemic in India [16].

Studies description proved that a number of older adults who were alienated on or after their kids and treasured ones need enviable sensible as well as emotional prop up. On the divergent, there were a few others, who were obligatory to survive with their family throughout the pandemic, in addition to that institute it complicated to acknowledge their amplified reliance on their younger children and the consequential demand is loss of sovereignty and modesty. Additionally, adult children of the old who play care-giving responsibility intended for their elder parents have agonized intended for the physical circumstance of the aged, and worn up in addition, fatigue due to the steady caregiving burden. a few in addition called for psychiatric referral to lecture deterioration of psychological illnesses in their elderly parents [17].

#### **5. Susceptible segment of society and psychological impact**

While COVID-19 pandemic is alleged and declared to be an equalizer in bringing out vulnerabilities during diverse stratum as well as segment of the public, it also prove to strengthen the previously obtainable structural disparity in the Indian society. The subsequent segment strongly looks at the psycho-social crash of COVID-19 pandemic on individuals who fit in to the susceptible segment of the society.

#### **5.1 COVID patients and health workers**

Journalism summit out to individual psychosomatic health vulnerabilities amongst persons who are quarantined and besides amongst the healthcare as well as frontline workers. People who be in quarantine at home and in health facilities, reported sense of dejection, disconnect, anxiety, and moreover occurrence of disgrace plus shock. Agreed their invariable experience to the health risk, countless testimony anxiety about death and anxiety about their individual health and also of their cherished ones. Disgrace is a chief communal determinant of physical condition that drive morbidity, transience, and physical condition disparities and has been portray by the World Health Organization as a 'hidden' burden of disease [18, 19].

Scandal flanking patients as well as health care donor all through COVID-19 pandemic, and its psychological wellbeing corollary are steadily being documented. The transmissible landscape of COVID-19 disease, all the length through restriction proceedings of lockdown plus subjugation, and discredit principally besieged at convinced communities, fashioned an ambiance of misgiving and qualms amongst Indian communities. Expressions like 'hotspot', 'COVID-suspects', criminalized and responsible persons who were the fatalities of the pandemic. Strategies such as get in touch with tracing and marking COVID-19 pretentious area by means of particular cipher, further supplementary to the disparity in management and disgrace was experienced by those who were contaminated with COVID-19. Relations member of patients too were objective of abhorrence and prejudice. Diminutive numeral

of call starting the healthcare provider and persons concerned in stipulation of indispensable services as well as vanguard workers, too, accounted disgrace faced by them, and the intimidation of human being dispossessed commencing from their households [20].

#### **5.2 Migrant workers**

Domestic migrants are between the majority vulnerable community in India, frequently facing numerous corporeal and psychological health challenges. Being an foreigner to the multitude metropolis plus civilization, already makes refugee a susceptible group of people. The pandemic and the succeeding lockdown lead to further escalation of vagueness and financial defenselessness amongst the migrant, as a lot of them misplaced their livelihood plus sources of revenue. The unforeseen lock down, emotionally involved through loss of earnings broken it complicated for migrant to persist to exist in the city. High commonness of COVID-19 cases, and the dread of astringent the disease itself, finely tuned their anxieties. The city became further and further unwelcoming, further growing a sagacity of fright and hostility amongst migrants; leading to worry to return to their homelands. be deficient in admission to information, shipping, revenue, accommodation, groceries, physical condition and indispensable amenities as well as protract system, worsen the dilemma of migrant in the metro cities. Male migrants statement being protected hooked on their miniature rented houses with their contemporaries, surfing on their mobiles for the complete daylight hours, plus perturbing for their esteemed ones who were back home. Conventional Masculinity script of being providers as well as bread winners frequently prohibited male migrants from sharing their vulnerabilities with the family members back home. Family member's flipside to home too were concerned concerning the protection of their migrant associations who lived in cities which were proliferation foundation of COVID-19 contagion as portrayed in the media. Some of the male migrant's employees uttered a sagacity of defenselessness and nervousness, while countless others uttered intense annoyance against the system. This also incorporated rage towards police force who demonstrate absolute indifference when were advance for help. Immigrant workers did not know what the opportunity detained for them as they felt unwelcomed by the city and cut off their families and communities back home [21].

#### **5.3 Women survivors of violence and abuse**

National charge for women in India, throughout the early phase of the lockdown itself, overtly recognized that the quantity of marital brutality gear in the nation had sustained to boost and amplified. Various pathway that augment women's jeopardy to brutality throughout the pandemic comprise augmented household stress, commotion of livelihoods, abridged admission to physical condition and indispensable services, proscribed admittance to money, disturbance of community as well as defensive networks and constrained bond by means of prescribed support services such as hotlines, catastrophe centers, shelter, permissible aid, and fortification as well as counseling services. They described exacerbation of brutality that stays alive before the pandemic. Separately from the daily violence experienced by girls and women within the family spaces, brutality throughout the pandemic implicit several newer expressions. Women's testimony document that men and other family members who be responsible for violence, assume newer 'fright tactics' that implicated mislead about the pandemic, furthermore generating a sagacity of dread for their individual lives or those of their dear ones. Brutality in addition take the outline of depriving women of possessions such as soap, sanitizers, mask that

were crucial in protecting them from the virus. Women were frequently the last ones to obtain health care and release services [22].

The financial disaster and thrashing of living unswervingly affected those women who were bread winners of the family, additionally mounting their financial reliance on the male members within the family. Women also experienced a tortuous crash of this financial disaster by fetching displaced target of the annoyance and aggravation experienced by their male members who misplaced their livelihoods. Attempts to emphasize their individual needs or to confer authority and responsibilities inside the household were often met with further brutality. Being trapped with perpetrators of brutality who had total admittance to their intelligence, labor as well as bodies, augmented women's susceptibility, furthermore provoked the broad disquiet and fright fashioned by the pandemic. Abandonment symptom practiced by their associates who could not contact substances, become excuse for the brutality fling at them. Inadequate potential of flee owing to mobility borders as well as lack of admittance to prop up structures; heightened women's sense of terror and helplessness. Given the patriarchal power over mobile and telephone devices, women had to find hushed and un-shriveled slots to call covid 19 helpline and share their stories. The police force and health systems, when contacted, were previously swamped with pandemic related responsibilities, and hence were less receptive [23].

#### **5.4 Geriatric population**

As component of a significant jeopardy group for COVID-19, the aged are presently being instructed to linger at residence and self-isolate. Nevertheless, it has been established that elder adults are at elevated jeopardy for fretfulness and hopelessness when put in situations of communal extrication. To individuals who do not encompass close relatives or acquaintances and to those only community contact is out of the home, these can be predominantly commencement times. Many persons within this assembly rely exclusively on group of people, places of adoration, charitable work and communal care, behavior which encompass been harshly reserved by the COVID-19 eruption. In addition, a lot of elderly persons encompass slighter admission and/or literacy to communal network, which prevent them from maintaining implicit association with others. Consequently, the mental and poignant collision is incredible. The social extrication causes and aggravates solitude, abandon, gloominess and apprehension, all of which can fabricate longterm fitness consequences. Furthermore, the background of this pandemic might augment suicide activities along with older adults. As an instance, subsequent to the SARS epidemic in 2003, suicide risks amongst elderly individuals were amplified by 30%. The loneliness in the aged has also been recommended to be escorted by biological modifications that construct this assemblage more susceptible to entrust suicide, which includes the altitude of inflammatory markers furthermore spreading out of peripheral blood mononuclear cells. Additionally, it has also been recommended that community disentanglement may deteriorate neurodegenerative disorders, such as Alzheimer's disease [24].

An supplementary subject of debate that additionally elucidate the poignant crash of the virulent disease amongst the aged is the experience of "ageism". In the early phase of the COVID-19 outburst, the ailment had been principally depicted as a sickness that affects approximately the older adults. At present, this stereotype has been confirmed flawed, as becoming old itself is not a dependable decisive factor to envisage the health impact of SARS-CoV-2 infection. Apart, although the systematic facts of such a declaration, the communal marginalization and separation of the aged persist throughout the population. Certainly, in

#### *COVID 19 and Myriad of Psychological Problems in Indian Context DOI: http://dx.doi.org/10.5772/intechopen.98768*

some countries, the plodding repose of the social estrangement recommendation does not seem to be relevant to the older adults, who are constantly advised to self-isolate. Additionally, there is a universal conviction that the security of this group should be forgo for the better goodness of society, chiefly in disadvantage to the economy. In this situation, the annoyance of the intergenerational nervousness can be experiential in social media content. As an illustration, the odious hash tag #boomer remover come into view in over 4,000 posts in Twitter in a 10-day epoch subsequent to the pandemic declaration of WHO in March. In this frame, there is a caustic augment in the psychological health load of senior citizens, which must be urgently addressed [25].

#### **5.5 Children**

Children, particularly the little ones, are also in a spot of susceptibility throughout the pandemic. This come to pass because, at home, they go through with inadequate communal association, vital for uniqueness and comfort at young ages, abridged physical activity, aloneness and tedium, which might upshot in long-term special effects. Certainly, the mental and physical health, as well as output in adult life, is intensely entrenched in the childhood years. Information from preceding epidemic display that brood those skilled segregation events be five times more prone to stipulate mental health services plus additionally disposed to the occurrence of PTSD [26].

It has also been established that children who are away from school be inclined to encompass longer screen times, asymmetrical slumber patterns as well as less constructive diets, which can be remarkably damaging in longer era of instance such as the yet unidentified period of this deadly disease. In addition, the financial slump, the restricting events and the general family pressure could be accompany by an boost in household brutality and child mistreatment, situation that crash the psychological health of children. Young people with preceding psychological disorders necessitate meticulous notice because disturbance of school schedule can turn down their mental health status. Furthermore, the existing events comprise additional provoked extension of remote work, while schools and daycare center have to break off their behavior. In this scenery, family and work environment enclose fused and decreased presentation can be seen in both field, as stress intensifies [27].

Subsequent to the estrangement events, social media has turn out to be a momentous reserve to uphold social communication. Although its exploit might ease a number of the psychological health impact of the isolation, it is necessary to examine its unconstructive crash in children plus adolescent. First, overwhelming haphazard information concerning the pandemic might activate pressure, nervousness, fright as well as despair. This consequence is still more powerful in younger persons with the intention of not boasting the judgment to sift information. Second, the extreme employ of the Internet might create an addiction, compromising the development of a healthier routine during the pandemic, which is also self-possessed by learning, spare time, and work out behavior. Third, digital society network be extremely based in the implicit edifice of a self-image and visibility, which, particularly for the youngest, might arbitrate self-esteem throughout the detection of community endorsement. Concurrently, social media can be an aggressive position. As an upshot, its extreme exploit might donate to self-harm proceedings throughout implicit dispute, in which the contributor has coursework associated to self-mutilation and even suicide that should be filmed as well as posted. The online chase for the term "challenges online" has amplified since the accomplishment of the restricting events. Eventually, eminent Internet use is connected by resources of behavioral dilemma such as neglecting fragile life, affiliation disorder, mood dysfunction and

slumber turmoil, as well as augmented apprehension and melancholy levels during the pandemic [28].

#### **5.6 Mental illness patients**

In psychiatric patients, the COVID-19 pandemic valor triggers an even inferior conclusion relating to mental health. As formerly discussed, the indecision, dread and community estrangement might aggravate pre-existing psychiatric diseases as well as impetuous its symptomatology. Additional to their advanced susceptibility to numerous stressors, they countenance deteriorate checkup and follow-up owing to the postponement of several discretionary schedule as well as redirection of physical condition specialized to countenance the pandemic. Additionally, they be inclined to encompass additional harsh form of COVID-19 owing to co morbidities, immunosuppressant and, perhaps, most horrible right of entry to checkup concern because of discrimination [29].

#### *5.6.1 Depression*

When carry out numerous balance to review the emotional collision of COVID-19 pandemic in China on 76 patients with major depressive disorder, anxiety disorders and mixed anxiety and depressive disorder patients and 109 healthy controls, the patients group have most horrible outcome on approximately all variables addressing gloominess, nervousness, pressure and sleeplessness. As for additional psychiatric symptom referred throughout the study, the patient's collection had additional doubts concerning their physical health, additional reasonable to harsh annoyance and impulsivity and more suicidal ideation. Nonetheless, it is significant to talk about that the control group was evaluate concurrently to the patients group. Control group was self-possessed of individuals devoid of psychiatric disorders that were evaluated before COVID-19 pandemic. For this motivation, consequences of the study can be contestable [30].

Furthermore, patients with widespread nervousness have augmented health anxiety. As a consequence, they are further prone to mystify typical outlook with COVID-19 symptoms, generate constant nervousness and anguish.

#### *5.6.2 Agony*

It is our character to employ evasion and refutation, frequently instinctively, to defend ourselves from the further stressful fraction of our life, counting indecision and possess death. Instead of tolerant the predictability of demise, and the indecision of quotidian livelihood, the majority populace is inclined to survive according to a misapprehension of conviction, persuasive himself they be able to calculate on the influx of future. We can regularly bear a shorter epoch of uncertainty for one to seven days. Commonly talking although, we do not perform good as inquired to suffer longer epoch of oblivion. During last year, Corona Virus 19 has been jabbing at the poignant security system numerous populace depend on to generate a sagacity of solidity [31].

Several of the schedule, associations, and chairs populace rely on to wait beached encompass been absent from their life. There has not been a lot of conviction to secure us, and we greatly favor sense anchored. The deadly disease has gone several populace emotions expressively unprotected, sensitively bare. Continuous coverage to frequently deprive of cruel authenticities has unlocked the gate to approach of susceptibility that is flattering fairly heavy to tolerate. Indecision with rejection clear finish insight has formed prevalent despair. A persistent sagacity of agony has resolved in.

#### *5.6.3 Obsessive–compulsive disorder*

Numerous patients with obsessive–compulsive disorder (OCD) exceptionally are anxious concerning having an ailment or contaminating others. Throughout this world fitness crisis, these feelings may strengthen. Also, a number of signs and symptoms of OCD are very comparable to significant precautionary events for COVID-19, such as obsessive hand wash and avoiding substantial contact. Consequently, this extends beyond grounds difficulty for physician to make an analysis and profligacy new possessions of OCD. At last, the stressors associated with the virus outbreak valor augment the quantity of new OCD patients, particularly amongst those "at risk" [32].

#### *5.6.4 Schizophrenia*

In psychiatric patients, extreme concentration to media or community networks might impetuous a sensitive stage of the ailment or modify its demonstration. For instance, a 43-year old German patient with schizophrenia has delusion as well as hallucination connected to the pandemic. He supposed he constricted the illness in the course of a WhatsApp video commencing from COVID-19 patients in China and on track encompass auditory hallucination, fretfulness and disheartening hilarity. Therefore, equilibrated announcement, based on systematic specifics, is important to diminish this probable damage [33].

Additionally, schizophrenic patients be less likely to immunize, hold fast to social distancing, wash down their hands as well as employ mask throughout virus pandemic. This actuality is in addition proper for patients by means of other psychiatric conditions, such as obsession. Consequently, they are a susceptible crowd for astringent COVID-19, particularly if their mental health is not as good as usual.

#### **5.7 Hospitalized patients**

Anxiety experience throughout COVID-19 pandemic is almost positively flush elevated for psychiatric patients hospitalized for illness. In India, these patients have to hang about in congested ward devoid of relations visits or electronic gear. These circumstances exacerbate their suffering plus psychological symptomatology. Furthermore, the patients in these amenities be inclined to create collection behavior, split dining and lavatory chairs, interrelate intimately plus put into practice less defensive events because of their mental state [34].

#### **6. Conclusion**

Though crash of this pandemic on universal psychosomatic health is not yet registered as well as deliberate, comparable in sequence of information as of previous research mechanism might present an clarification and imminent. Early as well as shrewd psychiatric intercession ought to be delivered by psychosomatic health practitioners to administer by the way of the eruption of high-mortality communicable diseases. The obtainable pandemic COVID-19 is the root for devastating psychosocial physical circumstance alarm such as disquiet, distress, fright, nervousness, depressive symptoms, sleep disturbances, rebuff, rage, dissatisfaction and distrust in the general public. For medical staff, these psycho-logical evils are connected to concentration as well as executive capacities which could impede the brawl against COVID-19. The incident of psychosomatic problems in the universal inhabitants has been ranging from 4–41% of posttraumatic symptoms and 7% of

depressive symptoms. Throughout any group of people crisis, citizens look for out event-related information to attain the illusion of control to give off the dread of the unidentified which escort to higher fretfulness, and in the case of deceptive propaganda as well as disinformation on social media, indistinct insight of jeopardy, tremendous fear of unidentified/indecision and community dread may lead to stigmatization, marginalization and scapegoat. And even though studies on COVID-19 are insufficient, several authors encompass envisage the probable repercussion on psychosomatic and physiological health not only on the vulnerable other than also on the general population. Psychological interference as well as psychosocial hold up would recover the communal mental health throughout the outburst of pandemic COVID-19.

Considerable substantiation as of the precedent studies of epidemics on the crash of psychosomatic wellbeing has exposed psychosocial penalty in the overstated persons and in the general population. The promising international psychological health issues relative to COVID-19 pandemic may progress into abiding health problems permeated during feelings of susceptibility, segregation/quarantine, dread, apprehension, psychosomatic distress, psychosocial stressors, posttraumatic symptoms, disgrace and xenophobia. It is fundamental to stress the psychological health and well-being of the inhabitants through upbeat psychological intervention throughout the COVID-19 pandemic.

## **Author details**

Ganapathy Sankar Umaiorubagam1 \*, Monisha Ravikumar1 and Santhana Rajam Sankara Eswaran<sup>2</sup>

1 SRM College of Occupational Therapy, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India

2 Tamil Nadu Teacher Education University, India

\*Address all correspondence to: dean.ot.ktr@srmist.edu.in

© 2021 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

*COVID 19 and Myriad of Psychological Problems in Indian Context DOI: http://dx.doi.org/10.5772/intechopen.98768*

#### **References**

[1] Chatterjee K, Chauhan VS (2020) Epidemics, quarantine and mental health. Med J 76(2):125-127. https ://doi. org/10.1016/j.mjaf.2020.03.017

[2] Kyu HH, Abate D, Abate KH, et al. Global, regional, and national disabilityadjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1859-922.

[3] Chokshi M, Patil B, Khanna R, et al. Health systems in India. J Perinatol 2016; 36: S9-12.

[4] Ministry of Health and Family Welfare, Government of India. New Pathways, New Hope: national mental health policy of India. 2014. https:// mohfw.gov.in/sites/default/files/

[5] Council of Europe (2020) Statement by human rights experts on the International Day against Homophobia, Transphobia and Biphobia. COVID-19: The sufering and resilience of LGBT persons must be visible and inform the actions of States. https://www.coe.int/ en/web/commissioner/-/covid - 19-the-sufering-and-resilience-of-lgbtpersons-must-be-visible-and-informthe-actions-of-states

[6] Alegría M, NeMoyer A, Falgàs Bagué I, Wang Y, Alvarez K (2018) Social determinants of mental health: where we are and where we need to go. Curr Psychiatry Rep 20(11):95. https:// doi. org/10.1007/s11920-018-0969-9

[7] Ko C-H, Yen Ju-Yu, Yang M-J (2006) Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan. Psychiatry Clin Neurosci 60:397-403. https://doi. org/10.111 1/j.1440-1819.2006.01522.x

[8] Kinderman P (2014) A prescription for psychiatry: why we need a whole new approach to mental health and wellbeing, 1st edn. Palgrave Macmillan, London

[9] Armitage, R., and Nellums, L. B. (2020). COVID-19 and the consequences of isolating the elderly. Lancet Public Health 5:e256. doi: 10.1016/s2468-2667(20) 30061-x

[10] Atchison, C. J., Bowman, L., Vrinten, C., Redd, R., Pristera, P., Eaton, J. W., et al. (2020). Perceptions and behavioural responses of the general public during the COVID-19 pandemic: a cross-sectional survey of UK Adults. medRxiv [Preprint]. doi: 10.1101/2020.04.01.20050039

[11] Banerjee, D. (2020). 'Age and ageism in COVID-19': elderly mental healthcare vulnerabilities and needs. Asian J. Psychiatr. 51:102154. doi: 10.1016/j. ajp.2020. 102154

[12] Depoux, A., Martin, S., Karafillakis, E., Preet, R., Wilder-Smith, A., and Larson, H. (2020). The pandemic of social media panic travels faster than the COVID-19 outbreak. J. Travel Med. 27:taaa031. doi: 10.1093/jtm/taaa031

[13] Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., et al. (2020). Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J. Am. Acad. Child Adolesc. Psychiatry doi: 10.1016/j.jaac.2020. 05.009 [Epub ahead of print]

[14] Liao, Q., Yuan, J., Dong, M., Yang, L., Fielding, R., and Lam, W. W. T. (2020). Public engagement and government responsiveness in the communications about COVID-19

during the early epidemic stage in china: infodemiology study on social media data. J. Med. Int. Res. 22:e18796. doi: 10.2196/18796

[15] Hao, F., Tan, W., Jiang, L., Zhang, L., Zhao, X., Zou, Y., et al. (2020). Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain Behav. Immun. 87, 100-106. doi: 10.1016/j.bbi.2020. 04.069

[16] Hewson, T., Shepherd, A., Hard, J., and Shaw, J. (2020). Effects of the COVID19 pandemic on the mental health of prisoners. Lancet Psychiatry 7, 568-570. doi: 10.1016/s2215- 0366(20)30241-8

[17] Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., et al. (2020). Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry 7, 468-471. doi: 10.1016/S2215-0366(20)30171-1

[18] Xiang, Y. T. (2020). Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry, 7, 228-229.

[19] Chen, N. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. The Lancet, 395, 507-513.

[20] Ford-Jones, P. C., & Chaufan, C. (2017). A critical analysis of debates around mental health calls in the prehospital setting. Inquiry, 54, Article 704608. https://doi.org/10.1177/ 0046958017704608

[21] Rubin, G. J., & Wessely, S. (2020). The psychological effects of quarantining a city. British Medical Journal, 368, Article m313. https://doi. org/10.1136/bmj.m313

[22] Spoorthy MS, Pratapa SK, Mahant S (2020) Mental health problems faced by healthcare workers due to the COVID-19 pandemic—a review. Asian J Psychiatry 51:102119. https://doi.org/10.1016/j. ajp.2020.102119

[23] Greenberg, N., Docherty, M., Gnanapragasam, S., and Wessely, S. (2020). Managing mental health challenges faced by healthcare workers during covid19 pandemic. BMJ 368:m1211. doi: 10.1136/bmj.m1211

[24] Roesch E, Amin A, Gupta J, García-Moreno C (2020) Violence against women during COVID-19 pandemic restrictions. BMJ 369:m1712. https://doi. org/10.1136/bmj.m1712

[25] Kawohl, W., and Nordt, C. (2020). COVID-19, unemployment, and suicide. Lancet Psychiatry 7, 389-390. doi: 10.1016/S2215-0366(20)30141-3

[26] Cheung, Y. T., Chau, P. H., & Yip, P. S. (2008). A revisit on older adults suicides and Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong. International Journal of Geriatric Psychiatry, 23, 1231-1238. https://doi. org/10.1002/gps.2056

[27] Jiménez-Pavón, D., Carbonell-Baeza, A., and Lavie, C. J. (2020). Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: special focus in older people. Prog. Cardiovasc. Dis. 63, 386-388. doi: 10.1016/j.pcad.2020.03.009

[28] Huang Y, Zhao N (2020) Mental health burden for the public afected by the COVID-19 outbreak in China: who will be the high-risk group? Psychol Health Med. https://doi.org/10. 1080/13548506.2020.17544 38

[29] Jacob K (2006) Social context and mental health, distress and illness: critical yet disregarded by psychiatric

*COVID 19 and Myriad of Psychological Problems in Indian Context DOI: http://dx.doi.org/10.5772/intechopen.98768*

diagnosis and classifcation. Indian J Soc Psychiatry 32(3):243-248

[30] John A (2020) Supporting students and the school community during a pandemic. In: Manickam LSS (ed) COVID-19 pandemic: challenges and responses of psychologists from India. The Editor, Thiruvananthapuram, pp 56-62

[31] Gao, J., Zheng, P., Jia, Y., Chen, H., Mao, Y., Chen, S., et al. (2020). Mental health problems and social media exposure during COVID-19 outbreak. PLoS One 15:e0231924. doi: 10.1371/ journal.pone.0231924

[32] Fontenelle, L. F., and Miguel, E. C. (2020). The impact of COVID-19 in the diagnosis and treatment of obsessivecompulsive disorder. Depress. Anxiety 37, 510-511. doi: 10.1002/da.23037

[33] Maguire, P. A., Reay, R. E., and Looi, J. C. (2019). Nothing to sneeze at– uptake of protective measures against an influenza pandemic by people with schizophrenia: willingness and perceived barriers. Austr. Psychiatry 27, 171-178. doi: 10.1177/1039856218815748

[34] Mamun, M. A., Bodrud-Doza, M., and Griffiths, M. D. (2020a). Hospital suicide due to non-treatment by healthcare staff fearing COVID-19 infection in Bangladesh? Asian J. Psychiatr. 54:102295. doi: 10.1016/j. ajp.2020.102295

#### **Chapter 42**
