Anxiety and depression, the legacy of COVID-19 with Dr Seedat

Mental health is an issue which affects millions of people around the globe on an annual basis. From stress and anxiety to PTSD and depression—people struggle with a multitude of challenges daily which affects their mental wellbeing.

However, following the outbreak of COVID-19, thousands of people are finding themselves strained under pressure posed by the virus and the world changes it introduced.

These include the failing economy, job losses and fears of contracting the virus or trying to deal with the loss of a loved one. The situation has escalated to the point, whereby the South African Depression and Anxiety Group (SADAG), has highlighted they have received an increase in calls since the start of lockdown from an assemblage of people feeling anxious, lonely, worried and depressed.

SADAG points out that many callers are stressed about a combination of issues. Issues which seem twice as concerning than they did a few months ago. These include the spread of COVID-19, finances, relationship problems, job security, grief, gender-based violence and trauma.

The organisation elaborates, “COVID-19 and the lockdown have affected many South Africans, and it has had a severe impact on people living with a mental health issue, often making their symptoms more heightened.

SADAG has been receiving calls from people with no history of anxiety or depression who are feeling overwhelmed, anxious and stressed”, says SADAG’s Operations Director Cassey Chambers.

When looking at KZN, just how are Newcastillians faring under the burden of the pandemic?

Obtaining insight into the mental state of our local communities within Northern KwaZulu-Natal, MediHub KZN spoke with Dr Fatima Seedat, a well-known and respected psychiatrist in Newcastle.

Dr Seedat is a Specialist Senior Psychiatrist with a private practice in Newcastle, who also utilises the Mediclinic Newcastle Hospital Kintsugi Wellness Centre to admit and treat patients, who urgently require voluntary psychiatric intervention.

Whilst in the thick of COVID-19, during lockdown level 5, and most of level 4, Dr Seedat explains, their unit closed (Kintsugi Wellness Centre), primarily as a result of the anticipated lockdown.

Saying, “This was an unprecedented time in our history, and patients were extremely anxious about the unknown and were uncertain about the safety of their families. The concern regarding access to essential needs, such as access to food supplies, as well as the concern regarding the care of their children, as many nannies and domestic workers, would be unable to travel during level 5 to work and home.”

Therefore, as a result, Dr Seedat specifies, patients tend to be single parents, or breadwinners within their respective households, with the level of responsibility being placed on them during this time of confusion and uncertainty—resulting in many patients who required in-hospital psychiatric interventions, delaying their admission to the hospital which was understandable but not ideal.

Digging further into the reasons why people did not reach out for help, the doctor says this was due to the uncertainty of the virus, and the fear of contracting COVID-19. Resulting in patients being apprehensive about being hospitalised, even though the Kintsugi Wellness Centre is a separate building from the Hospital.

Dr Seedat explains that during level 4, psychiatrists returned to their practice, due to the need for patients to continue with chronic psychiatric medication and requiring their prescriptions. She adds, “Some patients who work in Newcastle but reside in other provinces, and vice versa required assistance with obtaining their scripts and this service was provided, with prescriptions being emailed to the pharmacies.”

Furthermore, the medical sector predominantly attempted to consult telephonically with patients, as many remained apprehensive about consulting in person.

She states, “However, this was not entirely successful, as many patients were confined to their homes and were unable to obtain much privacy during their sessions, and the rapport that is established in person, was missing.”

Another issue faced with this form of consultation, Dr Seedat explains, is that patients could not afford data costs, which meant Skype or WhatsApp video calls were not possible. Also, mothers and fathers would have to care for their young children, making it difficult to express their emotions, whilst babysitting or lacking privacy to discuss their stressors.

When seeking assistance and undergoing psychiatric treatment, she points outpatients require a comfortable space in which to disclose their innermost thoughts to discuss their concerns and challenges.

Stating the reason why she is sharing this information, Dr Seedat says, it is due to the fact she believes the majority of her patients were and continue to be experiencing significant stress and anxiety, as well as depression.

Going on to affirm, numerous patients, she consults with are significantly depressed. This being due to the fact that they were unable to access intervention sooner. Additionally, many were not willing to confront their depression and obtain a psychiatric evaluation, prior to it developing.

Untreated depression can lead one down a destructive path, with the potential of self-harm or worse death.

“The stigma surrounding psychiatric and emotional disorders remains a significant issue that we deal with daily and is one of the factors why patients are reluctant to obtain assistance, possibly until the condition escalates, and results in an attempted suicide, which is often the case.”

When looking at mental health, Dr Seedat adds the circumstances facing the people of Newcastle and surrounding regions are significant.

The doctor expands on this by explaining, “With regards to the financial stressors experienced, this has been a major contributing factor to the stress experienced by our residents. Many people have faced retrenchment, have been forced to work from home, or on a rotational basis, which they are unaccustomed to doing, and with ArcelorMittal experiencing significant cutbacks, and retrenchments, our patients have been earning significantly less than ever before.”

She explains one element negatively affecting peoples’ mental states, is the fact that large businesses which provided much-needed employment within towns and cities succumbed to cut-backs, with some companies having even to close their doors.

Additionally, the increased cost of essential supplies, including food, has never before been such a significant stressor to patients, and many are already under debt review. Dr Seedat adds others have faced, the repossession of both their homes and vehicles. Others can’t even afford to pay school fees.

Dr Seedat says it is important to note; the stress is being experienced by the youth as well as their parents—Saying our learners are struggling to adapt to the new system of attending school.

Stating, “They are not utilising their time effectively, and the disruption of their routine has seen a significant increase with regards to substance abuse and the concern regarding the increase amongst the adolescents in teen pregnancies. The adolescents have been non-compliant with contraception use and the lack of supervision and disruption of their school academic year has had detrimental effects on their mental wellbeing.”

With people of all age groups facing overwhelming challenges, she highlights that suicide attempts have increased among adolescents as well as adults, seeing some people as young as 12 years old, having attempted suicide. This all due to the increased pressure of not attending school. Plus, their parents fear surrounding their children contracting the virus, and of course, the lack of support they are experiencing—being forced to work independently from home and not socialising with their peers, have all had a large effect on the youths mental status.

Highlighting parents were preoccupied with their own stressors, and gaming kept children entertained, seeing many adults also resorting to distracting themselves with social media and other forms of entertainment.

According to the doctor, this resulted in children becoming more addicted to playing games online or on their gaming consoles, with parents allowing them to continually play games with no structure or routine prior to the schools opening.

This subsequently increased conduct issues when children had to re-adapt to a school environment.  

“Family life and relationships have according to my observation, been irreparably damaged in many cases, and this is as a result of the pandemic, due to the economic and social consequences,” states Seedat.

Currently, the doctor and her colleagues are assisting many individuals who are struggling to come terms with the death of their loved ones, many of whom died from COVID-19, alone in a hospital, with only telephonic contact from the hospitals to inform the relatives of their loved ones passing.

Looking at people struggling to cope, Dr Seedat adds, never before have as many patients of mine expressed suicidal thoughts. Saying, “Not all have definite suicide plans, but over 80% have expressed moderate difficulty in coping primarily due to COVID-19 and the consequences of the pandemic, including the lockdown and the impact it has had on everyone and their lives.”

Post being infected with COVID-19, depression and anxiety is a phenomenon being experienced by said patients, who are still struggling with persistent symptoms of fatigue and fear of being re-infected, according to Dr Seedat.

“For some, the experience was terrifying, for others the ordeal of being tested repeatedly and the restrictions the pandemic had on them, is a perpetuating stressor.”

The management and maintenance of one’s mental health is imperative to more than just happiness. It is the key to how you see life, people and the world. Thus, do not leave your mental health to chance, visit your local professional today if you are experiencing symptoms of depression or anxiety. 

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