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Second wave of COVID 19 is spreading fast with force ,stretching healthcare system and having significant negative on various domains. Impact on mental well being was significant after relatively milder first wave.

Most common presentation, we see in adults are adjustment disorder with depressive symptoms due to multiple reasons including loss of loved ones, impact on economy and significant changes in life style. Adjustment disorders usually have good prognosis if handled with care. It usually improves as the situation improve. However we have to avoid negative coping like substance use, compromising healthy life style, taking impulsive decisions (major
life decisions) on family and work front. We have to be cautious and conscious about interpersonal relationships in this situation as we commonly see significant marital discard and family problems (blaming each other) and it will have long lasting impact.

Anxiety symptoms are another common presentation during this pandemic. Anxiety symptoms are partly due to Infodemic (information available in social and mainstream media). Henceforth it is advisable to follow single reliable source for information like health bulletin from respective states and strongly advised to avoid unauthorized social media information. Hoarding behavior is another common symptom of anxiety. Hoarding behavior
includes stocking excessive essentials than what is required, life saving medicines which cannot be used at home, and equipment like oxygen concentrator which cannot be used without professional help. Hoarding also results in burden to already stretched supply chain.

Anxiety can be handled with proper life style, having a lockdown routine including physical exercise, self management in cognitive and behavioral domains. Some of commonly followed cognitive strategies include, self feedback about negative coping style and cognitive errors (extreme negative thoughts and concluding that worse will happen irrespective of any safety precautions) We should listen to our mind for negative thoughts in a calm place, and should try to challenge it with facts. (for e.g. in case of fear of death, current mortality rate is 1% and 99% there is a chance of survival even when we are infected)

Lastly, we have to monitor redflags, including, persistent depression for more than 2 weeks, suicidal ideas at any point, loss of sleep, appetite, loss of routine activities (self neglect), agitation or aggressive behavior. When above said symptoms are present, it is strongly advised to take professional help.

Artical by
Dr Venkateshwaran ,
Consultant Child and Adolescent Psychiatrist

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