KUALA LUMPUR, April 7 — The Covid-19 outbreak has led the world, including Malaysians to engage in mandatory social distancing in a bid to help flatten the curve and contain the spread of the disease.

Although self-isolation may play a crucial role in preventing the spread of the infectious disease, some psychiatrists believe it may trigger mild to severe mental health complications even if the movement control order (MCO) is relatively brief.

University Malaya Specialist Centre consultant psychiatrist Dr Aida Syarinaz Ahmad Adlan said MCO was a unique circumstance that was stressful to anyone, even those without any existing mental health problems.

"The first phase of MCO was already inducing a lot of distress and panic in most people due to its sudden order.

"The reactions that one would expect to be facing was a mixture of fear, anxiety, sadness, anger, helplessness and a whole lot of mixed emotions,” she said.

Dr Aida added that the second phase of MCO, which took effect on April 1 for another two weeks, might exacerbate these feelings.

As a result, Dr Aida said people with an existing mental disorder, be it mild or severe, may have an exacerbation of their symptoms given the stressful period they are facing.

"For example, those with a history of anxiety may experience worsening of their symptoms, overwhelmed by their catastrophising thinking, along with difficulty in sleep and disruption to their daily life functioning,” she said.

"These are a vulnerable population at risk and close attention should be paid to them, especially by surrounding family members.”

Challenges of working from home

Despite its necessity to curb the spread of the virus, Dr Aida said MCO has disrupted people’s usual routine, structure and stimulation.

"These circumstances can easily induce distress and anxiety.

"The fear of uncertainty can be detrimental if not addressed appropriately, and we do not know for sure when this shutdown period is going to end.”

While most working adults are expected to carry on with their duties at home, Dr Aida said juggling personal life and work tasks at home may be tricky.

"Working parents need to juggle the deliverance of their work tasks, but at the same time needing to address the demands of their family and children.

"In some households, the home environment may not be conducive to accommodate everyone at one go due to limited space.”

For those who are working on a daily basis, Dr Aida said the challenge may be even more difficult if their work cannot be delivered online.

"For example, small business owners who rely on daily wages to live, this can definitely cause feelings of anxiety as their family might not have enough food on the table.

"If this continues for long, the anxiety can develop into depressed mood and helplessness.”

Apart from the MCO, Dr Aida said the other important thing to look at is the fear of contracting the virus itself, especially if one has possible exposure to the virus.

She pointed out that the fear of being ill and ultimately dying can cause a lot of anxiety as one is not prepared to die or lose people they love.

"The vast information about the illness and its mode of transmission can be overwhelming, hence the stigma associated with having the illness is also an important factor to look at as one might feel discriminated or being perceived ‘bad’ for having the infection and risk of spreading it to others.”

What should you do?

To help yourself mitigate the situation and stay positive, Dr Aida advised the people to first acknowledge the fact that having stress, anxiety, fear, panic or any forms of emotions is expected and normal during MCO.

"Once you understand why you feel in such a way, it would be easier to manage your emotions and reactions.

"For example, if a father is worried about not being able to provide enough food for the family, then of course he would feel anxious and scared.”

However, Dr Aida said the key is to understand that you are not alone in this as the whole world is going through these difficult times.

"Remember that this is only temporary and the country will be able to curb the rapid transmission of the disease to a much more manageable situation,” she said.

Dr Aida also advised the people to adjust to the current situation and find creative solutions to get through these testing times.

Re-adjust and stay positive

Dr Aida, who is also a senior lecturer at Universiti Malaya psychological medicine department, urged Malaysians to be creative and develop a structure to suit these difficult times.

"For example, upon getting up from bed, don’t stay in your pyjamas all-day-long.

"Put on your day clothes after bathing and get ready for breakfast or some exercise,” she said.

Dr Aida also advised people to take advantage of the technology as there are many educational videos on YouTube to help you exercise and stay positive.

"For school children, some may have Google classroom facilities, but if this is not available, there are also links to do e-learning and revisions individually.

"This is also the best time to pick up new skills like cooking, yoga, dancing and the list goes on.”

What to do if you have a family member with a mental disorder?

Dr Aida warned those who have a family member with mental disorder not to disregard their complaints easily, and instead, allow room for discussion on how best to help them.

"It’s tough for them to handle this on their own, therefore, it’s important to show your support by listening to them and acknowledging their emotions and fears.”

She also advised carers to be more cautious if they noticed worsening of mood in their family member with mental disorder.

"If someone has depression, they might start having a worsening depressed mood, associated with thoughts of hopelessness and worthlessness.

"They may start having thoughts of ending their life.”

For someone with anxiety, Dr Aida said their thinking might be too fearful that they do not sound rational.

"For those with psychotic disorders, such as schizophrenia, their behaviour may seem illogical due to worsening of their hallucination and delusion,” she said.

"When this happens, seek professional help.”

*If you are lonely, distressed, or having negative thoughts, Befrienders offers free and confidential support 24 hours a day. Contact Befrienders KL at 03-79568145 or 04-2815161/1108 in Penang, or 05-547 7933/7955 in Ipoh or email sam@befrienders.org.my.