Author: Dr. Akhil Chopra
MBBS, MD Psychiatry, FIPS Consultant Neuro-psychiatrist and De-addiction Specialistdownload Article
Covid-19 pandemic has created a panic and rapidly changing situation that has caused negative emotions and has altered the daily routine of the people.
The pandemic has caused fear, tension and stress across the globe. In such crisis, once emotional and mental health is of outmost importance.
Mental or emotional health refers to your overall psychological wellbeing. It can include the way you feel about yourself, the quality of your relationships and your ability to manage your feelings and deal with difficulties.
Mental health and physical health are very closely connected. Mental health plays a major role in your ability to maintain good physical health. Mental illness such as depression and anxiety, affect your ability to carry out day to day activities.
If one is not emotionally sound, it can eventually lead to catastrophic decisions and events.
According to the World Health Organization (WHO): “Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.”
WHO also states that, “mental health is more than just the absence of mental disorders or disabilities.”
So rather than being about ‘what’s the problem?’ it’s really about ‘what’s going well?' It’s not around the illness but regarding the wellness.
Mental health is an integral part of physical health. The health of the mind is just as important as the health of the body.
A report by the World Health Organization (WHO) revealed that 7.5 per cent of the Indian population suffers from some form of mental disorder. Mental illnesses constitute one-sixth of all health-related disorders and India accounted for nearly 15% of the global mental, neurological and substance abuse disorder burden. 
The treatment gap, which is defined as the prevalence of mental illnesses and the proportion of patients that get treatment, is over 70 per cent. WHO also predicts that by 2020, roughly 20 per cent of India will suffer from mental illnesses. And to cater to this demographic, we have less than 4,000 mental health professionals. 
Mental health doesn’t always remain the same. It can change as situations changes and as you move through different stages of your life. When someone has a mental health condition, it can effect on how they think, feel and behave.
A low quality life, is frequently aftereffect of extreme psychological wellness conditions, which is portrayed by sentiments of misery; absence of control, decision and self-governance; low confidence and certainty; a feeling of not being a part of society; lessened action; and a feeling of sadness and dampening.
It’s very important to maintain a healthy balance between life activities and responsibilities for enhancing mental strength. Mental strength is the capacity of a person to deal with stress, pressure, challenges and perform to the best of ability irrespective of the circumstances. If we want to be mentally healthy, then we need to build our mental strength and it developed over time by practicing gratitude. 
We can maintain a balance between life activities and responsibilities and become mentally strong by practicing these techniques :
Irrespective of age, gender, income or ethnicity everyone has some risk of developing a mental health disorder.
Individual attributes and behaviors, social and economic circumstances and environmental factors in together can affect a person’s mental health and well-being.
The following factors may contribute to mental health conditions :
The most common types of mental illness are as follows:
Depression refers to a wide range of mental health problems characterized by the absence of a positive affect (a loss of interest and enjoyment in ordinary things and experiences), low mood and a range of associated emotional, cognitive, physical and behavioral symptoms. Distinguishing the mood changes between clinically significant degrees of depression (for example, major depression) and those occurring ‘normally’ remains problematic and it is best to consider the symptoms of depression as occurring on a continuum of severity.
Symptoms of Depression include 
The essential feature of GAD is excessive anxiety and worry, occurring on more days than not for a period of at least 6 months, about a number of events or activities. The person with GAD finds it difficult to control the anxiety and worry, which is often accompanied by restlessness, being easily fatigued, having difficulty concentrating, irritability, muscle tension and disturbed sleep (Brown et al., 2001). GAD is mostly comorbid with depression.
Physical symptoms of GAD may include 
People with panic disorder suffer from regular panic attacks involving attacks of sudden short-lived anxiety with or without any visible cause. They frequently take action to avoid being in particular situations in order to prevent those feelings, which may develop into agoraphobia, a fear of places from which the individual considers to be dangerous, or difficult to escape from.
Agoraphobia may lead to a common avoidance of situations like: being alone outside the home or being home alone; being in a crowd of people; travelling by car or bus; being in a particular place, such as on a bridge or in a lift.
A person with OCD either has obsessions or compulsions, but mostly both.
An obsession is an unwanted distracting thought, image or urge that repeatedly enters the person's mind.
Common obsessions include contamination from dirt, germs, viruses, body fluids and so on, fear of harm, obsessions with the body or physical symptoms, unwanted sexual thoughts, including homosexuality, religious obsessions, including concerns about offending God.
Compulsions are form of repetitive behaviours that the person is obsessive to perform.
Common compulsions include washing and cleaning (including constant hand-washing), checking (including checking body parts or checking that nothing terrible happened), repeating (including rereading and repeating routine activities like getting up from a chair), mental compulsions (including praying to prevent harm and mentally reviewing events).
PTSD develops when a person has gone through some extremely stressful and traumatic events such as deliberate acts of interpersonal violence, severe accidents, disasters, loss of a loved one or abuse of some form like sexual abuse.
The core symptoms are:
· Recalling the acts or feelings as if the event is recurring;
· Nightmares; and repetitive and distressing intrusive images,
· Difficulty in concentrating,
· Sleep problems and
· Avoidance of trauma reminders
Social anxiety disorder is also known as social phobia, is an intense fear of being judge, negatively assessed or refused in social situations. This results in intolerable suffering and impacts a person's ability to perform effectively their daily life routine.
Common symptoms of social anxiety disorder
. Excessive blushing,
· Nausea and
. Panic attacks are the most common symptoms
SAD is often comorbid with other disorders such as depression and anxiety.
A specific phobia is an unjustified, strong and continuous fear of a specific object or situation that is not in proper relation to the actual risk, danger or threat. The fear and anxiety occur immediately after coming in contact with the feared object or situation and lead to avoidance or extreme discomfort. Specific phobias are long lasting, causes intense physical and psychological reactions, and can affects one’s ability to function normally at work, at school or in social gathering.
There are many types of specific phobias which can also occur along with different types of anxiety disorders.
Some of the common types of specific phobias are fear of:
How Coronavirus Pandemic Affect Mental Health?
After the outbreak of Corona virus pandemic in December 2019, it has affected the world as a whole, creating turmoil in the society as well as in the mental state of all humans. Maintaining the mental health in such a calamity is of prime importance.
Various studies and surveys on psychological impact of pandemic has shown increased negative mental health outcomes, such as sleeplessness, panic, anxiety, depression, paranoia, obsessive behaviour, post-traumatic stress disorder and even suicidal attempts. The general mass fear of COVID19, termed as ‘Coronaphobia’, has generated plethora of psychiatric manifestation across the different strata of the society. 
According to a study from China reports in total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. 
According to Indian survey, sleep difficulties, paranoia about acquiring COVID-19 infection and distress related social media were reported in 12.5 %, 37.8 %, and 36.4 % participants respectively. The perceived mental healthcare need was seen in more than 80 % of participants. 
As a human we all are socially dependent on each other for not only our regular day to day basic necessities but also for creating a sense of social wellbeing. This helps us human keeping mentally healthy and a wisdom that we all are together in adversities keeps us going on.
In today’s scenario of COVID-19, it is a must for all to keep social distancing to stop the disease from spreading and creating a catastrophe. This has not only led us from decreasing a social intellect, but as well has led us in confinement. The fear of contacting the disease, seeing our dear ones in distress or losing them has created the anxiety and stress. This has steered us in affecting our mental health as an individual and our families.
In response to COVID19 crisis, most governments have closed the non-essential business and schools; prohibited large social gatherings and quarantined the travellers in addition to social distancing. This has created the feeling of loneliness and isolation; that to for unknown duration. This lack of uncertainty about future, unemployment and disturbances in financial management has increased risk of mental and physical illness. The universal psychological impact has caused mass hysteria, economic burden and financial losses.
Ways to Manage Mental Health during Coronavirus Pandemic
COVID19 pandemic may have caused fear, anxiety and panic due to isolation and loneliness; but maintaining our mental wellbeing, caring and helping for the people around us is the approach how we can emerge victorious as humanity from this calamity.
Following are the various methods which can be employed to relive the stress and manage mental health during these times :
Besides all these, eating a well-balanced healthy diet can keep you fit physically as well as mentally. This also helps in enhancing immunity to fight infections and reducing the chances of getting sick. The goal can be achieved by taking nutritional supplements also.
Corona viruses impact our overall physical and mental health. While maintaining our mental health, it is also important to maintain the physical health as well. Coronaviruses primarily infect our respiratory tract, and eventually having an effect on our other systems also. Therefore, it is of prime importance to fight the infections and cure the symptoms. To do so one must have a strong immune system and/or should take measures to boost immunity.
Eating a balanced diet, regular exercise, drinking water and maintaining healthy lifestyle is a way for enhanced immunity. Although times like these of pandemics calls to take an enhanced measure; hence taking an additional supplement to boost immunity are essential.
Coronavirus attacks respiratory tract causing a burst in cytokine storm which causes symptoms similar to like that of flu, cough and cold. It leads to an excessive oxidative stress, inflammatory responses and demands energy to fight infections. In this case supplement which can support to reduce infection, have antioxidant and anti-inflammatory response should be added to diet.
Healthy immune system leads to healthy body and healthy mind. There are various nutritional supplements to help in boosting immune system and fight infections:
Easily absorbed form of Coenzyme Q10, plays a vital role in boosting the immune system. It helps to power cells to provide ample energy for immune cells. It also acts as an antioxidant scavenging free radicals and oxidants. Studies show it cleans up oxidants causing cellular damage and allows body to repair and restore health. 
Form of vitamin B12, active in human metabolism helps in immunomodulation. It is required for proper red blood cell formation, neurological function, and DNA synthesis. Studies have shown it to be associated with neuronal health and cellular immunity. [12, 13]
Derivative of thiamine (vitamin B1) has an antioxidant effect and exhibits a potential anti-inflammatory response. As well has a beneficial effect on cognitive impairments associated to mental disorders. [14, 15]
Naturally occurring dithiol compound in human body is a powerful antioxidant which can directly scavenge reactive oxygen species (ROS). It might have immunomodulatory effects on both adaptive and innate immune systems. It is also considered to have a role in neurodegenerative diseases and associated cognitive impairments. [16, 17]
Live micro-organisms that confer health benefit to the host. There are several genes and specific compounds derived from probiotics which mediate immunoregulatory effects. Also recent studies have demonstrated the connection between central nervous system and enteric nervous system. Studies have shown variety of mechanism by which gut microbiota can signal the brain and influence several processes in relation to neurotransmission, neurogenesis, and behaviour. As the proverb says health gut leads to healthy mind. [18, 19]
During the current COVID pandemic era the on-going confusion, fear and anxiety has created various mental issues among the individuals in society. In times like these it is important to stay healthy and mentally sound till this calamity subsides and also subsequently. For this one needs to keep calm, meditate, help others, engage in hobbies, exercise regularly, maintain proper lifestyle, etc.
For viral diseases like COVID19 when no cure is presently available, and therapies are done treating the symptoms, it is important to maintain a healthy immune system. Eating healthy has a positive impact on physical health and mental health as well. This can also be achieved by adding nutritional supplements to diet. Therefore, staying physically healthy and maintaining mental health is how we can beat the COVID pandemic all together.