• Vaccination & Covid
  • Seeking Solace
  • Talk it Out
Psychological rehab methods that should be employed for Covid patients and those suffering from post-Covid complications. Even general people are also suffering from loneliness during the pandemic. What needs to be done?

The suffering of the survivors of Covid is not only related to the traumatic events; rather, the subsequent life events and sufferings in the post Covid life cause higher emotional problems if an adequate, community-based, psychosocial care approach is not adapted. Individuals are not in any real sense autonomous or self-sufficient, their loneliness during the pandemic is real and healing occurs in the context of family, friends, and community.
Rehabilitation introduced the notion of a bio-psycho-social medical model, initiatives need to integrate psycho social care as an essential part of the overall care and rehabilitation. Those who receive a spectrum of care including health care, psychosocial, livelihood, educational, developmental activities would have less emotional reactions, better functionality and quality of life. Effective rehabilitation methods for persons who survived Covid and those suffering from post Covid social and other traumatic events including loss of loved ones to being children who were separated from the parent due to quarantine and their complications needs to address the problems posed by various potential events.
The post Covid rehabilitation planning continuum is broad in scope and must address collaboration across agencies and organizations, advance preparations, as well as needs assessments, event management, recovery and rebuilding efforts.
It is important to facilitate understanding of the meaning of personal and community losses and also to ensure adjustment and acceptance of change. To ensure this, working with individuals/families, facilitating support groups in the community, development of community-based organizations, community solidarity, and many other interventions are crucial. Failure to provide these services definitely will show higher distress, disabilities, and lack of social well-being. Local community support in coordination with Government functionaries need to reach each every families by providing with appropriate services. It is very important to focus on population than individuals to create a supportive and a resilient community.

Adults are advised to follow COVID-Appropriate Behaviour to keep them protected from catching Covid-19 infection. How can we protect the children?

Well, older kids can follow Covid- Appropriate Behavior to protect themselves.

We do not recommend mask in children below 2 years. In fact, we have observed it is difficult to make children between 2 to 5 years wear masks. So, it is advisable to keep them indoors. But don’t forget to engage them in playful and physical activities as the first five years are crucial for a child’s mental and physical development.

Every family member who is above 18 years of age should get vaccinated. If adults are protected, our children too remain protected.

Vaccines have been found safe for lactating mothers. So, they too should take the vaccine.

We have also seen cases of new mothers contracting the disease. In such cases, how should she protect her child from getting the infection?

In such cases any person who is not COVID positive should nurse the child. However, a lactating mother should extract her milk and feed the child. If there is no one else to take care of the child, the mother should wear a double mask and face shield, wash her hands and sanitise her surroundings regularly. Mother’s milk is important for the child’s proper growth and development. The milk of an infected mother has antibodies against coronavirus.

If a child is affected by Covid-19 but parents are not, how to take care of the child? What precautions should the caregiver take to protect oneself from catching the infection?

This can happen if the child has contracted the infection from someone outside the family. So, firstly, each member of the family should get oneself tested for Covid-19. The caregiver should wear full protection gear—double masks, face shield, gloves—while nursing the child. Care should be provided under the guidance and supervision of a doctor. The caregiver and the child should isolate themselves from the rest of the family.

How is the treatment for children different from that for adults?

We don’t recommend any medicine for asymptomatic children. In mild cases, but prescribe simple paracetamol to manage fever and other mild symptoms. Similarly, diarrhoea is managed with oral rehydration fluids and plenty of fluid. In moderate to severe cases, the treatment is the same as that for adults.

Immediately consult a doctor if you observe respiratory distress, increased respiratory rate, severe cough that is interfering with feeding, hypoxia, uncontrolled fever, or any other unusual symptoms like skin rash, excessive sleepiness in children.

There are cases of Long Covid-19 in children as well, in which a patient develops a new disease such as diabetes, hypertension even after the 3-6 months of recovery. The parents should be in touch with their doctor for follow up of children who have recovered from acute COVID illness.

Are more children developing severe disease this time?

A vast majority of children either remain asymptomatic or develop a mild disease. In a household, if several adults are diagnosed with COVID 19 infection, there is a high possibility that the children will also be infected. Fortunately, in most such cases, the children particularly those below 10 years are usually asymptomatic or have mild, common cold like symptoms, or diarrhoea.

However, children with congenital heart disease, diabetes, asthma, or those suffering from childhood cancers, or on immune-suppressants are at a higher risk of developing severe disease.
The parents should watch COVID sick children closely. Many of the serious complications in children occur in or after 2nd week of acquiring the infection.

Overall, there is no evidence that children have special predilection of developing COVID 19 disease during this wave as well. Due to larger number of persons getting infected, the absolute number of affected children has also increased.

What is COVID-19 among children, its prevention and management?

Thousands of children, in all age groups, from across the country have been tested positive for Covid-19, during the second wave, creating panic among parents. The experts say that though most children develop mild disease, there is a need to keep them protected from getting infection. Dr. Narendra Kumar Arora, a paediatric gastroenterologist and a senior member of the National Covid-19 Task Force tells how to treat and care for children who have contracted Covid-19. Excerpts.

Recently, a lot of States have reported an increase in the number of children tested positive for Covid-19. Do you think more children are being infected in the second wave of the disease?

Children are as susceptible to catching the Covid-19 infection as adults and according to our latest national sero-survey also, 25 percent of children surveyed were found to be affected by Covid-19. Even children below 10 years were also found to be as infected as other age groups. National data on the disease tells us that around 3-4 percent of children were symptomatic during the first wave of Covid-19 and this percentage remains the same during the second wave also. However, since the total number of cases has gone up, it has affected more number of children this time.

What are your views on recent problems such as shortage of oxygen supply, vaccines and the rising Covid cases?

In April-May there was a huge surge in the Covid cases, mortalities as well as over-dependence on the vaccines and oxygen for the patients. Even though the oxygen and vaccine deficit can be tackled, Covid-19 infection is still lingering. The basic precautions which have been advised to follow remain of crucial importance.

Dr. Deepak Khedekar, MBBS-M.D, Professor of Anatomy, LTTMC - Lokmanya Tilak Municipal Medical College

How soon can one exercise and get into daily routines post Covid recovery?

Fatigue is a known aftereffect of Covid 19. Hence, it is advisable to take it slow as your capacity to exert your body and exercise would have decreased considerably in the post-recovery period. However, you may be able to take upon the daily activities gradually. So rest up, till you are back to your usual energy level before taking up heavy jobs.

Dr. Meha Sharma. Consultant Rheumatologist - Specialist of Immune Disorders, Cedar Superspeciality Centre, Dwarka, Delhi

How can one mend relationships during lockdown/ post lockdown?

A couple of factors – seeing too much of each other, not having a structured routine, inability to step out for relaxation and being cooped-up with work, domestic chores, uncertainty about future etc—have led to relationship issues. This has manifested in the form of heated arguments, interference, nagging behaviour, hostile comments, passing judgements among couples. Here are a few ways you can mend your broken friendship/ relationship with your partner.

  • Be in harmony with your own self first, then you will be in harmony with your partner. Drop your ‘me attitude’ and adopt a ‘we attitude’.
  • Respect the four pillars of a relationship: Communication, Trust, Empathy and Respect
  • Prioritise your needs by keeping a flexible schedule, juggling between family time and work time
  • Ensure responsibilities between partners are shared. Multi-tasking by just one partner often drains the person out and lowers his/her threshold. Hence, there should be a rational division of roles and responsibilities of running the household.
  • During lockdown, there is an increase in substance abuse, be it alcohol, drugs or cigarettes. This is a form of maladaptive coping mechanism and should be addressed through building motivation to quit and seeking psychiatric advice.
  • Keep your body language positive while communicating with partner and do not indulge in stonewalling.
  • Couple yoga is a good way to bring in positive vibes and filling the vacuum in a relationship.
  • If one of the partners, however, is showing signs of personality disorder, abusive behaviour, substance abuse, projecting suicidal thoughts, obsessive-compulsive signs, significant changes in behaviour, mood, appetite or sleep, then consult a psychiatrist for timely recognition, rectification and treatment.
Tips to corporates facing a burnout and relationship breakdowns.
  • Invest in the people: Human beings make mistakes during stress. Health and socio-emotional needs have to take precedence in a time like this.
  • Corporates could give rotatory day offs/ reduce timings or alter timings for WFH practises to accommodate the needs of working parents, or those with elderly parents to look after.
  • Maintaining a sense of collective and belonging is essential.
  • Starting forums like “listening circles” or “chat with someone when you are feeling alone”, helplines to call when quarantined or isolated, are all helpful to prevent and alleviate the exhaustion that is prevalent right now.
  • The recognition that this exhaustion is not just about work but about the increased thinking and planning required to stay calm, that the needs of a household and therefore the requirements of presence and effort to nurture themselves and other members within a family has completely changed. If we can help each other acknowledge and provide for this need, burnouts can be mitigated. Resources within communities, when synergised are immense and are the way forward.
Being deprived of social healthy interaction, how can parents help kids in dealing with phone addiction, loneliness, irritability, and academic pressure.

By looking at the drivers that have led to this above cluster of symptoms - do we think the children are finding it meaningful to be passive recipients of the pandemic?

They have been told that adults are handling it- they just need to comply- regardless of the absolute change in standard- including our about-turn on screen time usage- preference for working harder to keep our jobs over family time.

The need is to recognise what the last year has taught us.

  1. Ask yourself – what are the skills and qualities that have helped most of us in this time?
  2. When you have your answer e.g. The sense of the collective over the sense of the individual (the “me” to the “we”), the humaneness, compassion, empathy, resilience, communication skills, looking after our own bodies, being able to connect to others, the ability to stay by and within one self and create our own grounding and joy—whatever the answer – the next step is to ask: Am I providing an environment where my child is being taught these skills? Or am I nurturing these qualities in them? If not, be mindful of nurturing these life skills in the family. When families and children are far more connected to the collective and to their inner sense of purpose and meaning- the loneliness and irritability decreases.
  3. Engage children in collective roles, make them understand their privileges over those who don’t have them. If adults appreciate each other and express gratitude, children will emulate.
Is it normal for kids to experience anxiety about Covid affecting their families and friends?

It is normal to feel anxious when you find out that your family member has contracted Covid.

Acknowledge these emotions. Give yourself time to work on stress management strategies, including exercise and meditation. Talking with your friends and family members, and reassuring yourself with the progress they are making daily, will help you manage your stress levels.

Dr. Meha Sharma. Consultant Rheumatologist - Specialist of Immune Disorders, Cedar Superspeciality Centre, Dwarka, Delhi

What should one say to the family members of COVID patients, which is sensitive and empathetic and non-intrusive and doesn't enhance their fear and trepidation? What are things that one should never say to family members of COVID patients?

First of all, offer support in a more practical manner. When a family member develops the infection, because of anxiety family members may not pay attention to their own well being. See if you can arrange meals, medicines or help them get registered for a bed. Offer to help out with procuring masks, sanitiser etc or groceries. Send encouraging messages and do not give any medical advice unless you are a doctor. Reassure them when they are anxious and ask them to note down their symptoms so that they can have an informed discussion with their doctor. Allow them to rest and don’t call them again and again. Assure them of your support in case of an emergency. Provide them with information about local volunteer group numbers and local triage centres. Provide hope, humour and lightness.

Both my parents are Covid positive and I am the only one at home to help them, what can I do to ensure their wellbeing while staying safe myself?

FOR YOUR PARENTS: 1. Be in isolation for 14 days 2. Do not share dishes or any equipment 3. If you have to share space, make sure the room has good air flow 4. Use gloved hands to clean dishes with hot detergent liquid 5. Stay connected with doctor

FOR YOU, THE CAREGIVER: 1.Double mask yourself in the house 2. Practise Covid-apt ways: handwashing, avoid touching face and wear gloves 3. Quarantine yourself for 14 days and stay in touch with doctor.

Dr. Bimal Prasad Padhy, Consultant Neurologist, Care Hospital, Nampally, Hyderabad

Will a patient who has recovered from Covid-19 still face health issues six months later? Will the body be able to gain the pre-corona strength?

Most patients of Covid-19 recover completely, regaining their usual strength and immunity after a few weeks of infection. Those having severe pre-existing illness may have problems persisting beyond four weeks in what is termed post-Covid-19 syndrome or ‘long Covid-19’. They may suffer from chronic fatigue to more severe organ dysfunctions. As we are grappling with a relatively new disease, it is too early to tell what Covid-19 survivors are likely to experience in a year’s time.

Dr. Bimal Prasad Padhy, Consultant Neurologist, Care Hospital, Nampally, Hyderabad

Does the effect of Covid-19 vary according to the different blood groups? Is there a chance of one blood group having a greater rate of Covid vulnerability?

There is no correlation among blood groups and severity of Covid-19. Infection is more severe in senior citizens and those with comorbidities.

Dr. M Narayanan, MD, DCH, FIAP, Consultant Paediatrician, SAN Children's Clinic, Ernakulam

How could we distinguish between a common cold and a corona virus infection? When should we be alarmed?

It is difficult to differentiate Covid-19 infection in children from other viral infections such as common cold. One can suspect Covid 19 when there is a history of contact. One should be alarmed if the child has any of these  symptoms – Irritability; feeding difficulty; breathing difficulty, fast breathing, tiredness, fever and reduced urine output.

Dr. M Narayanan, MD, DCH, FIAP, Consultant Paediatrician, SAN Children's Clinic, Ernakulam

Is Covid vaccination foolproof?

Getting maximum people vaccinated is definitely the need of the hour. However, as is the case with any other vaccine, there is an efficacy level to each of the jabs. Till the whole world is vaccinated, people will have to follow the Covid protocol.

Dr. Amrapali Keny Pawar, Senior ENT Consultant, KB Bhabha Hospital, Bandra

‘Healing together: Focus on population, not individual’
  1. The suffering of the survivors of Covid is not only related to the traumatic events; rather, the subsequent life events and sufferings in the post-Covid life cause higher emotional problems if an adequate, community-based, psychosocial care approach is not adapted.
  2. Individuals are not in any real sense autonomous or self-sufficient, their loneliness during the pandemic is real and healing occurs in the context of family, friends, and community.
  3. Effective rehabilitation methods for persons who survived Covid and those suffering from post Covid social and other traumatic events including loss of loved ones to being children who were separated from the parent due to quarantine and their complications needs to address the problems posed by various potential events.
  4. The post Covid rehabilitation planning continuum is broad in scope and must address collaboration across agencies and organisations, advance preparations, as well as needs assessments, event management, recovery and rebuilding efforts.
  5. Failure to provide these services definitely will show higher distress, disabilities, and lack of social well-being. Local community support in coordination with Government functionaries need to reach each and every family by providing with appropriate services. It is very important to focus on population than individuals to create a supportive and a resilient community.
How can you deal with grief of losing a family member and guilt of not being able to extend support and treatment despite efforts?
  • If feeling guilty, tutor your mind to process that the situation was beyond your control. Accept the fact that the pandemic hit the world and you did the best you could for your loved one.
  • One of the ways to live with a loss is by remembering positive aspects of the departed person. Think of the happy memories and talk to your friends about good time shared with the person.
  • If you have kids, tell them that the departed person is living through you and them. In a sensitive way, explain to kids how genetically you are connected, and therefore, will never be disconnected with the departed person.
  • Rituals help in some amount of healing process. If you are a relative of the departed person, try not to be inquisitive about cause and nature of death. Rather, focus on sending positive vibes and help during the quarantine period.
  • If the person who has lost a close family member, shows signs of weight loss, prolonged irritability, sadness, signs of clinical depression, one should not hesitate to approach a psychiatrist for timely recognition, rectification and treatment.
What precautions should family members take if someone tests Covid positive?

When a family member is infected, the situation is more challenging, First all the family members should be screened, as everyone in the house qualify as primary contacts. Infection is always higher among primary contacts, therefore family members should strictly follow covid-specific precautions. They must maintain social distance, must wear masks and sanitise regularly.

Dr. Amalaselvam A (MD, MDRC) Physician Diabetologist Joseph Medical Centre, Laxmipuram, Bengaluru

How does the Covid vaccine work? After how many days from vaccination does the immunity level increase?

A vaccine is a dead or alive attenuated virus, which when given in a required dose, produces a mild infection, triggering the body to produce antibodies. When a person is infected with corona virus, the antibodies produced will neutralise the virus. It will take 6-8 weeks from the second dose for immunity levels to increase.

Dr. Amalaselvam A (MD, MDRC) Physician Diabetologist Joseph Medical Centre, Laxmipuram, Bengaluru

What side effects can one expect after first dose of vaccination?

No major side-effects have been observed barring  some cases with fever, body pain, and pain at the site of injection. They are not worrisome symptoms and may last for 1 to 2 days. During this period, the vaccinated person is advised to take rest as much as possible and consume plenty of fluids. One can take anti-pyretic drug such as Paracetamol to control fever.

Dr. Deepak Khedekar, MBBS-M. D, Professor of Anatomy, LTTMC - Lokmanya Tilak Municipal Medical College

How do we deal with the psychological pressures of Covid-19 cases?

There is simple mantra of mindfulness meaning staying in the moment. It is a dynamic form of meditation that keeps you grounded and helps you manage your stress. Be it Covid- 19 or exam stress, it impacts the body and its immunity. Keeping away from negative news, maintaining gratitude log, meditation, mindfulness, taking a break from screen time and maintaining a dietary and sleep discipline would help you maintain your mental balance in these turbulent times.

Dr. Sweta Singla - Senior Consultant, Unit Head, Neurology Department at Venkateshwar Hospital, Dwarka, Delhi

Do you think there is a need for psychological rehab, especially after being affected by Covid or by lockdown?

Almost every family has been affected by Covid in some way or the other. While adults may have gone through health issues to financial problems, for children, the access to the usual spaces that formed their ecosystem for holistic development has been suspended. One needs to, therefore, be prepared for transition even when the pandemic is contained. For, a lot would have changed when the world gets back to work—business styles, how schools will function, how people would be looking out for new jobs, how new skills would be sought after, how women would have learnt the art of multi-tasking and in fact, even in the way the families would function.

How should organisations deal with the current situation and embrace people back to normal?
  • The two-year stressful period and unprecedented change has had an impact on people’s minds, far more than what meets the eye. Many people have lost their loved ones and hence, organisations must give employees time to heal and allow at least a partial closure of the tragedy, until they feel fit enough to resume charge.
  • Give people some time to accept the fact that a lot has changed in the past two years—be it in employment status, salaries, peer bonding etc. Hence, realistic goals and targets should be set, keeping in mind what the employee is going through in his personal life.
  • When employees get vaccinated, firms should facilitate a smooth transition from ‘work from home’ to resuming normal office by giving them options such as taking up WFH for three days a week initially and then, gradually moving to 6-days office. In fact, a hybrid environment is the way forward.
  • Psychological counselling is a must for those employees who have just recovered from Covid and are facing post-Covid fatigue.
  • Facilitate team bonding exercises to heal the overworked staff, motivate the ones facing brain fog and calm the cantankerous employees.
When should one get vaccinated if he has just recovered from Covid-19?

There is no definitive guideline on timeline for vaccination post covid recovery. But general consensus is that you should recover from active infection before getting yourself vaccinated. So, it is prudent to wait for atleast two weeks of your first day of symptoms before you get your Covid 19 jab.

Dr. Sweta Singla - Senior Consultant, Unit Head, Neurology Department at Venkateshwar Hospital, Dwarka, Delhi

Do masks limit our Oxygen intake? How are doctors and para medics keeping their morale high?

A fitted, good quality mask, if worn properly, will prevent the person from coming in contact with the virus. Besides, it does not influence the intake of Oxygen in any way. Masks are the most-effective way to be safe in this pandemic and is easily available, cost-effective, and covers all age groups. One life saved by any health care worker is worth a million-dollar smile and is the best gift of God. That's the way we keep our morale high by supporting one another.

Dr. Sushil Poddar, Child Specialist, Director Poddar Hospital, Jaipur

How can kids protect themselves from a supposed 3rd wave?

Kids should stay at home, eat home-cooked food, wash hands well and wear masks even at home, if possible. Children should take immunity booster in diet like multivitamins, vitamin C, and D along with fruits and vegetables. Besides, taking a good nap, limited usage of gadgets, regular gargle, and steam inhalation can work wonders. And of course, wait for shots for kids in India.

Dr. Sushil Poddar, Child Specialist, Director Poddar Hospital, Jaipur

How to deal with loneliness amid Covid?

There are two ways of looking at it—one is acceptance and the other, resigned acceptance. Acceptance is a defence mechanism, where you resolve conflicts in a healthy way. However, resigned acceptance leads to a sense of defeat, lack of purpose. Try to accept reality.

Dr. Sanjay Chugh, Senior Consultant Psychiatrist, New Delhi

How can we kick negative thoughts away?

When negative thoughts overwhelm you, a therapist practises cognitive behavioural therapy. So, if you are to describe an event that has led to a stream of negative thoughts, evaluate the thought in an objective way and figure out if it is valid, appropriate and healthy. If not serving any purpose, then find alternative solutions that serves a purpose.

Dr. Sanjay Chugh, Senior Consultant, Psychiatrist, New Delhi

What is the best diet for children now?

Good nutrition is crucial during Covid. The ideal plan is to follow the WHO- recommended balanced diet with adequate amounts of carbs, protein and fat. The regular Indian meal usually fulfills this. Drink plenty of fluids.

Dr. Bimal Prasad Padhy, Consultant Neurologist, Care Hospital, Nampally, Hyderabad

Does the coronavirus cause blood clots and how?

Covid infection causes inflammation in the body that leads to the platelets sticking together to form a clot in the arteries. That is why it is important to do the inflammatory markers like D'Dimer and CRP to predict the complications.

Dr. Varsha Rele Shirvekar, M.S. ENT

After getting vaccinated, what precautions should be taken?

After vaccination, expect some body ache and mild fever for 24 hours.  You may take paracetamol for the first three days. Immunity develops after three weeks, so continue to wear the mask, washing and sanitising your hands.

Dr. Varsha Rele Shirvekar, M.S. ENT

Once you recover from Covid-19, how long are you immune to it?

There’s no consensus in this regard but it can be said 3-8 months. Immunity can occur naturally after developing Covid-19 or from getting the Covid-19 vaccination.

Dr. Gurpreet Singh Bali, SR, Alchemist Hospital, Panchkula

Are there any dietary precautions to be observed before and after taking the vaccine shot?

There are no specific precautions prior to vaccination, but if you have flu like symptoms you must inform the vaccinating personnel about the same and also about any previous drug allergies. Post vaccination one may get fever, body aches, lethargy – which is a part of the post vaccination symptomatology; only paracetamol and good hydration needs to be done as symptoms may last for 24-48 hours. An immediate (and rare) side effect post vaccination is anaphylaxis, which will cause choking sensation/rashes/breathlessness. This has to be addressed immediately in a hospital.

Dr. Gurpreet Singh Bali, SR, Alchemist Hospital, Panchkula

If oxygen levels drop, and a patient is feeling breathless but is unable to reach a hospital or get cylinders, in what other ways can oxygen intake be increased?

Once a person is diagnosed with Covid, it is crucial to monitor O2 level once in 4hrs, & also do a 6minute walk test to see the possible chances of O2 drop. If SpO2 level is below 95% on room air, one should be alert & reach out for medical services and start right medicine as per your physician’s advice ( at times inhaled steroids or oral steroids ) along with other medicines. 

Apart from this, lying in PRONE-POSITION (see graphic) has shown to improve oxygen levels at initial stages. This position has been medically proven to improve breathing comfort and oxygenation in patients with low oxygen. This is because it helps keep the alveolar units open.

Dr. Supritha K M, Spandana Health Care, North Bengaluru

QIf someone has already had Covid-19, can he take the vaccine? Is it possible to get Covid again?

It is important for everyone to take the vaccine. However, if a person has had Covid already, then the patient must wait for 6 weeks after recovery to take the vaccine. Yes one can get infected for the second time. To reduce the chances of contracting again, self-isolation is the best way.

Dr. Shashikantha, HOD General Medicine, Adichunchanagiri Institute of Medical Sciences, B’luru

What is the extent of protection we get if we sanitise surfaces and our hands regularly?

Hand hygiene can significantly reduce the risk of infection and transmission. But then one needs to club it with social distancing and masking. Soap and water is indeed the best way to clean your hands but in the absence of the same, rely on hand sanitiser to protect yourself. Protect yourself by wearing gloves as you can’t keep sanitising surfaces.

Dr. Pravin Garg, Consultant Physician, Ahmedabad

What are the chances of me getting Covid if I meet a person who has just recovered from it?

We need to understand that the recovery period of Covid differs from person to person in terms of length and physical parameters. The person, who has recovered becomes non-infectious after 10 to 14 days of infection. We, however, need to keep follow Covid protocol post-recovery too.

Dr Pravin Garg, Consultant Physician, Ahmedabad

By when will India see children getting vaccinated?

As we have a large group of population below 18 years of age, chances of vaccinating children any time soon seem unlikely. The country is facing vaccine shortage, and also, trials on kids are not yet complete. The Govt is currently working on building paediatric makeshift infrastructure, keeping the third wave in mind.

Is a child’s immunity stronger than that of an adult’s?

According to research, children express higher levels of two specific immune system molecules: Interleukin 17A (IL-17A), which helps to mobilise immune system response during early infection, and Interferon that combats viral replication. So far, understanding of Covid shows that children tend to have less severe infection as per available data from first wave.

Dr. Rajendra Gunjotikar, Nephrologist, Director, Kimaya Kidney Care, Gunjotikar Nursing Home

Is it true that there is a major rise in depression since Covid 2nd wave?

Covid-19 has led to an explosion of mental health issues, especially depression. Many, including kids and teens, are going through anxiety and depression. The reason for this among young adults is anticipation about their future. It is advised that there is timely recognition and treatment for the same.

Dr. Sanjay Chugh, Senior Consultant, Neuro Psychiatrist, Delhi

How can children deal with pandemic-related stress? Is there a helpline parents can call?

Children facing Covid cases within their families are going through tremendous stress. The important tool to employ in such situations is to find a channel to vent out your feelings. But with peers also facing similar traumas, it's not easy to find someone who can listen to you and understand you. So, talking to a helpline is a good way to get an objective listener who can help you. Try this helpline set up by Delhi Police - 9311551393.

Dr. Sanjay Chugh, Senior Consultant, Neuro Psychiatrist, Delhi

Is it safe to be in the balcony alone without a mask if neighbours are Covid cases?

There is nothing unsafe about standing in the balcony, as long as there is adequate distance between the households. From the very beginning of the pandemic, the WHO has said that only in close contact (less than 6 feet) can there be transmission of the virus through cough/sneeze droplets, and that’s why one needs to wear a mask and sanitise when in a crowded space.

Dr. Tauseef Ahmed, General Physician, Nishat Hospital, Lucknow

How can I monitor my mental health and stay calm?

If you are developing anxious thoughts, palpitations, nightmares, notice changes in sleeping and eating pattern, finding the world irrelevant, getting irritated, having anger spells, or start crying for no reason, especially during this time, then talk to a therapist for identification and rectification of the symptoms. Additionally, divert your mind to positive chores/routine. Eg: Taking a walk, pursuing a hobby, avoiding negative messages from people.

Dr. Prashant Bhimani, Sr Consultant Psychologist, practicing in Ahmedabad

How can I fight the fear of losing my close family member who has contracted Covid?

One needs to avoid overthinking and understand that around 80-90% of people recover during in-home quarantine and isolation. We need to see things scientifically with caution and not with illogical fear. If you don’t panic, your family will be emotionally stable and recover faster. As a child, just help them to remain happy and communicative. You can send funny videos and good thoughts, and keep them happy.

Dr. Prashant Bhimani, Sr Consultant Psychologist, practicing in Ahmedabad

Because of lockdown and isolation many have found themselves to be extremely lonely in the past year, especially those who live alone. How can they keep their spirits high and not feel alone ?

Loneliness is being considered the new pandemic. What can you do to feel less isolated?

  1. Trying to stay connected and allocating time to stay in touch with family and friends including online group activities.
  2. Having a routine.
  3. Indulging in some daily rituals – like spending time in your balcony with plants, trying to learn a new skill, using your time to organise things at home- your paper, accounts, clothes.
  4. Finding ways of helping and supporting others – like within your circle or a volunteer group.
  5. Having a clear boundary between work and home especially if you are working from home.
  6. Move a lot. Get up every 20 minutes from a position and move around, stretch and walk a little even within the house.
  7. At the end of each day write down three things that you were able to do- not just work but anything that you did for yourself or others.
  8. Maintain a diary – either writing or audio where you jot down your thoughts and ideas.
  9. Keep a balance between bad and good news. Don’t avoid keeping up with the current situation, at the same time also pay attention to the happier things. Humour is a good way of forgetting all the problems for just a while.
How does a person's time in COVID ICU ward affect his/her mental health ? What can be done to help them?

Being in an ICU can be extremely isolating and lonely and scary even in non COVID situations. In the COVID pandemic, no relative can visit the ICU, the staff, nurses and doctors are in PPE and you can’t see them or identify a familiar face and there may be a lot of suffering and even deaths in the ICU. All this makes it an extremely isolating experience.

The main thing which will help them is to stay connected with family and dear ones through frequent video calls or messages. Having something familiar can also be calming and a photo of a loved one, a religious symbol or a good luck charm or some music playing in the ICU can soothe.

Doctors and nurses need to provide information about procedures, what they are doing, and mention about any improvement that is happening or when the situation is stable.

When speaking to your loved one who is in the ICU or when messaging them, send messages of hope, record your voice with a soothing message or some chants or soothing music, jokes and humour which they can play for themselves or the staff can play for them. If there are grandchildren, let them give messages and cheer them up and provide hope. Make sure they have their glasses or hearing aid, or a pen and a writing pad.

Once they are discharged from ICU and come home, many may continue to have flashbacks of the time in the ICU and relive the trauma. They may get anxious  or have nightmares and dreams. Some people may do the opposite and feel numb and not want to talk about it at all. Respect their individual wishes about this. If the anxiety, flashbacks, nightmares and sleep disturbances are too much- that is suggestive of PTSD. If anxiety is overwhelming, we might want to use some grounding techniques like encouraging some sensory stimulation using the five fingers method. In PTSD, people feel that they are in the traumatic situation again rather than realising that they are now out of danger. To make them get back to the present and for the brain to recognise that the threat is over and they are safe, these grounding techniques help;

  1. Name Five things that you can See at this time wherever you are
  2. Name Four things you can Hear at this time- the fan, kitchen noises, rain, dog barking, birds chirping are some examples
  3. Name Three things that you can Touch – touch different surfaces and describe the sensation
  4. Name Two things you can Smell
  5. Name One thing you can Taste

This will help in grounding, bringing the person back to the present and decrease overwhelming anxiety. If the problem is too much then, encourage them to seek mental health support.

With grief and doom everywhere, there is generally an atmosphere of fear and hopelessness. Many have even developed chronic insomnia because of it. How can people find a balance when so many are losing their loved ones and/or going through traumatic experiences?

It is very difficult indeed and we are all going through so many emotions. We hear about so many people dying or being critically ill that it is hard to stay positive. Remember that the pandemic will take time to come down. Many things are being done like vaccination, improving hospital services and having volunteer groups.

Each of us has our own threshold for feeling sad about the situation and anxious about it. Identify your threshold and be aware of how you are feeling. The moment you feel that you are overwhelmed, try to delink from the news or the conversation and pay attention to something else. While you cant stay positive always, what you can do is identify what stresses you out most. Is it your fear, is it death and dying, is it the fact that oxygen or beds may not be available- which kind of news makes you feel overwhelmed. Try not to shut yourself away from all news because that will lead to avoidance. Avoidance can increase anxiety because it increases your sensitivity to becoming anxious. You may find that if you are avoiding all bad news, you get triggered even with small things.

Also try and involve yourself in helping someone. Even if it a small thing like talking to an elderly person in your family over a call daily, organising food for the needy, doing an hour of volunteering or helping in the neighbourhood with some information. All this will make you feel that you are contributing and feel less out of control.

After vaccination, can stress affect the immune or the nervous system? How to deal with it?

Stress if excessive is known to decrease immunity overall and not specifically against COVID 19 alone. It is important therefore to follow a daily routine with four components- work, play and leisure, some social and family interaction which are supportive, rest. Try and balance all these components rather than focusing on one aspect only. Many a times when you are stressed it maybe due to HALT- Hunger, Anger, Loneliness, Tiredness. So if you are getting stressed try and label it, identify it, try to understand what the main cause of worrying is, specify it so that it becomes less overwhelming.
For eg- the stress maybe because you have a family member admitted with COVID 19. Try and see that you are not always thinking only about that and be aware that if you are too stressed, you will become less effective. Instead, make a list of things you have to do, try do some chores, spend time with a child or a pet or talking to a friend or relative, water a plant. All these things while appearing mundane, will help you calm down which is required when you have to handle a crisis.

Many people are suffering from vaccine anxiety before taking the first jab. How can they address this anxiety? Does this anxiety affect their bodies and the vaccination process?

One of the reasons of Vaccine Anxiety is getting a lot of misinformation about side effects and hence there is a fear of the unknown. Also most adults in India have not really had a vaccine in their adult lives so it seems really anxiety provoking for those who fear injections and hospitals.

For others there is worry about actually being able to get an appointment and go to a vaccination centre where they feel they may have chances of COVID infection if there are lots of people.

So the way to handle anxiety is to

  1. talk to someone who has already received the vaccine and find out their experience and how they handled the pain in the arm or the fever that might have happened after the vaccine. 
  2. Get informed about what a vaccine does. And if you have doubts ask a doctor to give you the correct information.
  3. Prepare yourself beforehand by having a painkiller or paracetamol tablets at home so that if there is fever or some pain you know how to handle it.
  4. Tell yourself that if you and everyone around you gets vaccinated- ultimately you will be able to go out without much fear and anxiety about getting COVID 19 infection.
  5. Anxiety will not affect your immunity or the vaccination. Wear comfortable clothes when you go for the vaccine so that your arm is not tense. Tell your work place that you may take a day off if there is pain or fever and want to rest.
  6. If anxiety is too much- try square breathing- Inhale 1-2-3-4, hold 1-2-3-4, exhale 1-2-3-4 and hold 1-2-3-4. Do this 5-6 times a day whenever you see anxious thoughts coming in
  7. When you go to the vaccination centre maintain 6 feet distance, wear a good mask and sanitise, The nurse will keep you there for half an hour after the vaccine. If you get any doubts and feel you have fever or pain after the vaccine, keep a doctors phone number so that you can contact them.
  8. Remember vaccine is a friend and is the nest way of tackling the current pandemic.
How to prevent the infection?

Doctors should guide a Covid-19 patient about how to look for its early signs. At the hospitals, doctors and nurses should check for the symptoms in patients being treated with steroids or other immunosuppressive agents.

Besides, it takes around 4 weeks for the steroids’ effect to wear off. So, it is important to keep oneself protected during this time. Patients should avoid visiting damp and dusty places for a few weeks post Covid recovery. If it is unavoidable, wear a three-ply mask, gloves, and fully cover your legs and arms. 

keep Covid-19 patients’ oxygen mask and canula sterile to prevent mucormycosis.

It is necessary to keep a regular check on water used in oxygenation for any possible contamination. 

Dr Arun Sharma, Director, NIIRNCD-ICMR and Community Medicine Expert

Is Mucormycosis treatable?

Yes, if detected early, it can be treated effectively with the anti-fungal drugs. In severe cases, however, to save the life of a patient, doctors may have to choose a more aggressive mode of treatment, including surgical removal of the part affected. It may require a multi-disciplinary approach involving specialists from internal medicine, microbiology, ophthalmology, ENT, neurology, pulmonology, dentistry, and reconstructive surgery to treat mucormycosis effectively depending on extent and severity of infection.

Besides, it is important to monitor and manage a patient’s blood sugar level and discontinue immunosuppressants. It is important to strictly follow the prescribed treatment for the prescribed duration to rule out the possibility of reoccurrence of the infection.

Dr Arun Sharma, Director, NIIRNCD-ICMR and Community Medicine Expert

Why is affecting so many Covid-19 patients?

It is generally affecting Covid-19 patients who are prescribed steroids or those who have uncontrolled diabetes. Though steroids are an effective treatment for some of the Covid-19 patients who develop severe inflammatory response. But steroids should always be given under medical supervision as if given too early, too muchandfor too long a duration, these can make one susceptible to catching secondary bacterial or fungal infections.

Dr Arun Sharma, Director, NIIRNCD-ICMR and Community Medicine Expert

What is Mucormycosis?

Mucormycosis or black fungus infection is caused by a group of moulds known as mucormycetes, which are present in the air, water and moist surfaces around us, in damp places. It appears as black spots in the nasal cavity, mouth, throat. In a healthy person, the body’s immunity does not allow it cause infection. However, in an immunocompromised person this can cause severe infection. 

Dr Arun Sharma, Director, NIIRNCD-ICMR and Community Medicine Expert

How do we treat mucormycosis?

Most cases of mucormycosis are treatable. And if we detect them early, the damage can be controlled. Drug Amphotericin B is highly effective.Its liposomal version allows doctors to give adequate doses over a relatively shorter duration than possible with conventional preparations of this drug, thereby helping control the infection early.

There are two other preparations: Posaconazole, which we have used as a stepdown drug after we control the infection with amphotericin; and Isavuconazole. The latter is a relatively newer drug, but initial information suggest that it is also a promising agent for treating mucormycosis.

Along with medications, surgical removal of the dead tissue is also strongly advocated.

Dr Nikhil Tandon, Professor and Head, Department of Endocrinology and Metabolism, AIIMS, New Delhi

How to prevent mucormycosis in Covid patients?

This fungus is present almost everywhere so, it is difficult to completely avoid the exposure.  However, one can limit it by avoiding going to damp and humid places, farms, and dusty construction sites.

Further, one should take all the precautions to protect oneself from catching Covid. Follow Covid-Appropriate Behaviour: wear masks, wash hands, avoid crowds, maintain physical distancing, and take the vaccine. If a person has diabetes, they must do everything to keep it under control. Another important point that we tend to forget is any infection can lead to an increase in blood sugar levels. Besides, steroids also can cause an increase in blood sugar levels.This aspect must be kept in mind by the patient and the treating team – periodic screening for blood sugar must be done in all patients with COVID, so that early treatment can be initiated as soon as the blood sugar shows a tendency to rise.

Dr Nikhil Tandon, Professor and Head, Department of Endocrinology and Metabolism, AIIMS, New Delhi

Why is it called black fungus? How damaging it could be?

Black Fungus is a term given by people. Mucoromycetes is not black coloured fungus. It is an invasive fungus; it invades smaller and bigger blood vessels, diminishes the blood supply to the tissues and kill them. The dead tissue looks black in colour. Mucormycosis , if not detected and treated, is potentially damaging. In immuno-suppressant individuals, it can cause lots of morbidity. For example, if it travels from the nose and sinuses towards the eye, it can damage the vision. If it travels into the brain, it could be fatal.

Dr Nikhil Tandon, Professor and Head, Department of Endocrinology and Metabolism, AIIMS, New Delhi

What is Mucormycosis and why is it affecting so many Covid-19 patients?

Mucormycosis is a fungal disorder. Fungi are present extensively in our environment. If mucormycete spores enters the nostrils of a healthy human being, the body’s immunity fights off the infection and does not let the disease happen. But in people with compromised immunity, these spores, transform in to hyphae, invade and cause the disease. Prior to the COVID epidemic, the mucormycosis infection was observed in patients with uncontrolled diabetes, especially in an acute condition called  diabetes ketoacidosis, cancer patients,especially in those on chemotherapy, and individuals with HIV disease among others.

The current wave of mucormycosis, however, seems to be directly related to Covid-19 and is widely affecting people who have Covid or are recovering from it.

Three reasons that may have contributed to this sudden surge of mucormycosis cases are i) a large number of Covid-19 patients in a small duration of time, ii) new variants of SARS-Cov-2, and iii) concurrently uncontrolled diabetes in these Covid patients

Early data from AIIMS suggest that a significant number of patients currently being diagnosed with mucormycosis had uncontrolled diabetes. Over and above this, we have seen a significant increase in the use and misuse of steroid. Steroids though a preferred treatment for moderate to severe Covid-19 patients, have to be given at a specific time, for a pre-defined duration, and in pre-defined doses. Injudicious use of steroids, including by self-medication can do more harm than good. All these factors have led to the recent surge in the mucormycosis cases.   

Dr Nikhil Tandon, Professor and Head, Department of Endocrinology and Metabolism, AIIMS, New Delhi

How is the second wave affecting children? How are we supposed to take care of the child if the kid shows Covid symptoms? When is the vaccine for children expected?

Till last year, we were seeing only 9-10 per cent of overall cases of Covid-infected children but this year, we have seen a huge burst of paediatric patients getting infected. In fact, even new-borns getting infected. The symptoms in children being presented last year were cold, cough, breathlessness and fever but this time, we are seeing symptoms of diarrhoea, skin rashes, conjunctivitis and other kinds of miscellaneous presentations. 

The RTPCR, at the best, is approximately 67% to 83% sensitive and hence, it is not a foolproof test. Hence, we have to take a combined picture of clinical symptoms, lab values in case it is required and the RTPCR. 

When you see a child with such symptoms the first thing you need to do is isolate the child, get the test done on day 2 or day 3, which is RTPCR, and make sure that the child gets adequate treatment initially just for fever with paracetamol. Consult your local physician and do not start on any antibiotics and other combination drugs at home.

With regard to the vaccine, it is the most important health intervention, which is known to mankind and the only we can arrest the pandemic. The vaccination so far for the pediatric age group have not been licensed in India as yet but the clinical trials have been completed and the mRNA vaccine in the US and Canada are now being approved for below 15 years of age up to 12 and soon, it will be even for a lower age group beyond 6 months of age. 

Dr Sanjeev Bagai, Senior Consultant Paediatrician and Neonatologist and Paediatric Nephrologist

I have been prescribed by my therapist anti-anxiety medicines. Is it safe to take the pills the day I am vaccinated or after?

It is mostly safe to be administered the Covid  vaccine even when on anxiety drugs as prescribed by the psychiatrist. Still it shall be useful to discuss it with the treating psychiatrist before the vaccination. It is noteworthy that in case of high grade fever, disorientation or drowsiness post the vaccine, alongside the general physician the patient should consult one’s psychiatrist for needful. 

Dr Sameer Malhotra
Director, HOD, Department of Mental Health and Behavioural Sciences, Max Hospital, Saket and Panchsheel Park New Delhi

I exercise every day to destress myself. Can I do heavy exercises/ go to gym after vaccination?

While a lot of people are doing exercises to keep their mind and body fit during the Covid time, it is advisable that just before the vaccine or soon after it, to not indulge in heavy load exercises. 

Dr Sameer Malhotra
Director, HOD, Department of Mental Health and Behavioural Sciences, Max Hospital, Saket and Panchsheel Park New Delhi

How safe is the vaccine for cardiac patients since there are reports of instances of blood coagulation post Covid? Also, should a patient with chronic obstructive pulmonary disorder take the vaccine?

There have been a few reports of Cerebral Venous Sinus Thrombosis reported in patients post vaccination, but these are rare cases. Hence, it is thoroughly recommended that all patients go in for the vaccine, especially those in the high-risk groups. In fact, data from the UK, US and Israel has shown that there is considerable impact in curtailing the disease with most people being vaccinated in these countries. Answering the second query, yes a person with COPD (Chronic Obstructive Pulmonary Disease) is also recommended to take the vaccine. In fact people with COPD, much like people with high BP, diabetes or heart disease are at higher risk of dying from COVID. Hence, they are likely to benefit even more from the vaccine.

Dr Rajiv Agarwal
Senior Director Cardiology, Max Smart Super Speciality Hospital

Is it safe for the baby if you are a breastfeeding mother and you get vaccinated? Also, is it safe for pregnant women to get vaccinated?

Pfizer and Moderna have shared safety data on the vaccine that has been clinically tested on 94,000 women—frontline workers, pregnant women and women with comorbidities. However, Covishield and Covaxin have not done so. The Office of the Director Of Public Health and Preventive Medicine issued a circular on May 6, 2021, stating the ‘vaccines at present in use are contraindicated in pregnant and lactating mothers.” Moreover, the Serum Institute and Bharat Biotech also does not recommend such vaccination, the circular states. 

Dr Anjila Aneja,
Director obstetrics and gynaecology, Fortis la Femme GKII
Director and Head Minimal Access Surgery, Fortis Memorial Institute, Gurgaon

How do you interpret hope to a man who has lost his near and dear ones in a span of two days due to Covid? ~ Titus Anto, Bangalore

Spiritual knowledge makes it easier to cope with the loss of a loved one. Spiritual awareness begins with understanding one’s true identity — that one is a soul. The soul is the imperishable sentient energy that gives life to the body, which is the physical medium using which the soul thinks, speaks and acts. Death is merely the soul leaving one body to take birth in another.

We come in contact with many people during the course of our life. We have brief interactions with some, and longer ones with others. The love, affection and support we receive from them creates close bonds, and when these are severed by someone’s passing away, we experience grief. But once we recognise the truth that each soul is independent and no one belongs to us forever, we do not get attached to any person. Yet we are able to have respectful, loving relations as we realise that each soul is playing a unique role in the world. When a loved one passes away, instead of creating thoughts of sorrow, we can remember their good qualities, appreciate their contribution to our life, and send them good wishes for their onward journey. If we grieve, we send vibrations of sorrow to the departed soul and disturb their peace. We must remember that we have a permanent companion and friend in God, the Father of all souls. The Supreme Soul is our eternal source of love and support. Developing a relationship with God, by regularly remembering Him, fills us with His love and peace, frees us from dependence on human supports, and makes us strong enough to guide others to connect with Him and be liberated from all sorrow.

Rajyogi B K Brijmohan, Chief Spokesman of Brahma Kumaris Organization

How to be happy and sustain that happiness, more so when the atmosphere is not conducive? ~ Yudhishtra Rakhija, Kanpur

Happiness, which is conditional, may be dependent on external circumstances or a beloved being whom you want to be with. It is all relative, as for somebody bothered with scorching heat in the summer, swimming or a boat ride may become a reason to be happy while sumptuous food may make gluttons gleeful. Then people derive happiness from wearing fragrances, high-end luxury clothing, and so on. In a way, I have covered all the five indulgences a human being wishes to have by the virtue of five sense organs.

Now, given the current scenario of imposed lockdown, your freedom to be delightful in the usual ways has got curtailed. So, when there is no way to go outside, the only way to go is inside! However, if you are bereft of an enriching experience of being with yourself, if you keep seeking the company of others, then you will find it hard to understand this. 

Be more focussed on yourself and less bothered about the whereabouts of others. This is what makes a spiritual person distinct from others. He is aware of his mind and witnesses it with aloofness. Being a witness is epitomized by the philosophy of Sankhya too. You do not have to make an effort to be a witness, you are one already. You are the absolute reality. You are Brahmn! When you are aware of your reality, where is the need to seek joy from others?

Also, know that no worldly object or pleasure accompanies you when you enter that most blissful state called deep sleep. It gives you a glimpse of what true state of meditation is like. When you start meditating, the mind will slowly turn inward and you will realise that being with your true self can give you everlasting happiness, without being dependent on situations around you. Besides, you can also turn self-sufficient by channelizing your creative energies for various art forms.

Anandmurti Gurumaa, founder of Rishi Chaitanya Ashram, Sonepat

I study in class Xll. I’m frustrated and anxious due to the postponement of exams and family problems. Please help. How to keep my mind calm and have negative thoughts when I am surrounded by so much negativity? ~ Riddhi Deb, Kolkata

Dear Riddhi,

No doubt the Covid-19 pandemic has devastated the entire world.  A vast majority of the human population has been very badly affected.  What is the way out?  Should we keep worrying and get into anxiety, frustration, etc?  No.  Rather, it is time to come forward and take a lead role because you are young and are in a far more advantageous position compared to the older people.  In your own family you must cheer up others with your positivity and enthusiasm.  Please look at the world outside.  Compared to millions of people you and your family are far better off.  As far as exams are concerned, you are in the same position as others.  Lakhs of students are suffering in the same way.  You shouldn’t be anxious at all.  Swami Vivekananda says that every one of us is blessed with infinite knowledge, power, glory, etc.  You are the maker of your own destiny.  The idle mind is devil’s workshop.  Saturate your mind with powerful ideas of Swami Vivekananda.  Please read these two books i.e. “Letters of Swami Vivekananda” and “Lectures from Colombo to Almora”.  You will feel tremendously energized and enthused.  Even a very small booklet “Thoughts of Power” contains very powerful messages of Swami Vivekananda.  You must have already prepared well for your Board exams.  So, you need not spend too much time on academics.  Keep just revising.  But, use this opportunity to saturate yourself with Swami Vivekananda’s powerful man-making and character-building messages.  You should never entertain any negative idea.  Rather, you should be an inspiration for others.  Because you have too much of free time, why not try a new hobby or spend quite some time in strengthening your existing skill i.e. music, art, etc.  You can also try your hand at cooking or helping your mother in household work.  But, the main support and strength would come from the ideas of Swami Vivekananda.

Swami Shantatmananda, Head, Ramakrishna Mission, Delhi

I have a friend, who seems depressed. His mom (he lost his father when he was very young) said he likes talking to me. I have been trying to find out why he is so sad. I tried asking him about his feelings to which he said that he feels like a destroyer. After he lost his father, the closest person for him was his granny, who died a month ago. His girlfriend also left him two months ago. This has only added to his pain. I just don’t know what to do or say to him to make him feel better. As a friend, what can I do to help? ~ Anonymous

He’s fortunate to have a caring friend in you. Dig a bit and ask him to specify what he means by being a destroyer? Does he believe he’s cursed? That life has chosen him to be the ‘sufferer’? Ideas like these can be quite detrimental to his emotional wellness and in a way will lead him to create a self-fulfilling prophecy. Our ideas facilitate how we react to circumstances. If he has come to believe that life has conspired to give him trouble, he will find it very hard to cope. One way to help is to give perspective about the things going ‘right’ in his life. The human tendency is to focus on the not so good and we need to train ourselves to learn gratitude and thankfulness. So if you can help him direct his mind to count his blessings in spite of having challenges at hand, you will do him a world of good.

It has been a year since I met my friends. My dad won’t let me step out of the house, because of the stupid virus spreading again! I’ve already promised to stay safe, with the mask etc but still, my parents won’t trust me and allow me to go out. It is very annoying to sit at home and attend online classes in your very first year of college and just chat virtually with classmates. This is driving me crazy. How can I explain to my parents that it’s okay to meet friends with precautions? I am stressed as I only binge on shows for company. I am desperate to step out and meet people ~ Anonymous

I can understand how hard it must be to have your freedom taken away from you. I have noticed that people of your dad’s age are more fearful, perhaps due to them being more vulnerable to catching the disease or it could be his personality to worry a lot. One thing to try is to not talk to him when he is already defensive, because by then the person has mentally shut down and is not open to change. Find softer moments and windows of opportunities and talk about something he can take, for example, can a friend visit you in the house with a mask and sanitise afterwards? This way you’re working with his rigidity than against it. Always comfort and validate him before asking for something bigger than what you have asked previously. Another option would be to opt for family counselling as I feel that this must be affecting other areas of life, even before Covid, and the lockdown is just bringing it to the surface.

I feel depressed every now and then during this lockdown period. No offline classes in college have made it worse. All I can do all day is overthink things that don’t even have anything to do with me. I’m losing focus and energy to do anything else. Sometimes it just feels too much. Please help ~ Anonymous

When we think too much, it means that a part of us (the part that copes by “fight” response) is trying to flash thoughts at you in order to keep you vigilant as it feels you are under threat. Our brain is wired to cope in this way by evolution. This means that we need to do more activities that make us feel safe and calm. Look up “activities to regulate the vagus nerve” and use that to soothe yourself. The other important thing to do is socialise in whatever way you can, for example, going for walks etc with a mask. Seeing some people is better than none. Also try and organise game or movie nights online with your friends.

I feel very lonely. My husband died a few years ago. The worst thing is that I was not supported by my in-laws. They never took care of me after his death. I was in a job but had to leave it though I need the money. I am frightened about the current situation. I am becoming sick day by day as I am going through depression. I want to travel to feel better but I don’t have friends to travel with plus it is impossible during the lockdown. I did not get into a relationship after my husband’s death. I want to be happy but don’t know how to. Please help ~ Anonymous

When we put our well-being into another person’s hands, we will always be susceptible. A loss of a spouse is traumatic and nothing can take away your grief. Self-support is the best support — this belief needs to be underscored in your mind. What can I do, with where I am, and with what I have, is a good way to begin. Unfortunately, too many of us do not ask accountability of ourselves when we find ourselves in distress. All problems have solutions, albeit not necessarily the most optimal ones. It is important to direct the mind to find those. That means not allowing oneself to wallow and instead trying to find purpose in what would otherwise be a meaningless existence. As Viktor Frankl said, “Everything can be taken from a man but one thing: the last of the human freedoms — to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

I lost my husband very recently to Covid-19 and it has been shocking, stressful and extremely sad. I have two kids, aged 11 and 6, who I have to bring up. I am suffering from anxiety. I have fears of how to bring up my kids and how to manage the rest of my life. Running around for paperwork and the inability to meet parents during this time is making it worse. Please help ~ Anonymous

I’m so sorry to hear about your loss. I can imagine how distraught you and your children must be. I am at a loss for words and any advice would seem shallow, yet here it is. It is important to grieve. Of course the ‘practical’ aspects that need to be taken care of may not allow you the space for sorrow. Would you have any relative or friend who could assist in the paperwork? Is it possible for you to delegate? At this time, physical contact with the kids is important. Tactile connect soothes. Cuddling, hugging, holding them are ways that facilitate oxytocin. It is a hormone that calms and reduces our stress response. Allow yourself to cry whenever you feel like it. Don’t hold back or control. Do not believe that you have to be ‘strong’ for your kids and not display emotions. In fact, crying together can be therapeutic. Take care.

I am 19 years old. I lost my father last year when I was preparing for NEET. After his demise, my studies stopped due to my family’s financial condition. I started giving tuition to other children. My mother is sick and I don’t know how to help her. Last week, my girlfriend left me for not being able to give her time. I feel depressed and do not have anybody to share my feelings with. The only person I could do it with was my girlfriend. Me and my mother never talk about my dad. What should I do? ~ Anonymous

Manish, sorry to hear about your loss. It seems like you are dealing with multiple losses and haven’t got the time to process the grief attached with them. Most times, we look to do the practical thing, which is okay but don’t completely ignore your emotions. I also see that it must be difficult for you to balance everything with mum being unwell too — remember to prioritise. Many people won’t understand and it’s okay. If you don’t have a support system, you always have an alternative to turn to professional help. As part of taking care of yourself and your mother, journaling your thoughts and feelings, talking to friends, and importantly taking help from a professional so you don’t keep functioning on autopilot mode can be helpful.

I am 24 years old, doing my masters. It has been more than a year since our college has been shut. I live with my father and mother and I am not friendly enough with them to share my thoughts. This magnifies my loneliness with no one to talk to. Nowadays I overthink about my career and other bad things. I can’t visit my friends or relatives because of the lockdown. I can’t sleep at night and wake up late. I feel depressed and aimless. Please help ~ Anonymous

Times are definitely tough and uncertain. A lot of students have been feeling a sense of being helpless and lost about their future and career, given the current situation. Talking to friends and staying virtually connected cannot just fill the void but also help you realise that many others are sailing in the same boat. A good way to tackle the job situation can be to keep looking for opportunities as and when. When you feel tired or less motivated, give the job hunt a break, utilise your time with learning, relaxing and recreating, taking care of your mental health and physical health and spending time doing things that make you happy and help you grow. The pandemic is not meant to be productive and being productive all the time isn’t a necessity. Take breaks, rest, stay put and remember you are not alone. This time shall pass too. Should the low moods persist, don’t hesitate to take professional help.

I am an undergraduate student. Since college was shut last year, I have been at home. Although I have a few friends, we only exchange texts and don’t call each other. My semester classes ended a few days ago. With nothing much to do, I feel very empty and tired the entire day, unable to be productive at all. Maybe this feeling of emptiness is due to the havoc caused by Covid around the country. My family keeps on worrying about my father losing his job. Last year, I used to read a lot to cope with this emptiness but now, I don’t know what to do anymore. Please help ~ Anonymous

Feelings like what you are experiencing can be a normative response to a pandemic. You could suggest speaking on phone to your friends once in a while and see who all make it to the call. It’s a tough time for everyone, whether infected or not; and each person is coping in their own way. Considering there is so much uncertainty about even the immediate future, worrying beforehand doesn’t help. Consider spending time with family, talking this through and understanding alternatives if the job loss situation arises. Don’t forget to make the most of and be grateful for the present moment. In such situations, taking one day at a time helps.

I am a teacher. I come across many students and I always want to be around them. Unfortunately, the pandemic doesn’t allow me to be the best companion to them. I have been under lockdown for 15 days. After being isolated I came into the cave of negativity. Whatever I read, whatever I watch on television doesn’t make me feel better. Mental sickness has colonised my brain and the impact of my negativity comes on my family. Please guide me in overcoming this unprecedented sickness ~ Anonymous

It seems like you have been having a very tough time. It’s clear that you care for your students a lot. I would like to start by affirming that you are not sick. The pandemic has been a lot for us all — struggling does not mean that you are ill. It means that you are a normal human being responding to these very difficult circumstances. Negativity is an understandable response to all this isolation, helplessness, worry, change. If connecting with your students and other people has helped in the past, I wonder if connecting with others who are feeling the way you do will help? There are many support groups and listening circles being offered at subsidised/no cost. Finding a community and people with similar experiences can be healing. It may also be helpful to connect with a professional.

I am 18 years old and have a younger sister. I am getting less tolerant and get easily triggered. I tend to ruminate. Some ideas keep getting repeated in my head — even though I distract myself and read good things. Often, I get confused. I think of some people and situations that demotivate me. I don’t like taking help because I think I can do it all. I neglect what I used to be interested in doing. Can you suggest how to cope with this inability to focus? I am also not getting proper sleep. Please advise ~ Anonymous

It seems like your body and mind are responding to things not being okay. Tune into that message and ask yourself “What does it mean that I am feeling this way?” What do you think you might be needing? I could suggest ideas to help with sleep and focus, however the larger picture might be about the things affecting your overall wellness and addressing those. It’s okay to ask for help — it’s not a sign of weakness. Rather, I see it as a sign that you value yourself and you want to create some changes in your life to feel better. Look up ‘sleep hygiene’ for the sleep related difficulties and try the Pomodoro technique for focus. However, feeling triggered, ruminating and neglecting what one is interested in can be indications of something more. I would encourage consulting a mental health professional for this.

I am a 27-year-old working in a private bank in Bhubaneswar. I am also studying to get a decent government job. Since the March 2020 lockdown, things have been far from normal. I tried to keep a positive mindset, thinking the lockdown will give me time to involve myself in studies but things did not go in my favour. Now things are worse. I cannot concentrate on my job because of fear of contracting Covid-19 and am continuously thinking of what I should do to be with my family in these hard times. I am very stressed and anxious ~ Anonymous

It makes complete sense that you feel things are far from normal and that you are feeling stressed and anxious. Health anxiety and worrying about the safety and wellness of our loved ones is a common response to what is going on. It’s okay to worry and to not feel positive at all times. It seems like some part of the anxiety is about protecting what is important to you and some part is getting in the way of your work. Try to focus on the things that are in your control rather than what is not. Remind yourself of the precautions you are taking. Have designated times where you focus on work. Take frequent breaks. Set limits on social media consumption. If the thoughts come up, try to practice some breath work with mindfulness apps and then refocus on work. If the anxiety continues to increase, consider consulting a mental health professional who can support you.

I am 42 and have fully recovered from Covid. My wife, 41, took care of me and supported me all around. Without her sacrifice I could not have recovered so fast. We are back to normal life but she is not mentally prepared to resume physical proximity. Is there anything wrong in my expectations or does she need to divert her mindset? ~ Anonymous

Issues of communication and consent are always important in intimate relationships, especially when your spouse’s comfort levels and concerns around touch and close contact have changed after being infected with Covid-19. It’s also absolutely normal to not feel like engaging in any sexual activity during this time. The anxiety that comes along with the pandemic, the stress of working from home while also managing the house and the worry she may feel for you can suppress her sexual drive. Don’t force yourself to feel something that isn’t coming naturally. Once things get better, your partner’s sexual drive may return to how it was before. It’s important to talk with your partner about what kind of behaviour she wants to engage in first. Remember that fondling, PDA (public display of affection), cuddling and kissing are also forms of physical intimacy, so enjoy them as much as possible.

I’m 18 years old. I have a smartphone addiction. First I didn’t recognise it as an addictive behaviour. I was procrastinating. I wanted to get rid of it but couldn’t get the slightest motivation to do so. I recently acknowledged my behaviour and have been feeling guilt, remorse, panic and overwhelmed. I had completely cut myself from around the world. I request you to help me out ~ Anonymous

Gadgets are useful and essential tools for communication, research, learning and entertainment, among other things. Spending a lot of time connected to your phone only seems to have become a problem as it is absorbing so much of your time. Try designating media-free times together with family, as well as media-free locations at home, such as bedrooms. If you use your smartphone as a “security blanket” to relieve feelings of anxiety, loneliness, or awkwardness in social situations, you’ll succeed only in cutting yourself off further from people around you. Try not to stare at your phone as it will deny you the face-to-face interactions that can help to meaningfully connect you to others, alleviate anxiety, and boost your mood. Go grayscale as there are many colourful apps on the phone. They are designed to trigger your brain’s reward system and make you feel good. Limit what’s on your home screen and take social media off your phone.

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