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COVID-19 Pandemic: Inducing Pan-Hysteria and Panic Disorder; an Overview

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COVID-19 Pandemic: Inducing Pan-Hysteria and Panic Disorder; an Overview 6600 Indian Journal of Forensic Medicine & Toxicology, October-December 2020, Vol. 14, No. 4 COVID-19 Pandemic: Inducing Pan-Hysteria and Panic Disorder; An Overview Arpita Aswinikumar Sahu Medical Intern, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India, Pin Code-442001 Abstract Summary: Wuhan Municipal Health Commission, China, gave an account of a few cases of pneumonia which were later established as cases of the Novel Coronavirus Disease by the end of December 2019. By 4th of January, WHO reported these cases on social media and by the beginning of March WHO had declared it as a pandemic which was preceded and followed by lockdowns in various countries and had led to a scenario of fear and panic amidst the minds of all. The coronavirus disease 2019 (COVID-19) pandemic has challenged the society in many aspects, one of them being the psychosocial aspect. The stress due to the pandemic could produce worry and fear about health for oneself, family members and friends. Even changes in sleeping or eating patterns, the worsening of chronic health problems,unavailability of alcohol, tobacco or other drugs in the market due to shutting down of manufacturing units and problems in concentration are among the possible etiologies of a precipitating panic disorder. Containment measures such as lockdown and isolationcan also precipitate psychiatric illnesses and morbidities such aspanic disorder, depression, anxiety and suicidal tendencies.COVID-19 may cause or exacerbate even the existing psychiatric illnesses or existing panic disorder in individuals which could lead to physiological symptoms like palpitations, sweating, shortness of breath and a decreased sense of wellbeing. It gives a feeling of impending doom or danger and is followed by intense fear which can all take place when one is facing such a pandemic. Conclusion: The COVID-19 pandemic has not only had physical but even mental and psychosocial impacts. New mental health challenges may arise owing to this pandemic. Keywords: COVID-19, Panic Disorder, Anxiety Disorders, Psychosocial, Novel Coronavirus. Introduction taken almost every country under its wing. It has affected nearly 10 million people till date and has taken the life of In December 2019, a life-threatening disease, the approximately 500 thousand people across the nations. Novel Coronavirus disease 2019 came into play, which Not only has it affected health physically but mentally has now become a massive global health concern. It had as well. It has gripped the mind of every human with commenced in Wuhan, China and has now escalated and fear, anxiety and panic. From the moment of declaration of this as a pandemic, to lockdowns being imposed, all of it has seized people with hysteria and panic attacks. [2,8] The psychosocial impact of this whole pandemic Corresponding Author: is huge and could lead to various disorders that could Arpita Aswinikumar Sahu be short term or long term like anxiety disorder, major Medical Intern, Jawaharlal Nehru Medical College, depressive disorder, mysophobia, acute stress disorder, Datta Meghe Institute of Medical Sciences, panic disorder etc.[1,2] Wardha, Maharashtra, India, Pin Code-442001 Mobile No.: 00919172009144 Panic disorder is classified underanxiety disorder e-mail: [email protected] and it is characterized by repeated and unexpected panic Indian Journal of Forensic Medicine & Toxicology, October-December 2020, Vol. 14, No. 4 6601 attacks. During this, a feeling of terror develops and and had to stay without their family, after which testing may trigger severe physical reactions combined with was done one final time before releasing them from the alterations in behavior or persistent worry over having quarantine facilities. This caused unease and increased further attacks. The fear of an impending panic attack panic.[1,3] can hamperroutine day-to-day life. Panic disorder is more common in women as compared to men and thus Cases of stigmatization, racism and xenophobia women are more susceptible to such an attack. It could against targeted communities were also being also possibly lead to Agoraphobia, which is a fear of highlighted in the news across the globe. WHO going into places that are crowded. This is because it highlighted in their mental health outline that beratement can cause an individual who has already had a panic and victimization of individuals affected by the disease, attack to circumvent from places and situations where an frontline health care professionals combating the disease attack has previously taken place because the individual and government officials is a predictable occurrence in experiences anticipatory anxiety. Diagnostic Criteria of epidemics and tragically this trend is still alive during Panic Disorder [300.01 (F41.0)] is given under DSM5 this ongoing pandemic of COVID-19, which has caused and says that at least 4 out of 11 physiological symptoms stress among the individuals affected by the disease as need to be present for an attack to be categorized as a well as among the healthcare professionals which could panic disorder. Even though these anxiety symptoms precipitate in even them having panic attacks. The may not be advanced enough to cross the diagnostic healthcare professionals are already under stress due to threshold of DSM-5, assistance and comfort from the increasing cases of COVID-19, increased working experts and specialists may help the people to get over hours, less rest when they are relentlessly working, their current anxieties.[1] which leads to an increase in their exposure towards the disease. This means that they do not get to spend Literature Review: much time with their family, worrying about themwhile at the same time trying to efficiently work with reduced Panic Disorder Correlated to Pandemic: As resting period. Even for those who are affected by the COVID-19 was spreading across the nations, the people COVID-19, it very difficult to cope as they are internally of these countries were mostly not aware of coronavirus panicking. They get respiratory symptoms which they and so ignored it. As soon as it was declared a pandemic, don’t know much about and wonder what is happening reality came crashing down on everyone as they realized to their body. They can’t meet their family and are there is no more escaping and ignoring what is going completely isolated which further aggravates the fear on around the world. The countries that had already and anxiety already brewing in them.[1,3] been affected and had an increased number of cases had already gone through the realization phase, but knowing Hence, it is very important for the mental health that almost all countries are affected by the same was professionals to take an initiative and educate the public still harsh on them as now they could see the same so as to decrease their fear and stigma and counsel those helplessness everywhere. affected by COVID-19. Certain psychosocial guidelines were also delivered by the WHO for diminishing the The disease was not known to many at the time as increasing stigma against COVID-19.[3,4] to what it was, how it spread and why it was the cause of death for many which thus created fear and panic Panic Disorder Correlated to Social Media: amongst everyone. They did not know who to approach, Over the last few years, social media has proven to who to ask and were completely ignorant on the topic. be a platform for circulating awareness and imparting Non- availability of vaccines and uncertainty at the knowledge regarding health. But, misuse of social time regarding the treatment further aggravated the media has also been done time and again. In a time problem.[1,3] like this, where already very little was known about the Novel Coronavirus disease, misinformation spread All individuals who were quarantined for 14 days like wildfire all across the social media platform, from post-travelling and those who were contacts and contact supposed cures to false information about the spread of contacts were also very scared as they feared the of the disease and gave rise to more panic and anxiety. outcome of their test results. They had to wait for a This fear and anxiety could lead to people trying various period of 14 days where they were completely isolated supposed cures which could be life endangering. Social 6602 Indian Journal of Forensic Medicine & Toxicology, October-December 2020, Vol. 14, No. 4 media also became a platform where fake sanitizers and effectively participate in society. Feeding and providing N95 masks were being sold and since the people were a roof over the head is not enough, but also increased going through so much at the time, they were vulnerable access to school or clinic, land for growing food, even and so fell for such schemes.[5,6,7] a job is equally important. Poverty means, one is living in a delicate environment, without access to clean water Panic Disorder Correlated to Lockdown: As or sanitation.[8] the cases kept rising, countries with so many cases eventually had to declare a lockdown to contain the Not just the poor but it created confusion even spread of the virus. In the past outbreaks, we have amongst people who had small-businesses, artists and seen that quarantine, lockdown and isolation has had everybody who did not have a steady income and job. a psychosocial impact whichvaries from overnight and They did not know how to deal and process the lockdown concerning effects like agitation,worry over acquiring the as there was too much uncertainty of what the future held. disease, worry over transmitting the disease to members This again led to anxiety and panic regarding how they of their family, anger, panic, denial, loneliness, despair, will feed themselves and their families and maintain a anxiety, insomnia, depression, hysteria, to extreme roof over their heads while their sources of income were effectslike suicide.
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