Five tactics may help stabilize mental conditions during lockdown

A psychologist in Taiwan has offered suggestions which may help Macau people to more easily endure this week with their mental health intact.

At Sunday’s daily health press briefing, president Hon Wai of the Social Welfare Bureau (IAS) was asked about the bureau’s preparation for this week’s lockdown.

He noted that his bureau alongside Health Bureau (SSM) and Education and Youth Development Bureau (DSEDJ), has regularly “held seminars” on special or specific cases with mental complications and provided various follow-up avenues in the hope of preventing the re-occurrence of such problems.

“In this coming week, there will be an extended period of time that family members remain [together] in a confined space,” he remarked. “Therefore, I recommend people to be mentally prepared and practice empathy.”

In addition, he asked people to exercise greater care when interacting with those family members with whom they did not meet regularly. “The changes in [environmental factors] will very likely cause anxiety and stress,” Hon admitted.

On the matter of support provided by the government, Hon concluded that support from family members and friends would be best.

In contrast to the intra-household support strategy that Hon mentioned, an article by Assistant Professor Yi-Wen Kung at the Department of Psychology of Fo Guang University in Taiwan listed five principles recommended by post-traumatic psychological specialists worldwide.

Colloquially referred to in Taiwan as “tranquility can bring hope”, the five principles promote security, tranquility, ability, connectivity and positivity.

To achieve security, Kung suggests people maintain good health. For tranquility, she suggests that people regularly, but not excessively or repeatedly, be exposed to news about the disease and the infection levels within the community.

As for ability, people should consider establishing a Covid-normal lifestyle, such as working or studying from home, as well as working out or engaging in a pastime at home. Kung remarked that this will help improve individuals sense of normalcy.

Moreover, technology can be used to foster connectivity. For example, people can engage in daily video calls with their friends or family members who do not live in the same household. Support can be offered through conversation.

Kung added that practicing these four principles will help settle mental conditions.

However, local-registered psychotherapist, Nadia Chan Hei-ka who is also a Britain-registered clinical psychologist and Pennsylvania-licensed professional counselor, emphasized that whenever a person shows symptoms of extreme unhappiness, depression, anxiety or self-harm, emergency rescue agencies must be notified immediately to safeguard the individual’s life.

“If family members know of [mental disturbances in co-habiting family members], they should pay greater attention [to them],” Hon said. “Of course, if they don’t know what is best to do, contact Caritas Macau’s Lifehope Hotline. Our fellows will provide adequate help.”

He added that IAS would not suspend its outreach help effort during this coming week.

Adding to Hon’s response, Chan emphasized the difficulty for laypeople to pinpoint or be aware of potential mental disturbances in themselves or the people around them.

“Symptoms might not be easy to notice by laypeople, as firstly, symptoms can be overlapping and interacting with each other and second, there can be misunderstanding about symptoms: for example, anxiety is internal while stress is external,” the psychotherapist explained.

In addition, a study by Associate Professor Danny Horesh at the Department of Psychology, Bar-Ilan University and Department of Psychiatry, New York University School of Medicine, and Associate Professor Adam D. Brown at Department of Psychology, New School for Social Research, and Department of Psychiatry, New York University School of Medicine, questioned the efficacy of conventional or existing trauma-focused therapy because these methods may not be appropriate to the specific situation of Covid-19-imposed restrictions.

The two academics added that since “the peritraumatic [distress experienced immediately after a traumatic event] phase of the Covid-19 crisis is likely to be rather long, treating people for acute stress disorder and/or initial posttraumatic symptoms, which have not yet crystalized into full-blown PTSD, may be of particular importance.”

mental burden  upon the elderly

Also on Sunday, the Judiciary Police (PJ) announced two separate cases of alleged suicide, involving two octogenarians.

The Suicide Prevention Resource Center at the University of Oklahoma Health Sciences Center pointed out on its website that social isolation is a risk factor in suicide amongst the elderly. The city’s current week of de-facto isolation, with police officers patrolling around the city to “encourage” – as the government describes – people on the streets to return home unless they have one of the few valid reasons for doing so, could be considered a scenario which creases an absence of social connectedness, as was seen in lockdowns in other cities across the globe.

In fact, Kung pointed out that people whose sociality gets restricted due to disease prevention measures will face social isolations and restrictions.

Social connectedness is a protective factor in avoiding or lowering the risk of suicide amongst the elderly. Government officials at the daily health press briefing have referred to activities that senior citizens do on a regular basis when they exemplify what they considered “survival activities.” For example, they said that “playing chess in parks or leisure areas” would not be considered a type of survival activity.

Before this week, elderly residents were regularly seen having chats on benches in leisure areas, either by themselves or with their grandchildren.

The resource center has also pointed out that physical illness, disability and pain are conditions that are worthy of worry as they pose greater risks on the mental stability and health of elderly people.

Kung highlighted that four psychological reactions would arise if elderly citizens experience mental distress as a result of the social isolation: non-specific and uncontrolled fear, pervasive anxiety, frustration and boredom, and disabling loneliness.

After confinement, Kung pointed out that instances of poor mental health could linger. Citing a study helmed by Prof Gianluca Serafini at the Department of Neuroscience, San Martino Hospital, University of Genoa, Italy, Kung pointed out that confined people will show symptoms of mental disturbances, such as post-traumatic stress disorder (PTSD), emotional fatigue, fury, insomnia and depression.

These changes in behavior, which can include hand washing with a vigilant intent and avoiding crowded locations, may occur for a lengthy period. 

Kung also stressed that these symptoms of mental distress might also occur in healthcare or other care members. This could be caused by separation from families, fatigue, or loneliness, posing great psychological threats to these groups.

They may also develop signs of depression, anxiety, insomnia and feeling distressed.

The Social Welfare Bureau (IAS) encourages residents to be aware of their psychological and emotional state as well as that of their relatives and friends. In case of need, residents can call Caritas’ Life Hope hotline (28525222) or IAS’ counseling hotline (28261126).