Get a handle on your family’s mental health

Mary Musau, a counseling psychologist. [Photo: Standard]

People with existing mental health challenges, such as those going through depression or anxiety are already ‘quarantined’ by their situation and it may get worse.

Those with depression and anxiety already prefer not to leave their houses. Part of their healing process is usually by encouraging them to go out, but now with quarantine, especially if they are alone, staying home becomes justified and worsens their problem.

It makes it difficult for them in terms of healing and recovery and their depressive episodes may heighten. And as was witnessed in South Africa when a woman in quarantine took her own life, there is the fear of suicide cases escalating.

Anxiety is also a challenge for everyone now because of the nature of the virus. It brings the spectre of the unknown. It removes assurances that would otherwise bring emotional safety and security. Anxiety is about fears and worry. People are afraid of the future, losing jobs, their health and are afraid of losing loved ones.

There are also issues of security, because apart from being a physical challenge, not feeling safe is also an emotional challenge. You don’t feel safe at home or outside now.

There is the question of ‘What if’? “What if I get the illness myself? What if someone in my house gets it? What will that look like? How do we cope? How do we manage? Will it spell death for us a family?”

How to cope:

Keep means of communication open with friends and family to help beat isolation. The same way you are working from home, keep connections alive.

Try to catch yourself when you are feeling anxious. Ask yourself, “What can I do?” instead of running away. When you run away you put it at the back of your mind but the anxiety doesn’t stop. It only continues running in your sub-conscious. Change what you can, and for what you can’t change, let it go.

Don’t forget to look out for your own physical well-being. If you are not eating a balanced diet, exercising and resting, it will escalate anxiety. Watch out that you don’t fall into comfort eating -- eating more than you need or not eating at all.

Keep a log of your anxiety, so that you can manage to spot patterns. That way, you will work it out with a clear mind.

Set worry time. Sometimes, you may have a worry or concern but fail to address it. You can say that you do not have time, but you can set aside time to face them. Not so that you can wallow in it, but so that you can get a solution and put it into action.

Do the things you love like reading and cooking. Keep good hygiene – keep windows open and stick to the safety regulations given by the government.

Develop your own toolbox to deal with anxiety. This can be breathing exercises, writing, seeking support from other people around you, yoga, praying and mediation, self-talk.

Vulnerable people

The most vulnerable people are those who have been through any form of trauma, especially physical, sexual or emotional abuse. Right now, some are at home with their abusers.

It is difficult right now because even if they reach out, there is a curfew, so people may not come to help. Even if they got out of the house, where would they go?

In this case, the most vulnerable would be women, children and the disabled, both physical and mental.

What to do:

Be each other’s keeper in the neighbourhood. Churches can create support forums and places where people can feel safe.

People in estates can also do this so people in trouble can be helped. Discussions can be had at the nyumba kumi level, and in chamas about what to do if someone needs help or gets the virus.

Families need to update the ground rules of the house, such as parents telling children which areas are off limits, such as going to a bedroom with just one person or secluded areas.

Talk about online safety – children need to know what to say and what not to say online. Keep lines of communication open.

Heightened anxiety

Families are forced to stay together, which can easily bring tension. Even the privacy that used to be there for couples is reduced.

Bread-earners are also vulnerable because there is unemployment looming. The person who is supposed to provide and protect will likely be going through a lot of emotional turmoil.

They may have no one to talk to, and men especially may not want to talk about it, but you will see it in their behaviour – they will be irritable, they may physically or sexual assault and they may start drinking alcohol more.

How to cope:

A problem shared is a problem half-solved. Let everyone have the freedom to talk about their worries. You can talk about your worries with your friends and family. You can also reach out for professional help like counselling.

Keep your usual routine as a family as much as you can. Having a structure will help everyone manage. Give everyone room to make that transition, because it cannot become the new normal overnight.

As a couple, try to address the issues that concern you two in a manageable way, without flooding all the issues that you did not talk about before. You can write down what your issues are and agree on how to address them one by one. You can access support and therapy online.

Now that you can’t run away, you are forced to deal with your own demons and it can be very lonely and frightening. You can use that opportunity to help each other deal with the issues.

The elderly 

This is a completely new setup in African culture, which is very communal. Grandparents are usually taken care of and visited by their children and grandchildren who keep them company. But now, for their own safety, they need to be left alone.

That may raise mental health issues for the elderly because they will feel lonely, isolated and not valued; which can be very tough. How will they unpack that in real terms? It is a sad situation.

What to do:

The family can discuss how they will come together to support one of their own where need be. That will be how to support and keep communication lines open with the grandparents and maybe where to set aside a room for a family member who may be exposed.

Help children cope

During school days, if a child had a problem a teacher would know. The teacher would be able to reach out to parents or social health workers. Now, that external support is missing and the children are likely to internalise all the negative repercussions.

Teenagers also find identity in their peers and it will be difficult for them to accept the reality of social confinement.

What to do:

Children look up to their parents and caregivers. If their parents’ faces are showing anxiety, worry and fear, the children will pick it. That is not the time to talk to your child.

Deal with your own anxiety first so that you do not transfer it to the child. Listen to the child when they express their concerns and fears. What they need is reassurance. Let the child lead you with their questions. Answer what they ask, so that they are not overwhelmed with information.

Have age-appropriate conversations about what is going on. Part of reassurance is telling them what you are doing to keep them safe by helping them with their health routines and schoolwork. Make sure you keep the lines of communication clear. If they are anxious you can distract them.

Listen out for the voice of anxiety in your children – they may be seeking more attention than usual through their behaviour, body aches, moodiness, irritability, tantrums, having trouble sleeping or having problems with eating. Try to understand what is beneath the behaviour.

With teenagers, you need to talk with them, understand their frustration and acknowledge it, even if they may sound unreasonable. Encourage them to name their emotions and say what it is that they are going through.

You can negotiate, loosen the rules on social media, look for creative and safe ways of social interaction, support them through remote schooling by creating realistic schedules. If they want to express themselves through text, that is also a place to begin communication.