Psychological Changes during Lockdown & How to Cope with Them

From headaches to anxiety to sleep disturbances, Dr. Farzana M. discusses the psychological changes that commonly affect people’s health during the lockdown, and how to treat them at home.

The Coronavirus pandemic has brought about sudden changes in everyone’s lifestyle around the globe. Everyone has new routines, work-from-home, fear or loss of jobs and changes in surroundings and sleep cycles. Along with physically keeping people shut indoors, the quarantine is making people experience many psychological changes as well, which affect their well-being.

As there are lockdowns in every part of the world, the most common health problems faced by people are:
1. Headache
2. Personality changes
3. Sleep disturbances

People have their own reasons, perspectives and diagnoses for their ill-being. Some may feel it’s because they are indoors, so they feel suffocated while others may think they are anemic and so on…

Let’s see the actual reasons behind these problems one by one.

1. Types of Headaches

Firstly, let’s have a look at the types of headaches. Actually speaking, there are different types of headaches that majorly fall under two categories as primary and secondary. Primary category usually doesn’t have any underlying causes for the headache, whereas the secondary has specific causes which are major and requires a doctor’s attention.

The common primary types of headache include:

1a. Tension type of headache
1b. Migraine headache
1c. Cluster headache

Let’s discuss them one by one to help you understand what type you are encountering.

1a. Tension Type of Headache

This is the most common type of headache that most of the population suffers from. People often mistake it for a migraine, which it actually isn’t. This usually occurs when the person constantly gets tensed or if he/she is short tempered. The facial muscles are in tension at this point, and this causes the headache.

In fact, being anxious about one’s headache itself will result in the continuation of the symptoms, convincing the person that he/she might have some serious medical issue. The pain is usually dull and gives a sensation of a band around the head. One might feel pressure at the vertex (upper part of the head) and when it’s constant, it gives a feeling of pain radiating from the back of the head.

In the current scenario, a person can suffer from this type of headache if they are stressed about the pandemic. These people may include doctors, nurses, health workers, and the policemen or government officials who are directly working on this situation.

The other set of people who may get this headache can be youngsters who are stressed about being at home. Hanging out with friends or exploring new cuisines with their favorite people would have been their pastime before lockdown. However being stuck at home might get them irritated. The constant thought of being idle at home itself is stressful for them. And the other reason is being glued to the phone/TV so desperately thinking that they can pass their time only through binge watching series or movies. By doing so, their mind can get tired and stressed, which make them feel a constant headache.

Another set of people who can suffer from this type of headache are the elderly. Before the lockdown, they would have spent their leisure time strolling the parks, chit-chatting with their mates, enjoying a laugh or two. So they will get stressed when they are being locked in one place over a period of time.

1b. Migraine Headache

This is the second most-common headache that generally affects people in their late 20s, middle aged people and occasionally, those in later life. In some point of life, 20% of women and 6% of men are affected by migraine headache.

Migraine can happen in two ways – with or without aura. The aura manifests itself as shimmering or silvery zigzag lines moving across one’s field of vision for up to 40 minutes. Sometimes, there can be a temporary loss of visual field. 80% of the people have migraine with no aura. The pain is severe, throbbing type, associated with sensitivity to light and sound, with vomiting. These symptoms lasts for 4 to 72 hours.

People with migraine would prefer a dark room during their attacks due to the above mentioned symptoms. The person who suffer from migraine with aura should consult a doctor as it may lead to neurological problems, sometimes brain infarct.

Some people get the psychological feeling of having a migraine, and the attack happens for them after going through a period of stress. This is more likely on Friday evenings, after their working hours or in the beginning of their holidays. This is actually not migraine, but actually a tension type of headache.

So the people who fall under this category during the Coronavirus pandemic, would be those who have work from home. It could also be mothers who are having to spend more time in the kitchen ever since the lockdown started, because everyone is at home the entire day and seem to feel hungry all the time out of boredom. So the work has doubled for her now.

Hypoglycemic Headache

The other type of headache is hypoglycemic headache, which occurs due to low blood sugar levels. In this, the patient has similar symptoms to that of migraine. But this type of headache goes away as soon as the person eats. When people start eating more, their diet clock will adjust to it and if they don’t stick to their new diet clock, they might get a headache, which is the hypoglycemic headache. So it’s good to eat on required time and not overeat.

1c. Cluster Headache

This is the third common type. This usually occurs in men in their third decades, but even women can get it. Cluster headaches are common among smokers, alcoholics and substance abusers. However, smokers are more prone to this type than those who consume alcohol. This includes both active and passive smokers; and the cause is unknown in some people.

Now, in quarantine, such people might not get the opportunity to buy the substance their body is used to, and this decreased usage may aggravate their symptoms. They might become aggressive or frustrated because of the headache or due to the dependence on those substances. For such people, this lockdown is an opportunity to try to get rid of this dependence rather than being depressed.

This headache is often recurring. The person might get either one or several attacks within 24 hours. This headache even awakens people from sleep and hence it has got another name, “alarm clock headache”. The pain usually presents itself as one sided with unilateral periorbital pain (pain with eye movement), ipsilateral tearing of eye and nasal congestion.

The pain lasts for 30-90 minutes during a day and occurs for a week, followed by a period of remission for a year. However, for some, there is no remission period.

Simple Remedies to Follow at Home to Cure your Headache

• Maintaining your sleep cycle and diet routine is the first thing you need to get in order.
• Keep yourself hydrated to maintain your fluid balance.
• Follow some simple exercises or stretching that regulate your body’s blood supply, leaving you feeling recharged.
• With the pollution levels on a drop, make more trips to the balcony or terrace to reap the benefits of fresh air.
• Social well-being plays a vital role in preventing headaches. One should interact with their family. Good thoughts bring in good tidings.

2. Personality Changes

Next, I would like to discuss the understanding of personality changes people might go through during a pandemic. Keeping idle and away from one’s daily routine often leads to negative thoughts and feelings. Building up on this negativity will unnecessarily worsen the well-being among your housemates.

As the entire world is going through a change in their regular lifestyles, people will tend to experience changes in their personality. At any point of time, a gradual change of behavior is normal, whereas a sudden change in anyone’s personality is something that should be paid attention to. Sudden personality changes usually negatively affect the person or the people around them. Mostly, people’s personality changes are stress related.

Let’s see the various personality changes in a nutshell.

2a. Anxiety

It can be phobic, panic or generalized anxiety. The common symptoms of anxiety include worry, irritability, headache, chest pain, fear of upcoming disaster, poor concentration, and depersonalization.

● Phobic anxiety is when a person is excessively fearful of any situation or a specific object. When a person starts fearing the current situation too much, they might become agoraphobic. This may tend to continue even if the lockdown is removed. Not everyone may experience this type of health concern, but those who are more sensitive may suffer from phobic anxiety more.

● Panic attack happens when one is alarmed by a situation. The attack may result in symptoms like chest pain, palpitations and mild numbness, or pricking/tingling sensations of lips. The fear of losing your job, or anything major that might happen during a pandemic, can end up in a panic attack.

● Generalized anxiety occurs to those who are anxious chronically. They will always complain of some medical concern, like muscle pain or bowel disturbances. This can happen when you constantly keep worrying about the current scenario.

2b. Acute Stress Reaction

A person, after going through a traumatic event such as a major accident or loss of a loved one/thing, may develop a pattern of symptoms, initially with a daze followed by agitation. Such an emotional state is usually portrayed in the movies as a “shock”.

This can also be referred as Post-Traumatic Stress Disorder (PTSD). Some people who may be prone to these attacks include those who are away from their families, or if any of their loved ones resides in a containment area, or those with a loved one suffering from Covid-19.

The symptoms may appear after a few days, or it may even take months. One may be awoken from their sleep due to nightmares or recurring memories of their togetherness, making them feel low.

2c. Obsessive Compulsive Disorder

With the routine of washing hands, rubbing sanitizer or wearing a mask as a preventive measure, some become extremely obsessed with these acts. Some repeatedly wash their hands and always keep checking up on those around them about washing their hands. Their obsession may make a transition to compulsion, which eventually leads them to develop an obsessive compulsive disorder (OCD).

2d. Adjustment Disorder

This is a psychological response of any major stressor, which is less severe but affects the person emotionally. Everyone responded to the Covid pandemic differently – some responded quickly, others didn’t. Some who don’t understand the importance of lockdown/ social distancing and think of it as futile, may develop trouble adjusting to today’s situation. The illiterates, the old, the kids and sometimes even literate people go through an emotional numbing, followed by a period of sorrow, tearfulness, anger and sleep disturbances. All they need is a hug that can give them reassurance.

Not everyone goes through all of this. We need to figure out who amongst us may develop a change in personality and give attention to them.

3. Sleep Disturbances

The problem that all of us seem to be facing during this lockdown is an irregular sleeping pattern. Sleep is the rest that both our brain as well as our body needs. We might not be physically exhausted, but with all this stress and news, we surely need to get our daily dose of sleep to function normally the next day.

The general notion running in our minds is, “Staying at home, we have nothing to do and we aren’t able to fall asleep.” But that is not the whole problem. What do we mean by sleep disturbances? It doesn’t mean that somebody is disturbing your sleep, preventing you from sleeping! It totally depends on an individual’s sleep pattern, technically speaking, their brain activity.

During sleep, your brain doesn’t stop working. But the activity of the brain can be fluctuating. Before the lockdown, going to your workplace made you exhausted both physically and mentally. So you tended to fall asleep at once. But when you work from home, you use your brain more than your body. The brain becomes more active when you use it more. So once the work is done, you shouldn’t let those thoughts run in your mind nonstop. You should get back to some entertainment and relax your mind.

Also, refrain from hitting the bed during the day. Because this is another reason for sleeplessness. When you start sleeping in daytime, naturally you won’t be able to fall asleep at night. The 10 minutes of proper deep sleep during the day is equal to an hour of night’s sleep. So try to avoid sleeping for hours during the day as this may lead to sleeplessness, which in turn causes your mood changes like anxiety, and irritability. Take a sound night’s sleep that helps you to function normally the next day.

So try, as much as possible, to stick to your actual routine that you were following before lockdown. Only then we can overcome these psychological changes. The tips I would suggest to beat these issues are as follows:

~ Early to bed and early to rise.
~ Simple physical activity – yoga/stretching/exercise.
~ Get some fresh air – e.g., go to terrace in your leisure.
Walking within your building premises.
~ Follow your daily schedule.
~ Make the most of this time by trying out something you’ve always wanted to, e.g. baking, singing, dancing, reading, etc.
~ Spend quality time with your family. Play cards, Ludo or any board games so that people in all age groups can participate.
~ Eat healthy.

With the extended lockdown, we can only expect to take life as it comes with a positive note. As WHO has informed that the Coronavirus is here to stay for a while, the lockdown will prevail for little longer than you may expect. WHO chief Tedros Adhanom Ghebreyesus said, “Make no mistake; we have a long way to go. The virus will be with us for a long time.” He added that the world will not and cannot go back to the way things were before. “There must be a ‘new normal’ – a world that is healthier, safer and better prepared,” he added.

So we should try to adopt ourselves to this new normal life, so that we can keep ourselves healthy, physically and mentally. And also take proper measures while going out as per the physicians’ guidelines by avoiding overcrowding. Practise social distancing, wear masks and gloves wherever you go.

Stay safe. Stay healthy.