There was a patient during the waning phase of the first wave of COVID-19 - let’s call him Mr. Xyz . He was 55 yrs old, and a known case of schizoaffective disorder (diagnosed in mental health patients when signs and symptoms of both Schizophrenia and Mood Disorders are seen overlapping. Mood disorders include Depression and Mania to name a few). He had been maintained well on oral medications for many years. He had an old working mother; his wife had left him due to ramifications of his mental illness. His already frail health had worsened when COVID-19 slithered into his life.
In the COVID-19 ward, the amount of psychiatric care that can be provided to such patients is limited by factors like shortage of psychiatrists catering to different wards, doctors, nurses and support staff all looking alike in PPE, insufficient training of support staff in handling mental health patients etc.
Mr. Xyz used to think that he was admitted to a 'SPACE WARD' near the moon because all the staff members were wearing space suits! (Which were actually the Personal Protective Equipment donned by the doctors). Narratives/complaints like these are usually common in schizophrenia where the patients try to understand the reality of their surroundings albeit in a delusional way.
His COVID-19 ailment was difficult to treat as he used to get anxious, afraid, irritated and sometimes even angry due to his mental health illness. Also, he couldn't meet his mother due to the hospital policies. After 12 days, he was transferred into the psychiatry ward where he was provided with better mental health care. But his brain took a lot of time to recover from the COVID-19 trauma. At times, he used to wear goggles and swimming shorts in the ward as he thought that the ward was a swimming pool. The symptoms were difficult to control despite using novel groundbreaking treatments like electroconvulsive therapy or ECT, (which contrary to what movies show, are very safe). To twist the knife further, he contracted malaria. The plethora of conditions caused him to go into an episode of delirium. For those who don’t know, delirium is an undesirable medical emergency in which a patient's orientation to time, place and person keeps fluctuating, and their perceptions of the surroundings get distorted.. Under his delirium, he used to try and climb the wall as if he were Spiderman. After more than 75 days of getting better and worse and better, he was discharged, with the herculean efforts of the doctors and support staff. Had it not been for COVID-19, Mr.Xyz’s stay in the hospital would have been shorter and recovery faster. His discharge from the ward, going back home, working and gelling in the society highlighted my sense of purpose. We doctors go bananas when such patients get better.
Anxiety, depression and psychosis have an uptrend due to COVID-19 and we psychiatrists are ready for some WrestleMania! The way I see it, it's a battle between this virus and mental health professionals. Let us see who will have the last laugh.
And yes, long live the spirits in space suits!!!
About the Author-
Dr Sagar Bhalke is a Mental health professional and also a public health enthusiast. He has his interests in the field of research as well. His hobbies include cycling, sketching, mobile photography and teaching.