During this pandemic of COVID 19 we all are facing lot of stress due to uncertainties of health and life. SARS-COV-2 virus becomes a deadly virus for the people who are suffering from hypertension, diabetes and cardiovascular disease and NDCs related problems. According to the studies recently published over comorbidities and mortality rate show that hypertension, diabetes and Cardio Vascular disease have high prevalence of Heart failure and death( Hypertension 47-55.4% Diabetes 37.3 %).
It is important to come under focus light for better prevention from life threatening situation of COVID 19 infection. In this article we have collected knowledge from multiple disciplines, including Neuropsychology and biological psychology or medical researches. In this article are connecting dots of Psychology, neuropsychology and physiology, will understand the role of anxiety and fear in COVID 19 infection and health outcomes.
Anxiety is a healthy emotion normally but prolonged and regular disproportionate level of anxiety might become a psychological or Medical disorder. Basically Anxiety is “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure, increased heart rate and altered breath rate”. When someone facing fear or countering anxiety, have sympathetic nervous activated and secretion of cortisol (Stress Hormones), suppression of immune responses.
According to World Health Organization depression is leading cause of disability. According to a Retrospective cohort study anxiety with (co-existence) major depressive disorder increase chances of incident heart failure, multiple times comparative to normal incidence of heart attack. According to studies 53.3% of the general population from 31 states and union territories of India currently perceives some form of psychological effect due to COVID 19. Some studies show “corona phobia” relatively high rates of fear (46.96%) prevailing in the Indian population.
It is important to understand ACE 2 play a crucial role in homeostasis of blood pressure simultaneously homeostasis of sympathetic nervous system and activation of parasympathetic nervous system. According to a systematic review article “Mechanical view of COVID 19 Infection in humans” published by Universal Psyche Care & research stated “when someone get infected more of ACE2 receptors by Novel Corona Virus SARS-CoV-2 damage the ACE2 receptors (that is involved in the process of decrease of heightened blood pressure ) will lead to pathological blood circulation”. Due to extreme fear and Anxiety patients of COVID 19 may have increase blood pressure, increased heart rate and altered breath rate and can be a precipitating factor for incident heart failure and poor health outcomes in patients with COVID 19. This is the condition where “mind and body concept” need to be understandable to every individual, Medical professionals and health care management authorities or policy makers. Since 2020 every individual facing varied level of fear and anxiety related to COVID 19. It is alarming situation for the people who have diagnosable major depressive disorder, anxiety, PTSD etc.
Major depressive disorder and anxiety may become a substitute of major medical complications like Hypertension, Diabetes, incident heart failure and other cardiovascular disease in long run. In case of India itself, India is leading in Depression (more than 45 million), anxiety (more than45 million) and more than 20% of total population is suffering from some kind of diagnosable mental health problems, need immediate intervention.
Study of International Journal of Community Medicine and Public Health recommend “It is imperative to integrate mental health into the broad framework of COVID-19 health care response with measure like counseling, behavioral strategies and social support”. Another published case-study advocating “A targeted combination of psychopharmacology (targeting acute anxiety and panic symptoms) and psychotherapy (relaxation techniques, breathing exercises, and encouragement) is recommended”. Our findings suggest compulsory inclusion of mental health support in management of COVID 19 Patient, will be helpful medically also. We recommend systematic management of data of psychiatric and medical history related to patients of COVID 19 to understand the role of psychiatric or psychological factors.
There are some tips that can help during this pandemic of COVID19
For those who are suffering from Novel Corona Virus SARS-CoV-2, especially for those who are suffering from hypertension and other related NDCs
Take proper sleep
Do not get panic
If have anxiety ask to your psychologist and Health counselor for better management
Take proper mental health support or counselling
Pharmacological management for symptoms of extreme Anxiety (may increase chances of Incident heart attack)
Do Mindfulness meditation regularly
Regular breathing exercise regularly
Regular physical exercise
Gold, M. S., Sehayek, D., Gabrielli, S., Zhang, X., McCusker, C., & Ben-Shoshan, M. (2020). COVID-19 and comorbidities: a systematic review and meta-analysis. Postgraduate medicine, 132(8), 749-755.
Srivastava, A., Bala, R., Srivastava, A. K., Mishra, A., Shamim, R., & Sinha, P. (2020). Anxiety, obsession and fear from coronavirus in Indian population: a web-based study using COVID-19 specific scales. Int J Community Med Public Health, 7(11), 4570-4577.
Khawam, E., Khouli, H., & Pozuelo, L. (2020). Treating acute anxiety in patients with COVID-19. Cleveland Clinic journal of medicine.
Ojike, N., Sowers, J. R., Seixas, A., Ravenell, J., Rodriguez-Figueroa, G., Awadallah, M., Zizi, F., Jean-Louis, G., Ogedegbe, O., & McFarlane, S. I. (2016). Psychological Distress and Hypertension: Results from the National Health Interview Survey for 2004-2013. Cardiorenal medicine, 6(3), 198–208. https://doi.org/10.1159/000443933
Gupta, R., Gaur, K. & S. Ram, C.V. Emerging trends in hypertension epidemiology in India. J Hum Hypertens 33, 575–587 (2019). https://doi.org/10.1038/s41371-018-0117-3
"Mechanical view of COVID 19 Infection in humans,https://mentalhealthindia.net/blogs-detail.php?cid=52
"Mindfulness Meditation in management of Novel Corona Virus SARS-CoV-2 for hypertension patient"https://mentalhealthindia.net/blogs-detail.php?cid=53