Covid-19 and its Effect on Mental Health of Adolescents

Aditi Rokade and Pramita Muntode^*

^*Correspondence: Pramita Muntode, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, India, Email:

Author info »

Introduction

There are more than 2 billion children in the world today, accounting for roughly 29% of the global population. Sixteen percent of the world population makes up those who are aged between 10-19 years. In the city of Wuhan, China, unusual cases of patients with pneumonia caused by the new Corona virus (COVID-19) were reported in December 2019 and the spread of the virus slowly started posing a global health threat.

Kerala, India, reported the first Corona virus infection in January 2020, with a patient who had travelled to Wuhan previously [1]. The main symptoms of corona virus primarily included fever, dry cough, chills, sore throat, muscle pain, vomiting and nausea, and diarrhea. In people with diabetes, hypertension, heart disease and other co morbidities, the infection can be seen to develop faster and cause complications. To reduce risks and control infections, social distancing strategies are followed, which mainly leads to the reduction of activities Tourism related activities and other activities related to sports had to be shut in order to maintain the social distancing which was seen worldwide. The global lockdown has had a serious impact on the mental health of adolescents and school-age children. This includes anxiety, stress, and powerlessness most of all. The pandemic of the corona virus and the unprecedented steps taken to stop it have changed practically every area of children's lives: their health, development, learning, behavior, family financial security, safety from violence and abuse, and mental health [2]. This forced proximity had a particularly negative impact on adolescents and their families, as they sought to become independent and spent more time socializing and spending time with friends rather than their family [3].

This kind of pressure produced unexpected consequences and bad effects on students’ learning and psychological development [3]. The devastating impact of COVID-19 on people's mental health was one of the additional impacts, in addition to the physical ones. During the virus's outbreak, it had a significant influence on various levels, including individual and community levels. It had an impact on countries and regions as well. Internationally, a wide range of psychological consequences had been observed [4]. Comparing all people, a previous research in June 2020 showed similar outcomes for young adults. The poll also found that adolescent drug addiction and suicide ideations were more frequent, with 26% reporting drug use in the pandemic (as vs 15% of all people) and up to 25% expressing serious suicide biases (compared to 10 percent of all adults) [2]. Some studies also mentioned that the negatives of the isolation were first self-reported by females. And also the substance use was found to decline unintentionally because of isolation and shutting of the shops which were the major source of the drugs. The pandemic may exacerbate the existing mental illnesses of young people, and with the closure of many schools, there is no equal access to key mental health services [5]. This report tells the impact of social distancing practices related to the corona virus and the current financial crisis on mental health, including challenges. Among adolescents, higher levels of loneliness, higher levels of stress, poor self-assessment of health and sleep problems, and longer time spent on social media predicted symptoms of depression [6]. Among others increased screen time during quarantine has also been observed [7]. Also an increased probability of getting infected, probability of being isolated and the probability of hospitalization and loved ones dying were amongst some other reasons for increased anxiety in adolescents during lockdown. Those who have had a strong romantic relationship (they reported the quality of their relationship as 'very happy' or better) reduce the possibility that will continue to be severely affected, and highlighted the importance of the family nucleus when the social circle contracted outside the family [8]. In terms of student responding to COVID19, urban student scores significantly different in terms of unhappiness, irritability, helplessness and uncertainty with a noticeable difference. This meant that although accustomed to the fast-paced lifestyle and corporate culture, urban youth find it difficult to cope with crises due to greater pressures and social requirements in cities than in rural areas. Over thinking about the future aspects seemed to affect women more than men as cited in some research, although females feel more at home during lockdown and have time to bond with the family in the times of crisis. It also raises question about the future in adolescents as these are the building years of future. Adolescents are more vulnerable to life's pressures, which lead to poor concentration, decreased achievement, and reliance on parents also anxiety, and depression, among other things. Furthermore, medical services were geared toward emergency situations, while non-emergency cases were pushed aside or postponed, resulting in mental health disorders going undiscovered and untreated for the most part. According to research on mental health in larger cities, the risk of various common mental illnesses (such as anxiety, psychotic disorders, mood disorders, or addictives) is around twice as high [4]. Lack of structural environment and the environment required for proper learning of the various academic activities, as well as restrictions on outdoor activities, not making friends, and not being able to participate in activities, lead to insufficient energy flow. Children grew and lead to abuse, irritability, and ultimately disinterest in activities, increased parental trust, and have an overall negative impact on mental health. It has also been observed that due to restrictions, employment and opportunities are reduced, students are anxious about their future. Some studies deal with the effects of confinement on children with intellectual disabilities. Autistic youngsters, for example, find it challenging to express and comprehend the frequent changes in their daily lives. Furthermore, with the closure of special schools and nurseries, there is a loss of resource evaluation materials, peer contact, and learning opportunities, all of which are crucial for the development of social and behavioral skills (Figure 1).

Figure 1. The various aspects of the effect of covid19 on mental health.

Several publications, on the other hand, claim that during the pandemic, mental health symptoms worsened prior to the imposition of confinement or stay-at-home orders. Mental health was stable and even improved once lockdown was implemented. During confinement, several families found that spending more time together drew family members closer together and promoted a sense of happiness. This resulted in improved communication between parents and children, increased parental attention to youngsters, and the ability for some people to communicate by working at their parents' homes [3]. In addition, some articles also show that the more people follow COVID19 news, the more anxious they are. The majority of the news on COVID19 is upsetting, and part of it is based on hearsay, so if a person is frequently exposed to COVID19 news, their anxiety will escalate. COVID19 misinformation and false stories can increase depressed symptoms in the general public [4]. Obsessive Compulsive Disorder (OCD) affects 0.26 percent to 5% of children and adolescents, according to estimates.

This pandemic is expected to have the greatest impact on children with OCD. Obsessions and compulsive activities related to hoarding, pollution, and physical attention are predicted to cause them more discomfort. One of the most important safeguards against the transmission of COVID19 is cleanliness [9]. Confinement allows healthy people to have enough food and prevention-related resources such as masks and disinfectants) and distress, which makes the situation of hoarding patients [9,10]. Although the daily work system has been negatively affected, amplification in sleep patterns was observed. In addition, there had been an increase in concerns about productivity, delayed planning of activities and the availability of medical care. Although people tried to create a new routine, the response showed raising concerns about the daily adjustments [1].

Objectives

The purpose of this study is to provide an insight on the various aspects and effects of covid19 on mental health of adolescents, like anxiety, fearfulness, loneliness, suicidal thoughts etc.

Methodology

We conducted a about a systematic review of various articles related topics on Pub Med, Google Scholar, Medline and some manual searches were done for the relevant studies and accordingly articles were selected. To acquire information regarding the research, we also conducted a manual search of references in relevant journals. The publication period was 2 months. Studies related to the effect of mental health on the adolescents which also included the school going children, as well as the effects of the same on the mentally challenged children studied. A total of twenty five articles were reviewed and selected on the eligibility criteria. It was possible to track the essential measures of management targeted towards particular children. The necessary selection criteria were made and with electronic databases as the only source of data collection and research articles. There is a chance that studies related to the care of children and adolescents will be missed. We were able to keep track of the appropriate management actions aimed at the children. It was observed that the awareness about mental health has increased also the importance of social distancing and cleanliness have been understood by the people.

Results and Discussion

Covid 19 is a fast spreading contagious disease that had a negative impact on people's mental health, as well as disrupting lifestyles and causing economic hardship. It has also raised the world's morbidity rates. To limit the illness, the world was placed in a state of isolation through social distancing, and a lockdown was established. People's mental health suffered as a result of the lockdown since they were separated from their loved ones, and one of the biggest causes of distress was the loss of loved ones. Several researches were conducted to determine the degree of Covid 19's impact on teenage mental health. For the study the age group of 13-19 was selected. As said by Quin et al in the study titled ‘Prevalence and risk factors associated with selfreported Psychological Distress among Children and Adolescents in corona virus Pandemic in China’, these findings suggest that during the COVID19 pandemic, the incidence of self-reported psychological misery among school-age children and adolescents was relatively high. In some studies, like the ‘Covid19 pandemic and mental health consequences’ by Vindegaard and Benros, the study has been subdivided in various categories like, Patients with Covid19 , Patients with Psychiatric Disorders, Psychiatric symptoms and Distress in Healthcare Workers and the result has been given accordingly [11-13].

WHO offered appropriate information and help to health professionals caring for the elderly and children throughout the epidemic, as well as additional preventive measures to safeguard their mental health.

Both hereditary and external environmental factors, such as stressful life events, influence the onset of depression. Adolescents are more sensitive to depression, anxiety and reliance as a result of life's pressures, and they also have a greater risk of acquiring helplessness and sadness. These are believed to be increasing, especially during the global pandemic. The fear of the corona virus has significantly increased negative emotions, depression, anxiety and fear about the future and also getting infected among other reasons.

Consequently, it is more important to promote healthy behavior to maintain child's overall health. The wellbeing of adolescents directly impact their overall growth which is necessary. Following the necessary guidelines given by WHO, which includes, washing hands, wearing masks at all public places, urging people to follow social distancing and avoidance of close contact with people, especially with any respiratory symptoms. Other norms like, indulging in healthy lifestyles like practicing yoga, taking small breaks from work activities and to avoid from reading, listening or watching news of the pandemic which can be distressing during these times. Communication with children can significantly reduce their pain and anxiety. During the corona virus pandemic, WHO collaborated with its partners to provide management and consulting to health care workers, health care facility managers, the elderly, child care takers, the isolated, and the general public also, offered appropriate information and help to health professionals caring for the elderly and children throughout the epidemic, as well as additional preventive measures to safeguard their mental health [14-16].

During the pandemic, the government has a critical role to play. Their job is to keep the community informed and updated by providing enough and reliable information. Measures by Educational Institutes to assist children with their mental distress by providing with licensed counselors and implementation of Psychological first aid guidelines should be incorporated. To make children aware about the medical facilities those are being provided. Also for better understanding, online sessions can be taken and videos can be made. Parents need to be made aware about the same through clear communication and assigning clear expectations. Mental health is significant throughout our lives for well-being of every individual and if untreated can limit the communication and most importantly can lead to chronic conditions like anxiety, schizophrenia, depression, bipolar disorder.

Conclusion

COVID19 has caused an unprecedented health and humanitarian crisis around the world. It has affected every domain of child, adolescents, and adults. Physical exercise has had a significant impact on children, and time spent at home has increased, leading to an increase in anxiety, loneliness, negative sensations, and hopelessness. Facts have proved that this pandemic has made people, especially teenagers, fearful of the future and the economic crisis faced by most families in the world. During the isolation period, people who had been exposed to the virus and had to quarantine, it was also shown to have mental health effects, such as feelings of loneliness and "fear of missing out”. In addition, onsite classes have been discontinued to prevent the virus from spreading, and numerous institutions and universities have chosen online learning as the sole way to continue studying and learning throughout the pandemic. Though the online form of learning assures that the student does not miss any of the content throughout the pandemic, it has instilled anxiety of the future and created parental dependency. Anxiety, loneliness dread, depressed thoughts, and a sense of hopelessness about the future have all intensified as a result of this. On the other side, several of the protective variables have been shown to be effective in preventing teenagers from developing mental health problems as a result of the pandemic. Paying attention to and complying with WHO regulations, such as wearing N95 masks when going out, washing hands frequently, observing physical distance, practicing yoga regularly, and following true information from reliable sources and paying attention to sources of fraud. Mental health services were switched to an online mode, with groups giving phone assistance to people via their social media handles.

Only with the support of educational institutions and open contact with parents, such as through "positive parenting," it is possible to protect and maintain the mental health of the future generation of teenagers. Children are incredibly resilient, and most will be able to cope with the help of their parents and classmate, as well as with the assistance of a proper healthcare system, which leads to positive child development. Psychiatrists, doctors, parents, and teachers are required to promote awareness of psychological changes through this narrative review in order to reduce major consequences on the future mental health of the young generation. In addition to covid 19 and seclusion, more research into the causes of mental illness is required.

References

1. Moghe K, Kotecha D, Patil M. COVID-19 and mental health: A study of its impact on students in Maharashtra, India. Med Rxiv 2021; 2020-08.

Google Scholar, Cross Ref

2. https://www.weforum.org/agenda/2020/05/covid-19-is-hurting-childrens-mental-health/
3. Janssen LH, Kullberg ML, Verkuil B, et al. Does the COVID-19 pandemic impact parents’ and adolescents’ well-being? An EMA-study on daily affect and parenting. PloS one 2020; 15:e0240962.

Indexed at, Google Scholar, Cross Ref

4. https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-020-00589-w
5. https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/
6. Murata S, Rezeppa T, Thoma B, et al. The psychiatric sequelae of the COVID‐19 pandemic in adolescents, adults, and health care workers. Depress Anxiety 2021; 38:233-246.

Indexed at, Google Scholar, Cross Ref

7. https://www.unicef.org/india/impact-covid-19-childrens-mental-health
8. Banks J, Fancourt D, Xu X. Mental health and the COVID-19 pandemic. World Happiness Report 2021:107-130.

Google Scholar, Cross Ref

9. Singh S, Roy D, Sinha K, et al. Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry Res 2020; 293:113429.

Indexed at, Google Scholar, Cross Ref

10. Available from: https://www.apa.org/
11. Gawai JP, Singh S, Taksande VD, et al. Critical review on impact of COVID 19 and mental health. J Evol Med Dent Sci 2020; 9:2158-2163.

Google Scholar, Cross Ref

12. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian J Psychiatry 2020; 51:102119.

Indexed at, Google Scholar, Cross Ref

13. Behere PB, Sinha AA, Chowdhury D, et al. Woman mental health-midlife. J Pharm Res Int 2021; 33:69–76.
14. Dixit S. A review on lockdown and its effects on mental health due to corona pandemic. J Pharm Rese Int 2021; 152-157.

Google Scholar

15. Mukherjee S, Sebastian T, Gawai J. Effectiveness of mental health first aid kit for depression and psychological well-being in adolescents. J Pharm Res Int 2021; 33:122–128.

Google Scholar, Cross Ref

16. Behere PB, Nagdive AB, Behere AP, et al. Innovation in community psychiatry for the delivery of mental health services: the sawangi model. J Neurosci Rural Practice 2020; 11:593-596.

Indexed at, Google Scholar, Cross Ref