THE ENEMY WITHIN: WORK/PRODUCTIVITY/TASK PARALYSIS 

For many years, attention has been on the impact of social media on children and young people. Huge body of knowledge have been generated on how to identify and protect these young minds from the potential dangers of accessing the limitless data online. The drive to protect these group of people was based on the reasoning that their brains’ executive functions are often not matured or developed enough for them to evaluate the costs and benefits of social media use or handle the volume of data they were consuming. While these concerns and drives still hold true now more than ever, there is another emergence that requires urgent clinical and research attention. This is the Social Media Addiction among Adults across all social strata. During the last few years, especially after the inception of COVID-19 pandemic, the online interactions have almost become a par with (if not exceeded) our face-to-face interactions. The move from the 100% online interactions that happened during the COVID to the conventional face-to-face interaction post-COVID seems to be a torturous effort for a lot of people. This ranged from difficulty in returning to office-work to engaging in interpersonal face-to-face interactions. For many people, the rate of social media engagement has not dropped that much from the 100% COVID usage. This has led to a new wave of virtual reality (existential fantasy) and a potential demise of the rich humanisation of face-to-face interaction. Exploring the possible causes of social media addiction (SMA), studies show that for young people, the main causes of their SMA include fighting boredom (86%), staying in contact with others (89%), getting information (37%), forgetting sorrows (38%), reducing stress (36%), and escaping reality (36%) (Paschke, et al., 2021). With the intense campaign and psychological help, the rate of social media addiction in young people are gradually coming down. Within the global adult population, however, the social media addiction seems to be gaining an alarming momentum and this has reached a spilling level especially post-COVID pandemic. There seem to be a sudden surge in the need for external validations (i.e., reward-seeking/ ‘likes’/ego-boost drives) and crave for instant dopamine rush among adults. Clinical data show the following as key contributors/causes: 1) dissatisfaction in personal, relationships, career, and/or life 2) need to escape reality (living in a world of dream/fantasy) and avoid responsibility and accountability, 3) loss of boundary between life (personal) and work (professional). While it may be easier to see that the first two causes of SMA are psychological problems with far reaching consequences and require urgent treatment, the third cause, however, seems to be met with divided opinions. To some, it is a work-life dysfunction which can worsen people’s dissatisfaction and need to escape realty. To others, it is a new normal that is gaining trends and tractions, hence, has now been upgraded and given a fanciful name: Work-Life Integration . Rather than the age-long concept of ‘work-Life Balance’ , there seem to be a call for ‘work-life integration. The big question is: Is the ‘work-life integration’ narrative our psychological tolerance for the emerging ‘Bloodless Self-harm’ of social media addiction? What is Social Media Addiction Social media addiction is described as a behavioural disorder whereby the individual becomes entranced by social media and are unable to reduce or cease their consumption of online media despite clear negative consequences. Some of the possible negative consequence of addictive social media use include: • low self-esteem, which may be prompted by incorrect perceptions that others’ lives are “better”. • increased isolation and loneliness (loss of friendships) • intense stress, anxiety, or depression • onset of social anxiety disorder • disrupted sleep patterns, especially if used before bedtime. • decreased physical activity, which may affect your overall health. • poor grades or work performance. (e.g., scrolling through your apps at work or instead of studying) • reduced ability to empathize with others. • increased reliance on social media to cope with life problems. • restlessness and irritability whenever you are not using social media. • anger or aggression whenever social media usage is reduced. For the social media use to be classed as addictive, the 5 out of the following 9 criteria are expected to be met: 1. preoccupation (not psychological present or engaged with surrounding activities). Thinking about social media whenever you are not using it, so much so that it is the first thing you turn to whenever you have the opportunity. 2. withdrawal (when not using) e.g., agitation/restlessness, irritation, emptiness. 3. tolerance (accommodating/excusing the persistent use), 4. persistence (unsuccessful attempts to reduce or stop usage), 5. continuation (of usage despite problems): fear of missing out, which can lead to even more social media usage. 6. deception (deceiving or covering up usage), 7. escape (usage to avoid or reduce adverse moods, or reliance for feel-good), 8. displacement (giving up other activities), and 9. conflict (risking or losing relationships or career opportunities due to excessive usage). Ignoring the relationships in your “real” life Social Media Addictio n has been explained via these models: a) social skill model – individuals prefer to use SMA for social networking rather than face to face. This may apply to people with low self-presentation skills, social anxiety. b) cognitive-behavioural model – the lack of executive control over motivational drives which are linked to the reward-seeking (instant gratification) behaviours. The uncontrolled reward – seeking habits could lead to poor decision making regarding the engagement or consumption of social media. c) socio-cognitive model – social networking produces a positive outcome expectation (such is likes, praises, commendations from other users). This could drive the excessive use in the absence of self-regulation (Turel & Serenko, 2012) d) biopsychosocial model – SMA results from a combination of the above model hence, mood modification, salience, tolerance, withdrawal symptoms, conflict, and relapse (Griffiths, 2005 Managing the Social Media Addiction Consider the following tips to help you achieve a healthier balance with social media: · Consider deactivating your social media apps from your smartphone. While you can still access them from your personal computer, keeping them off your phone may help decrease the amount of time spent on social media overall. · Where the above is not viable, consider turning off the notification of most of (if not all) the social media Apps on your phone. · Consider putting your personal phone on silence during work, as well as during school, meals, and recreational activities. · Set aside a certain amount of time dedicated to social media per day. Turn on a timer to help keep you accountable. · Leave your phone, tablet, and computer out of immediate arms-length reach at night. · Take up a new hobby that is not technology related. E.g., sports, reading hard copy books, intentional and scheduled face-to-face interaction with friends and family. · if possible, take break from social media (one hour, day, week, or month). Let yourself be in control of this decision — not your social media account. Manage the fear of missing out because there is always something new and the old ones are easily forgotten anyway. · If you have done the above and you are still not able to deal with the addiction, you may wish to engage an expert psychologist for professional help. If you need professional assistance with social media addiction, please contact us at: dr.oby@fcc-clinics.com / www.fcc-clinics.com Stay Safe and Psychologically Sound Dr.Oby @ FCC Clinics – Global Health

Death is an ‘ Existential Given’ that everyone must face yet it is one of the most selective concepts discussed and the least event planned. As we progress in technology and scientific knowledge, we are gradually creating a ‘death-averse’ society by minimizing the significance of death as a force in the human development and life trajectory. If death is one of the e xistential givens , can we really avoid, deny, or ignore its existence? The following are some common dispositions toward the concept of death and dying: Denial, fear & anxiety, and ambivalence a) Denial: This disposition means that we do not have to engage with the discourse and so our power of choice and control are suspended. The denial culture to death and dying has led to the modern society’s pandemic desire to look and remain young, consequently the multi-billion-pound cosmetic industries. Immortality is still not in the hands of humans, and so death still remains an existential given . The sooner we engage with the concept, the more empowering and reassuring it is for the person on the ‘death bed’ and the loved ones to be left behind. This is because it offers the individual the opportunity to decide the ‘ style of their exit’ as well as allows the loved ones to prepare and co-construct this ‘style of exit’ . b) Fear and anxiety: This disposition puts us in a state of overdrive with our thought processes. We tend to over-think the meaning and implication of death and dying. The grandiosity of our thought pattern around the concept of death and dying often contributes to or worsens many mental health disorders such as health anxiety, death anxiety, OCD etc. Rather than dwelling on the limitless power of negative imagination, we need to engage with our power of choice and action. c) Ambivalence: This disposition means that we distance ourselves from the thoughts and discourse of death/dying, make light of it or have laissez faire attitude towards it. By so doing, we take the position of ‘ we cross the bridge when we get there’ . The problem is that when we get there, the bridge may be broken and in need of repair hence, the crossing of the bridge becomes harder than expected . Just as we plan for ‘births/life and living’, we need to plan for ‘death and dying’. Ambivalence allows us to have knowledge of the concept of death and dying, but it hinders us from putting into motion any actionable plans. When the inevitable happens, we end up struggling to cope with the grief. This is one of the reasons why people find re-engagement with life after the loss of loved one very difficult and may end up with delayed or complex grief. Studies show that none of these three dispositions is beneficial to our mental health / wellbeing or our existential essence. Death is an unavoidable part of life, and it is no respecter of persons, social class, creed, age, or gender etc. Seeing death as an existential given enables us to plan and put in motion our desires and wishes. It provides clarity to our loved ones on what happens after the line flattens. We need to ‘make haste/hare while the sun shines’. It is good to have ‘life and health’ insurance, but it is essential to have ‘life and death’ plan assurance. If you need professional help in dealing with your health anxiety, and death anxiety, OCD, or complex grief etc, please contact us at dr.oby@fcc-clinics.com / www.fcc-clinics.com . Stay Safe and Psychologically Sound Dr.Oby@FCC Clinics - Global Health

In the recent months, psychologists have documented an increase in the number of hospital doctors and GPs seeking psychological support as a result of the high levels of stress, burnouts, and emotional distress that doctors and other healthcare professionals have encountered throughout the COVID19 pandemic. This is very concerning for our healthcare practitioners because we are about to go into the flu season when GP surgeries and NHS hospitals are usually stretched. If the GPs are not psychologically stable enough to cope with their life challenges, how then can they help the vulnerable people in our communities who are needing their help to survive the next winter flu and season? Mental health issues among general practitioners are not new information in healthcare. In Beyondblue (2013) study, 21% of 12000 doctors who took part in the study reported a history of depression, while 6% had an existing diagnosis. Approximately 9% of doctors experienced an anxiety disorder (compared to 5.9% of the population) and 3.7% reported a current diagnosis (compared to 2.7% of the population). The most common sources of work-related stress are the need to balance work and personal responsibilities (26.8%), too much to do at work (25%), responsibility at work (20.8%), long work hours (19.5%), and fear of making mistakes (18.7%) (Hayes, 2018). Many of these issues manifest themselves in the worst way, with suicide often very common among doctors. The actual suicide rate for doctors has been estimated at between two and five times the general population (WHO, 2019). It is obvious that the COVID-19 pandemic has caused untold havoc in the general population. The cost of this havoc ranged from financial ruins, marital breakdowns, increased health anxieties and even death in the communities. Recent study by the British Medical Association (BMA) (2020), showed that the claws of the pandemic have entered the doctors’ quarters. Studies have shown that more than half (53%) of GPs are experiencing work-related mental health problems and the percentage of doctors reporting worsening symptoms during the COVID-19 pandemic is on the increase (38%). Doctors are trained to be outward looking; very apt in identifying and managing effectively physical ailments of their patients. It is often a lot easier for the doctors to focus on their patients than focus on themselves. Doctors are people and humans too. They can be affected by being part of their patients’ lives, and awful things can happen to them too. They have emotions; t hey can feel pain, hurt, anger, fear, helplessness, low/depressed, anxious etc. With regards to looking inwards, doctors are better attuned to their physical body’s sign and symptoms. When it comes to their mental or psychological well-being, many doctors are very slow at identifying or acknowledging the strain on their mental health. Mental Health challenges: Double-edged sword of Stigmas and Shame Among some doctors, there are still some level of stigma and feeling of shame associated with mental health challenges for healthcare practitioners. Unlike the physical illnesses, people including doctors are still reluctant to openly discuss their mental health struggles. Many doctors therefore tend to hide and suffer in silence. The ‘suffering in silence’ also known among doctors as ‘resilience’ is a common problem. Many doctors believe that they need to soldier on irrespective of their own problems. ‘When you are finding it difficult to soldier on, you feel that you are letting down the profession’ one GP said. That can lead to anger and frustration with self. With the insurgence of the pandemic and its aftermath, many GPs and doctors faced untold pressure at work leading to unimaginable psychological distress. With this statistical picture of many doctors’ mental health on the decline, it is important for us in healthcare to engage on the hard discussion of SELF-CARE FOR HEALTHCARE PRACTITIONERS. There is need to emphasise that the medical ethos of ‘Do no Harm’ also includes ‘self’. It is OK to reflect on self-function and accept the need to seek help when necessary for a better, longer service and higher productivity. Resilience is good but self-care can be better! IMPLEMENTING SELF-CARE Self-care is defined by the Department of Health as:    ‘the actions people take for themselves, their children and their families to stay fit and maintain good physical and   mental health; meet social and psychological needs; prevent illness or accidents; care for minor ailments and long   term conditions; and maintain health and well-being after an acute illness or discharge from hospital.’ Self-care has been identified as one of the economically sustainable strategies for maintaining healthy lifestyle in the population. Doctors are not exempted from such strategies. EASY ACTION POINTS 1. Engage in hobbies for relaxation: ‘All work and no play, makes Jack a …….’ 2. Intentionally switching off from work: Give your brain a break! 3. Accepting that doctors are not super-human with ‘eternal powers’ 4. Your Mental Health Matters; live to fight tomorrow 5. Your patients, family and friends are counting on you to be active, effective and psychologically stable. If you are a healthcare professional and in need of a confidential space to explore your mental health challenges and receive support, please contact us at dr.oby@fcc-clinics.com / www.fcc-clinics.com . Stay Safe and Psychologically Connected Dr.Oby@FCC Clinics - Global Health

Grief can be described as series of responses to an unexplainable hole in one’s emotional self as a result of loss by death, through ill health, part of ourselves, or something valuable Over centuries, scholars have tried to understand the responses that should be ‘normal’ processes of grieving. In order to understand these ‘normal’ processes, theorists have propounded a number of theories. Based on the ‘normal process’ concept, scholars generally agree that Grief is a process that run at its own pace but time-limited. Everybody’s grief is unique and different. There is no right way to grieve. Strong emotions and thoughts are part of grief. Most grief theories tend to focus on the ‘ normal’ and ‘individualised’ griefs. Situations like the recent COVID-19 pandemic makes us question our grief models and their normality and individualistic constructs. The grief of the pandemic cut across global, international, national, cultural, belief boundaries. It goes beyond the ‘normal’ and time-limited framework originally believed. If humanity in itself is complex, how then do we try to understand grief in a simple stage or phase process as proposed by prominent theorists such as Bowlby’s (1996) four phases of grief, or Kubler-Ross’ (1969) five stages of grief? Just like the established binary response-stands of either ‘letting go’ or ‘continuing bond’. How about ‘ embracing the uncertainty’ ? Many people often try to make sense of the grief and tend to put pressure on themselves to accept either to ‘let go’ or ‘continue the bond’. It is also okay to just ‘ embrac e the uncertainty’ of the situation. It can also be okay not to know or have answers to the whys of the situations. I am aware that the fundamental reason why we feel the urge to make the either/or decisions is because we interpret uncertainty as threatening. The interpretation is what ends up causing or exacerbating anxiety, PTSD depression, etc. that people experience during bereavement and grief period. Hence · rather than focusing on the probabilities of the unknown, we could focus on the beliefs about uncertainty . · rather than classifying grief into ‘normal’ or ‘abnormal’, we could focus on the uniqueness of individual’s grief · rather than grouping grief into simple/linear process or complicated/prolonged grief, we could focus on the underpinning factors of grief COMPLICATED/PROLONGED GRIEF: A NEW NORMAL Before now, complicated/prolonged grief is said to occur in a small percentage (10%) of the population. One wonders if this is the case because we were measuring grief with the wrong scores. With the current global grief, we have seen various human expression of grief in ways that have not been documented. People are easily triggered into · mob actions, · rebellious behaviours, · dismissal of reality, · engagement in risky behaviours, and · exaggerated fear of the unknown. These expressions seem to be a new normal ways expressing global or group grief – the aftermath of the Pandemic. Before now, these behaviours would have been classed as abnormal. The pandemic loss and the consequent grief expressions seem to be telling us that there are still a lot to be learnt about grief especially from the ‘group grief’ perspectives. Grief is often explained in terms of time-limited, severity, ability to accept the situation, and moving on with life. Scholars holds that during the first few months after a loss, many signs and symptoms of ‘normal grief’ are the same as those of ‘complicated grief’. However, while normal grief symptoms gradually start to fade over time, those of complicated grief linger or get worse. One wonders if we have organised the grieving process in this binary way so that we can have a clean resolution to the chaos or uncertainty often faced during grief. Signs and symptoms of complicated grief may include: 1. Intense sorrow, pain and rumination over the loss of your loved one 2. Focus on little else but your loved one's death 3. Extreme focus on reminders of the loved one or excessive avoidance of reminders 4. Intense and persistent longing or pining for the deceased 5. Problems accepting the death 6. Numbness or detachment 7. Bitterness about your loss 8. Feeling that life holds no meaning or purpose 9. Lack of trust in others 10. Inability to enjoy life or think back on positive experiences with your loved one Complicated grief also may be indicated if the person continues to: 1. Have trouble carrying out normal routines 2. Isolate from others and withdraw from social activities 3. Experience depression, deep sadness, guilt or self-blame 4. Believe that you did something wrong or could have prevented the death 5. Feel life is not worth living without your loved one 6. Wish you had died along with your loved one LEVELS OF GRIEF SUPPORT Just as it is the individual that can truly assess the nature or severity of grief, they are the central person to decide the kind of help they want and need. Generally, there are three main levels of grief support: LEVEL 1: GENERAL SUPPORT & INFORMATION The first level of grief support involves offering general support and information. Most people who experience loss will only require first-level support, which involves providing people with information on the grieving process, practical help with tasks, and social support. Family, friends, and colleagues are often able to provide much of this support. The person needs to feel adequately supported for it to be appropriate LEVEL 2: EXTRA SUPPORT Some people may need extra support through their grief. Extra support might be needed if: The grieving person feels that they are still not coping well with the first level support. There are not enough network support (friend and family) for the grieving person. The grieving person is unable to discuss their feelings with family and friend because they do not wish to upset them. This level of support provides the opportunity for the person to reflect in a focused way on their experience of loss. This support can be provided as 1-2-1 or in groups and is used for both adults and children. The providers may be: self-help groups, faith groups, and community groups. The providers are trained to provide a listening ear, to help people talk about their experience, and to support them in finding their way through their grief. LEVEL 3: THERAPY SUPPORT This level of support is provided by specialised professionals (Psychologists, Psychotherapists, Counsellors, and Doctors with psychotherapy training). No experience of grief is easy and the circumstances surrounding certain deaths (e.g. devastated effects of COVID-19 pandemic) can cause additional difficulties for those left behind. People do not have to go through the first two level of support to access professional help. If they feel that they wish to be managed by professional, then they need to access such support. In a global grief as we have seen with the COVID-19 pandemic, it is important that we, as health professionals, have a group as well as individualised perspective of grief symptoms and the help we offer our patients/clients. We may also have to lean towards an integrated approach to therapeutic support because no one model will be able to fit all nuances of current grief presentation. If you need professional help, please contact us at dr.oby@fcc-clinics.com / www.fcc-clinics.com Stay Safe and Psychologically Connected Dr.Oby@FCC Clinics - Global Healthcare

The notion that 'there is no health without mental health' seems to highlight the centrality of the need for everyone to become aware of their mental health and function. Though, there has been massive conversations about mental health, there are still a huge level of ignorance about the concept in many quarters, cultures and societies. There are still unbelievable stigmas and discrimination against people who are facing mental health challenges. Many people who are challenged with mental illness tend to live in fear, shame, and guilt. No one should be made to live that way. The more we talk about it: 1. the more we are able to gradually break down the barriers of ignorance that surround the topic. 2. the more people with mental health are able to share their experiences and struggles that they live with on daily basis. 3. the more we are able to see that mental health problems are only four – people away from us. If it can happen to someone near you, it can happen to you. 4. the more we are able to understand that mental illness is in a continuum and we may be at different stage/point in that continuum. 5. the more we are able to develop empathy for those that are dealing and coping with situation you may not be able to cope with. The mental health week is a time for us to actively reflect on: 1. how mentally healthy we are 2. what we are doing to aid or hinder our mental health 3. what lifestyle we are upholding to promote our mental health and 4. what we are doing to support people challenged with mental health problems STOP AND THINK: YOUR MENTAL HEALTH MATTERS! If you need professional help, please contact us at dr.oby@fcc-clinics.com / www.fcc-clinics.com Stay Safe and Psychologically Connected Dr.Oby@FCC Clinics - Global Health

Traumas, tragedies and losses are said to be part of the inevitable givens of human existence. For example the COVID-19 and its devastating impact of loss of jobs, health, self, freedom, or life. How we respond to such traumas, tragedies and losses can predict the outcome we get from the situation. Our ability to respond one way or the other is often underpinned by a number of factors e.g. the resources we have at our disposal and how we have used these resources to build or protect who we are (our ‘selves’) From interactional perspective, human self can be categorized into three main dimensions: 1. the social (interpersonal) self: known to others 2. the private (intra-personal) self: known to self 3. the unknown self: unknown to self and others (other selves) The focus here is on the first two (known) selves because these are within our grasp and can help in unveiling the third dimension of self (the unknown self). SOCIAL SELF: Supersized! The social self is the self that you share with other ‘selves’. It emphasizes the DOING /ACTOR) side of self. In spirit of our modernization and actualization, sense of self have gradually but surely been immensely shaped and described in terms of lifestyle; job titles, social circles, attainments etc. This means that we have become more socially aware and connected than we may want to acknowledge or face. Our social self has become so super overrated. People have openly asserted that social connection/interaction is key to our mental well-being. As far as this is correct, it is only half true. We tend to be happier when we are in the midst of people who share common interests in hobbies, work, social spots/media, ideological trends and value sets. Our community spirit is in its most record high; the more we are at the centre of the social action, the better valued we feel. The psychological basis for building our sense of self heavily on our social self could be because it often provides us some excitement, tends to serve our ego, and enhance other ‘selves’ view of us. In crisis situation (e.g. COVID-19, and Lock-down), our socially constructed self tend to be put to test and forces us to reevaluate our self-formation and its effectiveness. In crisis situation like this, if the private self of an individual is not very well nurtured, the individual tends to experience the impact of the isolation, or 'aloneness' more. Consequently, such individuals tend to be more prone to experiencing mental health difficulties than their counterparts. PRIVATE SELF: Room 4 Growth The private self represents the self that only you can relate to and with. It emphasizes the BEING side of self. In a society like ours where the social-laden sense of self is promoted for a long time, our private self and its contributing values are often ignored or not given its due recognition. We are usually reluctant to relate with our private and emotive self because we have been cultured to see this dimension of self as weak, disgraceful, uncomfortable, babyish etc. Tons of studies have, however, shown that the more you are able to relate and express your emotive and private self, the better you are able to prevent mental breakdown, heal from traumas and develop to deeper height in self. While it is important to stay socially connected and continue to foster our social self, it is of utmost importance that the private self is nurtured as well. I would assert that for a healthier mental well-being, there is a need for us to consciously nurture and connect with both our private and social self. Private self has qualities that help us relate with self and other selves in our shared space. Dealing with crisis and uncertainty, the following internal qualities are essential for survival: 1. Resilience : #courage, #endurance, #perseverance, #determination, #willpower, #motivation, #coping, #flexibility/#responsive to change, #doing better than you think . Resilience is the ability to adapt well in the face of adversity, threat, tragedies and traumas. It is the internal resistance that keeps you buoyant in the face of thrusting forces of life. This is therefore an outward facing quality which helps you to perform and hold forth your social self better. It is the internal driving force that helps you not to give up in the face of adversity, traumas and loss. 2. Compassion for self: #care, #empathy, #patience, #kindness, #gentleness, #enabled to flourish/ to be happy, #nurture to self. This quality is inward facing; it helps you to acknowledge that you matter and should be counted, protected and valued. In times of trauma and tragedies, it provides you the soothing care that you need. It becomes your own best friend when all friends are gone or unreachable. 3. Acceptance of situation/help: #fallibility of human nature, #letting go, #beyond control . This is the quality that balances the resilience and compassion. It helps you know when to fight and when to flee, when to hold on and when to let go. This quality helps you change what you can as well as acknowledge that some things cannot be changed and should be accepted as they are. It also helps accept that others may be able to help you better than you can help your self. As a society, we need to return to the basis and begin to emphasize these great contributing factors to mental health. These can be the deciding factors whether we stay mentally well or challenged. These internal qualities of private self are emphasized within the third wave Cognitive Behavioural Therapies (CBT) such as: · Acceptance and Commitment Therapy [ACT], · Compassion-Focused Therapy [CFT] and · Mindfulness-based Cognitive Behavioural Therapy [MCBT], During therapy, clients are usually helped to learn how to develop and/or enhance these qualities in their everyday lives. OUR MODEL OF THERAPY In FCC, we use the KRAFT Model to help our clients. K = Kindness to self and others R = Reach-out to / Receive help from others A = Awareness of : where you are, what you can change, what you need to accept, and that you are not alone in the situation F = Focus on : physical and mental; personal and social well-being/fitness T = Thinking pattern modification For professional help on your journey to reuniting your lost self, please contact us at dr.oby@fcc-clinics.com / www.fcc-clinics.com We welcome questions, and/or contributions. Stay Safe and Psychologically Connected Dr.Oby@FCC Clinics - Global Health

Over the past weeks and months, there has been the storm of COVID-19 Pandemic. Governments of many nations and their citizens watched in horror the ravaging effects of this unimaginable disease called COVID-19. Though many heads have been battered by this disease, some loved ones fallen to its wicked arrows, and many still in shock of the force, we, as a nation, can proudly say that we did our little bits! Though we are physically distancing, we remain psychologically connected and continue to wage the war against the storm of COVID-19. After the storm comes the calmness, stillness or silence! What do these words mean? To some, they mean 1) Dis-aggregation from ‘objectification to personification i.e. from NHS (distant object) to identifiable faces (doctors, nurses, healthcare professionals, mums, dads, uncles etc) (Personified). 2) The reality of the loss of loved ones, of jobs, of relationships, of sense of self 3) The reality of the uncertainty and anxiety about returning to work 4) Yet another change to the new normal: #stayhome, #homeoworking, #multitasking. 5) New beginnings, adventures and exploration of opportunities Each of these meanings of silence stirs up in people different emotions, thoughts and behaviours. Rising Emotions 1) Fear of contracting the disease. People continue to make many emotion-laden decisions resulting in unpleasant consequences 2) Anger: against the mixed messages from different quarters. Some reliable and others not very reliable. 3) Anxiety: unknown, unfinished business. As long as there are still deaths from COVID-19, it will continue to be an unfinished business and the uncertainty will continue to hover. 4) Low (Depressive) mood. 5) Guilt for surviving: ‘why did I survive and my …… did not’. In some situations, the carriers were not affected but they infected others who died as a result. 6) Helplessness 7) Powerlessness 8) Confusion Prominent Behaviours 1) Rebellion/resistance to established systems from government, schools and healthcare professionals etc. People consciously do the opposite of what they are told to do irrespective of the merits or demerits of the instructions. 2) Critical of authority, self, others for decisions made or not made. 3) Hyper-vigilance: this could lead to or worsen people’s pre-existing mental health problems such as health anxiety, OCD, social anxiety, etc. 4) Resignation: This often follows a sense of powerlessness, hopelessness and helplessness many people are feeling during this pandemic crisis. It can also be seen in situations of multiple losses and complex grief/bereavements. Dealing with the silences For many people, these silences (calmness or stillness) will in no distant time fade way and life carries on as usual. For some others however, these silences can be deafening and overwhelming. They are faced with the ‘now’ reality which is unbearable. To deal with the emotions and behaviours, you will need to 1) Evaluate your personal situation 2) Identify whether you are coping well or not 3) If not, seek professional help. The sooner you start to deal with it, the more likely you will regain your balance If you need professional assistance in dealing with any of the above COVID-19 related issues, please contact us at dr.oby@fcc-clinics.com / www.fcc-clinics.com Stay safe and psychologically connected Dr.Oby@FCC Clinics - Global Health

COVID-19 stands for CO = Corona; VI = Virus; D = Disease; 19 = 2019 COVID-19 is a contiguous disease caused by a single-stranded RNA virus. It presents as a severe acute respiratory syndrome (SARS). The word 'syndrome' means that the disease consists of groups of symptoms or characterized by a set of associated symptoms. The COVID-19 is shown to present initially by marked systemic symptoms such as: muscle pains, headaches, and fever followed by 2–14 days of onset of respiratory symptoms such as dry cough, dyspnea (breathlessness) and Pneumonia From its presentation, the initial stage does not look like a respiratory problems but the patient at this stage can still be infectious. This is the reason why the moment you notice any of these symptoms, your are better off isolating yourself. Most patients with SARS are shown to have marked reduction in the number of lymphocytes in the blood. This means that the patients at this stage may be susceptible to secondary infections. Early self-isolation therefore helps you reduce the chance of you picking up secondary infections which will complicate your already serious health problem. Prior to the current COVID-19 outbreak, there has been other SARS in the past and it was reported to have caused some mortality but they were not world-spread (pandemic)as this current SARS. Sørensen et al (2006) reported that in the SARS outbreak of 2003, about 9% of patients with confirmed SARS-CoV infection died. The mortality rate was much higher for those over 60 years old, with mortality rates approaching 50% for this subset of patients. The current SARS (COVID-19) is also showing high mortality for older patients of over 60 years. There are increasing reported cases of fatality in young patients with no prior health issues. This has prompted National Leaders to embark on varieties of measures to combat this contagious disease that is currently ravaging nations and people across ages and class. One of these measures is self-isolation . Self-Isolation has been shown to have great positive impact on the reduction of the spread of the contagious disease as well as minimizing chances of secondary infections and complications. But because humans are social being, long-time isolation could have significant negative impact on people's mental and psychological health. The more number of people in self-isolation, the lower the spread of the disease. Psychologically, however, the longer the length of isolation, the worse people's mental health of people becomes especially those with preexisting mental health problems. We have to therefore have to do a balancing act in managing this disease and maintaining people's mental health. TIPS FOR MAINTAINING MENTAL HEALTH DURING SELF-ISOLATION Below are some tips on what to do during self-isolation in order to maintain your mental health reminding yourself that this period of self-isolation is temporary thinking of the benefits of self-isolation to the wider society, including slowing the spread of the virus and protecting those most vulnerable in your community remaining mindful that medical and scientific experts are following strict protocols to contain the virus and treat those affected ensuring you have access to accurate, reliable and up-to date information that communicates what is expected from you if you are in isolation maintaining relationships with family, friends and colleagues (e.g., via phone or video calls) not overusing social media as you are likely to be exposed to negative news and get drawn into doomsday discussions – try to keep your mind busy with activities you enjoy such as reading, watching movies, exercising and even spring cleaning the house structuring your day when working from home – allocate specific work hours, schedule breaks and set-up a dedicated work-space where distractions are limited. (Australian Psychological Society, 2019) We all need to be each other's keeper during this pandemic crisis. It is a war against humanity but together we will win and live to write, read, and talk about this attack! If you need professional help and support, please contact us at dr.oby@fcc-clinics.com / www.fcc-clinics.com Stay Safe & Psychologically Connected Dr.Oby@FCC Clinics - Global Health

As the world is waking up to the news of COVID-19 and its fatal consequences on human lives, the level of anxiety continues to rise within families, communities and nations. It is important therefore that we gain some skills on how to minimise the emotional and psychological impact that the global anxieties can have on people's lives. The worries and anxieties surrounding the COVID - 19 are often as a result of the following three main reasons: Uncertainty: The lack of clarity of the 'why, how, and where' about the COVID-19. New and Different: – The novelty of the situation means that there is no information or past experiences to draw inferences from and projections to. Powerlessness: The unpredictability of COVID-19 creates powerlessness, hopelessness and helplessness in all strata of human existence (people and their leaders) These will be discussed in my subsequent blog-updates PRACTICAL TIPS FOR PSYCHOLOGICAL WELL-BEING 1: Physical Distancing but Social Connection It is crucial that we all work extremely hard to slow the spread of of COVID-19 by observing social distancing. It is recommended that the social distance should be a minimum of 2 meters. From a psychological perspective, however, this can pose a problem of reduced social connection especially for people who are already socially isolated or feeling lonely. Studies have shown that social isolation and loneliness have high correlation with high risk of mental health problems such as anxiety and depression. It can exacerbate the already existing mental health problems such as PTSD, Bipolar Engaging in social activities without physical contacts is therefore very important at this time of pandemic crisis. The social connection can be achieved while maintaining physical distance by engaging with others through virtual platforms such as Skype, Zoom, Google duo, Google hang outs, messenger, WhatsApp etc ). Many of these Apps are free; all you need to do is to download and start using them. Rather than texting or emailing your friends and family, video call them. Rather than sitting in front of the TV all day, you can do some gardening if weather permits, speak to your neighbour from a distance Rather than sleeping all day, start a new hobby of art & craft, read a new book or blog to encourage someone that may be finding the current situation harder than yourself. Distancing does not mean inactivity, it means creating an environment which makes it difficult for COVID-19 virus to transmit from one person to another through physical contacts. This can still be achieved while maintaining your social connections and as a result protect your mental health and those of the people around you. If you are finding it difficult to cope on your own, you do not need to suffer in silence. Please contact us and we will provide you immediate appointment to speak online with one of our Psychologists or Counsellors Stay Safe & Psychologically Connected Dr.Oby@FCC Clinics - Global Health