Pandemic causing mentally ill patients to relapse
Since the arrival of COVID-19 in Jamaica, mentally ill patients have been experiencing episodes of relapse. Dr Jordon Eaton, psychiatrist and senior medical resident at the University Hospital of the West Indies (UHWI) said he has seen over 150 patients since last year who have suffered relapses.
The pandemic, potentially, plays a role in the relapse of patients. According to Eaton, the additional stress from the fear of contracting COVID-19 and the movement restrictions make patients reluctant to go to clinics to get their medication. As a result, they stop taking their medication and so they relapse.
When a mental health patient has a relapse, also known as an acute episode, the patient experiences a reoccurrence of symptoms of whatever mental illness they were initially diagnosed with. Doctors have to analyse the severity of their relapse by checking if they have become a danger to themselves or to others. Their symptoms can range from the patients wanting to kill themselves or others. They may be on medication but extremely depressed.
According to Dr Jardines Spaulding O’hara, resident in psychiatry at the University Hospital of the West Indies (UHWI), “patients in relapse may exhibit depressed moods, decreased interest, decreased concentration, change in appetite, or suicidal thoughts. When patients are relapsing, they start to demonstrate disorganized behaviour, disorganized speech, and have illusions or hallucinations.”
Dr O’hara explained that patients who work from home most of the time due to the pandemic often become dishevelled, fail to eat or drink regularly. But, relapse does not necessarily occur because their medication is not working, “relapse can occur because they stopped taking them. Patients might not like the side effects of the medications and stop taking them,” said Dr O’hara. “The side effects of the drugs may or may not include drowsiness, dry mouth and stiffness to the body,” he added.
“When patients become dangerous, the dosage of their medication is increased and they are taken to a mental institution and can be held for a week or up a month depending on the sickness,” Eaton stated.
Dr Geoffrey Walcott, consultant psychiatrist and clinical director at Psychotherapy Associates Limited, said the reason for a patient’s relapse could be related to medicine, psychology or their social life. “The social component is as critical, as being social is therapeutic. The patients communicate virtually with family and friends but that is not the same thing. Human beings thrive off interaction; it is a core part of our existence,” he said.
Dr Walcott observed that the very state of the world is cause for anxiety as one-third of people who have recovered from COVID-19 has developed mental sickness out of nowhere. They call this the post-COVID syndrome. In a study conducted by psychiatrists in the USA from the QJM: An International Journal of Medicine (2021) stated that people who have recovered from COVID-19 have started to develop posttraumatic stress disorder, panic disorder and obsessive-compulsive disorder between 31 and 50 months after recovery. So, the effect of COVID-19 on mental health is two-fold, mentally ill patients are relapsing and people who have recovered are now exhibiting mental illness.
