In December of 2022, authorities in Andhra Pradesh's Kakinada district 'rescued' a mother (44) and her daughter (21) who had refused to step out of their home since COVID-19 pandemic was announced in 2020.
An eerily similar incident played out this week on 21 February, when a 36-year-old woman and her 10-year-old son were coaxed out of their own home in Gurugram. Tthe woman had locked the two of them up for the past 3 years for fear of catching COVID-19.
'Illness anxiety' – or the constant, irrational fear of falling sick – has existed long before the novel coronavirus.
However, during the pandemic, extreme fear of COVID was so common that experts actually came up with terms specifically for it – 'Corona Phobia', and 'COVID Anxiety Syndrome' (though, neither are clinical terms).
Isolating, Breaking Family Ties, to Consuming Bleach: The Extreme Steps People Took
A study conducted by researchers in India and published in the Asian Journal of Psychiatry in December 2020 was one of the first to define the term 'corona phobia' as an 'excessively triggered response to fear of contracting the COVID-19 virus.'
It said 'corona phobia' manifested in the form of:
Obsessive concern over physiological symptoms
Extreme protective measures
Excessive avoidance of public places and situations
Extreme hopelessness, and suicidal ideation
In 2020, at the height of COVID paranoia, there were reports of multiple Americans consuming cleaning bleach, and hand sanitizers to prevent COVID. Following this, health authorities had to put out warnings against "injecting, ingesting, snorting household cleaners...it can be deadly."
Speaking to FIT, Dr Syeda says even less extreme safety-seeking behaviour not only caused personal harm, but also often led to friction and disharmony within families.
She talks about patients of hers who have experienced fights within the family over masking, hand hygiene and social distancing.
"There are cases where one person is more anxious about COVID, so they wouldn’t let anybody go in and out. Even family members, living in the same house, couldn’t really go out and then come back."Dr Ruksheda Syeda, psychotherapist
"They (the patient) would say things like, 'oh, they don’t follow COVID protocol, and we do, but they insist on coming over, that’s not okay'. That did lead to a lot of individual distress and family dynamics issues," adds Dr Syeda.
Why Did Some People Develop ‘Corona Phobia’?
Fear and worry about COVID during the pandemic was normal because it was a very real threat looming over all of us, "and the fear was not irrational," says Dr Kamna Chhibber, Head, Mental Health and Behavioural Sciences at Fortis Healthcare, Delhi.
COVID did lead to a spike in health anxiety, particularly in the initial months, but things settled when "people kind of understood what needs to be done, and how things are," says Dr Ruksheda Syeda, a psychotherapist based in Mumbai.
However, she adds, "Those who already had subclinical or clinical anxiety disorders, they continued to have concern about COVID and their behaviour was modified because of the pandemic."
"But, again it is not going to happen to everybody at the same level and for the same duration," adds Dr Syeda.
Speaking to FIT, Dr Hemalatha, superintendent of Kakinada Government General Hospital where the Andhra Pradesh mother-daughter duo was admitted, says, it was more than just fear.
"They had psychiatric issues for which they were admitted in the psych ward of our hospital for a while. They are okay now, and have been discharged."
However, in this case of the woman from Gurugram, Dr Syeda and Dr Chhibber both say that it would be unfair to diagnose without knowing the full picture.
"We don’t know whether this was part of a delusional disorder which already existed or got triggered in the last three years, or if it was like an extreme case of phobia and anxiety. So, to say that all kinds of anxiety and all kinds of anxiety behavior are same, wouldn’t really, is very simplistic."Dr Ruksheda Syeda, psychotherapist
The Pandemic Vs the Infodemic
Along with the COVID pandemic, the world also had to deal with a parallel COVID 'infodemic' – a constant barrage of COVID updates, stats, news about death and disease, accompanied by fear-mongering headlines and visuals, on top of rapidly circulating fake news.
People with illness anxiety generally have the tendency to seek more and more of it, which can lead them further down a rabbit hole of worry and stress. A global pandemic, with multiple lockdowns, and the internet being the only gateway to 'normalcy', is enough to heighten this anxiety further.
"Constant input from people around, information from media, news of loss of life, the unpredictability of the how it spreads and the effects it can have, not knowing future outcomes could have been some factors that triggered covid anxiety," says Dr Chhibber.
"That why we always kept saying, don’t look at the news too much. Only seek information as much as you require, or you need. Because that is going to be damaging to your mental health and make you take steps that might be damaging to your health overall as well," adds Dr Syeda.
Coping with Health Anxiety
For many, re-emerging into society proved to be a tough transition after years of isolation.
While some couldn't step out without a mask, others couldn't go out at all without severe bouts of anxiety. The flippant attitude of those around them didn't make it any easier to cope.
"If it is getting in the way of your daily activities, then you definitely have to seek professional help," says Dr Syeda.
This could involve therapeutic tools like Cognitive Behavioural Therapy (CBT).
"A lot of behaviour modification and a lot of emotional management and some amount of cognitive remapping is essential to tackle health anxiety."Dr Ruksheda Syeda, Psychotherapist
In another instance, speaking to FIT for a previous story, Dr Ritika Aggarwal, Consultant Psychologist, Jaslok Hospital & Research Centre, Mumbai, said practising mindfulness has helped her patients.
"I had someone come in with a fever who was convinced she had COVID even though her tests came back negative,” she said, adding that she had to get her patient to do certain mindfulness exercises, over multiple sessions, before she was able to make a breakthrough.
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