This pandemic of COVID-19 and the unprecedented measures that are being taking to “flatten the curve” and stop this contagion have brought the whole world to a screeching halt. Apart from

the medical crisis, and economic crashes, there is an enormous psychological impact of this particular Pandemic.

Here I have made an attempt to categorize these psychological reactions and put these within the modified framework of Elizabeth Kubler-Ross’s Stages of Grief. Also put together a guide to staying afloat during these strange and testing times. This living guide is adapted and modified from Abraham Maslow’s pyramid of the ‘Hierarchy of Needs.’ Instead of self-actualization, here you take care of the basic to your higher needs, while keeping your health and sanity.

Some other concepts used here are based on George Valliant's An Adaptation to life for the ‘Psychological Mechanisms of Defense’ and Aaron Beck’s concept of cognitive distortions from his cognitive behavioral theory.

Psychological Impacts within an Adapted Framework of Kubler-Ross’ model

●       Denial

●       Anger

●       Bargaining

●       Anxiety

●       Depression

●       Acceptance

Denial & Displacement

●       Denial of the painful reality, as it is too disturbing or distant

●       Taking a nonchalant or cavalier attitude and putting oneself at risk

●       Displacement as a psychological defense:

○       like blaming an agency,

○       an industry or a foreign government

●       Paranoid projection (as a psychological defense) like this outbreak is not real, latching on to conspiracy theories and propagating them

Anger & Frustration

●       Anger over the situation (Pandemic): Why me? why now?

●       Increased frustration can lead to misplaced anger

●       Anger can be displaced and directed towards:

○       Certain groups of people e.g. Chinese people

○       Government workers or officials

○       Health care workers etc

○       Sick people

○       Loved ones

Bargaining

●       Procrastination, buying time to avoid distress or discomfort

●       People are willing to do anything in an effort to stay safe/avoid the virus, and this can often lead to over-kill

●       Hoarding behaviors - stockpiling, “staying prepared” - the ‘toilet paper crisis’ in the US

●       Over-preparing: “Better safe than sorry”

●       Stock-market crash

Anxiety & Panic

• Generalized anxiety due to fear of the unknown, existential threat, and worry about income, supplies, loved ones, etc

• Panic attacks in closed spaces, crowed places, public transport, etc

• Worrywarts & worryguts: tend to worry unduly, personalization, generalization and catastrophization (cognitive distortions - Aaron Beck)

• OCD – increased anxiety, leads to increased obsessive thinking, this leads to increased compulsive activity like cleaning rituals, phobic dread from germs, etc

• Schizophrenia – increased paranoia and psychosis

• Mass hysteria

• Anxiety also stems from the indefinite suspension of many regular activities like attending schools or going to work. The unpredictability of the situation can exacerbate anxiety

Role of Media & Social Media

• Media tends to sensationalize. They want viewers to latch on to their shows

• Social-media can create fear, panic, and rumors

•Bogus remedies, personal opinions, to marketing gimmicks are being circulated

• Better to stay informed but avoid overload

• Light humor, but not at the expense of those suffering, can be helpful

• Scams, generation of mistrust, being taken advantage of

Depression

• Wide affective range: from feeling gloomy and lack of motivation to full-fledged depression

• Underlying psychological and medical factors play a role

• Coping skills of individual people play a role

• Cabin-fever: feeling closed-in, unable to go out, and isolation

• Frustration from loss of wages and time

•Cancellation and postponements of social activities (graduations, weddings, etc.), vacations, recreational activities, gyms, etc

Acceptance

• Most people accept the reality and gravity of the situation, and take the necessary precautions

• They tend to minimize the psychological impacts by healthy defense mechanisms and positivity

• Some have to navigate through the other stages to get to this stage

Some Special Considerations

•The impact on the collective psyche of smaller communities, which are hit the hardest due to high morbidity and significant loss of life

•Increase in domestic violence: social distancing creates an opportunity for the perpetrators

Psychological HELP

• Some need professional help, which may include:

i) redirection and insight

ii) counseling

iii) medications if necessary

•If you see someone struggling, try to help them

Dealing with the Pandemic: Adapted from Maslow’s pyramid of

‘The Hierarchy of Needs’

•Physiological Needs

•Physical Needs

•Social Needs

•Community Needs

•Psychological Needs

•Intellectual Needs

•Spiritual Needs

Physiological Needs

•Good Nutrition, Eat healthy: fresh vegetables, vitamin C, etc

•Hydration: Stay well hydrated

•Rest: Sleep well and enough, avoid caffeine after 4:00 PM if you sleep at 10:00 PM

•Go out and get fresh air everyday, aerate your living areas

• Try to get at least 20 minutes of sunshine (vitamin D), sit out or take a walk

Physical Needs

• Safety

• Hygiene

• Appropriate clothing, masks, personal protective equipment if necessary

• Supplies - anticipate, stay ahead

• Physical activity & exercise

Social Needs

•Social distancing and/or quarantine

•Keep virtual social connection through phone, skype, social media etc

•“Talk to them rather than worry about them”

•Have some family time, play board games, watch a movie together etc

•Social media has gone on steroids! Avoid information overload. Stay informed. Learn to Ignore

Community & Societal Needs

•Help, give donations/charity, volunteering, help in any way you can

•But also exercising the “virtue of selfishness.” Keep yourself safe and healthy

•Can’t help others if you are sick or become a source of infection

Psychological Needs

•Positive thinking

•Stay informed

•Exude kindness, compassion, love, affection

•Avoid negativity, cynicism, sarcasm, etc

•Healthy mind and positive emotions help your immune defense

Aesthetics (for extra credit!!)

• Keeps living areas bright

• Put fresh flowers if you can (if you don’t have allergies or asthma)

• Keep living areas neat and uncluttered to reduce “visual chaos”

• Incense or candles for aromatherapy

• Light music in the background

Spiritual & Intellectual Needs

• Reading, personal research, creativity to fill time

• Meditation, yoga, etc. is helpful for some

•Faith and supplication help many people as well. Any belief

system can serve as a source of hope and empowerment