Author: Lekh Parekh
Abstract
We conducted a survey to study the psychological impact of the COVID-19 pandemic and the associated lockdown on the mental health of a section of young people in urban India. We present the findings from data collected from more than 200 young people within the 14 to18 year age group. We explored early signs of anxiety and depression.
Hypothesis:
The duration of the 2020 Covid pandemic and the subsequent lockdown has a direct association with negative psychological states in young people, specifically early symptoms of anxiety and depression.
Introduction:
On the 24th March, 2020, the Indian Prime Minister Narendra Modi announced India’s first nationwide three week lockdown due to the Covid -19 pandemic. Stretching from 25th March to 14th April 2020, the lockdown sparked a buzz of problems, criticism and hope. While multiple studies have focused on the welfare of deprived communities and on the physical and psychological impact on adults, our study specifically focuses on one group, i.e. 14 to 18 year old in a cosmopolitan city. A lack of attention towards this age group and the psychological well-being of this population could have a catastrophic impact on motivation, social interaction and general health for years to come.
Methodology:
The survey respondents were 14 to 18 year old individuals who were characterized by a higher socioeconomic status with access to computers and social media, attending private schools. This group is more likely to aspire to enroll in foreign Universities. They were all residents of Mumbai, a cosmopolitan city in India.
The primary data was collected as part of a survey via a Google Form, with most questions designed to be answered on a linear scale of 1 to 5 (1 indicating “Not at all” and 5 indicating “Very”) to indicate severity of psychological symptoms. The form included a consent section to document consent from both participant and parent/guardian. Participants ticking the consent box were considered as having opted in to the survey. The respondents’ names and identifying details were not part of the Google Form in order to ensure anonymity of the respondents. The form was disseminated among different school social media groups. A total of 226 completed forms were returned. This collection of the data was during the active phase of lockdown.
Results and Analysis:
Anxiety:
The following symptoms were considered:
1) Worry about the Future
2) Duration of Sleep3) Difficulty in concentration
Worry about the Future:
University applications are a significant consideration for high school students within this specific socio-economic group.
Figure: 1
As seen in Figure 1, nearly 63.3 % of respondents were very worried (scores of 4 or 5) about their future college applications. High degree of worry about this aspect at a young age within the short period of three weeks of lockdown can be construed as an early sign of anxiety.
Duration of Sleep:
Figure: 2
Duration of sleep is an indicator of a rested body and a peaceful mind. We considered a duration of sleep of 4 hours a night or less as an inadequate duration of sleep. Almost 13% of the survey respondents reported an inadequate duration of sleep. Inadequate sleep is a sign of several psychological disturbances, including anxiety and depression.
Difficulty in Concentration:
Figure: 3
As seen in Fig 3, more than half of the respondents (56.2%) found it hard to concentrate for long periods of time.
Depression:
We considered the following as early symptoms of depression.
1) Helplessness
2) Irritability
3) Loss of Energy
Helplessness
Figure: 4
As seen in Figure 4, more than 55.8% of the respondents reported a sense of helplessness at scores of 4 and 5. This feeling of helplessness indicates the possibility of a depressed psychological state.
Irritability:
Figure: 5
Almost 72% of survey responders were feeling more irritated than before the pandemic which is a potential marker for the mood changes of depression.
Loss of Energy:
Figure: 6
As seen in Figure 6, more than 48% of survey responders scored 4 or 5 when asked to rate the extent of loss of energy. This is nearly half of the entire group. A prolonged period of inactivity due to loss of energy can have multiple effects ranging from deterioration of physical health to reduction of future career and life chances. Therefore, detecting this symptom in its early stages is vital in preventing long term impacts.
Despite these effects, we also found that a large proportion of the young people were partaking in positive coping activities involving exercise/yoga (56.6%), socialising with friends (72.6%) and games and interactions with their family (45.6%). These could potentially be protective.
Strengths and Weaknesses:
Weaknesses:
Many of the group of 226 young people were likely to have known other respondents to the survey which could be a source of bias.
Unfortunately, the economically challenged section could not be studied. The study population consisted of English speaking pupils of private schools from relatively affluent families. None of them were school dropouts or working to earn a wage. This limits the generalisability of the results. The impact of the pandemic on economically deprived groups from the same age category is likely to be very different and much more severe but this conclusion cannot be drawn from our study.
Strengths:
Considering the fact that this study is psychological, most of the questions in the survey were designed to be on a Likert scale which provided information about the severity of the symptom in question.
As the survey form was anonymised and avoided direct interview in person or on the phone, it minimised bias, for example, from societal bias that could have led to the need to present a positive view to an interviewer. As the survey form was likely to have been completed by the respondents on their own alone as part of their natural social media interaction, it is less likely to have introduced familial involvement and sources of bias.
As the survey could be completed by the respondents online at a convenient time and in their own space, it is likely to have provided triggers for introspection and reflection.
Potential for future research:
A group with similar characteristics could be surveyed again to see differences in psychological state after the end of lockdown.
Conclusion:
A high proportion of young people surveyed in this study experienced symptoms of anxiety and depression during the brief period of three weeks of lockdown. An association was found between the period of lockdown and some symptoms of depression and anxiety.
Our society has advanced to such an extent that young people are no longer content to spend time at home in isolation devoid of activity and social contact. The digital world has created the expectation for sensory or mental stimulation constantly. Restriction of normal social mobility and a sense of uncertainty about the future, exacerbated by the disruption of normal routines due to school closures as well as the inescapable 24/7 news coverage were unusual and hitherto unexpected and unprecedented challenges. This set of circumstances could be difficult to adapt to as an adult and even more challenging for a young person to process. It is in this context that the recent lockdown posed a risk to the overall wellbeing of the surveyed group.
However, as the duration of this concerning psychological state is likely to have been short at the point of the survey, it is plausible to consider that a significant proportion of respondents would not progress into clinical anxiety and depression, especially if addressed in the early stage. Further, recovery and resumption to a semblance of normality after the end of nationwide lockdown are likely to have reversed the adverse psychological findings reported in this study. However, given that a vaccination programme for COVID-19 will take a couple of years to be implemented and pockets of resurgence and localised lockdowns in the future remain a possibility, our survey highlights the need for awareness and recognition of remedial measures.
The measures described above could be efficacious in reducing the detrimental impact of lockdown on the mental health of young people.
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