Early detection of mental illness among young is key

It was a moment she had dreamed of since 8th grade. 19-year-old Riaana (name changed) was overjoyed when she secured admission into an Ivy League university. Excited, she moved across the Atlantic. Six months later, she found herself on a flight back home – Covid-19 had struck. Her world had changed. She was now alone in her room most of the time, feeling isolated and lonely. Though she tried to connect with friends across time zones, synchronizing times and finding things to chat about after a point was difficult. Sleep started evading her and she often stayed awake until 4am or later. She barely got sunlight or exercise and her routine was disrupted.

Sadness started to creep in and she experienced anxiety and panic attacks thinking about the future. She often cried and lay in bed watching the ceiling, and she found it difficult to focus during online classes. Her energy levels dipped and life seemed meaningless; she contemplated suicide. She went online and tried to diagnose herself. Her parents tried to grapple with her changed behaviour and asked her to ‘snap out of it’. She finally broke down in their presence and was referred to us for treatment. She was diagnosed with severe anxiety and depression.

As Covid cases surge, we are in the middle of a huge mental health crises. While everyone is affected, our youth are affected disproportionately. That the crisis is so devastating for the young could be due to the fact that youth (ages 15-24, as per WHO) is a formative phase of life, with unique changes and challenges. The brain is still in the process of development and matures by age 25. Dramatic physical, sexual, psychological and social and developmental changes occur simultaneously. Young people don’t just need to navigate academics, they need to cope with peer relationships, peer pressure, family pressure, sexual relationships and social challenges, including technology and social media. While providing opportunities for development, this transition poses risks to health and wellbeing.

Studies suggest over 50% of all mental illnesses first manifest before age 14 and three-fourths by mid-20s. Even before the pandemic, mental illness in this age-group has been on the rise, with up to one in four suffering. Suicide is the second leading cause of death in the 15-29 age-group (WHO, 2019). Research shows the pandemic and lockdown have had mental health consequences for the youth. Early detection is key. Parents need to have discussions with children on mental health, watch out for warning signs and seek professional help if required.

A comprehensive approach of biological and psychosocial treatments is most effective. It includes evaluation, medication if required, individual and family counselling and social support. Lifestyle modification helps considerably, especially with mild symptoms. Exercise, adequate sleep, a balanced diet, judicious use of gadgets, internet and social media are beneficial.

Riaana was treated with medication and counselling and her family counselled to be more supportive. As she got better, she was encouraged to follow a routine, exercise and pursue a hobby. She responded very well. All it She responded very well. All it took was seeking help at the justify time.

(Shamsah Sonawalla is consultant psychiatrist, Jaslok Hospital and former assistant professor, Harvard Medical School)