Coming from a family of doctors, recently I was chatting with a very close family friend who is a very senior and experienced psychiatric doctor. Of course the topic of discussion like in most households these days revolved around the recent pandemic.  He was telling me that he has become twice as busy than before due to the deluge of patients who have succumbed to extreme stress and anxiety in the wake of this pandemic. Fear and anxiety of contracting this virus, the fear of unwittingly infecting their loved ones, economic loss and most importantly the fear of death, has pushed people to the edge.  The most hard-hit are the people who were already suffering from some form of mental illness, because this is like their worst nightmare coming true. The lockdown has made this human race which thrived on social contact feel lonely, alone and scared of the unknown.

But this psychiatrist friend ours, pointed out that many of these stress and anxiety related patients had one thing in common and that was- Financial insecurity and instability.

Mental health issues and financial problems are interlinked intricately.  And it would be wrong to think that only the underprivileged sections are affected by financial stress, in fact many well-to-do people who have money and can withstand such setbacks are equally affected.  Although one man’s trash can be another man’s treasure so we are comparing apples and oranges here. Millions have lost their jobs and their livelihood, thousands have had to leave the cities where they were working and return to an uncertain future with no means of feeding their families who relied on their income.  The middle class too has had to bear the brunt of this curse.  There have been large scale layoffs in most companies, almost all have had to face pay-cuts and are not finding any new jobs.

All this while their expenses have remained more or less the same.  They have had to pay their bills, their groceries, their medical expenses and most dangerous of it all EMIs, be it home loan, vehicle loan or personal loan.  Finally, the so called upper class, we might feel that what have they to worry about, but higher one goes, the harder one falls.  Many have had to pay their employee salaries out of their own pockets in the wake of zero income, many sectors have completely shut down with no signs of revival in the near future such as tourism, wedding and celebration related allied industries such as catering, decorators, etc; the list is endless..  Many of these so called big names have had to close their outlets, reduce staff, run from pillar to post to recover money from their debtors, and many have filed for bankruptcy.

The fact remains, that this once in a lifetime crisis has affected us all and affected our mental health knowingly or unknowingly.

All these stressors lead to a gamut of psychiatric illnesses such as

• Anxiety,
• Depression,
• Post-Traumatic stress disorder,
• Obsessive Compulsive Disorders (OCD) to name a few.

The boarder terms fall under the heading of ‘Psychosomatic Disorder’ that is effects of emotions causing problems like asthma, depression, stomach ulcers, anxiety, heart problems and others.

The recent pandemic has increased the number of cases of psychosomatic disorders two fold. And its high time we talk about it.

Let us understand the vicious cycle of financial problems and mental problems.

Financial problems due to mental problems

• Mental health problems makes it harder for people to be motivated and go out and earn money and this further pushes people into financial despair. As people with anxiety or depression have a hard time being focused on the job at hand.  This decreases their productivity and efficiency in their jobs.  Thus they are generally not given any important jobs, which limits their growth in the company, they are not promoted or given salary hikes in comparison to their colleagues which develops a feeling of despair, anger, frustration, self-loathing and even animosity towards their colleagues and bosses.
• Many a times individuals with depression or loneliness go out and spend on things that give instant but short lived gratification and many enter into vices such as alcohol, drugs, etc spending spree just to cheer them up.  They spend every penny to fulfil these vices even resorting to crime to earn money for this vices. All these empties their life savings and even put them under debt.
• People suffering from mental problems suffer from memory problem and rational thinking and they end up marking wrong financial decisions or rely on others to make decisions for them, ultimately leading to financial loss or a fraud.

Maintaining an expense sheet is a difficult task even in normal circumstances, but for individuals suffering with a mental illness, it is almost inconceivable as they have lost interest in everything.

• Individual suffering from mental health often go into a shell where they stop communicating and paying attention to daily details often leading to nonpayment of basic bills resulting in compounding of bills and penalty charges.

The above financial problems act as a fuel to the already burning fire of a patient’s internal anguish and pushes the person to the edge where the mental problem aggravates to the point of suicidal tendencies or antisocial tendencies like causing harm to others.

The biggest financial problem as cited by the doctor was the inability to pay the ‘ EMIs’ every month, thanks to the cheap bank loans provided without any collaterals. Also, plastic money has been cited as an additional problem as a person spends haphazardly since he does not need to open his wallet. During the time of this pandemic with a complete lack of income and using up of all savings, the end result is nonpayment of instalments of loans and credit card debt. The constant harassment by loan recovery agents and their threats adds to this stress, fear and anxiety problem.

A few pointers to avoid this scenario in the future.

How to control debt?

Debt if not controlled can spiral out of control easily which in turn becomes a fuel for mental health burnout. The best way to control debt is to maintain a constant check on the Debt servicing ratio. This ratio states how much EMI is going from your total gross income. The ideal ratio is 40 percent. Which means, if more than 40 percent of your income goes towards paying EMIs the alarm bells should start ringing and one should try to pay off the existing loans and refrain from taking any further loans.

Savings– do not forget to keep aside the emergency fund of at least 4 months of mandatory expenses and make sure at least 15 percent or more is going towards savings.

Taking care of your mental health as much as your physical health: start by believing that “This too shall pass”. Keeping yourself busy in some work. Pursuing a hobby like music or painting. Socializing with people even if its 6 feet away. Exercising, practicing yoga, doing breathing exercises, always keeping a positive attitude. And if you feel you need help do not shy away asking help from your family and friends. Sometimes knowing that you have someone who understands you is therapy enough.

Seek medical help if required: In a survey in 2017 it was seen that nearly 150 million people in India suffered from mental health problems but less than 30 million are seeking care.

Unlike in many other developed countries, India does not have any dedicated support system for mental health patients. The problem with majority of our Indian population is that we still equate mental health problems with insanity.  And going to a psychiatrist is considered a ‘Stigma’ or ‘Mortal sin’.

Everybody needs help at some time and there is no shame in asking for it.  Any mental distress or problem, when detected early either by oneself or by their loved ones can be fully treated by a trained doctor and can prevent the problem from reaching a stage of no return. As wisely said by Michelle Obama, wife of ex American president Barack Obama, an author and American attorney, “It is time to tell everyone who is dealing with a mental health issue that they are not alone, and that getting support isn’t a sign of weakness, it’s a sign of strength.”

Family should look out for signs of anxiety, depression, change in financial habits be it excessive spending or ignoring bills or an ability to not hold jobs for long or signs of avoiding people. All these are red flags and should not be ignored. Seek professional help and prevent a destruction of a beautiful mind!!!