For The Way We Cope, We Survive

The recent pandemic of SARS COVID-19 made its impacts for almost all of the field involved, this implies that the pandemic is more than about a respiratory virus. In the scope of global health, the pandemic also plays a huge role in the psychiatric implications. Current data suggests that patients with COVID-19 might experience delirium, depression, anxiety and insomnia (Rogers et al., 2020). As we know, some viral infections are known to influence the central nervous system and cause neuropsychiatric syndromes affecting cognitive, affective, behavioural and perceptual domains. These populations might obviously being harmed by the concern of their outcome of health or stigma people had on them. Not to mention that the non-infected one are also likely to be harmed by this psychiatric consequences as a result of the social distancing, financial difficulty and uncertainty of the might-never-ending outbreak.

I once discovered stress of not knowing what the future holds for me, the idea of pandemic came up to destroy the optimistic inside me on continuing the 2020 resolutions. Being on my last semester of pre-clinic journey, I feared in capabilities I had as a medical
student—knowing that the lectures and OSCE were held through what they called as study from home as I believe the most effective way to learn medical skills can not be replaced by online classes. Some relations of mine might have experienced financial difficulties on paying the college tuitions, some can not stand of being lonely by the physical isolation the government recommended. We all had difficulties, we all experienced psychiatric consequences. The thing is—how harmful are these?

Stress causes adverse effects when it is too strong or lasts too long, thus exceeds an adaptive capacity for the sufferer (Orzechowska et al., 2013). According to Kay and Tasman (2006), the prolonged one increases risk of mental disorders, in particular anxiety (neurotic) disorders and depression. Too much stress can trigger post traumatic stress disorder (PTSD) and personality disorders, as well as the onset of psychosis. Depressed people tend to perceive life events as threatening and difficult to deal with. This fitsto the concept of Lazarus’ Cognitive Appraisal Theory, which states that the event is regarded as stressful depending on the importance assigned to it by the individual. The reason for such negative assessment of live events may be dysfunctional cognitive schema used by patients with depression (SariuszSkapska et al., 2003). The next thing is—how do we cope to survive?

Coping is defined as thoughts and behaviors we had consciously and voluntarily, much different with defense mechanisms that are such an unconscious adaptive response—though both are used to deal with the stressful situations. According to Algorani and Gupta (2020), individuals happen to have varied coping styles but generally it can be classified into reactive coping and proactive coping. Reactive coping happens to face the current stressors, while the proactive one is aim to the upcoming stressors that might come. How come are these react to our body? Those are related to the serotonin and dopamine input to our brain while the
neuropeptides vasopressin and oxytocin also are being associated to these coping styles (Coppens, 2010).

Coping strategies could be monitored by coping scales, such as COPE (Coping Orientation to Problems Experienced), Ways of Coping Questionnaire, Coping Strategies Questionnaire, Coping Inventory for Stressful Situations, et cetera. Based on COPE questionnaire, there are 4 general styles: focus on the problem, avoidance behavior, seeking support, and focus on emotions. However, coping mechanism once again are varied by individuals based on the previous experience they had.

If you are not aware of strategies you had to cope all this time, I recommend to try the COPE questionnaire created by Carver, Scheier, and Weintraub and adapted by Juczyński and Ogińska-Bulik as it had 60 questions in total to describe best on how you cope your stressful events. The question itself are detailed enough to you imagining your behaviour under stressors and it will get calculated to classify your style with table shows your score on each of styles. There are no right or wrong methods and different events might bring you different coping mechanism—but it would absolutely help you to consider methods available or would
like to explore styles you have not done before. I personally go the most with planning on problem-focused coping where I tend to think about what steps to take and how to handle the matters, but I do want to explore another styles that might be better to handle matters such as positive reinterpretation and growth in emotion-focused style.

Again, coping mechanism is the way we handle and control our things under stressful events. Our way might be different, but we knew it best when it comes to ourselves. We could always seek help to an expert and work it up ourselves to survive. This whole pandemic is a huge thing, but to cope and survive in our way is another level of huge we are capable of doing. Indeed, for the way we cope, we survive. Let these words sink in your head as we are altogether in this World Mental Health Day, ain’t we?

-by Joan Pemila
Public Health Leader (PHL)