A mother of a 5 year old girl is in a lot of distress due to the fear that she, her daughter or other family members might get corona. She is crying and crying, washing hands excessively, etc. How can I help her?

QuestionsCategory: Health worriesA mother of a 5 year old girl is in a lot of distress due to the fear that she, her daughter or other family members might get corona. She is crying and crying, washing hands excessively, etc. How can I help her?
sakhujatripti asked 2 years ago
2 Answers
You can begin by trying to understand the extent of the behaviour in terms of how often, since when she has been distressed. Ask whether cleaning, washing etc. were present even before the onset of Coronavirus. Assure her that this problem can be addressed if her fears are understood better and explain that the present situation may have led to exaggeration of threat and responsibility towards loved ones.   Ask  if she is worried she might be the source of the infection to her family(excessive responsibility), and explain that responsibilities of infecting others are shared by all in this current scenario.  Explain expected rules of hand washing, differentiating it  from excessive  hand washing. Self-monitoring of hand washing can be suggested and assuring that hand washing is for specified activities, need not be excessive in terms of time or frequency. Structure activities, to reduce preoccupation with infecting others can be suggested. It is important also to look for any signs of hopelessness, depressed mood(with risk for self-harm, suicide)  and  accordingly   do  the needful, including  referrals.  

The first step in helping her is gathering further information to ensure that she belongs to the ‘worried well’ category. ‘Worried well’ are people who have no pre-existing mental illness, and the current symptoms are an exaggerated response to the COVID-19 pandemic. In this group of clients, there is no past psychiatric history, sleep/appetite are normal, and there are no pervasive changes in mood. For such clients, the mental health professional (MHP) can focus on – a.) validation of concerns, b.) reassurance, c.) examining sources of information that are making the client anxious and d.) teaching simple relaxation exercises. Validation should include how uncertainty and rapidly changing scenarios affect healthy people. Specifically, a dialogue can be initiated about – what are the ‘realistic chances’ of contracting severe illness for the client/family members and what are ‘reasonable precautions’. Limiting information sources to a newspaper or government websites, maintenance of routine, deep breathing exercises and seeking help again are some prescriptive suggestions for these clients.
Additional Resources:
Section A.10, Allaying anxiety of the worried well, Mental Health in the times of COVID-19 Pandemic, NIMHANS, 2020, Available at:  <a href=”http://nimhans.ac.in/wp-content/uploads/2020/04/MentalHealthIssuesCOVID-19NIMHANS.pdfhttp://nimhans.ac.in/wp-content/uploads/2020/04/MentalHealthIssuesCOVID-19NIMHANS.pdf”>http://nimhans.ac.in/wp-content/uploads/2020/04/MentalHealthIssuesCOVID-19NIMHANS.pdf</a&gt;