As we face all manner of new pressures and uncertainties each day with Covid 19, it is natural that dealing with crises and roadblocks has amped up levels of anxiety and depression.

To get some insight into how we can manage all this, we turned to Prof. Dr. Abdel Nasser Omar, Professor of Psychiatry and Neuropsychiatry and CEO of Al Mashfa hospital.

Dr. Abdel Nasser, have you noticed a substantial increase in anxiety-based cases in the past few months?

Yes, definitely with the Covid-19 issue the rate of anxiety has increased in both my patients and the general population. Buts let’s differentiate between anxiety and depression symptoms and anxiety and depression disorders.

Anxiety increases with people who are already predisposed to it. The main problem with Covid-19 is uncertainty. We are faced with tremendous stress. A lot of people first went into denial, saying it is some sort of conspiracy, that it doesn’t exist, but this has quickly been followed by anger and resentment at having to endure lockdown and social restrictions.

This has been followed by depression, and now a phase of acceptance, with the widespread wearing of masks and social distancing. The realization has hit people that it is an equalizer, that it makes no difference how wealthy or influential you are, you can still contract Covid-19 like anyone else, so they are looking at a different meaning in their lives.

We must differentiate between anxiety symptoms and anxiety disorders, and depressive symptoms and depressive disorders. We are actually seeing an increase in the symptoms of anxiety and depression, not in the actual disorders. It is mainly the people who are predisposed to anxiety or OCD who will manifest the chronic stress symptoms.

Which issues are uppermost in people’s minds?

Apart from the actual virus, people are undergoing financial hardship, grief and a lack of social activity. Social interaction has always been a great lubricant for dealing with stress, where people can find relief from a bad marriage or difficult children by enjoying relaxing with friends.

Now everyone in the family is locked down together, with no way to escape. So beyond the fear of the virus and fear of death, there is also the burden of social hardship, monetary pressures and marital discord.

How dangerous are anxiety and stress in terms of general health and the immune system?

Both anxiety and stress are very serious conditions. In order to have proper immunity in life you have to have the right mood. Our advice to people suffering from cancer, diabetes and other conditions is to maintain good spirits in order not to be impacted too much by the disease.

The presence of anxiety and depression really affects the immunity of the body and its ability to heal. This can mean psychiatric disorders and other illnesses. Our psyche is well prepared to handle acute stress, but the problem lies in chronic stress, which is very debilitating to our physical and mental health, especially when we don’t know when it will end.

When your immune system is weakened by chronic stress you are inviting many sorts of physical disorders.  You can have a lot of disturbances in your blood glucose, your blood pressure, and develop complications in a variety of chronic conditions.

How does stress usually manifest?

When you are suffering from chronic stress you may see symptoms like heart palpitations, hand tremors, increased sweating, bowel problems like irritable bowel syndrome, breathing difficulty, and a disturbed sleep pattern.

Other than these physical symptoms there may be edginess, irritability, a negative outlook and gloominess, a loss of focus and concentration and apathy in meeting challenges.

While social interaction has always been considered a source of happiness, now it is linked with fear and anxiety, with people worrying about how to avoid contracting the virus, how to protect themselves and loved ones.

People must make a conscious effort not to fall into this type of stress. With this interruption to normal face-to-face interaction, there can also be a level of paranoia. Critical situations can arise when people are dependent on WhatsApp and telephone calls, so misunderstandings can arise more easily.

How important is it to seek professional help when anxiety disrupts normal life?

You need to see a psychiatrist or psychologist when the symptoms you are suffering from affect your functionality. That means your social functionality, your mental functionality and your occupational functionality.

Everyone can go through moods, but if you are starting to lose your grip with your work and social functions, you need to see a psychiatrist.

What are the dangers of self-medicating?

This is a serious problem, as Egyptians are known for self-medication. Medications available are safe when prescribed by a doctor, but there has to be a diagnosis first. A person cannot self-diagnose, it requires professional help.

You shouldn’t take medication for psychiatric symptomatology; it is prescribed when needed for psychiatric disorders. By using medication without being under a doctor’s supervision you are risking turning yourself into a person dependent on medication, with a psychiatric disorder.coronavirus

Care must also be taken in the use of any substances like alcohol to cope with anxiety and help in falling asleep. In reality, alcohol can make things worse by increasing depression and anxiety. The same goes for marijuana and hash.

They can create severe depression and cause amotivational syndrome, which creates lethargy, and a lack of motivation and direction. Heavy use of these substances can result in alcohol or cannabis psychosis which manifest as becoming very paranoid and suspicious of people around you, with associated delusions.

Sleeping pills are another problem. You start with just one, as needed, and then it can become a habit.coronavirus

What positive steps can you take to keep anxiety to a healthy level?

It is important to accept the stress and the situation and find tools to deal with it in a normal way. Try to live as usual, and go out, but with the social distancing guidelines like handwashing, wearing of masks and staying the required number of meters away from others. Recent studies have shown that around 60% of people who caught the virus were already staying at home.coronavirus

There are many positive aspects to social distancing, so make the most of your new leisure time. Make a wish list, catch up on books you never had time to read and movies you wanted to watch, and consider it some sort of partial early retirement.

By all means, do some exercise at home or go out for a leisurely walk, wearing your mask and keeping a safe distance. Relax, and don’t push yourself to work and be overly productive unless you absolutely must.

It is not a competition! The chance to spend time at home can be a gift, even if you have financial pressures through the Covid-19 situation. You can avoid the expense of going out, traveling and shopping, which means of course be careful about online shopping temptations.

Bio:

Prof. Dr. Abdel Nasser Omar is CEO and Managing Director of Al Mashfa and Professor of Psychiatry, Neuropsychiatry Dep. Faculty of Medicine, Ain Shams University.

Contact info:

Tel: 0120 000 0603/0100 642 2220 | 0100 008 3561 / +20 5544 00922
Facebook: almashfa.eg
Instagram: al_mashfa
Website: https://almashfa.com.eg/

By Wedad Z. Mostafa, Dermatology Professor, Cairo University and Consultant Oasis Clinics

Although staying home and practicing social distancing are recommended to minimize exposure to COVID-19, the truth of the matter is that many of us need to work, shop, exercise, and interact with others. In all of these cases, wearing a face mask has become essential, mandatory even; evidence suggests that it reduces the chance of the virus spreading, whether or not the person wearing it is in fact infected.

Masks vary in terms of material; they are either surgical masks, N-95 masks, made from a fine mesh of synthetic polymer fibers, or reusable, fabric masks. While surgical masks are mostly made from a soft synthetic or non-woven fabric — some are made from foam material — N-95 masks are firmer. Both have an enforcement metal piece or sticky bands to ensure occlusion for safety. However, these protective components exaggerate the humidity produced by breathing and talking.

Some of us may develop allergic contact dermatitis to one kind of mask or the other, due to the materials used. However, most people will develop irritant dermatitis or, put simply, irritation. Irritation can be caused by friction when coupled with humidity. This results in itching, which could develop into scratches or wounds.

Well-fitted masks made of cotton are less likely to produce dermatitis, unless the person wearing them is allergic to a special color or dye. Multilayered cotton masks made from fabric used in making T-shirts are by far less likely to produce irritation or rashes than masks made from polyester, nylon or rayon.

In the heat of summer, irritation coupled with scratching and sweating can produce rashes. Those who suffer prior acne or rosacea are most at risk of developing a rash and hence should contact their dermatologist for solutions. De novo pimples i.e. new break-outs, can occur underneath the area covered by the mask, which is particularly rich in oil glands and associated moisture, a consequence of sweating, breathing and talking.

To avoid or minimize irritation from face masks, here are a few tips that may be helpful:

• Avoid wearing makeup. Wear a well-fitted mask, neither loose nor tight, to achieve protection while preventing skin agitation.
• Wash your face with a mild facial cleanser or soap before wearing a mask and immediately after removing it. A facial moisturizer can protect against skin damage from increased friction.
• In areas where there is continuous rubbing — over the bridge of nose, chin or behind ears — it is recommended to apply a zinc oxide cream before putting on the mask to cushion the area and guard against chafing.
• In case of mild irritation, a hydrocortisone cream may be applied onto the irritated area for a day or two.
• In case of skin abrasions, which may occur after prolonged hours of wearing a mask, creams containing Aloe Vera and pantothenic acid should provide a quick relief. It’s then that you need to schedule an appointment with your dermatologist.

At all times, make sure you are breathing in and out freely without feeling distress or dizziness, and avoid exercising heavily while wearing a mask.

Stay safe and sanitized.

Essential Nutriments

There’s a lot of uncertainty around these days when it comes to Covid-19. Whether you tested positive and rode out the storm, suspect you may have passed through it earlier in the year and passed it off as a rather strange flu bug, or have detected some mild symptoms and decided to self-isolate or go for testing, there is one thing you can be sure of. coronavirus

Your best defense is to make sure you stay as healthy as possible. Leading nutritionist Noura Hassaballa shares what you should know about the vital role each vitamin and mineral has to play in boosting our immunity levels and what foods provide them.

Vitamin A coronavirus

Vitamin A helps in the production of white blood cells in the bone marrow. It plays an important role in boosting immunity and fighting infection from viruses and bacteria.

Foods: Green leafy vegetables, sweet potatoes, red peppers, mango, apricots, papaya, cheese, eggs, liver, milk, yoghurt and oily fish like sardines, mackerel and salmon.

Vitamin C coronavirus

Vitamin C is important for growth and repair of tissues. Though it may not keep you from catching a cold, there is some evidence that high doses of vitamin C may decrease the length of cold symptoms by as much as one to one-and-a-half days for some people. However, other studies did not result in the same findings, and the risk of side effects is greater with high doses of vitamin C supplements. As an antioxidant it fights free radicals.

Foods: Strawberries, broccoli, guava, oranges, potatoes, tomatoes, kiwi, spinach and bell peppers.

Ironcoronavirus

Iron is crucial for the normal development of the immune system and necessary for immune cells proliferation and maturation, particularly lymphocytes which are associated with the generation of a specific response to infection.

Foods: Liver, red meat, beans, nuts, dried apricots, brown rice, dark green leafy vegetables (such as spring greens, kale and spinach).

Zinc

Zinc keeps the immune system strong, helps heal wounds, and supports normal growth.

Foods: Whole grains, milk products, red meat, oysters, baked beans, nuts, poultry and chickpeas.

Selenium

Selenium lowers oxidative stress, which reduces inflammation and enhances the immune response.

Foods: Brazil nuts, fish, meat and eggs.

Vitamin D

Vitamin D helps the immune system stay balanced. Our body produces most of the vitamin D we need when exposed to the sun. Although it’s found in very small amounts in foods such as oily fish, liver, egg yolks, red meat, fortified food, mushrooms and red meat, it’s better to take a vitamin D supplement. We should get at least 600 IU of vitamin D daily.

You should take supplements if you’re deficient in any of these, otherwise you should be able to get all of the necessary nutrients from a balanced diet.

To avoid contagion, it’s all about how strong your immune system is. If you have been practicing a healthy lifestyle for a while you should be fine. But that doesn’t mean going wild on supplements to avoid contagion. Overdoing supplements can be toxic and cause hypervitaminosis.

You may ask how long an immunity boosting diet or regimen should be continued for. The simple answer is that it should be an ongoing thing because it’s basically a lifestyle, not a one off.

Take into consideration some important lifestyle modifications:

• Quit smoking.
• Stop eating processed sugars and junk food or processed food.
• Use monounsaturated fatty ac ids (MUFA) in your diet, as found in avocado, nuts and olive oil.
• Sleep well.
• Reduce stress.
• Lose a few kilos and maintain a healthy weight if you’re over weight.

Bio: Noura Hassaballa, BSc, CHP, CHC, is a certified health coach and nutritionist, TV personality and founder of Diet Rite Nutrition Center.

Contact info:

Tel: 0100 503 0021
Facebook: dietritenutritioncenter
Instagram: nourahassaballa