Dr. Manju Antil, Ph.D., is a counseling psychologist, psychotherapist, academician, and founder of Wellnessnetic Care. She currently serves as an Assistant Professor at Apeejay Stya University and has previously taught at K.R. Mangalam University. With over seven years of experience, she specializes in suicide ideation, projective assessments, personality psychology, and digital well-being. A former Research Fellow at NCERT, she has published 14+ research papers and 15 book chapters.

Impact of COVID 19 Pandemic on Mental Health| Dr Manju Antil


The coronavirus pandemic is causing widespread anxiety, worry, and fear among the general public, as well as specific groups such as older adults, teenagers, caregivers, and people with existing health conditions. In public mental health terms, the main psychological impact to date is elevated rates of stress or anxiety (S.M. Didar-UlIslama, 2020). Quarantine, self-isolation, social distancing, and financial crisis affect many people’s usual activities, routines, or livelihoods. Levels of loneliness, depression, harmful alcohol and drug use, self-harm, or suicidal behaviour are also expected to rise (Seyyed Mohammad, 2020). Children who are at home, away from school, classmates, and colleagues, may have more questions about the outbreak, and they look toward their parents or caregivers for answers.

Children and parents do not both respond to stress in the same way. Anxiety, depression, social isolation, and an unstable environment may all affect a child's mental health in the short or long term (OECD, 2020). Besides, due to the lockdown, and for preventing the spread of the virus, people cannot run their businesses properly. Many people have lost their job. The fall of the economy occurred in almost every country. As a result, people cannot meet their daily demands like before. Lifestyle has been changed. These factors are also increasing the stress and frustration of people, especially in middle-class and lower-class families (Bilal Javed, Abdullah Sarwer, Erik B. Soto, Zia‐ur‐Rehman Mashwani, 2020). Physical distance caused by the COVID-19 outbreak may have a severe detrimental influence on the mental health of elderly and disabled individuals. The mental health of the aged and disabled will be jeopardized by physical isolation among family members. Fear, tension, sadness, and even putting 7 them in a traumatic environment are all possible outcomes.

Elderly individuals rely on young people for their daily needs, and self-isolation may be damaging to a family structure. The elderly and disabled people living in nursing homes can face extreme mental health issues (Bilal Javed, Abdullah Sarwer, Erik B. Soto, Zia‐ur‐Rehman Mashwani, 2020). Doctors, nurses, and paramedics who are the front-line fighter or workers of the COVID-19 outbreak may be more vulnerable to mental health issues. Fear of contracting a disease, long working hours, lack of safety gear and equipment, patient load, lack of effective COVID-19

the drug, death of coworkers after COVID-19 exposure, social distancing, loneliness, and isolation from their family and friends, and the bad situation of their patients may play a negative impact on the mental health of health workers (Bilal Javed, Abdullah Sarwer, Erik B. Soto, Zia‐ur‐Rehman Mashwani, 2020).

Depression

Depression, unlike many conditions in the current psychiatric canon, has a lengthy and readily identifiable history. Indeed, it is perhaps the most easily recognizable psychological disorder throughout history; similar symptomatic descriptions occur over 2,500 years, representing what historian Stanley Jackson (1986, p. ix) calls a “remarkable consistency.” From the earliest medical texts in ancient Greece to the present Diagnostic and Statistical Manual of Mental Disorders (DSM), deep sadness and its variants—hopelessness, sorrow, dejection, despondency, emptiness, despair, and discouragement—have been mentioned as core features of depression. Related symptoms have included an aversion to food, sleeplessness, fatigue, irritability, restlessness, fear of death, repetitive focus on a few negative ideas, lack of pleasure or interest in usual activities, and social detachment.

There are multiple variations of depression that a person can suffer from, with the most general distinction being a depression in people who have or do not have a history of manic episodes. The depressive episode involves symptoms such as depressed mood, loss of interest and enjoyment, and increased fatigue. Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe. An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities, but will probably not cease to function completely. During a severe depressive episode, on the other hand, it is very unlikely that the sufferer will be able to continue with social, work, or domestic activities, except to a very limited extent. • Bipolar affective disorder typically consists of both manic and depressive episodes separated by periods of normal mood. Manic episodes involve elevated mood and increased energy, resulting in over-activity, the pressure of speech and decreased need for sleep.



While depression is the leading cause of disability for both males and females, the burden of depression is 50% higher for females than males (WHO, 2008). In fact, depression is the leading cause of disease burden for women in both high-income and low- and middle-income countries (WHO, 2008). Research in developing countries suggests that maternal depression may be a risk factor for poor growth in young children (Rahman et al, 2008). This risk factor could mean that maternal mental health in low-income countries may have a substantial influence on growth during childhood, with the effects of depression affecting not only this generation but also the next.

The earliest written accounts of what is now known as depression appeared in the second millennium B.C.E. in Mesopotamia. In these writings, depression was discussed as a spiritual rather than a physical condition. Like other mental illnesses, it was believed to be caused by demonic possession. As such, it was dealt with by priests rather than physicians. The idea of depression being caused by demons and evil spirits has existed in many cultures, including those of the ancient Greeks, Romans, Babylonians, Chinese, and Egyptians. Because of this belief, it was often treated with methods such as beatings, physical restraint, and starvation in an attempt to drive the demons out. Greek and Roman doctors used therapeutic methods such as gymnastics, massage, diet, music, baths, and a medication containing poppy extract and donkey's milk to treat their patients.

The Classical Tradition Writing in the fifth century B, C Hippocrates (460–377 B )C and the school of Hippocratic physicians that formed around him provided the first known description of melancholia (the Greek name for pathological states of depression), stated succinctly in Hippocrates’s Aphorisms: “Fear or sadness that last a long time mean melancholia” (Hippocrates, 1923– 1931, Vol. IV, p. 185). In addition to fear and sadness, the Hippocratic writings mentioned as symptoms of melancholia “aversion to food, despondency, sleeplessness, irritability, restlessness” (Hippocrates, 1923–1931, Vol. I, p. 263). This description is remarkably similar to the current definition found in the DSM-5 (American Psychiatric Association, 2013). Unlike DSM-5, however, the Hippocratic did not view depression as a free-standing condition but linked it with other conditions, especially anxiety (“fear”) and delusions. On the basis of the latter feature, melancholia was often characterized as “delirium without a fever.” A combination of anxious concerns and nameless fears, depressive symptoms such as blackness of mood and suicidal impulses, and paranoid tendencies such as sullen suspiciousness characterized melancholic conditions. Similarly, Galen (131–201 AD) indicated that although “each (melancholic) patient acts quite differently than the others, all of them exhibit fear or despondency” (Radden, 2000). He went on to note: “Therefore, it seems correct that Hippocrates classified all their symptoms into two groups: fear and despondency” (Jackson, 1986, p. 42). Although the Hippocratic agreed with contemporary accounts of the symptoms of melancholia, the Hippocratic definition of Aphorisms also specified the contextual constraint that the symptoms had to last an unusually long time to constitute melancholia. This indicates that it is not depressive symptoms alone but symptoms of unexpected duration that indicate a disorder. This insistence that the sadness or fear must be prolonged is a first attempt to capture the notion that disproportion to circumstances is an essential aspect of depressive disorder.



Hippocratic writings rarely focused on distinct external causes of melancholic disorders. Rather, their foundational principle was that health is a state of equilibrium within the body and that disease is due to a disturbance of this balance (Porter, 1997, pp. 55–62). The Greeks viewed mental diseases, like diseases in general, in terms of four basic senses of humour: blood, phlegm, yellow bile, and black bile. Each humour possessed two of four properties: hot, cold, moist, or dry. When the humour was in balance with each other, a healthy state resulted. Diseases, both mental and physical, stemmed from too much or too little of one of these humors, a notion that would recur when theories of neurochemical imbalance were developed at the end of the twentieth century. For the Greeks, melancholia was connected to an excess of black bile. Yet mental disturbances that resulted from an excess of black bile were not localized but disrupted a holistic relationship between individuals and their surroundings. A variety of factors, including diet, lifestyle, living conditions, and atmospheric elements, could lead to humoral imbalances. Given that the symptoms of normal sadness and depressive illness could be the same, ancient physicians understood that differential diagnosis required careful exploration that went beyond the symptoms to the context of the symptoms. For example, the Greek physician Aretaeus of Cappadocia (ca. 150–200 AD) explicitly separated melancholic patients who “are dull or stern, dejected or unreasonably torpid, without any manifest cause” from those who experience “mere anger and grief, and sad dejection of mind” (Jackson, 1986, pp. 39, 40). To illustrate the distinction, Aretaeus recounted his own version of the diagnostic triumph famous in ancient times of Erasistratus (304–250 BC), physician to King Seleucus of Syria, in which Erasistratus discovered through shrewd observation that the king’s son, Antiochus, was not suffering from melancholia as his symptoms suggested, but was instead suffering from unrequited (and unexpressible) love —for his father’s young wife! As Aretaeus tells it: A story is told, that a certain person, incurably affected, fell in love with a girl; and when the physician could bring him no relief, love cured him. But I think that he was originally in love and that he was dejected and spiritless from being unsuccessful with the girl, and appeared to the common people to be melancholic. He then did not know that it was love; but when he imparted the love to the girl, he ceased from his dejection, and dispelled his passion and sorrow; and with joy, he awoke from his lowness of spirits, and he became restored to understanding, love being his physician. (Jackson, 1986,)

The Anatomy of Melancholy

Subsequent to early Greek and Roman medicine almost no new developments in medical thinking about melancholy occurred until the end of the eighteenth century. Rober. Burton’s The anatomy of melancholy. published in 1621, illustrates the persistence of the classical tradition. It is the most renowned of all classical discussions of melancholy and perhaps of any volume ever written about depression. Burton described three major components of depression—mood, cognition, and physical symptoms—that are still viewed as the distinguishing features of the condition. However, he insisted that melancholic symptoms are not in themselves sufficient evidence of disorder. According to Burton, only symptoms that are without cause provide evidence of disorder. As he explained in this codicil to his definition: “without a cause is lastly inserted, to specify it from all other ordinary passions of Fear and Sorrow.” And, he noted, “signs in the mind” of melancholia included “Sorrow ... without any evident cause; grieving still, but why they cannot tell.” 

Burton emphasized that a propensity to melancholy was present in all men, and was a normal and ubiquitous aspect of the human condition: Melancholy ... is either in disposition or habit. In disposition, it is that transitory melancholy which goes and comes upon every small occasion of sorrow, need, sickness, trouble, fear, grief, passion, or perturbation of the mind, any manner of care, discontent, or thought, which causeth anguish, dullness, heaviness, and vexation of spirit....And from these melancholy dispositions, no man living is free, no Stoic, none so wise, none so happy, none so patient, so generous, so godly, so divine, that can vindicate himself; so well composed, but more or less, some time or other, he feels the smart of it. Melancholy, in this sense, is the character of mortality.

Burton’s work is clearly situated within the Hippocratic tradition. In effect, medical commentators throughout the eighteenth century relied primarily on Greek physicians, especially Galen, as authorities on depression and other mental illnesses (Simon, 1980). Likewise, the association of sadness and fear under the general melancholic umbrella persisted for centuries. The humoral theory of disease also endured in medical understandings and treatments of melancholy until the end of the seventeenth century and, sometimes, beyond then. Humoral thought was foundational not only in the culture of physicians but also in the medical lore of common people and lay healers. Diseases resulted from imbalances between the various senses of humour: treatments aimed to correct such imbalances and restore the body to appropriate equilibrium. Hippocratic preferences for altering lifestyles continued to prevail over more intensive medical interventions. Fresh air, exercise, good sleeping, eating, elimination habits, and control of passions remained prominent treatments for melancholy. Such treatments were typically intertwined with religious, magical, and folkloric methods (Shorter, 1992). In addition to this serious melancholia, a new category of “nervous disorders” began to emerge that viewed the nervous system as the source of health and illness, emphasizing the importance of nerves, fibres, and organs. Accordingly, the causes of nervous conditions were found in physiology, particularly brain lesions. Depressive symptoms were viewed as one component of a syndrome of “nervous disease,” “nervous illness,” “neurosis,” or, later, “neurasthenia” which referred to nonpsychotic conditions related to problems of the nervous system. The depressive component of such states was not seen as distinct from the variety of heterogeneous anxious and physiological symptoms that comprised this diagnosis. Nervous disorders encompassed anxiety, fatigue, somatic preoccupations, and obsessions (Shorter, 2013). Because these conditions were related to an organic system, they were not seen as mental problems. Nervous disorders fell under the domain of general physicians, neurologists, and spa doctors (Micale, 2008).

The two leading diagnosticians of the late nineteenth century took sharply different approaches to depression. German psychiatrist Emil Kraepelin (1856–1926), who spent his entire career practising in mental asylums, focused on the melancholic type of depression. He linked depression with mania under the general umbrella of manic depressive conditions, sharply distinguishing it from his second psychotic state of dementia praecox (schizophrenia). Manic depression and dementia praecox were homogeneous and distinct entities that presumably had entirely different causes, prognoses, and outcomes (Kraepelin, 1921). Early in his writings on classification and diagnosis, Kraepelin (1903) described melancholia as a separate disorder unrelated to manic-depressive psychosis. Subsequently, however, he was impressed by the fact that in some cases that initially looked like melancholia, eventually—often after long periods of time—there developed a manic episode. He was also persuaded by a study by Dreyfus (1907) that the nature of melancholia and of the depressive pole of manic-depressive illness is in fact qualitatively indistinguishable, and thus likely represent the same underlying aetiology. Kraepelin thus eventually combined all depressive and manic-depressive mood disorders into one category that, although encompassing a variety of clinical presentations, had as its hypothesized source the same underlying pathophysiology: “Manic depressive insanity as it is to be described in this section, includes, on the one hand, the whole domain of so-called periodic and circular insanity, on the other hand ... the greater part of the morbid states termed melancholia... In the course of the years, I have become more and more convinced that all the above-mentioned states only represent manifestations of a single morbid process” (Kraepelin, 1921/1976, pp. 1–2). However, with the subsequent development of treatments specific to bipolar versus unipolar illness, all the Unipolar forms were united under the DSM’s major depressive disorder.

In contrast to Kraepelin, who was generally concerned with the conditions of severe, hospitalized patients, the second towering figure of the time, Sigmund Freud (1856– 1939), had little concern with psychotic conditions. Instead, Freud was centrally involved with nervous conditions found in community practices. Yet Freud gave short shrift to depression, giving anxiety pride of place in his pantheon of neurotic symptoms. Freud’s sole major essay on depression, “Mourning and Melancholia,” focused on the distinction between the normality of grief and the disorder of melancholia: Although grief involves grave departures from the normal attitude to life, it never occurs to us to regard it as a morbid condition and hand the mourner over to medical treatment.

We rest assured that after a lapse of time, it will be overcome, and we look upon any interference with it as inadvisable or even harmful. Freud emphasized that symptoms associated with mourning are intense and are “grave departures from the normal,” in the sense that grief is greatly different from usual functioning. Nevertheless, grief is not a “morbid” condition; that is, it is not a medical disorder that represents the breakdown of a biologically normal response and in fact does not require medical treatment. Medical intervention, he suggested, could actually harm the grieving person by interfering with this natural process. By the early decades of the twentieth century, then, depression was sharply split into melancholic conditions marked by serious symptoms that were linked to psychoses and neurotic depression which was one of the psychoneuroses. Whereas melancholic depression was thought to be due to some as yet unknown brain dysfunction, nonmelancholic conditions were seen as products of various psychosocial adversities, especially the loss of a love object. The former usually required some form of inpatient treatment while the latter could be handled within outpatient settings.

The DSM-II also grouped psychotic depression with states of mania, much in Kraepelinian fashion. It defined the category of major affective disorders as follows: “This group of psychoses is characterized by a single disorder of mood, either extreme depression or elation...” (American Psychiatric Association, 1968, p. 35). It continued to submerge depressive neurosis within the broader category of anxiety conditions, stating that “Anxiety is the chief characteristic of the neuroses” (American Psychiatric Association, 1968,). In contrast to the prominence these manuals accorded psychotic forms of depression, they viewed psychoneurotic depression as one type of defence mechanism against anxiety. During the 1950s and much of the 1960s, nonpsychotic forms of depression were largely submerged into the broader conception of psychoneuroses.



Researchers argued over whether these depressions were continuous or discontinuous with psychotic forms, on the one hand, or with normality, on the other. They disputed how many forms neurotic conditions took and even whether they had any distinct forms at all. Diagnosticians who argued for discrete types could not agree on how many types existed. Some concluded that in addition to a melancholic, psychotic type, depression had only a single neurotic type (Kiloh & Garside, 1963). Others suggested that three or more distinct, neurotic states of depression existed (Hamilton & White, 1959; Paykel, 1971; Raskin & Crook, 1976). Various classifications of depression embraced from a single to as many as nine or more separate categories (Kendell, 1976). Still, others conceived of neurotic depression as more closely resembling a personality or temperament type than a disease condition (Eysenck, 1970). Nor was it known whether some milder forms of depression were early indicators of eventual psychotic forms. In addition, little consensus existed about the particular symptoms that were essential to definitions of nonpsychotic forms of depression and more disputes abounded over whether depression should be classified according to its symptoms, aetiology, or response to treatments.

Major Depression also became the major target of a new class of drugs, the selective serotonin reuptake inhibitors, which came on the market in the late 1980s. Because the DSM-III depression criteria could encompass such a wide variety of everyday psychosocial problems, it made the most marketing sense to call them “antidepressants.” In fact, these capacious drugs were, and are still, used to treat an enormous variety of conditions including not only depression but also anxiety, obsessions, alcohol abuse, eating disorders, and a host of undifferentiated symptoms. The label “antidepressant” reinforced the popularity of the depression diagnosis because if some condition was treated with an antidepressant it must be depression. In the urgent quest for reliability, the adoption of the current depression criteria for the most part inadvertently rejected the previous 2,500 years of clinical diagnostic tradition that explored the context and meaning of symptoms in deciding whether someone is suffering from intense normal sadness or a depressive disorder. The DSM-III criteria, which persist into the present, also blurred the traditional distinction between melancholic and neurotic depression, calling both forms “Major Depression.” The unwitting result of this effort, especially as psychiatry turned from the serious conditions of inpatients to the far more heterogeneous conditions of outpatients and community members, was to be a massive pathologization of normal sadness. Ironically, this can be argued to have made depressive diagnosis less, rather than more, scientifically valid. The sole remnant of the “disproportionate to cause” tradition was the bereavement exclusion that remained in DSM IV-TR. The removal of this criterion from the diagnostic criteria in DSM-5 indicates that far from making diagnostic progress, the recent history of the mood disorders shows significant regression in understanding the most basic of all distinctions the difference between normal sadness and depressive disorder.

A study reported by WHO, conducted for the NCMH (National Care Of Medical Health), states that at least 6.5 per cent of the Indian population suffers from some form of serious mental disorder, with no discernible rural-urban differences. Though there are effective measures and treatments, there is an extreme shortage of mental health workers like psychologists, psychiatrists, and doctors. As reported latest in 2014, it was as low as ''one in 100,000 people''. The average suicide rate in India is 10.9 for every lakh people and the majority of people who commit suicide are below 44 years of age. According to American Psychological Association (APA, 2018), “Depression is more than just sadness. People with depression may experience a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide”.



Depression is one of the common mental health issues prevailing among people of different age groups worldwide and it can adversely affect our feeling about ourselves, the way we think, act and our whole perspective on life. It also causes various emotional and physiological disturbances and can seriously impair the ability of an individual to perform different tasks. Any traumatic experience or physical or psychological loss may cause depression. It may be the loss of a job, death of a loved one, loss of possession or any serious injury. Depression leads to feelings of loneliness, sadness, and loss of interest in activities of the day today life. It is a serious illness caused by changes in brain chemistry. The problems caused by depression are made worse by the fact that most people suffering from the disease are never diagnosed. Other factors like genetic characteristics, changes in hormone levels, certain medical illnesses, stress, grief, or substance abuse may also contribute to the onset of depression.

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SATISFACTION WITH LIFE SCALE (DENIER, 2006)| Dr manju antil| wellnessnetic care


SATISFACTION WITH LIFE SCALE (DENIER, 2006):

A five-item scale intended to calculate worldwide cognitive conclusions of self’s life satisfaction. The individuals who participated in the research tend to show how much they consented or opposed each of the five items by using a seven-point scale that ranges from highly satisfied to extremely dissatisfied.

SCORE RANGE INTERPRETATION

30-35 Highly Satisfied

25-29 Satisfied

20-24 Neutral

15-19 Slightly Dissatisfy

10-14 Dissatisfied

5-9 Extremely Dissatisfied

30-35 Highly Satisfied

Individuals who score between 30 -35 are highly satisfied in their life. They live their life happily and feels that everything is going well in their life. They love to live in the present. This kind of person accepts every reality they see or they feel. Even they tried their best to find perfection in imperfect things or they keep trying to make them perfect. They acknowledge their limitations and flaws. Maximum peoples who score in this range are enjoyable and their major domains of life for example School, family, job, and friends all are going well.

25-29 Satisfied

Peoples scoring in the range of 25-29 like their lives and feel that all is well. Obviously, their lives are not perfect but still, they believe that things are going good. Moreover, just because the individual is satisfied, it doesn’t mean that he is contented. Actually, development and dispute might be part of the reason the individual is pleased. Peoples in this range accept challenges and let them down with optimistic beliefs. They are flexible; tolerant and do not lose hope very easily if sadness strikes in their life.

20-24 Neutral

A neutral person is that who did not take part in any heated discussion and does not support any party during the conflict. The people scoring in this range (20-24) are usually contented, but in some areas they require improvement. They often avoid fear-provoking situations, as they are not interested in becoming part of the conflict.

15-19 Slightly Dissatisfy

Individuals scoring in this range (15-19) have little, but significant problems in many domains of life, or doing well in all areas but one area creates a substantial problem for them. If an individual has momentarily moved into this level of life satisfaction from a superior level due to some unpleasant event, matters generally get better over occasion and contentment will normally come back. On the other side, if an individual is persistent to some extent displeased with many areas of life by expecting too much, temporary dissatisfaction is common and normal. A number of people got motivation from a minor level of dissatisfaction, however habitual dissatisfaction among a number of life domains is distractive and gritty as well.

10-14 Dissatisfied

Individuals scoring in this range (10-14) were significantly dissatisfied with their lives. A variety of areas in the life of these individuals is not going well or one or two areas are going very badly. Life dissatisfaction is a reply to current occurrences such as demise, marriage break up, and momentous problems at the job, the individual will probably come back over time to his former level of higher satisfaction. An individual with low life satisfaction in this range is sometimes not functioning well because they are distracted in almost each and every domain of life. While talking to a close friend, psychotherapist, or another professional can continually assist the person to get moving in the right direction to bring positive changes in their person. Individuals who significantly scored in this range did not have the ability to cope with the disturbance or distress, efficiently. Instead of dealing with the problem and attaining a conclusion, the disputes that life throws on these individuals pulverize them and leave them with emotional scars.

5 – 9 Extremely Dissatisfied

Persons scoring in this range (5-9) are awfully discontented with their current life. They prefer to stay in their comfort zone and surround themselves with things and people that make them feel comfortable. Monotony becomes the order of the day, and despite believing that staying in their comfort zone is best for them, this only serves to increase their feeling of insecurity in the world. These people are often in denial about their true circumstances in life. They use a series of defence mechanisms to prevent them from having to face various issues in their life. Unhappy people do not take responsibility for their own lives. Instead, they prefer to blame other people or general circumstances for their woes. They find it very difficult to accept that the situation they are in is due to their own choices that they have made in the past. This links in with the first point about denial using a negative filter is a cognitive distortion whereby everything in life is viewed in a negative way. They find it impossible to see the positives in life. Again, this may be a defence mechanism associated with a core belief that if they expect the worst, they will never be disappointed. The problem with this attitude is that if you expect the worst, it can become a self-fulfilling prophecy. The more negative you are, the more you notice all the bad things in the world. This can lead to resentment and bitterness.

Reliability of SWLS:

The data from six studies was presented by Pavot and Diener in 1993. The coefficient alpha of Satisfaction with life scales is between 0.79 to 0.89 which clearly shows that this scale has sky-scraping internal inconsistency. In the recent time, Adler and Fagley in 2005 and Steger, Fraizer, Oishi and Kaler in 2006 confirmed that the co-efficient alpha of satisfaction with life scale is 0.87 and .86

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SENSORY DISABILITIES: HEARING IMPAIRMENT| WHAT IS HEARING IMPAIRMENT| Tips and Strategies for Inclusion of Children with HI in Language Teaching and Learning|Dr Manju Antil


When a child has only hearing problems, the brain is not involved and intelligence is not impaired. It is possible that some children's cognitive development is slower than their peers in terms of hearing, but the difference is very insignificant. Early assessment and intervention are also important for a child's healthy speech and language development, and social, educational, and personality development.

While the learning needs of children with IH can vary in severity of problems and in the amount, quality, and duration of support services a child receives, this section highlights some common challenges. and the specifics that these children have to face.

AREAS

  • Development /Acquisition of Speech and Language vocabulary, syntax and figurative language( like similies, metaphors and idioms);
  • Understanding of abstract concepts;
  • Reading and spelling (because of difficulty in phonemic awareness and speech sound discrimination);
  • Communication Skills (speaking and listening understanding);
  • Mathematics;
  • Organising ideas; and,
  • Communicating ideas (although students may have a lot to say on the topic, they are restricted by their vocabulary).
Specific Needs related to Language

  • Comprehending new vocabulary
  • Discriminating between words
  • Understanding words with multiple meanings
  • Forming connections between ideas or concepts
  • Organizing thoughts or composing ideas (Composing ideas involves producing grammatically and semantically correct text at one time which may be difficult for these learners)
  • Understanding and using phrases
  • Grammar usage (past tense, prepositions, active and passive construction)
  • Sentence construction
Tips and Strategies for Inclusion of Children with HI in Language Teaching and Learning
  • Prepare a visual vocabulary sheet on the topic taught (displaying words with pictures.
  • Write new vocabulary words on the chalkboard. One can use a dictionary of words with pictures, if available.
  • Relate new vocabulary to the child’s daily life and repeat it in different contexts.
  • Make visual classroom displays with captions and explanations.
  • Write footnotes along with examples for comprehension.
  • Verbs used in sentences can be taught through dramatization.
  • Use multiple modes of communication (verbal and non-verbal cues) like gestures, signing, lip/speech reading, facial expression, graphics, cartoons (speech balloons), pictures, symbols, concrete objects and examples to assist in comprehension.
  • Break and summarise and rephrase the text in short and simple sentences.
  • Make children write on topics related to their everyday life in simple forms such as diary, dialogue, journal etc.
  • Give repeated exercises on sentence construction so that the child can learn to use words and phrases correctly. Use examples from pictures/news/current events/scrapbooks etc.
  • Provide or adapt reading materials and resource material at the appropriate reading levels of the child.
  • Brainstorm to bring out the diverse experience of learners.
  • Give numerous experiences for the target/keywords in a lesson.
  • Make use of colour coding (use different colours for vowels, and different for consonants) and concept maps.

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Cognitive, Intellectual Disabilities| What is Impairment and Disability| revisiting terms, terminology, and phrases | Dr Manju Rani

Cognitive, Intellectual Disabilities

A child's way of learning is affected by how different sensory organs, parts of our body and brain work together, or how they are affected. Specific disabilities, such as autism spectrum, intellectual disability, and learning disability are primarily related to brain function and/or how the brain processes incoming information. They are treated as cognitive and intellectual disabilities.

With the increased use and sometimes misuse of many of these terms, a little clarification and insight into cognitive and intellectual disability would be helpful to our work in inclusive classrooms. The following paragraphs provide a brief understanding of these conditions and disabilities. To make the information presented in the handbook easier to understand and help you enhance your learning, we also explain how the terms cognitive and intellectual disabilities are used in the handbook.

Among the conditions that arise as a result of brain function and have a direct impact on teaching and learning, Specific Learning Disorders/difficulties (SLD) and Autism have received particular attention during this time. recent times. Among these, we often hear the term SLD. We need to better understand what these terms mean, as it has direct implications for our work with students in the classroom. We must understand that screening and evaluation of a child must meet certain expected criteria in order for them to be identified as living with these conditions and to receive services and interventions. relevant and compulsory education.

Difficulties and disabilities such as SLD, autism (and learning delays) require detailed assessment, testing and diagnosis, and are available to the children and families who attend our schools for learning and education. may not or may not be accessible. Therefore, it is important to exercise caution before labelling or misdiagnosing a child with a disability. Mislabeling and identification can result in children's needs not being understood. In many of our situations, students are often discriminated against because of their inability to understand how children perceive and learn about the world. These misconceptions can prevent students in our schools from receiving educational interventions that help them begin learning in the classroom. Disorders that teachers often talk about today, such as SLD, and autism, are therefore increasingly difficult to understand in our context.

First, it requires proper research-based field-test evaluation by trained professionals. Second, and more importantly, these assessment procedures are relevant and need to be addressed in a wide variety of situations. And third, a better understanding of these disorders and how the brain works is evolving even in a context where research and understanding of these disorders are relatively advanced. and provide basic information about intellectual disabilities.

Multiple terms and phrases related to disability and special needs can lead to confusion and lack of understanding. This section reviews and explains some of the terms you are likely to come across while working on inclusive classroom design.

Impairment and Disability

Two terms related to special and inclusive education that are most commonly used, often interchangeably, are impairment and disability. While impairment refers to a lesser degree of complexity in the way our bodies work, disability refers to the inability or not being able to perform a task. Most of us have felt inability at some time or other in our lives: during illness, following a physical injury or, when in an unfamiliar environment. For example, during a bodily injury like a fracture or severe sprain, disability would involve not being able to use your limbs effectively to walk, run or write etc. Given that often these and related terms are used interchangeably, the following section offers explanations of pairs of terms often heard while referring to persons with disabilities.

Impairment: (Dosh, Vikaar)

Illness, injury, or complexity arising from any difficulty in how our body works or functions.

Disability: (Nishkta)

Disability is more than a problem or difficulty with how our body works – a child with impairment may experience disability when functioning in an environment that impacts the child’s triumphant performance at a task. Thus, impairment alone may not cause an inability to perform in a manner equal to others, but the systems within which one has to live, learn, work and operate can cause a child with impairment to be unable to perform successfully, (for example, a child with hearing impairment may be able to successfully function within own immediate contexts of family and neighbourhood, and not experience any ‘disability’ in going through routine, day-to-day interactions, but may experience an inability to perform with the same success as her classmates in a classroom setting involving expected expressions of learning.) Overcoming or successfully being able to navigate, participate, function and contribute in a school, classroom or any organized system thus needs suitable interventions for a person with impairment/s. The interventions need to be effective in reducing or eliminating challenges and barriers.

In this article, the term disabilities would include sensory disabilities, cognitive disabilities, intellectual disabilities and physical disabilities.

Assessment: (Aankalan)

This involves gathering information to understand the student teacher-performance and classroom functioning, and is thus an interactive process. Assessments are formative and diagnostic in nature, that is, they provide information about students’ areas of strength and help recognise the teaching-learning aspects requiring attention or improvement.

Evaluation: (Mulyankan) This involves making a value judgment on a performance which is then graded. The process is summative in nature.

Integration: (Ekikaran)

In the context of education of students with disabilities, integration means providing education to students with special needs in regular classrooms. In this process, the focus is on having the child adapt and adjust to the regular classroom.

Inclusion: (Samavesh)

Inclusive education refers to education for all students, where all students are equal participants in the learning process.

Adaptation: (Anukulan)

Adaptation refers to adjusting assessments, material, curriculum or classroom environment, to accommodate a student’s needs to enable him/her to participate in and achieve the teaching-learning goals.

Some examples include:

  • use of audio tapes, and electronic texts where available, having a peer or a classmate to assist with class activities, or simply reorganising the seating of a child who is unable to be attentive, is easily distracted or distracts others in the classroom
  • alternatives to written assignments to demonstrate knowledge and understanding (for example, through oral presentations, drawing or other artistic presentations)a
  • extended time to complete assignments or tests;
  • computer software that provides text-to-speech or speech-to-text conversion capabilities;
  • provide multiple experiences with materials to allow for different learning styles or needs, and also to help reinforce learning (for example, learning in multiple ways how plants grow, through textbooks, through hands-on experience by growing one in the class, preparing observation records of its growth and through group or whole class discussion about the on-going learning).

Modifications: (Sudhaar)

Modifications involve making changes to learning goals, teaching processes, assignments and/ or assessments to accommodate a student’s learning needs.

For example: changing an assignment to accommodate a student’s learning needs: allowing the use of letter cards to spell words as a modification to saying the spelling aloud, allowing the student with intellectual impairment to utilise concrete and/or more hands-on experiences, changing the conceptual difficulty level for some students.


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Having both depression and anxiety can feel a bit like| Clinical Psychology| Mental health| Dr Manju Antil| Wellnessnetic Care| Anxiety disorder| Depression Disorder


Hey everyone, wassup, Hope you all are doing amazing, in this article, we going to dig into the psychological issue in-depth. Although depression and anxiety have distinct clinical features, there is some overlap in symptoms. For example, irritability, poor concentration, and sleep disturbances are common in both depression and anxiety. It is not uncommon to experience occasional short bouts of depression or anxiety. Let's explore today having both depression and anxiety can feel a bit like...

Can you diagnose both anxiety and depression?
Anxiety can present as a symptom of clinical (severe) depression. Depression is also often caused by anxiety disorders such as B. Generalized Anxiety Disorder, Panic Disorder or Separation Anxiety Disorder. Many people are diagnosed with both anxiety disorders and clinical depression.

Are there similarities in the symptoms of anxiety and depression?
Depression affects a person's mood and energy levels, among other factors. Nervousness, concern, or fear are all symptoms of anxiety. The two circumstances can coexist even if they are distinct from one another. Depression may sometimes be accompanied by irritability and restlessness.

What behaviours are associated with anxiety and depression?
difficulties with concentration, decision-making, or memory. persistent melancholy or worthlessness. losing your regular enthusiasm for hobbies or activities. being frequently exhausted and irritable.

Why do anxiety and depression suddenly appear?
Excessive anxiety may be brought on by a major incident or a pile of lesser stressful life circumstances, such as a loss in the family, work stress, or persistent financial worries. 

Personality. Anxiety disorders are more likely to affect some personality types than others. 


1.  being simultaneously restless and too exhausted to do anything


2. worrying about the future and feeling hopeless at the same time



3. isolating yourself from others because socializing is too overwhelming but feeling deeply lonely because of it


4. oscillating between not caring at all and panic


5. having no energy to address the things you're anxious about

Is there a drug that treats both sadness and anxiety?
The medication that doctors most frequently prescribed to treat anxiety and depressive disorders is known as a selective serotonin reuptake inhibitor (SSRI).


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AIDS CONTROL SOCIETY VACANCIES 2023 |Psychology Jobs 2023| OFFICERS POST | SALARY- 55000 | Psychology vacancy| Dr manju Antil

Applications on prescribed proforma are invited for filling up of following vacant posts on a Contractual Basis under the National AIDS Control Programme in District Integrated Strategy for HIV/AIDS (DISHA) clusters of Punjab State AIDS Control Society (PSACS):

Name of the post

No. of Vacancies

Category to be filled as per Punjab Govt. Roaster

Vacant at

Salary(In Rs.)

Cluster Programmers Manager

(CPM)

04

SC (1), SC(Female-1)

Gen-2

Jalandhar, Patiala, 

Bathinda, Ferozepur

54,300/-

Clinical      Services                  Officer (CSO)

04

SC (1), SC(Female-1)

Gen-2 )

46,800/-

Data         Monitoring         and

Documentation                                 Officer (DMDO)

04

SC-1 (Female)

Gen (2), Gen (Female-1)

37,500/-

Before you apply, please ensure that you fulfil the eligibility in terms of the following terms & conditions, educational qualification & experience (see below) and age.

1)Interested candidates having the qualification mentioned against the posts may submit their application by 13-01-2023 in the office of Punjab State AIDS Control Society, Prayaas Building, 4th Floor, Sector-38-B, and Chandigarh in the prescribed format along with the attested copies of the relevant academic certificates/experience certificates/other relevant documents/testimonials and two recent passport size photographs.

2) Last date for receipt of applications is 13-01-2023 (till 05:00 pm). Applications received after the closing date will not be entertained.

3)The number of posts is subject to increase or decrease as per the decision of the Project Director, Punjab State AIDS Control Society.

4) The details of the maximum age limit for the above-said posts are as under:-

Name of the post

Maximum Age Limit

Cluster Programmers Manager (CPM)

50 years

Clinical Services Officer (CSO)

45 years

Data    Monitoring    and           Documentation 

Officer (DMDO)

45 years

 

5)The SC/BC Category certificate should be by the instructions of the Department of Welfare Punjab.

6)These posts are purely contractual and temporary for one year, extendable based on work performance and conduct.

7)Reservation policy of the Punjab Govt. will be followed in the recruitment of the above posts.

8)   Incomplete applications will be rejected.

9)   Kindly send the applications by Registered/Speed/Ordinary post or in person at the O/o PSACS. Applications sent through email will not be accepted.

10)Educational qualifications must be from a recognized University/Board. Candidates must pass the requisite educational qualification on or before the last date of filing the application.

11) There will be a written test (50% minimum passing marks) and an interview for the above-mentioned posts.

12)There will also be computer typing (English) (30w pm) and computer knowledge tests (50%) as qualifying criteria for the above-mentioned posts.

13)Short-listed eligible candidates will be called for document verification. Original certificates/testimonials will be checked at the time of document verification.

14)The candidate should have passed Punjabi up to Matric standard or its equivalent standard from any recognized institution/Board or should have passed the Punjabi Language Proficiency Test conducted by the Department of Languages, Government of Punjab

15) If Any candidate is found not to be fulfilling the eligibility/selection criteria at any point of time in the entire recruitment process by the screening or selection committee, his/her candidature will be cancelled/rejected for the said post.

16)  Candidates will not be paid any TA/DA for document verification.

Project Director, Punjab State AIDS Control Society reserves the right to cancel/amend/change/modify the entire recruitment process at any stage without issuing any notice.

Details of Qualification & Requisite Experience

Sr

No.

Name of post

Eligibility Criteria

1.

Cluster Programme Manager (CPM)

1.Essential Qualification:-bachelor  in Degree in Medical or Allied Health Sciences/Master's Degree in Public Health/Healthcare Management/HealthCare Administration/Social Science/Psychology/Applied Epidemiology/Demography/Statistics/Population Science or similar fields.

2.     Experience:

  • Three years experience for candidates with a Master’s Degree in Public Health/HealthCare Management, HealthCare Administration/Applied Epidemiology
  • Five years experience in Public Health for a Bachelor’s Degree in Medical and Allied                         Sciences/Master in                         Social Science/Psychology/Demography/Statistics/Population Sciences, including a minimum of two years of experience in the HIV/AIDS sector

3.Age limitation: -Maximum 50 years of age. The crucial date for determining the age limit will be the closing date of receipt of the application.

4.Desirable:-The suitable candidate should be familiar with the organization and functions of the state and local public health system/State AIDS Control Societies.

  • Excellent written and verbal communication skills in the local languages and English (Speaking, Reading and Writing).
  • Strong analytical, advocacy and negotiation skills.
  • Willingness to travel extensively.

5.  Other expertise includes:-

  • Program Management Skills
  • Good Knowledge of computers
  • Coordination and leading teams

 

 

2.

Clinical Services Officer (CSO)

1. Essential Qualification:-Bachelor Degree in Medical or Allied Sciences/Master’s Degree in Public Health/Healthcare Management/HealthCare Administration/Social Science/Psychology/Applied Epidemiology/Demography/Statistics/Population Sciences

 

2. Experience: One year’s experience for the candidates with a Master’s Degree in Public Health/Health care Management / Health Care Administration/Applied Epidemiology.

  • Three years experience in Public Health with a bachelor's Degree in Medical or Allied Sciences/Master's in Social Science/Psychology/Demography/Statistics/Population Sciences, with a minimum of One year of experience in the HIV/ AIDS sector.

3.  Age limitation:-Maximum 45 years of age. The crucial date for determining the age limit will be the closing date of receipt of the application.

4.  Desirable:-The suitable candidate will be familiar with the organization and functions of the state and local public health systems/State AIDS Control Societies.

Excellent written and verbal communication skills in the local languages and English (Speaking, Reading and Writing).

  • Strong analytical, advocacy and negotiation skills.
  • Willingness to travel extensively.

5.  Other expertise includes:-

  • Program Management Skills.
  • Good Knowledge of computers.
  • Capacity building and team management.

3.

Data Monitoring and Documentation Officer (DMDO)

1. Essential Qualification:-

bachelor's degree in Public Health/health care Management /HealthCare Administration/Social Science/Applied Epidemiology/Demography/Statistics/Bio-Statistics/Population Sciences/Mathematics/Economics.

2. Experience:-

  • One year experience for a candidate with a Master’s Degree in Public Health/Health care management/health care Administration /Applied Epidemiology.
  • Three years experience in Public Health for a Bachelor’s Degree in Medical and Allied Sciences/Master's in Social Science/Psychology/Demography/Statistics/Bio-Statistics/Population Sciences with a minimum of one year of experience in the HIV / AIDS sector.

3. Age limitation:-

Maximum 45 years of age. The crucial date for determining the age limit will be the closing date of receipt of the application.

 

4. Desirable:-

  • The suitable candidate will be familiar with the organization and functions of the State and local public health system/State AIDS Control Societies.
  • Excellent written and verbal communication skills in the local language and English (Speaking, Reading and Writing) and the ability to work well in an interdisciplinary team.
  • Strong analytical, advocacy and negotiation skills.Willingness to travel extensively

5. Other Expertise includes:

  • Program management skills.
  • Good Knowledge of computers.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Mental Health Reminders From Therapists To Make 2023 Better Than 2022| Psychologist advise| Dr Manju Antil| Wellnessnetic Care

1. "Don't shrink and act less than what you are so people can feel at ease. Instead, let them meet you at your level and if they can't, that's their problem."

2.  "Remember 2 rules:

The 2 Minute Rule: if something takes less than 2 minutes to do, do it now.

The 5 Minute Rule: if you can't fix it in under 5 minutes, Stop worrying about it."

3. "Chances are you've been beating yourself up whenever you make a mistake...and you Still make the same mistake over and over again. Try replacing that with self-forgiveness and see how that works."

5. "Perfect is the enemy of good. Insisting on perfection prevents you from doing as much good as you are capable of doing."

6. "Life is unfair enough to all of us already without us being unfair to ourselves.

Stop adding on pain that you know you don't need to add on.

7. "When you are anxious or worrying, consider 2 things:

1. Even if the scenario you fear happens, is it really the end of the world?
2. Have you underestimated your ability to cope?

Chances are, one of those will defuse your anxiety."

8. "Anything worth doing is worth doing badly. Whether it's basic things like walking instead of running or washing your face instead of showering, something is always better than nothing."

"Stop tying your self-worth to other people's inability to communicate."


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