Assessment on Mental Health Status during Post Covid-19 Pandemic

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Introduction
The COVID-19 pandemic was proclaimed on March 11, 2020, by the World Health Organization. This spurred the adoption of harsh public health measures that had an impact on larger populations of adults and adolescents [1][2][3]. The symptoms of COVID-19 infection include tiredness, a sore throat, difficulty breathing, chest pain, nausea, diarrhea, and nasal congestion [4][5][6][7]. The first important thing to understand is that our mental health is a complex and multidimensional aspect of our general wellbeing. Mental health includes aspects of our psychological, social, and emotional well-being. Numerous elements, including our genetics, environment, and life events, might have an impact on our mental health. People's bad lifestyles, such as sleeping in late, eating poorly, and not exercising, were on lockdown during the COVID-19 crisis. All of these behaviours have had an adverse effect on lifestyle and led to mental disease, insomnia, rage, and other problems with both physical and mental health. The COVID-19 epidemic has had a serious influence on people's mental health worldwide, especially adolescents and middle-aged people. Screaming, stress levels have climbed, feelings of loneliness have grown, post-traumatic stress disorder (PTSD) has developed, and sleep and eating routines have changed as a result of the pandemic's disruption of daily life, loss of loved ones, financial strain, and social isolation. According to studies, people who have healed from COVID-19 may nevertheless struggle with their mental health and encounter some physical restrictions [8][9][10][11][12]. Post-traumatic stress disorder (PTSD), sadness, or anxiety symptoms have been seen in COVID-19 survivors, for example. In a follow-up investigation, it was found that patients with a mild form of COVID-19 were less likely than those with an acute form of the infection to have mental illness six months after recovery [13][14]. To make sure people are getting the help they require, it is crucial to evaluate their mental health. Our study will look at the occurrence of emotional mental health conditions like stress, melancholy, and anxiety as well as the general population's high-risk demographics. In light of these extraordinary and difficult circumstances, we are convinced that our study will assist governments and mental health professionals in organizing and providing mental health support to the high-risk population while also preserving the psychological welfare of Indians. Previous data claimed that more than 40% of Korean participants in a prior survey said the epidemic had caused clinically significant levels of sadness, anxiety, or stress [15][16][17][18][19]. There have been further reports of findings about the decline in mental health brought on by COVID-19.The COVID-19 epidemic in Italy has also been linked to an increase in the prevalence of mental health issues, such as depression, insomnia, and high levels of perceived stress. The psychological well-being of the general population was found to be declining, and those who had pre-existing mental disease reported their psychiatric symptoms getting worse. Adolescence is a crucial time for identity formation as well as a moment of transition to adulthood. Adolescents may also go through a number of lifestyle changes during this time, making them susceptible to the impact of their social circumstances. They may struggle with emotional regulation, and they are more likely to develop mental diseases like anxiety and depression [20][21][22]. When an adolescent's mental health declines, it can negatively impact all aspects of everyday life, including academic performance, and last far into adulthood. The pandemic has made it impossible for adolescents to consistently attend school, and restrictions that may significantly impact adolescents' daily life have persisted. Even in the best of circumstances, middle adulthood can be a difficult stage of life, yet the COVID-19 pandemic has increased anxiety and uncertainty to a completely new level. As the epidemic has spread, mental health has been an increasing worry for many individuals, especially for middle-aged persons who may be dealing with a variety of difficulties like job loss, financial stress, and family obligations. All of these essential selfisolation techniques could have a detrimental effect on people's lives, including their mental health and lifestyle-related behaviours [23][24][25][26].The majority of public surveys show higher symptoms of sadness, worry, and stress linked to COVID-19 as a result of psychosocial pressures including life disruption, fear of illness, or concern of negative economic effects. The contradictory results of these polls are probably due to the different techniques, research locations, and timings in relation to the pandemic's development.
There have been instances of phobia anxiety, panic buying, binge-watching television (which has been connected to self-control impairment, mood disturbances, sleep disturbances, and exhaustion), and social media exposure has been connected to increased anxiety as well as depression and anxiety when combined [27][28][29][30]. In this paper we'll look at the different ways that middle-aged persons' mental health and adolescent mental health status can be evaluated in the time after the COVID-19 epidemic. The process of determining a person's mental health state entails gathering data regarding that person's wellbeing. Online surveys (questionnaire approach) can be used to collect this data. The evaluation procedure seeks to spot the existence of mental health illnesses, gauge the severity of symptoms, and assess how mental health affects a person's life. Taking into account the particular difficulties presented by the pandemic is one of the most important parts of assessing mental health in the aftermath of COVID-19 pandemics. Suffering a loved one's passing, being admitted to the hospital, or being quarantined are just a few examples of the horrific occurrences that people may have gone through as a result of COVID-19. These events have the potential to cause PTSD (post traumatic disorder) and other mental health disorders that need for specialized evaluations and treatment. Globally, the COVID-19 outbreak has a significant impact on people's mental health. It is essential to evaluate the level of mental health in order to provide the appropriate interventions and support during post-COVID-19 pandemics. In order to evaluate the state of a person's mental health, mental health practitioners might employ a variety of techniques, such as clinical interviews, behavioral observations, and self-report assessments. When evaluating the state of one's mental health, it's crucial to take into account the particular difficulties brought on by the pandemic, such as traumatic experiences, financial hardship, and social isolation. A comprehensive approach is necessary to adequately assess the state of mental health during post-COVID-19 pandemics. However, the purpose of this article is to evaluate adolescents and middle-aged adults' mental health following the COVID-19 pandemic. • Mental health status-Mental health Status of the respondents was assessed by using questionnaire relating to Anxiety, Stress, Depression, Insomnia all related to Post traumatic disorders (PTSD), and mental health status after Covid-19 pandemic using self-assessment method (Fig 1). The questionnaires included 10 items which consists different options such as (Almost, sometimes, little and never etc.). • Other Measures: In this study, the affective components of the participant's mental health, such as anxiety, depression, and stress are assessed. To assess depression, anxiety, and stress, Lovibond and Lovibond created the Depression Anxiety Stress Scale 21 (DASS21). The DASS21 is a suitable method that can not only quantify but also distinguish between the three negative emotional states in clinical and nonclinical samples [31]. The sub-scores for stress, anxiety, and tension were combined and categorized as "average," "mild," "moderate," "severe," and "highly severe." • Sociodemographic data-Information was gathered based on age, gender, education level, occupation, income, address, and way of life. • Before the analysis, a number of socio-demographic characteristics were categorized. Three coteries of ages (16-20 years, 21-30 years, and 31-40 years) were created based on the respondents' ages. Additionally, there are three classifications for life styles: Sedentary, Moderate, and Heavy. • Anthropometric data-The BMI was calculated from self-reported measurements of height and weight using the Quetelet equation (body mass (kg)/height (m2)), and it was then assessed in accordance with WHO guidelines (underweight is less than 18.5 kg/m2, normal weight is 18.5 to 24.9 kg/m2, and overweight is more than 25 kg/m2).

Figure 5: Anxiety Level during post Covid-19
Al most

Some times 27%
Little 33% None of the times 38%   Figure 6: Result found that 2% of participants were changed in sleep pattern and felt difficulties in sleeping in night. 27% of participants were changed some times, 33% of participants were changed little and rest of 38% of participants didn't change in their sleep and they didn't feel any difficulties in sleeping in night after covid-19 pandemic.

Discussion
People of all ages have experienced severe adverse impacts on their mental health as a result of the COVID-19 outbreak. But middle-aged people and teenagers may be particularly vulnerable to the pandemic's effects on mental health because of the unique challenges they face. The pandemic has caused disruptions in adolescents' social and academic lives as well as heightened worry and anxiety. Teenagers' rates of melancholy and anxiety have increased throughout the epidemic, according to research, and they may also be at risk for post-traumatic stress disorder (PTSD) as a result of the stressors associated with the pandemic. Middle Adults have also been disproportionately affected by the epidemic in terms of employment loss, financial instability, and increased caring duties. Increased rates of anxiety, sadness, and other mental health problems can be brought on by these stressors. PTSD, despair, and anxiety are just a few of the chronic mental health conditions that adults with COVID-19 may experience. Maintaining one's mental and physical health is a vital topic that worries people all around the world during the Covid-19 pandemic. The COVID-19 pandemic and associated restrictions (such as rigorous quarantine and social activity limits) are more likely to cause adverse psychological effects. Signs of extreme anxiety, despair, stress, and loneliness are just a few of them. Previous studies have shown that the COVID-19 pandemic has a deleterious impact on adolescent mental health. The COVID-19 pandemics' immediate and longterm consequences on middle-aged and adolescent health behaviours are still unknown. Therefore, this paper purpose to assessment of change in mental health status among adolescents and middle adulthood groups and after this survey, the result was found that the covid-19 pandemic affected the mental health status and lifestyle behaviours of individuals during post covid-19 pandemic. Less than 15% of participants experienced mental health problems such as Anxiety, Stress, lowliness, insomnia (difficulty in sleeping), PTSD (post-traumatic stress disorders) and reduce their happiness level. Most of the participants reported that they have experienced some times or little mental health problems and rest of' the subjects reported that they didn't experienced any type of mental health issues after covid-19 pandemic. This survey result found that 31 Figure 9:Mental Health Status depressive mood frequently. 26.7% of subjects reported experienced low mood and depressive mood sometimes, 36.7% of subjects felt little and 23.3% of subjects didn't experience low mood and depressive mood during post Covid-19 pandemic. Only 8.3% of participants experienced irritation, very nervous and stress frequently. 38.3% of participants experienced sometimes 15% of subjects have normal mental health and life style. According to survey, Subjects have experienced anxiety (panic attack, difficulty to control and trouble concentrating fear). And 60% of participants reported that they have experienced little or sometimes.8.3% of participants experienced with insomnia and 52% of participants experienced difficulties in sleeping in night. Due to Covid-19 pandemic there are different issues occurs such as loss of loved once, financial issues and social problems that caused PTSD (post-traumatic stress disorder) during post Covid19 pandemic. The survey found that only 2% of participants experienced PTSD (posttraumatic stress disorder) symptoms such as terrifying events, flashback nightmares, sever anxiety, lowliness etc. and 50% of participants reported that they have experienced sometimes or little and rest of participants didn't experienced any such type of issues after Covid-19 pandemic. Post Covid-19 pandemic also affected the work performance of individuals. Due to Covid-19, subjects felt physical tiredness and less energy during all the times. 53% of participants reported that they have reduced the ability to get work done. 4% of participants experienced always tired during all the times during post Covid-19 pandemic. 20% of participants reported most of the time, 23.3% of participants were often of the time, 29% of participants were once in a while, 3% of participants sometimes and 21.7% of participants didn't any changes occurs after covid-19 pandemic. Above the following data, 42% of subjects reported that their mental status were good after covid-19. 32% of subjects got average, 11.7% of subjects were excellent mental health status and 8.3% were poor mental health and 7% of subjects didn't any idea about their mental health status.

Conclusion
It's critical to remember that not everyone who is affected by the epidemic will have mental health issues, and those who do may do so to varied degrees of severity. But it's crucial that people are aware of their mental health status and get assistance if they show signs of depression, anxiety, PTSD, or other mental health issues. In order to flourish and perform at one's best on a psychological, physical, and interpersonal level, one must achieve subjective wellbeing, which is a major life objective. However, because of their lifestyle decisions and negative experiences, this study focused on the mental health of teenagers and middle-aged adults.Evedence from this study indicated that less than 15% of participants change in their mental health status disease such as insomnia, stress, anxiety, PTSD (post traumatic disorder) and reduce happiness level. And rest of subjects didn't experienced any kind of changes and some subjects reported that they experienced such type of changes less likely during post Covid-19 pandemic.

Acknowledgement
I am very happy to express my gratitude to my supervisor Prof. Sunita Mishra, Dean School of Home Sciences, BBAU Lucknow for her suggestion to work on this dissertation and help me in this research paper.

Conflict of Interest
There is no conflict of interest among authors regarding the publishing of this paper.