BALKAN BLOG: Bulgaria’s hidden mental health crisis

BALKAN BLOG: Bulgaria’s hidden mental health crisis
By Denitsa Koseva in Sofia February 17, 2021

While the Bulgarian authorities are busy reporting the number of new coronavirus (COVID-19) cases daily and taking some measures to support the economy, no institution has focused on the mental health of children and parents. Yet they have been badly affected by the restrictions, with data showing that anxiety, depression and sleeping problems have risen significantly over the past year. 

As Bulgaria recovers from the severe autumn wave of the pandemic that saw daily new cases top 4,000 in the country of 7mn people, the playgrounds in Sofia are as busy as ever. Nobody seems to care about social distancing any more and children play freely with each other. Primary schools and kindergartens already reopened at the beginning of January. 

Yet as the government prepares to ease restrictions further — despite fears of a third wave caused by new variants of the virus — the year of fear and isolation have taken a heavy toll on young Bulgarians and their parents. 

While some parents report that their children are handling the isolation rather well, particularly in families with three or more kids, most have observed elevated levels of anxiety and disturbing consequences on the mental and physical health of their kids. The situation worsened significantly in the autumn, while during the spring lockdown most families managed to handle the situation with more optimism.

“After staying home in the autumn, my children started having nightmares. Initially, they were afraid of telling them to us, but we helped them to normalise the telling of dreams. And they were dreaming about zombies who do not know they were zombies but are threatening everyone else,” Victor, father of two sons, tells bne IntelliNews by phone.

“My daughter did not to go out during the spring lockdown as it was forbidden. After getting the virus, now she does not want to go out with anyone else but her best friend. She prefers to stay at home and does not want to move a lot,” Iva, mother of two, says. She adds that her son, now in eighth grade, has gained weight and seems apathetic.

No support 

The only survey on the influence of the pandemic on families was carried out by Ida - Foundation for Child Palliative Care and the results show that they have been bearing a heavy burden in the past year, while lacking any institutional support.

The survey, carried out among 2,410 people, shows that two-thirds are seriously worried they might lose an elderly relative, while half are concerned about the mental health of their children and about 45% are worried about their own mental health.

The survey has attracted significant interest and in the first day of its release more than 1,000 people participated. A quarter of respondents have lost someone close due to the coronavirus, while the income of one quarter has decreased.

Venelin Stoychev, a sociologist on the Ida team, said that the data from the survey is alarming, because more than half of respondents believe that the healthcare, education and social systems will take more than five years to recover. In comparison, similar surveys carried out in other countries show that people worry the most about the current situation, but believe the recovery of these systems will not take long.

“The impression is that the current situation [in Bulgaria] is bad but what is coming next is even worse,” Stoychev said during the online presentation of the survey results live-streamed on Facebook.

Aneta Kalcheva, a psychotherapist specialised in working with children, commented that children, who are among the most vulnerable groups in society, are the most affected by the pandemic in Bulgaria. Students from the fifth grade upwards have been studying online since last autumn and most of them have spent just a few weeks in school.

Kalcheva also commented that the social burden of the current crisis will fall on a generation that will be far more susceptible to mental distress.

Danger to society 

Adding to the stress of the pandemic, children have been bombarded by messages from state officials and in the media that they are asymptomatic careers of the virus and pose a danger to their grandparents and other loved ones. They appear to have internalised this message, as many parents say their children dream about being a threat to other people or being endangered by invisible threat. 

There is speculation the government is deliberately trying to shift the blame for the situation onto the population to avoid responsibility itself. Many people say the measures taken were inadequate and have accused the government of not having plan to deal with the pandemic, including for schools and the economy.

Victor says his kids are even afraid of talking to their grandparents on the phone in order not to contaminate then with the coronavirus, as a consequence of the constant claims in the media and online that children are the most dangerous potential spreaders of the infection as they have no coronavirus symptoms but they pass it on to elderly people.

“It is very dangerous to put the guilt and responsibility on children for the health of all other members of the society. And this is guilt that can have very bad consequences on them and their psychical well-being in the coming years,” Kalcheva says.

According to the survey, 27% of children have sleeping problems, and 24% have eating problems due to the pandemic-related isolation.

“My daughter has gained weight and her level of anxiety is the highest ever. She cries for no reason, sometimes becomes rude without provocation and says that staying at home makes her feel angry,” Daniela, mother of a boy and a girl, says.

Other parents shared that their children have sleeping disorders. “[My daughter’s] circadian rhythms were disrupted, she got sleeping disorder and lost weight,” Boyana Petkova, a prominent doctor and mother of two daughters, told bne IntelliNews in an exchange of messages.

Petkova says her younger daughter, who is seven years old, also handles the situation badly.

“She is seemingly feeling well at home but the disruption of the usual rhythm of life is leading to increased anxiety and the appearance of irrational fears, for example from hurricanes and other disasters, she thinks a lot about death, has troubled sleeping, does not want to stay alone. She sees a child therapist to work on these issues. After the lengthy stay at home, she has difficulties adapting to life outside the home again, her desire to go out and play outside is decreasing,” Petkova says.

More than half of the children in the survey are more irritable than ever before and 40% of them have higher anxiety. Another 25% of children feel apathy, while 25% feel aggression. 14% of all children are afraid to go out.

Meanwhile, the survey showed children have trouble focusing and they have more screen time than ever. 30% of children have difficulties studying, while 30% have communication problems.

Teenagers are paying the highest toll as they need to socialise but have few opportunities. Some of them think more about suicide, while there are cases of kids sending scary messages to their peers, telling them they will die for sure. Others have become aggressive to their parents and peers due to the uncertainty and higher tension.

Torn between work and family 

The lockdown has posed numerous challenges to Bulgarian parents who have been struggling for months to cope with work, taking care of children and helping them with online classes. Moreover, the majority of teachers have struggled to adjust their methods of teaching to the situation and many lack the technical skills needed to shift to online teaching. 

According to the survey, the pandemic has negatively affected two thirds of parents. The younger their children are, the more stressed out their parents are. 33% of parents of children aged up to seven years have assessed their own mental health as either poor or bad. In comparison, 20% of parents of children aged 7-11 and 12-15 said that, while 22% parents of children aged 16-18 said their mental health is not OK.

“Half of the time I am in the position of single parent. I am divorced and two weeks a month I am alone with the two kids. Being a parent, teacher and worker eight hours a day is extremely difficult. There is no support at all. I can say that the education ministry has not done almost anything,” Kristina Domozetova, HR specialist and mother of two sons, says.

Many parents agree and say they are feeling exhausted, stressed out and guilty for not parenting or doing their jobs or well. Many of them say they work harder than before the pandemic, but this does not bring them more income.

“As a parent I am torn between my commitment to my children and to my patients. It is impossible to work at full capacity, my income has drastically decreased, while the costs of therapies and private lessons for my children have risen. I feel guilty all the time and I have the feeling I am not doing either of my roles well,” Petkova says.

Viktor says he must try all the time to find balance between his work and the needs of his children, as well as between their interests and those of his wife who has a serious illness and needs proper rest.

Parents feel unsupported by institutions. Moreover, when they say kids should return to schools as their mental health has worsened significantly, they do not get support from other people. 

“There is no compassion among people. It seems the worst has come up on the surface, not the best of us, including accusations that if someone’s children do not feel well during the pandemic their parents are not taking proper care of them,” Domozetova says.

State institutions have also failed to invest enough in enabling teachers to cope with the situation properly. Parents say their children have been punished and low grades when they missed lessons because of poor internet connections.

Teachers, on the other hand, says they feel alone and abandoned as nobody has explained them how to use the online platforms for their classes. Some of them posted hand-written lessons as pictures on chat groups, leaving it to parents to help their children learn.

But despite the ongoing pandemic and the toll it has taken, neither teachers nor parents seem willing to get anti-coronavirus vaccines. The share of parents is around one quarter and this is lower among women. Among teachers, around 20% would like to get the vaccine. The survey showed that the more educated parents are, the more willing they are to get the vaccine.

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