Government-enforced moves to deal with coronavirus outbreak are forcing millions of Chinese people to deal with the emotional and psychological fallout.
BEIJING — Zhang Meng, a college student from Changchun, in China's eastern Jilin province, was concerned that her sudden weight loss was related to fear and anxiety over the coronavirus outbreak sweeping the country.
So she called a hotline offering mental health assistance.
"The doctor patiently answered my questions and gave me some useful suggestions," Zhang said.
After following his guidance, she said she is starting to feel better. "The doctor played a comforting role to ease my conscience," Zhang, who didn't want to disclose her age, added.
As China struggles to get the epidemic under control, government-enforced lockdowns, transportation bans and strict quarantines have brought parts of the country to a standstill, with no end in sight. The outbreak has already claimed more than 2,000 lives, mostly in China.
Aimed at preventing the virus from spreading, the moves have had the collateral result of leaving millions of Chinese people frustrated and frightened, putting pressure on the government to offer them assistance in dealing with the emotional and psychological fallout of feeling trapped in their own homes.
Chinese state media reported last week that mental health services have been deployed across the country, and Li Keqiang, China's premier, the No. 2 official after the president, demanded this week that further measures be taken to improve mental health offerings.
The crisis may be most acute in Wuhan, the center of the outbreak. The city has been on lockdown for four weeks, with its more than 11 million residents hunkered down inside their homes, afraid and reluctant to venture outside. Several neighboring cities have imposed the same conditions.
Zheng Nanru goes to college in Beijing, but has been stuck in her native Wuhan for nearly a month.
"Two weeks ago, we were still able to go on grocery runs," Zheng told NBC News. "Since last week, things have changed. If we do have to go out, when we come back to the compound, the security guards will spray us with disinfectant from head to toe before we enter.
"People aren't really coming out. I rarely see people walking outside in the compound. Wuhan is still very quiet."
Zheng said she was aware of the two 24-hour hotlines that were opened when Wuhan went into lockdown on Jan. 23, as well as other mental health assistance being offered. But she has yet to pick up the phone.
"I feel like resources like those should be available to people who are on the frontline, like the medical staff who are battling the virus every day," she said. "I think the hotlines should help those people more, so I'd rather not take that away from them."
China's state health commission has released specific guidelines for local authorities to help reduce psychological distress and prevent "extreme events" caused by anxiety.
Online platforms offering counseling have also been popular amid the outbreak, offering more immediate help and an alternative to face-to-face consultations, which can be tricky under lockdowns.
And people have been seeking support on social media, too. A coronavirus-related hashtag, which translates into English as #howtodealwithfeelingveryanxiousathome, has racked up 290 million views on Weibo, China's biggest social media platform, as of Thursday.
Huang Ziwei, 25, a psychology researcher from Beijing, has volunteered to offer online counselling during the epidemic.
Huang said that she's had to deal with many college students anxious about interrupted studies, many of whom felt "powerless" amid the outbreak.
"College students who are going to graduate this summer worry about whether it will delay graduation and affect their job search," Huang said.
She said most people are concerned about more immediate consequences of the outbreak and its effect on their work and day-to-day life.
"But the real difficulties can't be solved overnight and the epidemic situation is unpredictable, life-threatening and difficult to control, so many patients will fall into a state of stress," Huang added.
It's hard not to give in to fear and desperation amid an epidemic that has been declared a global public health emergency — especially in a country where mental health remains relatively taboo.
The government sometimes hasn't helped. Senior Chinese officials have been using military language to describe their efforts to get the epidemic under control, announcing "war time control measures" and legal repercussions for anyone who defies government orders.
And videos surfacing online appear to show people being forced into quarantine.
A survey conducted by the Chinese Psychology Society this month found that of 18,000 people tested for anxiety related to the coronavirus epidemic, 42.6 percent registered a positive response. More than 20 percent of those who joined post-traumatic stress disorder assessments had obvious symptoms, the survey showed.
Paul Yin, a psychologist who counselled the families of passengers on the missing Malaysian Airlines flight in 2014,has used an online education platform to offer classes on how to cope, and has worked with insurance companies that have access to millions of people to spread audio clips and articles on how to mentally deal with the outbreak.
"People are scared, their lives are being interrupted, so to have a voice that helps to reassure them and calm them and kind of guide them through this process can be very helpful," he said.
Yin said fear of the unknown, especially in the initial stages of the outbreak when little is known, leads to generalized anxiety.
"For many patients, families and medical workers, it all happened too fast and it also happened during the Chinese New Year, a time when people are expected to be happily getting together," he said. "Instead everybody is locked up in their homes."
He said lockdowns that have been dragging on for weeks are having a toll on people's mental state.
"For a lot of people, a day or two in isolation may be OK, but weeks without getting out of the house — the stress will certainly build up," Yin added. "Every day you are being reminded that life is not normal, constantly, you can't escape — you can't pretend that it's not there."
Eric Baculinao reported from Manila, Alex Shi and Vivienne Wu from Beijing, Yuliya Talmazan from London.