Stress, anxiety and depresion among adolescents due to the ethnic clash in Manipur

Vidula Abhyankar *

INTRODUCTION

Everyone experiences stress to some degree. The way we respond to stress, however, makes a big difference to our overall well-being. Stress can be defined as a natural human response that prompts us to address challenges and threats in our lives. Typically, the bad stress, also known as Distress has the potential to do more damage to a person’s mental and physical well-being.

According to a qualitative study on perceptions of stress, stressors and coping mechanisms among urban adolescents in India conducted by Dr GV Krishnaveni and others in 2021 for National Institute of Health India, adolescents in India are exposed to a wide range of stressors in their daily lives.

Anxiety disorders are characterized by unrealistic or irrational fears that cause significant distress or impairments in functioning. (Butcher, Hooley, Mineka, 2019) According to Bernstein, in a study of 988 adolescents, female gender, somatic complaints, history of physical and sexual abuse, poor grades, use of street drugs, and family history related to depression were among factors that differentiated adolescents reporting high anxiety from those reporting low anxiety. (Bernstein, et al.,1989)

Depression is the common cold of mental disorders; most people will be affected by depression in their lives either directly or indirectly, through a friend or a family member. The incidence of depression rises sharply during adolescence-a period of great turmoil for many people. Approximately 15-20% adolescents experience major depressive disorder at some point. (Avenevoli et al. 2008, Lewinsohn & Essau 2002)

According to the World Health Organisation, Depressive disorder (also known as depression) is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods of time. Depression is different from regular mood changes and feelings about everyday life. It can affect all aspects of life, including relationships with family, friends and community. It can result from or lead to problems at school and at work. Depression can happen to anyone. People who have lived through abuse, severe losses or other stressful events are more likely to develop depression. Women are more likely to have depression than men.

Adolescence represents an important time for building identity, setting clearer goals, and planning for the future (Johnson et al., 2014). Rapid changes and growth in adolescence make them sensitive to heightened stress within the family, interpersonal relationships, socio-economic status, and education (Steinberg, 2014). Adolescents go through physical, biological, social, and intellectual transformation, and adjustments must be dealt with concurrently. Experiencing Stressful Life Events and being at risk of violence at this stage in their lives can disrupt this transition, affect adaptive capabilities, and make their adjustment burdensome, leading to adverse health outcomes (McMahon et al., 2020).

Experiences of traumatic stress are prominent in adolescence and can have deleterious effects on healthy development and psychosocial wellbeing (Ponnamperuma& Nicolson, 2018). In adolescence, social relations are vital and can thus have a protective role against the harmful effects of such events (Washington et al., 2017). Studies have shown that there may not be a direct association between experience of hardship, stress, and mental health, but the link is modified by different factors (Huang et al., 2021; LeMoult et al., 2019).

Demography of Manipur

Historically, the Meitei dynasty ruled the independent kingdom of Manipur. The region has been prone to ethnic violence for decades, ever since the king of Manipur, Bodh Chandra, signed an accord with the Government of India to become a part of the newly independent Nation of India in 1949. After Manipur formally joined India, it became a Union Territory in 1956 and finally a full State, with Governors, in 1972. The traditional conflict was between the Naga and Kuki tribes, but the recent violence has been between the Meiteis and Kukis.

The ‘cultural distance’ widened with almost all the tribes coming under the Christian fold by the 1930s (Ministry of Development of North East Region ARC- 7th Report, Chapter 12). Further the conflict widened between Meiteis and Kukis caused by the influx of immigrants from Myanmar following the assimilation of Manipur into India. The State’s population rapidly increased with the arrival of new residents from Myanmar, with the demographic shifts leading to structural changes in land holdings and jobs.

Ethnic clashes in the past: There is considerable tension among the tribes over land and boundaries and violence between Nagas and Kukis took a toll of more than 2000 lives during the 1990s. In the southern parts of the State Hmars, Paites and other tribes have been waging violent struggles partly for local hegemony and partly for their own enclave in the form of a Union Territory called ‘Zomiland.’

Recent Meitei-Kuki ethnic clash from 03 May 2023 till date as a stressor for Adolescents : All the tribes in hills have got Scheduled Tribe Status, while Meiteis are in General Category, hence the Meitei groups also have been demanding ST status for last 15 years. According to the affidavit submitted by Union Home Secretary in the Supreme Court, “large-scale violence broke out in the State of Manipur on 03.05.2023 after a Tribal Solidarity March undertaken by All Tribal Students Union Manipur (ATSUM) in opposition to the demand for inclusion of the Meitei community in the list of Scheduled Tribes.

Thereafter large-scale violence broke out in the State of Manipur, and due to the violence, many residents of Manipur lost their lives and several others got seriously injured, their houses and properties were burnt down due to arson and many of them were rendered homeless. Moreover, incidents of violence and heinous crimes against women have come to light.”

The intensity of violence rose ten folds in the months that followed as both communities started their own systems of armed village defence volunteers who started guarding each village boundaries. Since all schools and colleges were closed with immediate effect, adolescents were engaged in acting as village defence volunteers to keep vigil at respective village borders. Many adolescents had to flee with their families in search of safer places to stay.

Due to the mass exodus that followed many of these innocent people found themselves being thrown out of their houses, their valuables looted, their houses/shops burnt down and destroyed using heavy equipment such as Bulldozers, Cranes and Earth Movers overnight without any provocation. The displaced families were gradually moved to various Government schools/Sports stadiums which were converted into transit Relief Camps.

NEED FOR THE STUDY

Previous studies on mental health of adolescents in India concentrate on onset of stress, anxiety and depression due to academic stress (Jayanthi, et. al., 2015) or stress caused due to natural calamities such as earthquakes (R Mondal, S Sarkar, et. al.,2013), cyclones and so on. There is not much literature published on the effects of armed conflicts, ethnic clashes, or riots on adolescents in terms of onset of Stress, Anxiety and Depression.

Further, there is not much published literature on Anxiety, Depression and Stress among adolescents of Manipur as the ethnic clashes between the Meitei and Kuki communities are unprecedented and still ongoing in the State. There is a need to study the impact of traumatic experiences that these adolescents have undergone during the ongoing ethnic clashes and understand whether there is a prevalence of symptoms related to Anxiety, Depression and Stress in them.

Also, there is a need to understand other factors associated with the traumatic experiences such as gender and its influence, if any, on the mental status of the adolescents. It will be worthwhile to understand if there is any correlation between Stress, Anxiety and Depression experienced by the adolescents displaced or living in affected areas of Manipur.

OBJECTIVES

As the ethnic clashes continue still, one of the most affected groups are students studying in classes from IX-XII. Since most of the Government schools were converted into transit camps for the displaced people and/or the Central Armed Police Forces and thus, remained closed for more than 04 months, adolescents are struggling hard to resume their life normally. This study aimed to find and analyse the prevalence of Stress, Anxiety and Depression among the adolescents because of the ongoing Meitei-Kuki ethnic clashes in Manipur.

The objectives of the study are:

1. To analyse the difference in levels of Stress, Anxiety and Depression amongst the adolescents displaced/living in affected areas as compared to those living in non-affected areas.
2. To identify the association, if any, between Stress, Anxiety and Depression among these adolescents, and
3. To identify the difference in levels of Stress, Anxiety and Depression with reference to gender of these adolescents.

HYPOTHESIS

1. There will be significant difference between the level of Stress, Anxiety and Depression experienced by adolescents displaced/living in affected areas of ethnic clashes as compared to those living in non-affected areas of ethnic clashes.
2. There will be a relationship between the prevalence of Stress, Anxiety and Depression experienced by the adolescents displaced /living in affected areas of ethnic clashes and those living in non-affected areas of ethnic clashes
3. There will be difference in levels of Stress, Anxiety and Depression experienced by the adolescents displaced/ living in affected areas of ethnic clashes as compared to those living in non-affected areas of ethnic clashes with reference to gender.

VARIABLES UNDER STUDY

The impact of two experimental variable, that is, Impact of Ethnic Clashes and Gender on three dependent variables i.e., namely Stress, Anxiety and Depression among the adolescents sample population in Manipur was studied and analyzed.

MATERIALS AND METHOD

Participants : An objective, cross sectional study was conducted to analyse the prevalence of Anxiety, Depression and Stress among adolescents of Manipur State

a. who have been victims of ethnic clashes between Meitei and Kuki tribes from different districts of Manipur and as a result had to be housed at Relief Camps in the Imphal Valley
b. who are living in non-affected areas of the State, predominantly the Imphal Valley
c. who were studying in senior /secondary schools before their displacement in classes IX-XII in Manipur.
d. who are studying in different Senior/ Secondary schools in classes IX-XII in Manipur

Sample. A total number of 138 adolescents belonging to various tribes and communities from the state of Manipur participated in the study. These participants belong to the age group of 14 -16 years of age and are studying in classes IX-XII. Out of the total 138 participants, 70 number of participants are male and 68 number of participants are female.

Measures/Tools used. The scale used for the study was the Anxiety, Depression and Stress Scale (ADSS) developed by Pallavi Bhatnagar, Megha Singh and others published through National Psychological Corporation Agra, India.

General Description of ADSS: It is a self-administrable test that measures the Anxiety, Depression and stress experienced daily by the human beings of the age group 14 years -70 years. It can be administered on an individual as well as a group. The test consists of a total number of 48 items divided into three subscales. Higher scores indicate Greater Anxiety, Depression, and Stress and vice-versa. The reasons for choosing this scale to measure Anxiety, Depression and Stress among Adolescents are

a. its suitability for Indian population
b. unique ability to assess all three mental states (Anxiety, Depression & Stress) into a single scale
c. its high applicability due to being bilingual and being accessible to both literate and illiterate population
d. its suitability as both a diagnostic as well as rating scale
e. its generalizability (due to use on both clinical and non-clinical samples),
f. its equally high Reliability and Validity

Method.

The Nodal Officer for Relief Camps in Imphal Valley was approached and due permissions from the parents were sought to administer the ADSS questionnaire to their wards falling in the age group of 14-16 years of age. Similarly, permissions were sought from Principals of various schools and colleges. Once permissions were accorded, conduct of test according to the convenience of the inmates of relief camps and the school authorities was held.

RESULTS AND DISCUSSION

Data Collection Procedure & Data Analysis

Data Collection: Sample: The study was conducted on a total of 138 adolescents studying in classes IX-XII in different schools of Manipur. Out of total 138, 70 were Male and 68 were Female. A total of 18 samples were discarded due to incorrect and incomplete filling of responses. After filtering out the irrelevant samples, the final number of samples (total 120; 60- male, 60-female) were considered for the study from affected areas and non-affected areas

Statistical Analysis: The results of the test was then fed in MS Excel sheets and tabulated before treating it by descriptive statistics methods to obtain the significant differences and correlation between the three sub-scales among the adolescents from the affected and non-affected areas. The website DATA tab was referred to for obtaining the Mean, mode, median, variance, Standard Deviation, t-test results, 95% confidence interval of mean and Pearson’s Correlation coefficient of the data.

Table I (a), (b), (c): Significant difference in levels of Anxiety, Depression and Stress in adolescents displaced/living in Affected Areas of Ethnic Clashes as compared to those living in Non-Affected Areas of Ethnic Clashes

Discussion

This study was conducted to find out the effect of ongoing Meitei-Kuki ethnic clashes on mental health of adolescents in Manipur and to analyse if there is any other factor such as gender that influences their mental health.

With the help of the ADSS developed by Pallavi Bhatnagar and others, the levels of three sub scales of mental health namely Anxiety, Depression and Stress amongst a sample of 60 adolescents displaced or living in affected areas were analyzed in comparison with a sample of 60 adolescents living in non-affected areas of Manipur.

A look at results displayed in Table I (a), (b), (c) and Graph 1, shows a comparison between the Mean, Standard Deviation and levels of Anxiety, depression and Stress experienced by the adolescents displaced/living in affected areas and the adolescents living in non-affected areas. This, in turn, proves that First Hypothesis: there will be significant difference between the level of Stress, Anxiety and Depression experienced by adolescents displaced /living in affected areas of Ethnic Clashes as compared to those living in non-affected areas of Ethnic

CONCLUSION

The findings of this study have proven that the mental health of adolescents has been adversely affected by the ongoing ethnic clashes in Manipur. There is a significant prevalence of Anxiety, Depression & Stress amongst adolescents in Manipur due to the ongoing ethnic clashes in Manipur.

The levels of Anxiety, Depression and Stress are significantly higher in the adolescents displaced/living in affected areas as compared to the adolescents living in non-affected areas. Also, within the adolescents displaced or living in affected areas, the female adolescents have shown significantly higher levels of Anxiety, Depression and Stress as compared to the Male adolescents displaced/living in affected areas.

It is felt that timely counselling, guidance, and encouragement for participation in academic and co-curricular activities would go a long way to improve the mental health of the adolescents who have been either displaced or living in affected areas of Manipur.