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COVID AND MENTAL DISCOMFORT / “The idea is spreading that positive phases are an illusion”

Social isolation, fear of contagion, uncertainty, financial distress, fear or badly resolved pain are undermining the mental health of many people. “An uneasiness that has been stratified for years has come into the open without any filter anymore” writes someone on social media. “Isolation leads to isolation, I don’t look for anyone and I stay in mine. I also speak little with my family, as if I could no longer interact ”. According to Giampaolo Perna, pExtraordinary Professor of Psychiatry at Humanitas University (Milan) and head of the Center for Personalized Medicine for Anxiety and Panic Disorders at Humanitas San Pio X, “the current situation is due to the prolongation of an emergency that seems to have no end. The vaccine is currently the only real possibility of a hope, but even if this proves capable of resolving everything, we will have to deal with heavy effects on mental health for a long time ”.

Several scientific studies tell us that depression, anxiety, fear are on the rise as the pandemic continues. In your opinion is it justified? Is there a medical or endemic reason?

Unfortunately, it is true that we notice an increase in discomfort. After a first period where anxiety and fear were master, in the second phase of in recent months, fatigue, tiredness and demoralization have invaded the population. Now things are changing a bit.

How?

A sort of intolerance is felt, in the sense that we are more irritable, indeed intolerant, for a situation that is prolonging. It is also easier for you to mount a little anger with the risk of fueling conflicts.

Anger due to the lack of health and government responses able to satisfy us, to give concrete perspectives?

Anger due to the fact that after the first wave with the first restrictive measures we had a hopeful pause in the summer, then the pandemic returned and with it the restrictive measures, to have then experienced another moment of freedom in the pre-Christmas period followed by the current restrictions. The feeling that the pandemic does not pass and that the positive phases are illusions begins to mount. Basically we always feel “trapped” with the consequence of increasing negative emotions, passing from the phase of resignation and fatigue to the ignition of the current negative energy. Clear answers on the pandemic would be needed, but these are not easy to find.

Are situations of irritability, annoyance, isolation even in the family context created?

Outside the family and also in the family. Months go by and families are compressed in the house without external outbursts and this can exacerbate tensions and conflicts. Let’s remember that people are not all the same, everyone has different needs, behaviors, habits. Normally one adapts and finds a balance, and diversities find valid satisfaction with activities outside the family environment. When outside activities are impeded, sparks and conflicts are likely to ignite.

What happens then?

A kind of anger mixed with discouragement emerges, because the situation does not improve easily, because one feels forced. However, it is true that we now have the great hope of vaccines, which can act as a barrier to the pandemic, also representing a kind of human challenge to nature.

What do you mean by these words?

In fact, vaccines are being created by man and, if they are truly the winning element, they would become a test of strength of mankind capable of challenging such a devastating situation and winning it. Without, however, detracting from the need to understand how much this pandemic also arises from man’s lack of respect for nature and to act accordingly to prevent similar situations in the future. In any case, the vaccine, an expression of science and human ingenuity, is a very important challenge. This is the positive drive that could also psychologically help to overcome discouragement and anger.

The negative one?

Don’t see the end. We would return to having that sense of being in a cage that we thought we had won a couple of times, in summer and at Christmas. If we were to lose the vaccine challenge then it would be really hard to regain confidence. Let us not forget that alongside the direct health effects of the pandemic, the current and near future economic difficulties will further increase the stress level of the population with the strengthening of a whole series of uncertainties and fears. However, I am optimistic and I trust a lot in vaccines which I hope will be the starting point to begin to crumble this pandemic and start the restart.

But was this discomfort we experience already present before the pandemic and remained hidden? Or is it born now?

There are various aspects of the discomfort. Among the current ones, one of the most important is social isolation, due to the drastic reduction of social and physical contacts. This is undoubtedly a negative factor because man is a social being who draws positive stimuli from social contact. Physical contact is essential for the correct psycho-physical development of the individual, especially in children and adolescents. The prolongation of this deprivation could therefore have negative effects in the possibility of shaping effective sociality in young people. Another aspect that acts both directly and on hidden vulnerabilities is the prolonged stress we are experiencing and which risks becoming distress.

That is?

It means a toxic psycho-physical state that in the long term brings out our weaknesses and vulnerabilities, such as the tendency to be anxious and depressed, which can manifest themselves in an intense and disabling way. While at the beginning, paradoxically, for people with some disorders the lockdown could be an advantage (if I am agoraphobic, it is okay because I do not have to go out; if I have strong social anxiety, it is okay because I avoid having social contacts) in the long term deprivation of liberty has a negative effect on everyone.

Therefore?

The basic elements of well-being begin to crumble and, for some, a whole series of mental disorders emerge. There is data to suggest that the mental effect of this pandemic will be intense even after its end and that we will be dealing with its effects for a long time. We are analyzing the data collected by my research team on mental health at Humanitas University precisely on the effect of the pandemic on mental well-being and a not-so-reassuring picture is emerging. The study will continue for the next two years and we hope they can give us a complete picture of the post-pandemic as well.

There will be psychic consequences, how should we equip ourselves for this?

Let us always remember that there is no health without mental health. The real challenge will be distinguishing anxious or moody pathological conditions from normal and consistent, albeit intense, emotional reactions to the pandemic. In the first case we will have to treat and in the second we will help to manage and overcome the discomfort without necessarily clinging to a pill. In a period of such intense, prolonged and unpredictable stress, the training of mental health workers who are able to face each person’s discomfort in a personalized way without limiting themselves to reducing discomfort to convenient diagnostic labels will be decisive. In this gigantic challenge to man, it is the duty of every mental health worker to understand the needs of each individual person and to intervene accordingly in a tailored manner.

(Paul Vines)

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