Sanremo. Every day, for almost a year, we have been hearing about Covid-19: news related to the number of new cases, deaths related to the virus, swabs and vaccines follow one another relentlessly since the Coronavirus entered the lives of the Chinese first and then the rest of the world. Furthermore, the economic consequences due to lockdown and the measures taken from time to time by the central government to stem the spread of infections. But there is another aspect that must be taken into consideration due to its importance, an aspect that, however, is currently treated in a marginal if not completely forgotten way and is theimpact of the pandemic on people’s mental health.
To deepen this delicate issue was Dr. Giancarlo Ardissone, director of Integrated Department of Mental Health and Addictions dell’Asl1 Imperiese.
“We are living in an extremely dramatic moment – Ardissone began – At the beginning of last year no one could have thought that such a thing could happen. We live in a condition of extreme discomfort due to uncertainty, confusion. We understand that things that were safe up to a year ago suddenly lost a whole series of securities. We hear comments, especially on television, from specialists who represent an extremely critical reality both from a medical and economic point of view. Given that the foundation of our mental health is safety, in a dimension like the one we are experiencing, people, even those who have excellent resilience and therefore an excellent ability to withstand difficult situations, can be put in crisis. And even more so, people who in themselves have a fragility have a whole series of disorders such as anxiety, depression, sleep disturbances and struggle to be able to face even everyday reality “.
What weighs more than anything else is the lack of bonds, of sociability, of moments of encounter that are fundamental for man to express himself as an individual and within society. «The most effective indicator of mental health is the number of our relationships – explains the professor -. The more positive relationships I have with people, the more I am able to interact with people, and the more I am able to have a good condition of well-being: this contagion situation has put all of this to the test “. In short, if on the one hand the measures of social distancing are necessary to stem the infections, on the other hand they are harmful to the psychophysical balance of people. Especially of the most fragile subjects and of the young and very young. It is to them that, once the Covid emergency is over, more attention must be paid. “Our brain is an extremely plastic organ that has the possibility of taking on a whole range of information and being able to truly consolidate and create with a certain type of structure – declares Ardissone -. This is extremely important in childhood, adolescence, youth. Brain maturation ends around age 25. Therefore this situation dictated by Covid will certainly have an extremely problematic rebound in boys, children and adolescents, due to the impossibility of being able to meet, touch and share a whole series of emotions in an affective way. This memory will not go away any time soon and it will be something that needs to be addressed. For some it will even be a traumatic condition that will also have to be treated to restore a normal ability to socialize. This, I believe, is the field that, in a few months, when the situation is normalized, we should deal with “.
If at the moment, the greatest attention is paid to the “physical” effects of Covid-19 and to the economic ones, the time will come, therefore, in which «We will have to face the recovery that will show us a world that will certainly be very different from what it was at the beginning of 2020 – explains the head physician – And many people, in my opinion, will have to be helped, even by specialists, in order to resume their lives, making sure that they have the opportunity to socialize in the most appropriate way “.
In addition to young people, particular attention should be paid to the elderly, who have remained completely isolated for months to be protected from a virus that is particularly lethal for them: “I believe that they, especially those hospitalized in the RSA, are the people who have suffered most – dice Giancarlo Ardissone – Because they did not have the opportunity to find comfort with their family and receive visits from more or less close relatives. Many people have died alone, without any kind of comfort. This has created a great deal of unease in them and in their families and it is also one of those aspects that it generates a post-traumatic condition. In the family members of people who have been afflicted by Covid and then passed away (and there are more than 70 thousand in Italy), a very great sense of concern is basically generated. We must therefore pay attention to the elderly, to ensure that, at the time of recovery, they have a certain type of rehabilitation “.
The situation is certainly not rosy even for adults: there are those who found themselves without a job, those who had to lay off their employees and those who saw their routine upset by the smart working: “Smart working was initially considered a good thing – explains Dr. Ardissone – “I stay at home, work, perhaps even more than before, and I also manage to have advantages”, we thought. But this then does not allow that communication, that socialization that also occurs in the workplace and therefore at a certain point it dries up. Even the same activity, which can also be very pleasant, then becomes a routine thing and also generates a difficulty. I don’t think that smart working, like remote lessons, have a real advantage from a psychological point of view, not even from an economic point of view, in my opinion. We are gregarious beings, who live in groups: we need to socialize, we give energy to the people who are together with us and we receive others from them, so if we lose this we enter a situation of difficulty “.
As for the direct effects of the pandemic on the department headed by Dr. Ardissone, we can speak, generically, of a decrease in both cases treated in the clinic and in hospitalization. But this does not mean, of course, that psychiatric problems have disappeared. On the one hand, the numbers necessarily take into account the reorganization of the hospital structures and the decrease in services linked to the health emergency, so focused on fighting an enemy, especially at the beginning, completely unknown. “Our patients too – declares the doctor – They feared they would have to face the risk of going to the hospital, going to the clinic. We tried to find a whole series of measures to avoid gatherings. In the waiting room, for example, it cannot hold more than 4 people. The same interviews have decreased “. On the other hand, there are those who, just to avoid going to a doctor, have opted for a do-it-yourself remedy: «The current situation – adds – It has caused many to go to the pharmacy to request therapy on their own, then buying an anxiolytic or looking for a remedy to sleep at night “. This is because, as also revealed by some surveys on population samples carried out by Center of Reference for Behavioral Sciences and Mental Health of the ISS (National Institute of Health), during the lockdown are increased levels of anxiety, depression and stress-related symptoms, especially in female subjects. Furthermore, the duration of exposure to lockdown was a significant predictor of the risk of experiencing worse anxiety-depressive symptoms. Loss of work productivity is also a major contributor to poor mental health.
A comforting fact, even if only “temporary”, is that suicides have not increased: “When everyone is sick – explains the professor – In people who usually feel sick when everyone else is well, psychiatric symptoms decrease: severe depression, suicide attempts or suicide. During the wars, for example, psychiatric pathology does not disappear, but let’s say that it hides a little and basically does not become so obvious. When people start to get better, and certainly when this Covid ends, there will be a positive rebound, many will take possession of a series of things that are lost at this moment, the most fragile people will notice this detachment and will aggravate their situation of fragility and certainly an aggravation of their symptoms will ensue ».
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