From addictions to “syndrome cabins”: mental disorder, triggered by covid-19 (El Mundo, Spain)

Even back in 1997 when we could not imagine that words like coronavirus, self-isolation or social distance, will be included in our everyday vocabulary, we have conquered the story of Melvin Udell. The plot of the movie “never Better” he is a famous novelist who suffers from obsessive-compulsive disorder. Melvin Udall (starring Jack Nicholson) hated when people touched him, and he always wore gloves in order not to touch anything. In his bathroom there are countless numbers of bars of soap, coming from the street, he washed his hands of almost boiling water, each time for washing used a new bar of soap. Us something like…

Throughout the period of self-isolation and right now, after him, we experience a range of emotions, because our social structure and way of life was destroyed. We have to create it again arise due to this uncertainty, insecurity, fear… We observed an acute panic attack, for example, people were buying large quantities of toilet paper and other products. In addition, because of the fear of Contracting coronavirus in stores began to be suspicious towards others. The following questions arise. Will we be worse of Melvin Udell? Will the mode of isolation on the mental health of the Spaniards?

“When in health, or the economy is a crisis, I always have a problem with mental health. And there are already examples. All of us will become mentally ill, however, this situation will affect many,” — said the head of the Department of psychology and psychiatry of the hospital “Klinik de Barcelona” and the scientific Director of the Center for biomedical research network in mental health (CIBERSAM) Edward Viets (Eduard Vieta). As explained by the expert, in the beginning of the period of isolation in the study hospital was attended by 3,800 people. 16% had experienced moderate or severe anxiety and 14% reported depression. In addition, it was observed symptoms of OCD, such as frequent cleaning or refusal to visit any place. Some refused to be hospitalized because of fear of being infected, and died from another disease. In addition, more and more people suffer from agoraphobia, afraid to go out or have trouble sleeping. Basically the study was conducted in Catalonia, however, studied cases in other areas of Spain. Before publishing will be checked results of the study.

“Since the beginning of the period of isolation some of my patients have experienced symptoms of anxiety and hypochondriasis, as the disturbed their way of life, more time to observe him. Sometimes the concerns of the physical condition leads to hypochondria, and sometimes the anxiety over an uncertain future develops into an anxiety disorder. However, people have a certain predisposition to it, and the regime of isolation have exacerbated it. Some even have to take drugs” — describes the situation of a psychiatrist, the employee of University hospital “fundación Alcorcón” Kazuhiro Tajima Pozo (Kazuhiro Tajima-Pozo).

According to social psychologist Fous of Guillermo (Guillermo Fouce), “in many ways, the consequences will depend on the backgrounds of each person. There is a difference that is left after the quarantine, You have a job or not, You suffered damages or not, whether You have a chronic illness, not if You stopped to consult with the doctor… All of these conditions have a major impact, in particular, how You will return to a normal life, if you have questions, dictated by the uncertainty, for example, “would I go Back to work? Even if you come back, whether there will be a social distance?” After all, some jobs will have to convert”.

Professor at Madrid’s Complutense University and member of the National Board of psychologists of Madrid, Guillermo the Fous talks about her own experience of suffering. “It’s hard to survive the mourning, as it is impossible to say goodbye to the dead or to accept the loss, because not even seen close to the ICU, information was reported on the phone. At the funeral couldn’t embrace, had some unresolved questions, was conducted the Wake, the society lacks the support. You don’t see the body, don’t know what happened, don’t say goodbye, no funeral or other rituals that are required when parting with loved ones. You again find yourself in the four walls, and it brick by brick”.

According to the head of the psychiatric service of the hospital Ramon and Cajal and chief, research unit, CIBERSAM ibáñez, ángela (Ángela Ibáñez), despite the possible harmful consequences for the population, not all of our changes are consistent with the concept of “mental disorder”. “In some cases, we noted very high resistance and a person’s ability to adapt. We are well able to adapt. Some people with a predisposition can occur disorder. There will be consequences, but not as large as predicted earlier. One thing symptoms such as depressed and depression, phobias, fear, irritability… and the other disease. There is a big difference. Disease affects us and simply prevents to live.”

When should I worry?

How to understand: our feelings are normal in such a situation, or it can be considered a pathology that should be treated? “Either You tell or say to You about this family. As a rule, if You do not notice psychiatric disorders, which means that the situation is very serious,” said Dr. Edward Viets.

Guillermo the Fous explains: “When You can’t go back to a certain lifestyle, if the whole day You don’t want to do anything or You are constantly feeling anger. First, it is a violation of normal life, and secondly, we’re talking about suffering. This is the first indication that you need to seek help from a specialist. You need to understand the nature of the problem, not look for easy ways. For example, after the terrorist attacks in Madrid in 2004 was recorded in demand for benzodiazepines. In the short term they help, but in the long run can harm, because addiction, and the problem is not solved. The disease to be treated”.

As noted by Dr. ángela ibáñez, experience some uncertainty about health and financial situation — this is normal. Due to feelings of anxiety, which is normal, sometimes it can be sleep problems and difficulties in everyday life.

If You can still lead a normal lifestyle and have fun even under restrictions, then all is well. Where does the pathology when there are problems? When it is difficult to focus on work, not getting enjoyment from the rest, don’t want to chat with friends, this feeling pervades You from head to toe.”

Listed below are some of the major mental disorders that we may face during and after isolation.

Sleep disorder

During this crisis, this disorder has become one of the most common problems. “Because of the isolation, changing daily routines, and sleep and wakefulness. One of the main rules is to stick to the usual routine every day, including Saturday and Sunday. In addition, because anxiety reduces sleep time. Sometimes sleep during the day, which worsens the quality of sleep at night. Can have nightmares and weird dreams. They are caused by a glut of news, deaths, information, socio-sanitary services, representatives of the health sector and the views of the so-called experts… the Brain is actively working the whole day”, explains ángela ibáñez.

According to Edward Viets, “the most obvious problems are the hardest to solve. In addition, the more You try, the worse, because more nervous. Is the so-called violation of the biological clock that affects hunger, sleep… Biological clock go astray, people no longer eat between meals, have trouble sleeping, because physical activity is less. Sometimes set, often sitting at the screen, that’s too bad, because it reduces melatonin”.

“If you do not create a reasonable schedule then to return to the old rhythm of life will be more difficult. In many ways, the work on udalenke built incorrectly, because people are connected 24 hours a day, overloaded with information, almost no time to rest, constantly on the network,” explains Guillermo the Fous.

Because of these violations of the graphics possible irritability and anxiety.

Anxiety

“Stress and anxiety “key figures” of this crisis. This is a normal and adaptive reaction, You need energy to cope with arising difficulties. Disruption occurs when You experience a stressful situation that You do not have the strength, or renting, or it lasts too long. Thus, there may be disorder. If You have been exposed to coronavirus or lost a loved, or the pathology You have been before, You are more vulnerable, may feel more vulnerable and scared,” says Guillermo, the Fous.

Dr. Viets speaks about premature fear, that is the understanding that the threat we face. “For example, starting to get nervous a few days before the exam. Common for people and not animals when the human race was less developed, this feeling was not. The problem is that we have to anticipate what may develop into a neurosis and suffering, if you constantly ask the question: What will happen in the coming months? The work will be? If I pay the bills?… “. Edward Viets offers to think about the following: “members of the family began to spend more time with his family. And here there are a number of issues associated with too much time spent in the family circle”.

According to Dr. Angel Ibanez, “at some point, almost the entire population were concerned, an integral part of horror and fear. If people have not experienced anxiety — it happened because they started to deny everything. Another protective mechanism. Anxiety is a normal mechanism for solving problems, for example, has changed the usual process of grocery shopping: there is a heightened suspicion, with suspicion look at others, swear at those who get too close, afraid to touch what should not be, or we thoroughly wash everything at home. When this mechanism is not simply adaptive, then we can talk about pathology”.

The country could become famous meme, which was clearly manifested during the pandemic. In Spain, the pandemic began powerfully: in the chat there was a huge number of images and videos, fixing each moment. One of the most discussed jokes: after quarantine, many appear overweight and alcohol. Well, it looks like the Spaniards guessing was close to the truth. Thus, another manifestation of anxiety is manifested in the “panic hyperlexia, the so-called excess appetite, what we constantly want to eat,” explains Dr. Tajima.

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Alcohol dependence is also directly linked with anxiety. “In the end, alcohol is the best sedative, the option of self-medication,” — said Kazuhiro Tajima. As noted by ángela ibáñez, this does not mean that people who used alcohol, started drinking, “the number increased, but not everywhere, this is not a concern, unlike those who already liked to drink and to quarantine. However, the mode of isolation had a positive impact on teenagers, who have less to Smoking cannabis and drinking in large companies. On the other hand, were more likely to show symptoms of withdrawal from hard drugs because it was impossible to get them physically or economically due to the increase in value.”

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Hospital Ramon and Cajal, one of the two basic centers in Spain, helping people with a gambling addiction, so ángela ibáñez may consider this question. “When we are approached, we will definitely recommend you put your name in the black list of the casino. You can keep control of gambling in casinos and online, when a man in a black list, no problem. Among gambling games occupy a significant place sports betting, betting shops were closed, but the youth began to play more often in mobile apps. Despite the fact that these games do not involve making money, they encourage competition, the same feeling which leads to addiction, because many people play for hours. We are going to conduct a study and within a few months find out what was the impact of the whole mode of isolation on the people because they have more time played in a network”.

As noted by ángela ibáñez, one of the ways to assess the impact of is “the number of people who asked for help. Curiously, we began to address less often than in recent months. May not know that they can call us directly, don’t need to go to the hospital for direction. In the future we will know it after hearing the complaints and understand when people have problems.”

Depression

The initial euphoria of the first days has changed dramatically. Over memes in their place came the famous graphs of the number of cases of coronavirus, predictions, how long self-isolation and emotional depression, because the situation dragged on. “When stress and anxiety persist over time and You don’t know what will happen next, the feeling of insecurity and helplessness. Because of the constant stress cover sadness, depression and hopelessness. Sounds like depression, but it is not real depression”, explains ángela ibáñez.

“We are beings living in society, so for social exclusion arise anxiety and depression. Less see my family, there is no incentive, there are some… Such conditions is one of the main reasons for the emergence of symptoms of depression or of depression,” explains Dr. Viets. In this respect, ángela ibáñez emphasizes the importance of interpersonal communication, video calls, chat with friends and family. “This defense mechanisms. It’s one thing to be in isolation from spouse, family or friends, it’s another thing to be alone. On defense mechanisms is affected by every detail, for example, those who walked to work or worked at home, exposed to less risk and not as prone to depression as those who stand at the labor exchange in the conditions of economic instability”.

“Syndrome cabins”

All four experts agree that “it is very bright the name of the phenomenon that already exists”. “The concept covers those who have a rational fear to go outside due to the fact that scared to get infected, and those who believe that if something happens, they will cover anxiety and no-one to take care of. The latter is more reminiscent of agoraphobia. The wild mix of common anxiety disorders and anxiety, that is, the disease has been to quarantine, and it just escalated,” explains Kazuhiro Tajima.

“Rather, it is social phobia — fear of communication. Living at home in my own world, I don’t want to deal with the other world, I don’t know what it is. This is a rational fear, without it we would not observe measures of self-isolation, and now security measures. The main thing to fear we have not covered completely, we have to deal with it, you need to go out and not staying at home. If You are a hypochondriac, the symptoms can manifest acutely, or if You are prone to isolation or social phobias,” says Guillermo, the Fous.

According to Dr. Viets, that “slight agoraphobia, but it is not a disease, nothing serious. This often happens with the elderly, because everywhere said that they are at risk and don’t want to go outside. The conflict arises on the basis that the most careless or the least worried about facing the street, and those who are more nervous, still at home and criticize those who have already started walking”. As noted by ángela ibáñez, agoraphobia is not limited to, “is something else. There was too much information, but did not talk about emotional state. Said, “stay home, don’t go outside”, and suddenly, almost overnight, allowed to go out, but the situation hasn’t changed much… Despite the fact that people want to go outside, there are warnings and fear, but it means nothing, everyone has their own routine. When the fear to go outside prevents the return to normal life, to go to work… Then there is cause for concern, however, we think that most will return to a normal life.”

Obsessive-compulsive disorder

All the experts agree that we are not waiting for the fate of Adella Melvin (Jack Nicholson) and learned behavior will disappear once this is all over. “Obsessive-compulsive disorder is a mental disorder which usually appears before 20 years, there are many inexplicable and irrational. It is necessary to distinguish this disorder from new orders, appeared now. Symptoms can seem similar, because the person, thinking that can become infected by touching something, running to quickly wash my hands. However, due to the regime self-isolation of coronavirus or people suffering from OCD, will no longer possibly discover some easy and obvious cases as it was not noticed earlier”, — says Kazuhiro Tajima.

“People have obsessions and behaviors they wash their hands more often. As a rule, the obsession arises from the fact that we are not afraid to get sick themselves, but infect parents or children. However, we are not all aciklama on this, mostly people have changed behaviors, but we hope that fear will disappear, as soon as anything changes,” explains Edward Viets.

“It is one thing to be mad, another to suffer with OCD, it is only 1% of the population. This is a serious disease, characteristic of absurd, ill make even more absurd actions. Some carefully watch how to wash their hands, clothing,… who Have more zeal, do more than necessary, but this is not obsessive compulsive disorder. Often half of those who suffer from OCD, really obsessed with cleanliness, fear of dirt, you can wash the hands for 20 minutes,” says ángela ibáñez.

Post-traumatic stress

“After the terrorist attacks in Madrid in 2004, post-traumatic stress disorder suffered no more than 20% of the population, and now it will not have a majority. People are stronger than we think. When faced with a problem and solve it, then we grow, and those who will cope, will also become stronger,” — emphasizes Guillermo the Fous. All the experts say that such a mental disorder occurs if You or a loved one experienced a traumatic psyche of the situation. “For example, You have lost a loved and never got to say goodbye, You were sick, lying in the intensive care unit, saw how people died, and thought that, too, will die. However, most affected medical personnel. Symptoms appear late, after about six months, so we will be able to assess the scale in September or October,” explains Kazuhiro Tajima.

“Healthcare workers can suffer from so-called neurosis of the war, especially those who have been “at the forefront”, that is, working in the ICU. All health care workers have experienced stress, which is characterized by strength and duration. Based on projections, they had to choose whom to help and whom not to. Medical professionals know that patients die. Fortunately, they are usually a bit, but this time it was different. Those who worked in the ICU, had a hard time, the staff, the workers who are preparing specialized equipment for such offices… a Large number of medical professionals will experience post-traumatic stress,” explains Edward Viets.

“We need to help them, so they had the opportunity to share emotions and accept that they did what should have been,” emphasizes Guillermo the Fous.

The mentally ill are the most vulnerable group of the population

“According to some studies, the less new cases of infection with coronavirus, the more cases of mental illness. For crisis patients were few, now centers more people. Due to the mode of isolation worsened the condition of patients suffering from schizophrenia, bipolar disorder and depression. And also other people who experience anxiety and neurotic disorders such as OCD or hypochondria, or take psychotropic substances… Many centers were closed, we are now seeing the results,” explains Dr. Tajima. In addition to the stigma caused, as a rule, mental disorders, people who have certain problems to the midst of the pandemic, suffered due to the closure of centres in which many were treated. For such patients, observance of the daily routine is just as important as the air itself.

“I see that the most affected children, adolescents and the elderly. For example, I every day call close those who are ill with Alzheimer’s, said that they have hallucinations, they have no control over… For patients with Alzheimer’s was greatly influenced by the lack of a hard day. In addition, patients with autism also had a lot of problems due to changes of the rhythm of life. Primarily affected these two populations” — emphasizes Kazuhiro Tajima.

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