October 28, 2020

experts reassure before expected anxiety



On Saturday, the entire population will be authorized to go out into the streets with restrictions to play sports or walk, but many face this recovered freedom with fear. Psychiatrists and psychologists send a message of calm: it is normal to feel anxiety after seven weeks of confinement.

“Having a certain fear, a certain anxiety is absolutely normal. It is even good and healthy. Whoever does not give respect going out will be less able to assess the dangers and will have a higher risk of contagion,” Celso Arango, president of the Spanish Society of Psychiatry.

Despite the fact that citizens have been listening for weeks to news about deaths and saturated hospitals, Arango remembers that any change, even the one that is for the best, such as moving to a bigger house or a professional promotion, generates stress and anxiety and requires a period of adaptation.

“Locking up at home or going out after confinement is going to be accompanied by a normal and expected physiological reaction and people don’t have to worry.”

This psychiatrist is irritated by the expression “social distance”: “what we need is physical distance and social closeness; now we need people to empathize a lot, to maintain physical distance but to be very fond, even if they are virtual kisses”.

People, he emphasizes, also have to be aware that they are going to start doing activities, such as walking, with less risk than they did until now, such as going to the supermarket.

According to a study by researchers from the European University based on a survey of more than 16,000 people in Madrid, Cantabria and the Canary Islands, 70% are afraid of getting it and 50% feel fear or anxiety when leaving home.

Timanfaya Hernández, clinical and forensic psychologist, sees how the consultations of people with anxious symptoms, fear of contagion and now also fear of the street increase.

“We know that it will happen. We have never experienced a pandemic and confinement of this dimension, but the phenomenon has already been described in other groups who have lived in seclusion, such as patients who are discharged after long hospitalizations or inmates who leave prison” , explains to Efe.

Seclusion, he points out, is unpleasant, but our survival mechanisms counteract that feeling and have allowed us to adapt to confinement; the problem can arise when that defense mechanism becomes “maladaptive”: “Our brain is very intelligent, but also very bloody.”

SHOULD YOU FORCE YOURSELF OUT?

Arango recommends taking advantage of the walks, returning little by little returning to the normality of the future. “In the confinement we go from nothing to nothing, but the progressive adaptations are better; that the people go out gradually, taking walks, and if they don’t feel like it, they are forced.”

Timanfaya Hernández is committed to each one considering their own “lack of confidence” and setting their guidelines to see how they feel.

“It’s okay to go out on Monday instead of Saturday. How far? Instead of a kilometer, I’m going to take a walk around the block first. If I look very out of control, I can’t handle the situation and it causes me a lot of discomfort This indicates that there is a problem and we will have to do a job to redirect this state, which is not going to lead itself “.

We must assume that this fear is normal, coincides with Arango, but also to see that it does not interfere in daily life, which allows us to follow routines and maintain social relationships, ask for help if anxiety or fear incapacitates us.

PEOPLE WITH PREVIOUS PATHOLOGIES AND NEW PROBLEMS

As Arango explains, psychiatrists are seeing exacerbations or relapses in vulnerable people, with basic mental disorders.

But his main concern is not in the mental problems derived from the confinement, but in the psychic disorders that the economic crisis will cause, as it was verified in the 2008 one: “A wave is coming and health managers have to be aware of it”.

The mental health of those who have been in the front line, the health workers, also focuses the attention of psychiatrists, in addition to addressing “pathological mourning”, those thousands of people who have died a loved one without burial, without funeral and without the ritual of farewell.

Hernández agrees in the concern for those with previous pathologies, who can confuse the discomfort caused by confinement and lack of confinement, which affects the entire population, with a worsening of their own symptoms.

This refers, for example, to patients with agoraphobia or obsessive compulsive cleaning disorders. “They already followed sufficient cleaning guidelines in their day-to-day life to deal with a coronavirus. We have to work with them again, explain to them that the councils are aimed at the population without this pathology; that they have to wash their hands when they come out, but not to wash them again twenty times a day. “

NEED FOR CERTAINTIES

Arango regrets that the Government, in its decision-making, has not taken into account the mental health of the population, when it is verified that most of the problems generated by confinement have to do with it.

The entire population has been confined to their homes to control people who would not have followed the rules, he explains, but it has been shown that there are fewer mental health complications when confinement is done “in an altruistic and non-compulsory way,” when the government informs of the risks and the individual makes the decision to stay at home, without impositions.

There are also fewer problems in countries that have set a plan with dates, although they later change, he adds. “There is no thing that generates more anguish for the human being than uncertainty. When a person is going to receive the results of a cancer test, they have more anxiety than later, even if the result is bad.”

“That lack of certainty with which they have had us is very harmful,” he warns.

Noelia López

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