Article by Dr Manuel Martín Carrasco, Psychiatrist, Medical Director of the Sisters Hospitallers’  Centres in Navarra and current Vice President of the Spanish Psychiatry Society. It is about mental health and release from insolation.

We are sharing this article by Dr Martín Carrasco in which he analyses the impact of the current pandemic and his own emergence from isolation from the point of view of people’s mental health.

He first discusses the various factors that may have affected mental health while living through the COVID-19 period and their repercussions on the general public and also on people with pre-existing mental health disorders.

Factors such as “the direct impact of the infection on people and on their family and social environment. Grief over the loss of colleagues, family and friends. Measures to isolate individuals and their changing lifestyles, and uncertainty about the way the epidemic is likely to proceed, and its aftermath. The other factors he mentions are the economic crisis and unemployment. And lastly, the shortcomings in psychiatric and social care caused by the situation.”

Dr Martín then goes on to talk about “The stress of being released from isolation, saying that” “There is no doubt that isolation has been a very stressful experience, but the way people react to stress varies widely from one person to another. It should, therefore, come as no surprise that certain people are looking forward to the end of restrictive measures to be able to resume their normal lives, while others need a much greater degree of security, which they will only acquire gradually. It is much easier to learn to be afraid than not to be. While fear can be learned with a single experience, a sense of security needs to be experienced many times for it to be able to develop.”

The article, therefore, devotes a whole section to “Recommendations when emerging from isolation” to address this situation. One section focuses especially on three distinct population groups: children, adolescents and adults.

Dr Martín Carrasco says that “It is important to distinguish between normal feelings and reactions during the process of emerging from isolation, and what may be warning signs of a mental disorder. The answer to this question is complex, as many factors come into play when deciding between what is normal and what is pathological, mainly because there is a clear gap between them in the working of the human mind. Not everything normal is healthy, and not everything abnormal is pathological.” And he provides means of detecting “when professional help is needed.”

The final pages of Dr Martín Carrasco’s article are dedicated to the important issue of “Preventing Depression”, “Our experience with other disasters has shown that depression, together with anxiety disorders and post-traumatic stress disorder are some of the most common psychiatric problems in such situations, although it must be stressed that the vast majority of people will cope with their adversities without any serious repercussions hanks to the natural resilience of the human being, and we must not handle these situations as ‘psychiatric’ cases or by ‘psychologising’ them”. He then offers a series of risk factors of the onset of depression along with a number of “Self-care measures to prevent depression in social crisis situations”.

The article ends with a reference to the impact of this pandemic on people with some pre-existing mental illness such as depression or a severe mental disorder, “It is obvious that people suffering from a serious mental disorder are more vulnerable to the various adverse situations caused by the COVID-19 epidemic, which may result in a relapse or a worsening condition, due to their high susceptibility to stress compared with the general population. On the other hand, many people with severe mental health disorders regularly attend consultations for assessments or tests and reviewing their prescriptions. However, national regulations on movements and quarantine have seriously affected these regular medical visits. Hospital or intermediate care facilities – such as day hospitals or psychosocial rehabilitation centres – have also been affected.” Dr Martín Carrasco ends the article with various recommendations for releasing from isolation people with schizophrenia.

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