… our conversation with the head of the outpatient department of the regional psychiatric hospital named after N. N. Solodnikov, psychotherapist, chief freelance specialist in medical psychology of the Ministry of Health of the Omsk region, candidate of medical sciences, doctor of psychological sciences Dmitry Chetverikov.
- Dmitry Vladimirovich, has the number of patients increased during the pandemic?
- The number of patients has increased significantly. This is primarily due to a general disturbing background, a feeling of a certain confusion, a significant change in lifestyle. For a decade and a half, people have become accustomed to actively contacting each other, making plans, traveling, relaxing. A year ago, it was easy to buy tickets on the Internet and fly to any country. And suddenly, all of a sudden, the situation changed dramatically. In May-June, a tough self-isolation regime was announced, and we practically did not leave the house at all. Now the situation has softened somewhat. But there has been an accumulation of these anxious states. And people who for some time, depending on suspiciousness, age, psychological characteristics, family circumstances, withstood this anxiety, now began to fall into depression.
This is actually the classic stress response pattern. First comes denial. Remember how we said: this is all nonsense? Then there was the stage of bargaining. Now we are in the stage of depression, confusion. But at the same time, we are already beginning to see some positive aspects. This means that we are gradually moving on to the stage of acceptance. A person begins to realize that he will have to live with this virus. And it is already necessary to build your life based on the fact that there is COVID-19. Remember there was a terrible wave of covid dissidents? When even doctors refused to wear masks and gloves? And today it is rather strange to meet a person without a mask in a public place.
- Now many do not believe in vaccination
- Just one and a half to two months ago, my fellow doctors and patients said that they would never be vaccinated. Moreover, I myself thought that I would not be vaccinated, I would not participate in this experiment. But nevertheless, seeing what is happening around, on December 21, I gave the first vaccination, on January 5 - the second. And I do not regret it at all.
- Is there already research on how the coronavirus affects our brain? Are the consequences of its impact on our mental faculties reversible?
- The Omsk Psychiatric Hospital has a very active community of psychiatrists. And "Omsk Psychiatric Journal" was the first in the Russian Federation to publish a selection of articles on the impact of coronavirus on human mental activity in June this year. Of course, there is research. If we talk about the consequences that come after the coronavirus, then first of all it is the so-called asthenia - very pronounced fatigue. So far, scientists cannot explain the mechanisms of its occurrence. But many patients who have had a coronavirus infection and who complain of unprecedented fatigue have already passed through our department. This happens after the functions of the internal organs have formally been restored.
It is clear that there are no clear recommendations for the treatment of this asthenia yet. We consider these patients as patients with nonspecific asthenic syndrome that occurs as a result of trauma, surgery, and treat them accordingly. But at the same time, we see that people are starting to recover quickly. This is a very positive point.
We cannot yet say how the statistics will develop. How many patients will recover, how many will not, how many will have residual infection.However, as a doctor in this situation, I am more concerned about another problem. We see that patients get sick again, and the interval between infections is only a few months. Here these asthenic phenomena, the phenomena of fatigue and mental exhaustion are more pronounced.
- Can the drugs used to treat coronavirus infection affect our psyche?
- We do not see this yet. Any drug in one way or another affects health. Even banal aspirin or analgin. And in the treatment of coronavirus, very strong drugs are used: antibiotics, hormones. But again, one must understand that in this case we are talking about a person's life, and the doctor makes a reasonable choice.
- Do you recommend that all those who have been ill contact the specialists of your profile?
- Of course not. Most patients survive coronavirus infection without complications in the form of mental disorders. But if you see that your mental state has changed, that you cannot get yourself together for a long time (a month, two), if you notice that you have some changes in the neurological sphere, then, of course, you need to go. One more point. We note that against the background of coronavirus infection, severe depressions often develop, real depressions with suicidal thoughts, with feelings of worthlessness, worries, up to psychotic disorders. In this case, it is better not to postpone a visit to a specialized specialist. It is better to start the examination with a local neurologist. If a specialist sees mental disorders, he will already refer you to a psychotherapist or psychiatrist.
- Previously, many people had a fear of going to a specialist, whose name contains the root "psycho". Have these stereotypes changed now?
- Yes, absolutely. I have been in the profession for almost 30 years and I see that the situation is really breaking through. Both on the part of the population and on the part of doctors. There were cases when, even seeing an obvious mental disorder in a patient, general practitioners convinced him - "just don't go to a madhouse, they will make you a vegetable there." Now people are beginning to understand that mental illness is the same illness as cardiac, gastroenterological, endocrinological. And they also need to be treated. And they are well treated if the patient turned to a specialist on time and received competent qualified assistance.
Mentally healthy people often need psychotherapeutic help. And turning to a specialist of our profile does not mean that a psychiatric diagnosis and registration are required. In our time, such help can be anonymous, which helps to overcome this fear. People are increasingly beginning to understand that their quality of life depends not only on the bodily, but also on the mental well-being of themselves and their loved ones.
- How is the appointment with the psychiatrist going?
- As an appointment with any other doctor. The doctor will ask what you are complaining about, what worries you, what has changed in your life, where you feel any problems. Then the assessment of the so-called mental status begins. The doctor finds out to what extent a person is oriented in himself, in a place, in time, in a situation. Evaluates the patient's thinking, his perception features. After this, the emotional sphere (reactions, mood) is assessed, the physiological background (sleep, appetite, sexual activity) is assessed, the cognitive, cognitive spheres (memory, intelligence, critical abilities) are assessed. On average, an initial consultation lasts an hour. The specialist acts according to a certain plan and detects or does not reveal mental disorders.
- Are there any measures to prevent various mental disorders and diseases?
- Live a normal, full-fledged human life, not limit yourself, but within reasonable limits. Love yourself, love your life, love that corner of the Universe in which you live now.
Despite the fact that we are in a difficult situation, life goes on. Remember that people have lived in more dire conditions. For example, when the plague was raging and there was no medicine, when there was a war and there was a terrible famine. You should never despair. And please listen to the doctors. They wish you only the best!
To be vaccinated or not?
About the point of being vaccinated against coronavirus, who is shown and contraindicated in vaccination, "Your OREOL" was told by the head of the epidemiological department of GKB 1 named after. Kabanova Ivan Melnikov.
- Ivan Vladimirovich, the mass vaccination campaign has already begun, but the mechanism of action of the vaccine is not completely clear. The most common question people ask is: what is the point of being vaccinated if the virus is constantly mutating? Will the developed vaccine be effective against its mutations?
- Virus mutation is an evolutionarily formed mechanism that contributes to its survival in a constantly changing environment. It is important to understand that the mutation does not completely change the genome of the virus, therefore, after the vaccination, the immune system will still recognize it and direct all its forces to fight it. This will allow you to avoid illness or, if you draw an analogy with the influenza virus, to transfer the disease without complications and avoid death. When deciding on vaccination, it is worth remembering that its meaning is not only to protect a specific person, but also to increase the level of herd immunity.
- Who can and who cannot be vaccinated against coronavirus?
- The vaccine can be given to any person who has reached the age of 18, respectively, children are not given it. You can not get vaccinated for those who have contraindications. For example, it is forbidden to vaccinate those who have suffered acute coronary syndrome or stroke within the last year. Also, you cannot vaccinate people who suffer from chronic systemic infections, tuberculosis, neoplasms, syphilis, HIV, and those who suffer from acute infectious and non-infectious diseases or are experiencing an exacerbation of any chronic disease. For these groups, vaccination is possible no earlier than two to four weeks after recovery or remission. Remember that any, even a slight ailment, an increase in body temperature are also contraindications to vaccination. The person must be completely healthy at the time of vaccination. Pregnant and lactating women should also not be vaccinated. Those who have had any other vaccinations in the past 30 days are not allowed to get vaccinated. It is highly undesirable to rush to get a covid shot after getting a flu shot.
- How do you prepare for vaccination?
- Two to three days before vaccination, you should not burden the body physically, hypothermia should be avoided. Sudden temperature changes are perceived by the body as a strong stress factor, and sports are quickly exhausting. This can weaken the body and affect immunity. It is necessary to exclude alcohol a couple of days before vaccination, as well as a few days after it. On the day of the vaccination, you should not visit the bathhouse, pool and consume allergenic foods (chocolate, citrus fruits, berries, etc.).
- Are there any side effects of the vaccine?
- Painful sensations and swelling at the injection site, chills, fever, headache, fatigue, as well as pain in joints and muscles - all this can appear in some people after the administration of the Sputnik V vaccine. Sometimes there is nausea, loss of appetite, swollen lymph nodes - everything will depend on individual intolerance. Many who have already experienced the vaccination note a slight increase in temperature, but these symptoms disappear on the second day.
- Is it possible to vaccinate those who have already undergone coronavirus?
- Yes. To do this, you need to donate blood and see the amount of antibodies.If there are few antibodies left in the body, there will be no extra protection. I recommend that those who come for the vaccination do not hesitate and ask the health workers the appropriate questions.