Not only the virus itself is dangerous - experts are concerned about the growth of anxiety and depressive disorders, which in medical circles have already been dubbed "postcoid syndrome." Insomnia, depressed mood, feelings of hopelessness and helplessness make life miserable for many.
How to get out of this "black hole", how to regain a feeling of fullness of life and control over the situation, how to defeat the notorious "postcoid syndrome" - we are told by the chief researcher of the department of treatment of borderline disorders and psychotherapy of the National Medical Research Center for Psychiatry and Neurology named after V.M. Ankylosing spondylitis of the Russian Ministry of Health Tatyana Karavaeva.
- Tatyana Arturovna, what to do with these conditions, which the doctors have called "postcoid syndrome"?
- First, we need to define what we include in the concept of "postcoid syndrome". It seems to me that there are at least two components here. The first is the direct consequences of the postponed coronavirus infection. After all, coronavirus is a neurotoxic virus that affects both the human nervous system and the mental sphere. In this case, asthenic-depressive states occur, in some cases, post-traumatic disorders are formed with the formation of protracted chronic anxiety disorders.
Especially after being in a hospital in a serious condition, and even more so - in intensive care. Such conditions certainly require medical attention, including pharmacological. The second component is psychological: when a person is faced with an immediate threat to life and a feeling of uncertainty: what will happen? A mild course of the virus, and everything will go well - or will the disease lead to serious complications? This affects huge layers of experience, and such people require professional psychological help.
- Are today's experiences of people different from those experiences that were at the very beginning of the pandemic?
- At the beginning of the pandemic, the number of anxiety disorders increased sharply, and this looked like a reactive reaction to a change in the situation. There was an absolute sense of uncertainty and insecurity: we did not know how everything would develop. A large number of patients with anxiety disorders and severe disorders in the form of panic attacks and generalized anxiety disorder came to us, who required both outpatient care and, in some cases, inpatient care.
Gradually, taking into account the length of this whole situation, a second wave began, from our point of view, when a large number of depressive disorders joined, which were already associated, rather, with the processing of ongoing events. Disorders of the hypochondriacal plan have appeared (hypochondria is a condition that manifests itself in constant anxiety about the possibility of getting sick or preoccupation with one's physical health. - Approx. Auth.), When people begin to listen to themselves and the slightest feeling of some kind of trouble from the body is interpreted as a catastrophe. And, alas, we have a lot of such patients.
- How many?
- The number of hospitalized and patients seeking help in an anxious state increased by 30 percent. If we are talking not about psychiatric, but about psychotherapeutic help, then the numbers are even higher: the need for emotional support, relieving stress - including in connection with family problems and an increase in aggression - has grown significantly. Moreover, not only in our country, but also in Europe, Japan, China …
- What is the main difference between the first and second waves?
- The difference lies in the content of the experiences. Anxiety syndrome - it is alarming, but only we are worried for various reasons. If the first wave was associated, on the one hand, with the fear of getting sick, and on the other, with anxiety around the situation itself, then in the second wave people are more overwhelmed with worries about how to live something further in conditions of lack of resources, money, what kind of some opportunities, when fatigue has accumulated … Someone lost their job, someone - housing, and someone - loved ones … And there are families where there is more than one loss … That is, the content of our experiences changes depending on what is happening in society.
- Well, here, probably, there is a certain risk zone. Who do you think is more prone to these disorders?
- These are people who initially have a high level of anxiety and who have a mechanism for responding with anxious experiences to various and unexpected events in their lives. This includes people with a hypochondriacal mood, who are very alert and anxious about any somatic sensations from their bodies. And also those who have low resistance to stress loads, as they are quite vulnerable in stressful situations.
Alas, most people do not have the skills to solve their problems on their own. They think about the problem - how complex it is, look at the details - but don't care about how it can be solved. And, of course, we are talking about patients with emotional instability, for whom it is rather difficult to regulate the level of emotional stress. These are people who, in prolonged stressful situations, deplete all resources and opportunities, and it is they who will give severe psychological reactions to a greater extent.
- How can a person understand that he needs help?
- Of course, in such cases, a person is guided by self-esteem. And in this situation, it’s better, as they say, to overlook - and turn to a specialist not when it seems that it’s impossible without help, but when he is just beginning to think about what is hard for him.
- What should you pay attention to first of all?
- For sleep or appetite disturbances, decreased ability to work, increased fatigue, anxiety, irritability, increased conflict - that is, if a person understands that the reactions that arise in him differ from the reactions and the state that is usually characteristic of him. In these cases, without waiting for more severe conditions, you need to contact a specialist so that he can give recommendations on time, offer help or a route to provide it.
- What forecast would you give for the near future?
- I think that a "depressive tail" awaits us, and hypochondriac experiences will join it. The dynamics of clinical changes will be related to what will happen with the pandemic and the coronavirus, whether there will be changes in the strains of the coronavirus, whether vaccination will bring relief. It must be said that right now we are seeing an increase in anxiety related to vaccination issues - since many people are not ready to answer for themselves: is it necessary to be vaccinated? This trend is noted by the WHO in many countries, and this concept of "unknown in relation to vaccination" is among the top 10 major threats to public health.
- Are there ways to prevent covid blues?
- Yes, there are such methods. They seem very simple to us, and therefore we often devalue them. However, sometimes such simple tips as organizing work and rest, organizing living space, limiting the influence of bad habits, maintaining a commitment to a healthy lifestyle, supporting positive communication, supporting loved ones, actively filling your time, normalizing the climate in the family - can work wonders! These are things that are not always easy to take and do.However, these are the recommendations that really work, help to increase their adaptive capabilities and cope with the problems of self-isolation, additional stress, as well as the problems of anxiety in situations of uncertainty.