After the coronavirus, a depression epidemic is looming

The life we ​​were leading before was perhaps not perfect, but it had an essential ingredient that gave us security: normality. Now that ingredient is gone. We found ourselves living in a sort of limbo in which we await - more or less impatiently - the return to that normality.

But to think that the coronavirus pandemic and this endless period of isolation that has turned our world upside down will not leave psychological damage behind is simply naive. The post-coronavirus reality is not exactly pink, so we will need to prepare for an uncertain future in the best possible way.

Disappointing phase: sadness and emptiness after the impact of the trauma

 

Thinking that we will overcome this collective and individual trauma without paying a psychological bill implies resuming the bad habit of closing our eyes in front of a perspective that we do not like or frightens us. “The man tells himself that the plague is unreal, that it is a bad dream that will pass. But it doesn't always happen, and from bad dream to bad dream, it is men who pass by ”, warned Albert Camus.

When we go through a traumatic situation, such as catastrophes and pandemics, we all go through what is known as the "stage of disappointment". At this stage, the illusion that everything would be fine vanishes. Optimistic slogans give way to sad reality. And the rainbows that animated us hide behind black clouds. The initial optimism that allowed us to resist and fight gives way to discouragement and pessimism.

Stress, which gave us the strength to endure it all, begins to show us the bill. We enter a phase of apathy and anhedonia . Physical exhaustion takes root. And the world starts to look uphill, very uphill.

Many of these changes have a physiological explanation. They are due to the hyperactivity of the hypothalamus-pituitary-adrenal axis, which at first provides us with the almost superhuman energy we need to fight the threat, but then takes it away, plunging us into depression, as a King's study revealed. College London .

Of course, not everything depends on our physiology. In the phase of disillusionment - both communities and individuals - realize the limitations of care. The gap between the need for help and the scarcity of it begins to widen, which usually generates a painful feeling of abandonment.

"The explosion of compassion", typical of the heroic phase in the face of great catastrophes , "and the frenzied public relations demonstrations of politicians mitigate the effect of the trauma for a while and provide temporary relief to people burdened with old debts who they had suddenly been deprived of income. But all of this turns out to be a short-lived truce, ” writes Zygmunt Bauman, referring to the way our society tends to manage disasters.

Later, when aid groups leave, the media shifts the spotlight to other news, politicians get back into the habit of discussing trivia, and banks begin to reclaim debts, despair and abandonment will grow in the population, especially in the most vulnerable.

As the world picks up its pace and many people return to longed for normalcy, others will lag behind. Either because they lost their jobs or because they are suffering the psychological consequences. They are the forgotten ones of the system. Those who slip away through the cracks of society. And those people become perfect candidates for another pandemic: depression.

The "perfect storm" that the coronavirus will leave behind

There are people who, right now, are looking at everything through gray lenses - and they're right. Faced with a health emergency that is also eroding our economy and that has blown up the pillars that gave us security, it is inevitable to feel the touch of vulnerability and insecurity.

We are going through a storm that attacks us from all fronts. There are those who work under unprecedented pressure, exposing themselves day after day to contagion and the possibility of dying. And there are those who have lost their jobs and feel the pain of economic instability. There are those who have lost their loved ones, without being able to say goodbye, condemned to suffer their pain in complete solitude.

All of these people are experiencing, one after another, the emotional components that lead to a "perfect storm" that causes depression: sadness, irritability, tiredness and a feeling of emptiness.

Being isolated at home doesn't help either. Confinement can trigger depression, especially in completely lonely people. Enforced loneliness, the one we don't choose, has been shown to be a risk factor for depression .

In fact, a study recently published in The Lancet revealed that the most common side effects of quarantine are post-traumatic stress and depression. And it's not that easy to get rid of - symptoms can persist for up to three years after the experience.

Loss of financial support also leads to depression, as a study published in the journal Neuropsychiatrie has shown . The profound social insecurity generated by the sudden loss of income, added to the desperation, feeds a negative mental state that can make us hit bottom emotionally and from which it is not easy to get out.

What can we do to prevent depression - individually and as a society?

“To prevent a catastrophe, you must first believe in its possibility. We must believe that the impossible is possible. May the possibility always hide, tirelessly, inside the protective shell of impossibility, waiting to break through.

“No danger is so sinister and no catastrophe strikes as much as those considered a paltry probability; conceiving them as unlikely or ignoring them completely is the excuse that nothing is done to avoid them before they reach the point where the improbable becomes reality and suddenly it is too late to mitigate their impact, even more so to prevent their appearance. Yet this is exactly what we are doing, or rather 'not doing', on a daily basis, without thinking about it, ” Bauman warns.

It is worth clarifying that at this time, the level of stress, anxiety or sadness we experience is a perfectly normal reaction to the events we are experiencing and should not be confused with a psychological disorder. Depression doesn't show up overnight. And that's precisely what leaves us leeway to prevent it from becoming the next epidemic, as it appears to be in China, where 16.6% of people already report signs of moderate or severe depression, according to a study. of the Chinese Psychological Society .

On an individual level, we must learn to manage stress and take loneliness as an opportunity to be alone with ourselves and reconnect with our feelings. This is a good time to learn transcendental meditation techniques and deepen Buddhist philosophy to help us manage uncertain times while maintaining our mental balance . Philosophy and psychology, now more than ever, can become our best allies.

However, we cannot expect the individual to fight alone against the structural and systemic problems that are already endemic and weigh on our society. “It is never pleasant to be sick, but there are cities and towns that support us in disease, countries that, in a sense, can be trusted. A patient needs tenderness around him, he needs to lean on something ”, explained Camus.

If a society and a system do not offer this, they do not bother to support the most vulnerable, both physically and psychologically and economically, they will push some of their citizens into the deepest depression. We need to know that we are not alone. Who have not abandoned us. That we can count not only on other people but also on an institutional support network. This comforts us and allows us to recover earlier and work together to rebuild our dreams.

We need to recognize that the initial plan failed. We have already left behind thousands of people, they have lost their most precious asset: their life. Now we must make sure that we do not leave the new victims of the social crisis behind. And if the system we have doesn't allow us to do that because it's too rigid to allow some humanity to enter, we'll have to change it. Without excuses. Or we will be doomed to repeat the same mistakes.

Sources:

Brooks, S. et. Al. (2020) The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet ; S0140-6736 (20) 30460-8.

Cooper, B. (2011) Economic recession and mental health: an overview. Neuropsychiatr; 25 (3): 113-117.

Pariante, CM & Lightman, SL (2008) The HPA axis in major depression: classical theories and new developments. Trends Neurosci; 31 (9): 464-468.

Bauman, Z. (2007) Miedo líquido. Barcelona: Ediciones Paidós.

Cacioppo, JT et. Al. (2006) Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyzes. Psychology and Aging ; 21 (1): 140–151.