The corona pandemic has been raging all over the world for two years now. In addition to the danger posed by the virus itself, our psyche is also increasingly suffering. The consequences can be depression, anxiety disorder and post-traumatic stress disorder, among others.
Professor Dr. Johannes Kruse. He is the Medical Director of the Clinic for Psychosomatics and Psychotherapy at the University Hospital Gießen and Marburg in Gießen.
In an interview with the RHÖN health blog, he talks about people who are particularly at risk, at first glance paradoxical behaviors of certain people – and ways to protect your own psyche in the best possible way.
Professor Kruse, what effects does the pandemic have on our psyche?
They are substantial indeed. Science now knows from numerous studies that the pandemic is associated with increased depression and anxiety. Many people feel clearly stressed, and often over a long period of time.
Do we humans consciously perceive this stress, or does it all happen in the subconscious?
We are very aware of it. From my clinical work as a psychosomaticist, I can also confirm that more severe forms of mental disorders have increased noticeably under the pandemic conditions.
How do you explain these effects of the pandemic on our psyche?
The problem is not just the virus itself, but the circumstances that meanwhile determine many parts of social life. Just think of the pictures from the hospitals in Bergamo, Italy, from which the coffins of the deceased were carried last year. These images have passed into the collective memory of our society. Such visual impressions shape the image that many of us have of “Corona”. This was partly due to media coverage that placed a great deal of focus on the disaster aspect.
Are you sure you also include the contact restrictions among the difficult circumstances?
Certainly. Simply because social contacts are of great importance for our mental health. The so-called social distancing, which is necessary for infectious reasons, and the associated loneliness that many people experience have become a major problem. In addition, many leisure activities are no longer available. All of this has resulted in many no longer feeling “involved”. Single parents were and are particularly affected. The situation can also become dramatic if a person also has to deal with financial problems. Some have also found themselves in a situation in which the protective measures prevented them from saying goodbye to a close relative. It hurts.
Are there basically people who are particularly at risk of developing psychological problems under the current conditions?
Especially patients with chronic physical illnesses. For example, I know from people who have diabetes that they have developed more anxiety and depression. Because they are among the risk groups that have a less favorable course of a corona infection. On the other hand, it has to be mentioned that they have generally adhered to the relevant medical guidelines much more consistently than before. So you paid more attention to exercise and often controlled your blood sugar better. So out of fear they protected themselves better. The other group that is particularly at risk are children and adolescents. Since the school closings, you have sometimes had to struggle with major psychological problems. We know that eating disorders have increased significantly, especially in adolescent girls, and so have anxiety disorders. There is also an increase in gambling addiction, especially among boys.
How does it fit together that many people do not get vaccinated – and are anxious at the same time?
That sounds paradoxical at first. Some studies suggest that we are talking about people who have a lot of fears. And in order to fight this fear, they say to themselves: “I’m not getting any Corona!” So you are denying the danger, so to speak – and trying to fight your own fear. That seems to be an essential mechanism. But of course other social aspects should also play a role.
What can help if you feel stressed, anxious and depressed in the current situation?
In these current phases of high uncertainty, good, reliable information and comprehensible policies are key. Trust in interpersonal relationships is just as important. This is also suggested by a current OECD report, which has compiled relevant literature on the subject. This trust is central to our quality of life and to dealing with a social crisis.
A notable example of this is the first major press conference by Chancellor Angela Merkel at the beginning of the pandemic. It was noticeable that the clear measures announced have ensured that many people have reduced their level of fear.
Are there any other ways to help?
In order to cope with emerging fears and depression, the first step is to consciously feel and name them. Then, as a rule, they will also be a little less. And you can do things that relax or calm you down. The second step is then to talk to other people about the fears and depression, to share them – and to check whether they are justified or unfounded. Exercise, sport and hobbies can also help to deal better with fears and stress.
What can you and your colleagues do for people with depression or an anxiety disorder?
If real mental disorders develop, then psychotherapy is often the method of first choice. For depression and anxiety disorders, it is supplemented by so-called psychotropic therapy. On the one hand there are outpatient treatment options, but also day clinic and inpatient offers. At the various RHÖN-KLINIKUM AG locations, we have a number of psychosomatic and psychiatric outpatient clinics that those affected can turn to. Here experts help to offer a suitable therapy concept. The number one contact person is the family doctor, who can refer you to the respective outpatient clinic. There are also inpatient facilities that are particularly useful for people with severe depression, anxiety disorders, eating disorders and post-traumatic stress disorders. Especially when intensive psychotherapy can help.
Let us also take a look at the people who are going through or have gone through the disease Covid-19: Do they develop mental disorders?
These patients suffer more from depression and anxiety disorders. And after intensive medical treatment, often with post-traumatic stress disorder (PTSD), which can last longer – and should be treated. For those who have not been treated as inpatients, the situation usually normalizes relatively quickly.
There are repeated reports in the media about the post-Covid syndrome, i.e. the suffering after surviving the Covid disease. What does science say about it?
Those affected repeatedly mention tiredness, lack of concentration and lack of drive. One aspect in the development of this “post-illness” is actually also of a psychological nature: Some of the patients: After going through the Covid illness, they evidently develop great body-related fears and insecurity. And it is precisely these factors that are likely to be part of the problem of the “Post-Covid” syndrome.
How can people find a way out of this uncertainty and loneliness?
First of all, it is important to know: The fear that we all, more or less, feel is something perfectly normal. It protects us all from being too reckless. I recommend everyone to get solid, but not excessive, information. That means: not corona reporting from morning to evening! It also makes a lot of sense to maintain social contacts as best you can at the moment. Which brings us to a positive aspect that the lockdowns brought with them: That parents and children have become more aware of each other again. Simply by being together at home. This contact is important, especially for the children’s development.
Is it about talking to one another, or about touching, or about both?
It’s a mix of many components. It is also not the number of contacts that is decisive, but that there is at least one person with whom you can talk openly. Telephone, video conference – all of that is good. But face-to-face meetings are the most important thing! In this regard, the vaccination and, if necessary, the mask are of course also important: So that we do not perceive ourselves as a threat to the person with whom we meet. And in return, don’t be afraid of the other, because we ourselves are protected by the vaccination.
Your expert for psychosomatic medicine:
Professor Dr. Johannes Kruse
Medical Director of the Clinic for Psychosomatics and Psychotherapy at the University Hospital Gießen and Marburg at the Gießen site.