Coronavirus: Concerns from Lockdown and Uncertainty for the Future. Interview with Prof. Giuseppe Bersani.

We asked some questions to Prof. Giuseppe Bersani, psychiatrist Coordinator of the Brain Clinic Salvator Mundi International Hospital.

The Covid-19 pandemic and lockdown have caused a considerable increase in discomfort, not only material but also emotional. On the one hand the economic worries about work, on the other the anxiety about the disease, the fear of contagion. Prof Bersani, in your experience, confirms or denies this fact? Who turns to you what do you need in particular?

Yes, of course, this is a macroscopic fact. In such a context, anxiety represents the dominant emotion. This is true of course for all people already to some extent affected by emotional problems, who insistently seek the reassurance of the doctor and who suffer further from the impossibility of direct contact with this, both for many subjects who in the past had not presented particular problems but who now live with increasing suffering the condition of prolongation of a situation of intense and prolonged stress. It is certainly a general picture with very negative and widespread repercussions on the state of psychological well-being of the population, also witnessed by the frequency of the search for medical contacts, both for reassuring purposes and for requests, even if only by telephone, pharmacological or psychotherapeutic support.

How much does being forced into social isolation affect the psychological state?

Forced social isolation is an absolutely new experience for the vast majority of the population. The reduction of personal contacts and the feeling of isolation corresponds in many cases to the activation of compensatory behaviors, aimed at maintaining relationships with others in all alternative ways to direct contact. Hence the huge increase in telephone communications, video calls, online contacts, the creation of groups in whatsapp, the presence in social media, etc. The use of these technologies certainly plays a useful function in this period in relieving the emotional discomfort associated with isolation, but their excessive use can also entail the risk of the development of addictive behaviors. It is the risk of the so-called Problematic Use of the Internet that, at least in subjects in some way predisposed, can result in pictures of real behavioral dependence, even according to specific methods, such as, for example, those of compulsive shopping, gambling, gaming, etc. In already predisposed subjects, the risk of abuse of anxiolytic drugs or psychotropic substances, such as cannabinoids, aimed at attenuating the state of emotional tension may be concrete. For some, with less adaptive abilities, the forced reduction of personal contacts can result in depressive reactivity, with a tendency also towards conduct of further closure, both towards the outside and towards people who may be cohabiting. Finally, it is evident that prolonged forced coexistence can exacerbate situations of pre-existing relational difficulties, with the development of tensions, negative emotionality and even phenomena of aggression.

The need to stay indoors can also become an opportunity. How can we turn it into an opportunity? What benefits can it bring?

Isolation can also constitute for many a phase of greater relaxation of interpersonal relationships in general, of recovery of relationships previously lived in a hasty way, of greater availability of time, etc. It is evident that the pre-existing psychological structure plays a central role in orienting this entirely new life experience towards negative or positive emotional responses. Well-marked times of the day, distinct individual and common occupations, sharing of interests but also of worries and anxious responses, common planning, can become not only functional to the best possible degree of adaptation but also an opportunity for recovery or improvement of relational profiles with previous characteristics of difficulty.

Probably soon we will begin to return to "normal" life even if there are still uncertainties for the future. What advice would you give in view of this new phase?

On a strictly strategic level, it will be important not to move abruptly from the state of almost total limitation of external relationships and activities to that of complete and uncontrolled recovery of the previous lifestyle. On the psychological level, one should not move from the depressive elaboration of the limiting situation to the euphoric one of liberation from it. It will be useful, both practically, to limit the general risk of resumption of contagion, and psychologically, to gradualize the return to normal life, still maintaining the recommended prudential behaviors and resuming only over time the previous rhythms of activity. It cannot be excluded, however, that only in times following the end of the isolation the negative psychological consequences of this are experienced in a more manifest way, even with the possible appearance of anxious, depressive, psychosomatic or other symptoms. Bearing in mind the almost physiological nature of these reactions, it may in some cases be useful to resort to psychotherapeutic or medical support for the period necessary to protect the gradual return to normality of life.