Stress from Covid-19. You can manage it. Interview with Prof. Giuseppe Bersani.
Covid-19: mental health is also at risk.
Concern about contagion and illness, uncertainty about the duration of the pandemic and the consequent limitations of life, social isolation, economic difficulties, in summary, the entire experience of the epidemic has provoked inevitable adaptation reactions and a complex series of psychological responses. Result? Unfortunately, a risk and a very high incidence of situations of intense emotional and psychological suffering.
The experience of the epidemic represents a real condition of stress. This has given rise to the need to give an answer to the different types of psychological distress and psycho-physical malaise. Response that the Center for Psychiatry and Psychology – Brain Clinic of UPMC Salvator Mundi International Hospital has chosen to give through the new stress management service associated with the COVID-19 epidemic.
We asked the coordinator of the service and of the Brain Clinic itself, Prof. Giuseppe Bersani – Full Professor of Psychiatry at the Sapienza University of Rome – to explain how Covid-19 stress manifests itself but above all how it can be faced and managed.
Prof. Bersani, what are in particular the real aspects of life during the pandemic that can induce conditions of psychological suffering?
We are faced with a completely new situation, of high complexity, in which different individual experiences can involve states of true emotional suffering. The most widespread and shared experience is of course that of the fear of contagion, referring both to oneself and to one's family members. It is a situation based on an absolutely real risk, but which can become a source of conditions of generalized and pathological anxiety, state of alarm, hypochondriac attitudes, obsessive, etc., in turn a cause of psychological suffering also marked. As well as the real experience of the disease, both personal and of a relative, it can lead to even serious emotional repercussions, which can last even after the resolution of the disease. Needless to say, how much the loss of a family member linked to the epidemic can be a source of suffering. In addition, the condition of social isolation, absolute or partial, in which we are forced, constitutes in turn a condition with potential serious emotional and behavioral repercussions, maladaptation reactions, etc.
When you talk about psychological suffering associated with the epidemic, clinically what conditions are you referring to?
Of course, not for all conditions of emotional implication is possible a framework in strictly diagnostic terms. But these can reach a level of severity even marked and present the risk of turning into real psychopathological disorders. We are observing an increase in anxiety disorders of various kinds, generalized anxiety, panic disorders, hypochondriac disorders, post-traumatic stress disorders, as well as obsessive-compulsive disorders and social phobias, insomnia and depressive disorders, as well as psychosomatic pathologies, such as cardiac and gastrointestinal ones.
How can we know if what we are experiencing is a "normal" condition of stress, adaptive and therefore of response to the situation, or if it is a more "profound" disorder that would be better to face together with experts?
Our Covid-19 stress management service team evaluates every single case, with interviews and tests. The first objective of the service is to carry out an evaluation of the individual characteristics of the stress response, both through a first interview and through the administration of specific psychodiagnostic tools. The modalities of response to stress, the severity of individual suffering linked to it, the tendency to anxious or depressive processing, the ability to react are investigated. At the same time, the presence of possible states of suffering that can really be defined in terms of psychopathological disorders is deepened.
How do you tell if a physical disorder is psychosomatic in nature or not?
On the basis of the individual symptoms described by the patient, a series of investigations are carried out to provide an objective indication of the somatic implications of stress. In particular, parameters relating to possible alterations in the neuroendocrine and immune systems, metabolic and inflammatory states are analyzed, all potentially altered in relation to the condition of prolonged stress. This is an assessment of considerable importance in providing a measure of the severity of the experience of stress, to monitor its trend, to evaluate its possible influence on previous or concomitant pathologies of a somatic nature.
What therapeutic program is proposed to deal with and manage the stress of Covid-19?
The integrated therapeutic program always follows a personalized indication based on the individual characteristics of the individual case. In summary, the basic program includes a first psychiatric examination with a framework of the individual symptomatic and psychopathological characteristics, administration of psychodiagnostic tools for the objective evaluation of the methods of response to stress and request for somatic examinations for the measurement of somatic implications. If necessary, drug treatment or nutraceutical support is prescribed. This is followed by a cycle of individual or family psychotherapy sessions, which can be carried out both in presence and in online mode, to support the patient in the phase of greatest suffering. The course can also be concluded with cognitive-behavioral psychotherapy sessions or with a period of recovery of psychophysical balance using mindfulness techniques.