Elisabet Rodríguez: «There are more consultations for anxious-depressive symptoms»

The health crisis of the SARS-CoV-2 pandemic has led the media to focus on in the areas of hospitals dedicated to patients with symptoms directly generated by the virus.

However, we must not overlook that much of this crisis has been reflected in the mental health of people, even those who have never been infected.

And is that the psychological complications derived from both the fear of contagion and the perception of risk and the isolation generated by the restrictions Faced with the pandemic, they have greatly damaged the emotional balance of a large part of the population. We will talk about this with the psychologist and therapist Elisabet Rodríguez Camón.

• Related article: "Types of Anxiety Disorders and their characteristics"

Interview with Elisabet Rodríguez Camón: the most frequent psychological consequences of COVID-19

Elisabet Rodríguez Camón is a General Health Psychologist who is an expert in caring for adults, children and adolescents, with consultation in Granollers. In this interview, she tells us about the way in which the coronavirus pandemic has affected the mental health of society.

What are the types of psychological problems in which you have noticed the impact of the coronavirus on society?

In this last year, consultations for anxiety and depressive symptoms have increased especially in adults, and the presence of difficulties in social interaction in the population has also increased. childish.

In the first case, we are working with many cases of panic disorders and agoraphobia, specific phobias of contracting diseases and also obsessive compulsive disorders. In addition, in many lawsuits we focus on addressing strategies for managing uncertainty, a problem that has also been accentuated in recent times.

As for depressive states, many of the consultations are associated with an interruption of very diverse vital projects, with a loss of performing a large part of leisure, and finally a higher level of social isolation that is exacerbating feelings of loneliness.

The latter is also leading to a very specific problem, which is fear and avoidance of facing social situations. We are encountering many situations in which the act of expressing ourselves emotionally and communicating a difference of opinion, solving discrepancies, reaffirming one's own decisions, among others, is ceasing to be seen as a natural process to become a phenomenon adverse. Thus, we are also carrying out many interventions aimed at re-training the repertoire of social skills of patients.

What aspects of the pandemic could favor the appearance of disorders such as depression?

As I mentioned before, a prolonged state in time in which there are restrictions of social contact, in the leisure available, even in some cases inability to maintain the job or a routine in general, entails various consequences that can lead to the generation of symptoms depressive

First, the consequences of the pandemic and lockdown have led to an increase in the amount of daily "free" time to think and rethink. We have made it easier for our less busy mind to overanalyze the few events, motivated by restrictions, experienced on a day-to-day basis. A key aspect at this point is closely linked to the reasoning style that people use; This can be more rational, and therefore healthier, or it can contain certain distortions that magnify the negative aspects of the events that we live.

It is very important to know how to detect these cognitive biases and modify them, since the opposite can lead us to normalize this type of pessimistic thoughts and adopting a more irrational general belief system, which is more likely to contribute to the discomfort psychological.

On the other hand, a second factor that has been able to contribute to the development of depressive states has been originated due to the own restrictions of access to the pleasant activities that could be enjoyed before the pandemic. Specifically, our Latino culture is more given to social interaction and activity outside the home. Therefore, we are more used to this type of social functioning.

In addition to this, it is worth considering the postulates of Maslow's theory of human needs, which defends the relevance of feeling emotionally linked to other people, where affiliation and social recognition are elements essential. Thus, a state of isolation maintained over time can lead to adverse psychological consequences for the individuals who experience them.

And as for anxiety disorders, what profiles of people do you think are most vulnerable to such a situation?

According to the consensus of expert authors in the field, there are various factors that can predispose a person to manifest greater vulnerability to this type of disorder, some more of an internal nature and others more of an environmental or external.

As for the former, there are certain personal profiles that present more marked traits of neuroticism, a component that is defined by low emotional stability, tendency to worry or nervousness as aspects more relevant. Characteristics such as high sensitivity or apprehension are also usually more pronounced.

All this results in the almost innate development of behavioral inhibition in the face of the unknown or the uncertain. In fact, in anxiety disorders a factor that maintains the symptoms is precisely the avoidance behavior, which It prevents the person from perceiving the situation that he considers "threatening" as surmountable, since he cannot cope with it. Thus, working on reducing said avoidance is usually one of the most important objectives of intervention in anxiety disorders.

On the other hand, the above can be combined with environmental factors such as repressive or repressive educational styles. too self-critical, where autonomy and active coping with adversities.

There is also a significant component of responsibility for events, whereby the person tends to erroneously attribute the responsibility to himself or herself. sole responsibility for situations in general and this leads to increased alertness and wakefulness in order to control and avoid potential errors or own mistakes.

Another significant variable refers to the cognitive interpretation that the person makes before certain situations, for which he classifies them as threats or dangers, when they do not really present that value. The latter also contributes to maintaining a constant state of tension, which can lead to more likely anxiety.

Finally, the occurrence of previous adverse external experiences such as illnesses, traumatic situations, problems that act as stressors derived from different life spheres such as family, conjugal, professional or social can also precipitate the appearance of this type of disorders.

How have confinement measures been able to affect those who already had a psychological disorder associated with social isolation?

In its aggravation, undoubtedly, and also in the appearance of other problems comorbid to the original one. The "permanent" nature that this pandemic situation is adopting is a factor that adds more complexity to the psychological problems that a person may present previously. The human being is prepared to tolerate a state of punctual, transitory, circumstantial stress, which can be understood as adaptive and natural; But it is not enough to bear that same state of uncertainty, tension or sadness for more than a year without interruption.

In the area of ​​social relations, as indicated above, problems have increased when dealing with, dialoguing and interacting with other people. The mechanism of behavioral habituation explains that the stimuli or situations that we are used to facing stop causing a state of alert in our nervous system.

Thus, after more than a year of pandemic, it seems that human beings have "become uninhabited" to these types of situations, and therefore have stopped normalizing them. In this year we have found many cases in which the fear of negative evaluation, feeling observed and judged in social contexts have been noticeably accentuated.

Can the fear of contagions become pathological?

Yes, of course. It can be more likely when different variables or factors are activated acting together; as I mentioned before, some more internal and others more contextual. It should be mentioned in advance that the experience of fear by itself is not a problematic phenomenon. A frequently observed belief in patients is the tendency to avoid experiencing the unpleasant.

Fear is a clear example: although it generates unsatisfactory sensations in our body, fear is an emotion useful and necessary because it communicates to us the existence of a potential danger or real threat, and allows us to prepare for its coping. The problem is when in neutral situations where there is no real threat, the person generates a distorted and irrational cognitive interpretation and behavioral avoidance of their coping. It is at this moment that fear begins to be pathological.

How is it possible to address these problems in therapy, from the cognitive-behavioral model?

From the cognitive-behavioral model, we work from the analysis of the problem based on what is called the triple system of answer: cognitions and emotions, physiological reactions and behavioral factors, all of them closely related between Yes.

In this way, depending on the reason for consultation and diagnostic orientation presented by the patient, what styles of thinking and what beliefs are dysfunctional and work is being done to make it adopt a more realistic type of reasoning and rational. On the other hand, emotional intelligence content is addressed and resources are provided to learn to identify and express emotions more appropriately.

As for the second factor, the physiological one, it is treated with greater emphasis on problems of anxiety and stress. In these cases, training is usually applied in breathing techniques, meditation type mindfulness and relaxation exercises, in order to reduce and regulate the nervous activation of the person.

Finally, regarding the behavioral variable, dysfunctional behavior patterns are analyzed and using techniques such as modeling or behavior rehearsal, learning and practicing more effective behavioral alternatives, as well as It also tries to promote the increase in daily pleasant activities or the progressive coping with complex situations or problematic. Progress and improvement in these three areas occurs more quickly in patients who carry out the task proposals between sessions, so that really cognitive-behavioral therapy is considered as a dynamic process of joint work between therapist and patient.