Interview with Fabián Cardell: anxiety problems in the COVID crisis

The way in which we manage anxiety is one of the psychological aspects that is most sensitive to the crises that occur around us. Radical changes in the economy, culture or social dynamics can affect us greatly, and even more so if these transformations are clearly for the worse.

In the case of the coronavirus crisis, all the ingredients are given for anxiety problems to skyrocket. To better understand the logic to which they respond, we interviewed an expert on the subject: the psychologist Fabián Cardell.

• Related article: "The 7 types of anxiety (characteristics, causes and symptoms)"

Fabián Cardell: understanding the anxiety problems triggered by the pandemic

Fabian Cardell Munoz He is a psychologist specialized in clinical psychology and based in Pozuelo de Alarcón, Madrid. He also works as a teacher for trainee psychologists, and disseminates behavioral science topics to make them more accessible to the general public.

In this interview, he gives us his perspective, as an expert in mental health, about the effects of the coronavirus crisis on citizens' anxiety management.

As a psychologist, in these months have you noticed changes in the type of problems for which people seek help?

The current situation is extremely demanding on the psychological resources of the majority of the population. Living with uncertainty sometimes becomes a very difficult mission. We do not know if we can infect ourselves or infect our families. We do not know when they will confine us again. We don't know if our jobs will be affected. We don't even know if tomorrow I will be able to go to work or study.

In addition, we have been exposed to situations that are very difficult to assimilate in a short time. Some of them very abnormal. We have experienced near deaths (without being able to say goodbye to our loved ones), social isolation, work stress (in the case of health workers and state security forces and bodies, for example)...

All these circumstances have had emotional and psychological consequences, which are reflected in mental health consultations in our country and in the rest of the world.

In our center we have noticed an increase in problems related to the family, mainly marital problems and emotional problems in adolescents.

We've also seen an increase in anxiety-related problems: agoraphobia, health anxiety, worries about the future.

It is also noteworthy that we have noticed an increase in relapses in people who already had a psychological disorder or problem. I believe that the aforementioned variables are the perfect breeding ground for people with a previous pathology who have seen their symptoms increase.

What do you think are the population groups most vulnerable to anxiety problems in this new situation of the COVID-19 crisis?

We already know that the elderly population is the most vulnerable to direct contact with the virus. However, the opposite happens if we talk about anxiety, depression or Post Traumatic Stress Disorder. Our elders are the least vulnerable to this type of problem.

Studies show us that the young population (18-39 years) is the one that has had it worst. The data shows that they have suffered more anxiety, depression and somatic symptoms than other population groups.

If we talk about professions, the ones that have suffered the most have been health workers and state security forces and bodies, as well as people who work in the transport sector. They have endured a heavy workload and have sometimes been overwhelmed by circumstances.

In our center we are specialized in the treatment of anxiety and we are aware of these difficulties. To help in these moments of crisis we are offering: Free first aid to health workers, Special prices for large families and also the unemployed.

Can cases of Obsessive-Compulsive Disorder and phobias intensify due to concerns about hygiene and prevention of contagion?

Agoraphobia and Obsessive Compulsive Disorder are anxiety disorders. Any stressful situation can affect this type of pathology, increasing its symptoms.

The person who is suffering from these problems has probably noticed that she has increased the time she spends on her rituals of cleanliness and has increased their avoidance (not going down certain streets, not being in contact with certain people, avoiding certain strips hours,...).

These behaviors that can decrease your anxiety in the short term and give you some sense of control, in the medium and long term they are increasing their obsessions, their fears and therefore maintaining the problem.

What I would recommend is that if you have noticed that these behaviors have increased and are affecting your quality of life or the quality of your relationships, get in touch with a specialist in anxiety disorders so that they can advise.

Many times, the most severe problems come not through the anxiety itself but through the behaviors that people adopt to alleviate that discomfort. Do you think that the pandemic situation encourages many people to try to combat anxiety by consuming addictive substances?

Indeed, for many people the way to manage discomfort is through addictive behaviors, both consuming some substances and alcohol, cocaine, cannabis,... such as increasing certain behaviors that can become addictive such as: online gambling, video games, networks social...

The trap of these forms of emotional management is that some relief or well-being is achieved in the short term (due to the dopamine that my brain secretes), but in the long term I add discomfort and more problems in my life, my family and social relationships worsen, my academic or work performance decreases and above all, I lose my abilities to manage my emotions properly. fury.

Addiction (consumption of alcohol, cocaine, technology,...) ends up being my only way to feel good. It seems that this model is repeating itself and increasing a lot these days, as a result of the moment in which we live.

Regarding the consequences of social isolation that many people have to undergo, which do you think are more related to stress and anxiety?

Social isolation entails in most cases a decrease in activity. We have less contact with our friends (except for video calls), our sports activity decreases (gyms are closed) and consequently, we destructure our day to day.

In addition, and also very importantly, spending more time alone at home increases the attention we pay to our problems, difficulties, dangers, etc... This favors an increase in anxiety problems and also depressive.

When we repeatedly look at the same problem, without taking action, it tends to feel bigger, overwhelming, disabling. This has very negative consequences on an emotional level. We will assess these consequences when planning our intervention.

What can be done from psychology to provide an answer to these anxiety problems caused by the coronavirus crisis?

We started this interview talking about how we have no control over what is going to happen, we don't know if we will get infected, if we will continue working... but what we do have control over, what we can choose, is what happens in us, what we think, feel or we make. We decide how we deal with this situation. This is going to be decisive in how we are going to experience this crisis.

All the techniques that we use at the center are based on scientific evidence, they have demonstrated their effectiveness in multiple patients who experienced similar problems.

The first thing we must understand is that anxiety is a normal and necessary emotion in potentially dangerous situations, thanks to this emotion we have been able to evolve as a species because in moments of threat we have been able to prepare ourselves to flee or fight (before a predator for example). The problem arises when this anxiety becomes very intense (for example with panic attacks), very frequent (every time I go out) or lasts a long time (I spend weeks in strain).

The first step to start redirecting my emotions is to identify my internal speech. It will be fundamental to know what I am saying to myself when I am distressed. For example: "I'm going to get infected and I'll end up infecting my family, I'll lose my job,...". We must learn to have a more realistic discourse, based on the present and on realistic data. Mark Twain said: "I have experienced many terrible things in my life, most of which never really happened."

Always putting the focus of attention on the most negative and dangerous aspects of reality will only stress and anguish us. Isn't it true that every time I take a curve with the car at a certain speed I'm not constantly thinking about the possibility of crashing? That would affect my stability and my driving. In the same way, it is important to focus on the aspects of our lives that we do control. For example, we can focus on our personal challenges, our sports routine, our friends, our family.

In therapy we accompany this process so that the person is able to address the circumstances of his life in the healthiest way possible. And thus achieve greater tranquility and quality of life.