Fernando Huerta: "We are little trained to manage the aversive"

Beyond the medical and economic implications of the SARS-CoV-2 pandemic, it must not be forgotten that the crisis unleashed by this situation has a strong negative impact on health mental health of many people: drop in income levels, movement limitations, risk of suffering from a life-threatening disease or of our loved ones suffering from it, etc

This type of psychological discomfort is often expressed through anxiety disorders and depression, two of the most common psychopathologies. To learn more about the relationship between these and the coronavirus pandemic, this time we spoke with psychologist Fernando Huerta, expert in the treatment of this type of problems.

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

Interview with Fernando Huerta: anxiety and depression in the pandemic crisis

Fernando Huerta Moreno He is a psychologist and trainer, and has been helping people with problems such as depression and anxiety disorders for more than 25 years. In this interview he talks to us about the way in which the coronavirus pandemic has had an impact on people's mental health through these two types of psychopathology.

Given that anxiety disorders and depression are part of the most frequent psychopathologies in Western societies, before the pandemic it is also expected that they are among the psychological disorders that grow the most in the number of cases and in influence on the people?

Yes, it is normal for them to grow, because there is already a high prevalence of both problems in our societies.

There was a proportion of people who had sustained signs and symptoms of anxiety or depressive disorders but had not addressed them, and when a factor like this appears from the pandemic, all these people see the problem increase considerably, in addition, other individuals who did not have samples of any of these also begin to be affected. both pathologies, but because of this new issue in their lives they begin to have them, although normally to a lesser extent in terms of intensity and frequency of the themselves.

Obviously, the longer the situation remains, the more damage it will do, to a greater extent to those who already had these manifestations. But also to those who did not have any, since when we see a threat and it is not solved, we get stressed and our state of mind is affected in an almost unavoidable in a graduated way, depending on the previous predisposition of how we were when this variable appears and the type of personality that each person has of base.

What elements of the pandemic do you think contribute the most to the emergence of cases of anxiety disorders in this context of the COVID-19 crisis?

The first is that it is an unknown situation for us, which requires special daily attention to something potentially dangerous, which can really harm or kill us, especially for some people who, due to their physiological and psychological characteristics, have the most immune system debilitated, previous diseases or genetic predisposition and therefore are more vulnerable to having worse consequences before the contagion of this disease. In addition, there are people who are very scared by illnesses or other events, or they were already very anxious or depressed, and that also lowers their immune system to a certain extent.

The second factor is that we can lose or have lost people we love on the front lines of our lives, with all that this represents or would represent. In cases of loss we must learn to adapt to the new situation, and that is always something complex that is not trivial. Normally an adjustment disorder occurs as a normal reaction, and this fact will have to be restructured well both at a cognitive and behavioral level, so as not to have stable negative consequences in our existence.

On the other hand, the simple negative expectation, that is, seeing in imagination something serious happen to our loved ones, or even cause their death, we It generates a lot of anxiety in a stable way and our mood progressively lowers, and as time goes by and things do not improve, we can become anxious and helplessness

Another aspect would be that without realizing it, our personal software to deal with situations of this type depth was not prepared in our society, if we compare it with respect to other times or other places. Before, the number of dangerous diseases was very high, and the means to deal with them were microscopic, because the sanitary science had not advanced, or its remedies were not available due to the economic characteristics of the country.

Our tolerance for frustration has been going down on this issue and on many others. We were almost setting up our life very faithfully to what we wanted, and now everything has changed drastically, causing us great disturbance. Not being able to go out, the masks, not interacting like before, the impossibility of traveling... there are many factors that have changed negatively and we have been caught weak in terms of the level of preparation to face them. We are very little trained to aversive and uncertainty, because we live in societies that have sold us the fallacy that everything is appetizing, that everything was controlled and predictable.

Finally, note that the accessibility we have of family, friends, acquaintances, neighbors, colleagues work, people affected by the disease both mildly and severely or lethally, it is increasingly frequent. But not only the disease and its possible primary and secondary consequences in us or in our loved ones or close, but also others such as labor issues, which has been complicated in some with what that implies, since it affects many of us aspects; We depend on income for a wide variety of things. All this puts us on alert and makes us see things more apprehensively, increasing our anxiety and undermining us emotionally.

And regarding clinical depression, in what ways do you think this situation can reinforce the presence of this disorder among the population? Through isolation measures and reduced ability to pursue hobbies and stimulating activities outside the home, perhaps?

Normally, when we have some anxiety more or less frequently on a daily basis for several months, depressive symptoms usually appear as a consequence. It is very logical that it occurs due to tension and negative vision, which ends up damaging our state of mind. Once we have this, or if we already had it before the pandemic appeared, in the first case it will usually increase until circumstances change, and in the second case it will be worse.

We have learned a way of interpreting the world and processing emotions and now our vision is going to be determined by that style of thinking that is usually given by a very typical of the anxious or depressed type, or both, so we take data, interpret it and label it following that format that guides us without realizing it, conditioning us negatively.

Regarding isolation, without a doubt there are direct correlations between social relationships and humor, the restrictions affect in any sphere of relational life, whether in family, work, school, merely recreational interaction or any other guy. Social interaction, whatever the type, is very important for people's mood.

Teleworking is not a blessing for the state of mind because it isolates us; spend all day with the computer, the tablet, the mobile, or the television... Everything in its fair measure is good, but when we abuse for whatever reason, it turns against us.

What tips do you recommend following to adapt to the new situation, preventing the appearance of anxiety disorders and depression?

Establish personal social protocols for action within limitations and prudence, not forgetting all the daily reinforcements that we have and that are for a fixed term. And to think that it is something temporary that is in the process of being solved, to take it as a vital challenge that has touched us, and that for many generations that we have not gone through any circumstance really complicated is something only relatively penalizing with respect to other situations of greater depth, with objectively much harsher consequences in their lives, than many people have had or have on a daily basis, but through habituation they have developed a greater ability to adapt depending on their usual circumstances, thinking that we can do it we also.

It is also important not to forget that we have more tolerance for frustration than we think, even though we have practiced it little; It's a matter of getting progressively stronger, so we'll get stronger as we go. getting we give ourselves positive feedback, and every day we will be stronger with respect to a situation.

It is also true that human beings have good resilience when things happen to us that limit or injure us, so if we train them well we will obtain good results; not immediately but in the medium and long term. Our ability to accommodate events is better than we think, and we will return to our previous state better than we think.

In addition, all this can help us to appreciate the situation in which we usually live thanks to science and technology, a quite pleasant or controlled world, thanks to its good use, in which everyday life is quite conducive and rewarding.

How do you know what is the point at which an anxiety or low mood problem has already acquired the seriousness of a disorder that requires going to the psychologist?

When the discomfort has a significant frequency and intensity, or persists for more than three to six months approximately, my advice is to go to a professional, since the Punishment is very hard and it is not convenient to bear it because of the suffering and the consequences, or because once we are acquiring a habit and a direction of negative thought it costs more undo it. It is for these two reasons that it is desirable to intervene, to stop the intense and concomitant discomfort, or to avoid make stable a cognitive interaction and pathological response in our relationship with the environment and internally.

If the level of suffering is harmful on a day-to-day basis, or if there are habitual interferences in normal life, in our work, in our relationships, in our hobbies or any other vital field, is that we are paying too high a rate and disproportionate to the external situation, and it would be good to address it in a way clinic.

If we have acquired psychopathological habits and have automated them, we should also treat them, otherwise we will feel almost the same even if circumstances change, because we have created neural networks that prevent us from thinking and acting correctly. In this way we will avoid chronic anxiety or low mood.

In cases where the person has already developed a very disabling disorder of either type, what is done in psychotherapy to help them overcome it?

The first thing to do is an individual story, in which the different aspects of the person's life are explored. We need to know this well to make a serious approach to the approach, a problem is not understood outside of a vital context, because it is decisive. This story is complemented by a biography, so that we do not have pieces of the puzzle without knowing and avoid errors due to lack of data that could be important when addressing the problem concrete.

Next we pass personality tests. Personality is the internal structure with which a subject relates to the world and to himself, therefore it is also fundamental. To explain it in a more understandable way, we would say that it is our operating system, which makes us think and act from a certain perspective with what that means at all levels; In addition, it will also determine in part the way of treatment is a matter since it must be adjusted to that structure.

Then specific tests are passed for each problem, either for anxiety or for mood. With these tests we obtain the intensity and also the diversification, that is, the severity of the problem and also to which areas the pathology has spread, in order to establish priorities when it comes to Act. We cannot give the same importance to light things as to those that are serious, the second would be the first to deal with and the first we would leave for later.

Subsequently, an analysis of variables is made, which are both the structural and situational causes that have created the disorder and that also maintain it. For a problem to have arisen, we have had an apprenticeship; In addition, for it to continue present, there must be factors that make it persist in a person, because otherwise, it would have disappeared. quickly, and that is why knowing well the elements that have created it and those that keep it there is essential for a good treatment.

Finally, the techniques and strategies are applied according to what was previously said, the problem, the environment, the lifestyle, the variables and the personality. To do this, you have to explain the theory to the person, do some training, adjust them, graduate, and request that they have an attitude of involvement and co-responsibility with the professional, since we are the technicians, but he is the one who executes, especially in the techniques of behavior because the cognitive ones can be applied to a greater extent in the office or online by the professional, but they still have to learn and activate them out.

With all this a diagnosis, an evaluation and a treatment are made, both problems would be addressed. Psychology as a science obtains very good results, as long as it is used and worked properly by the psychologist and the client, solving problems that are painful for people, but whose prognosis is good when they are intervened, so We must not despair of them, but address them to eliminate the discomfort and thus achieve well-being and happiness in our lives. lives.