the current pandemic is one obvious side effect: we all become more educated in terms of medicine and health. We know there is a covid, it is fraught with severe pneumonia, thrombosis. And, as it turned out, not without mental health disorders.
George Kostiuk: each of the pandemic his face, or rather, many faces. Yes, pneumonia, thrombosis, and Yes, unfortunately, Yes, very serious stress. The feature of this pandemic that its information component in strength not inferior infectious and can be even more serious impact on our mental health. I don’t need to go far. Take for example one of the largest psychiatric hospitals in the country – Alexis hospital. Patients are almost without exception now find themselves in the viruses, blamed himself for the spread of this infection. Some become aggressive, while others go away. And we, the professionals, is very difficult to remove them from such conditions.
But today we are talking not so much about them, but about those who on all counts is mentally healthy. Look around and you will notice: someone complains about the fears of someone in a bad mood, someone is on insomnia, someone on headaches, numbness in hands and feet, loss of appetite. And someone suddenly changed the perception of odors and taste. Yeah, the last clear. All already know that one of the manifestations covid – loss of taste and smell. And now all these symptoms are also felt in the absence of the virus.
Then our conversation suddenly breaks into a phone call: Georgy Petrovich reported that Alexis to the gate of the hospital with sirens came five fire crews. What’s the matter? Someone of the patients lost his nerve, and his message: “Fire, burn!” was so convincing that firefighters arrived. Alas, almost a common situation of our days of withdrawal from self-isolation.
My friend fire is not. She was a little over seventy, and she constantly complains that sweating that she felt dizzy, she stopped sleeping. She swallows handfuls of tranquilizers. Appeals to different specialists – from cardiologists and neurologists to psychiatrists don’t help.
George Kostiuk: You know, she’s lucky. Somehow she manages to get to all the experts. Meanwhile, we need to consider that all medical institutions, even in Moscow, work with an extraordinary tension. Some patients at the time lost the opportunity to get to specialists. But I must say, the complaint of your friend is not uncommon. Indeed, long-isolation in conditions of conflicting information that we hear on TV, when we some say that self-isolation is useless, others say it’s the only chance to defend yourself… ToUDA poor man to go? Now who says the accelerated arrival of the second wave. How not to go crazy?
George Kostiuk: I am Sure that if all goes well and all the conditions of self-isolation will be removed if there is no second wave, if they work as fitness clubs and parks, if you will resume operation theatres, all accumulated over the months, the voltage will gradually recede, and we all soon forget as about a bad dream.
You listen, because everything goes so unnoticed? And all so simple?
George Kostiuk: unfortunately, no. There are so many vulnerable groups that suffer most from isolation. People with increased anxiety, experiencing a parallel to other stressful situations related to loss of loved ones, fundamental changes in living conditions. For them, the isolation may lead to depressive disorder, which in itself will not work.
This help – and do you know this – not widespread. It may be remotely, via telemedicine technologies?
George Kostiuk: Telemedicine technologies are included in everyday psychiatric practice. And it is not necessary to treat this ironic. It really is for many a way out. And most importantly, what help of telemedicine technologies in our profession, is to overcome the psychological barrier of turning for psychiatric help, and not territorial. Because it is fear that treatment to a psychiatrist – the main obstacle to obtaining aid. No one wants to seem crazy. And the fact that psychiatric care is very often in need of absolutely normal people – fact. By the way, if you still covid second wave was coming and we will have to return to isolation, the so-called psychiatric consequences can be much bigger.
So maybe it is necessary in advance to prepare for it?
George Kostiuk: And we are ready. How? Create a complex telemedical forms of providing psychological and psychiatric assistance. Here and work with people 65+, and this is one of the most vulnerable groups.
Four years ago you have created in Moscow the Clinic of memory.
George Kostiuk: the Number of people wishing to become participants in its rehabilitation program initially exceeded its ability, and because we are constantly expanding the scope of patients. And now it turned out that this clinic is very to the court that its programs it is possible to work online. And now the memory Clinic is not tied to Moscow, she went to the regions. And immediately became obvious: the main difficulty – the footage will help those who have depression and stress.
And in addition to the memory Clinic? I had stress. Where to go to whom? Who n��means drugs? Whether these drugs?
George Kostiuk: In your question is where and who to contact. Again, no need to fear the treatment. Ideally, you should turn to specialists psychoneurological dispensary. It is in these institutions work clinical psychologists, psychotherapists, psychiatrists. As a rule, no prior tests, medical reports are not required. Notice that in addition to the public institutions there are private professionals. But here attention! They must be licensed to provide mental health care. I say this not by accident, because multiplying occasions when instead of a specialist patient gets, to put it mildly, to the quack. Very important is the patience and the specialist and the patient. Specialist – in order to listen carefully. The patient to learn to Express their grievances. Yes, say, insomnia. One sleeps badly, wakes up often, the other night, and the third arise early awakening with inability to fall asleep until morning. It is a completely different condition, and recommendations will be different too. And not always salvation brings even the most modern the best tablet. In some cases, the patient is most effective will assist psychotherapy, sometimes just conversational psychotherapy. Often to hear all the experiences of the patient and to understand them – is more effective than taking best pill.
Sounds nice. But in practice, an employee of the same neuropsychiatric clinic have the knowledge and time to listen, understand and prescribe treatment?
George Kostiuk: These professionals are often the biggest deficit. I really hope that the lessons of the pandemic will force us to think not only about what is always and everywhere need infectious disease specialists, but also experts in the field of mental well-being.
How do you feel about the fact that the stress relieve a good cigarette or a glass of wine? Maybe the same shot of vodka would help.
George Kostiuk: Is not an option. A shot of vodka, maybe it’ll help you sleep. But later it will only worsen the condition, the psychological load will increase and more toxic. Unfortunately, we know that in the early days of the pandemic, the shelves of alcohol were devastated, people were bought in store. Whether it led to an increase in alcoholic psychosis, I can not yet say. After a month of isolation, we conducted an anonymous mini-survey. Evaluated the level of anxiety, depression, distress. For the month of isolation of the big changes in the psyche we have not found. However, about one-third of women and a quarter of men showed increased levels of anxiety. Many have observed signs of depression in men 10%, women 15%. However, the clinical valuethe physical volumes these changes did not represent special treatment of such cases was not required. The results after three months are now processed and analyzed. But we can safely conclude that the prevalence of anxiety and depressive symptoms increased in multiples. And yet undertake to say: if the beginning of the removal of restrictions will consistently continue, we will emerge from this situation with minimal losses.
we Conducted a survey showed what the population expects from experts on mental health. First, this is a serious correction, the media’s work to reduce the flow of negative information. For many it is important to contact the hotline for psychological support. We cannot say that such a service we have. It is, but its efficiency is below any criticism. And that’s because, again, not enough specialists. Especially disturbing is people’s lack of family psychotherapy. For anybody not a secret that in recent years, more tragedies occur in families.
Who is more likely to suffer from depression: men or women?
George Kostiuk: it is generally Accepted that women are more likely to suffer depression. But men suffer depression more severely. And male alcoholism is often a result of depression. There is an expression “to go into the bottle”. It’s just about men who stress drink alcohol. So it was, unfortunately, so is, although science and practice have proved that any alcohol only exacerbates the suffering. And in addition, causes a rash, often fatal actions.