A second confinement would be more psychologically damaging than the first, experts say

• Life crises, reactivation of traumas, phobic behaviors, relationship problems and feelings of anguish and hopelessness, which occurred then, would return to Spanish families.
• Top Doctors experts explain “Our resilience is affected by fatigue. The effects of the first confinement would emerge faster and stronger” and give tips to overcome partial confinements and a possible second wave

Barcelona, August 11, 2020.- Holidays are being for many an escape route from situations of confinement in which they have lived moments of anguish, stress, fear and uncertainty, and great sadness. Experts have seen how obsessive behaviors, phobias or temporary psychological disorders have affected the population to a greater or lesser extent, with or without previous symptomatology, and warn that a possible second confinement could reopen sequelae not yet healed, and could be much more harmful to mental health than the first. The experts at Top Doctors explain.

The Spanish population is worried about their economic health, and also mental health. “When the door opened and Spaniards left home, we began to receive consultations with hypochondriasis and compulsive behaviors, apprehensions, obsessions and fears. But, in general, what patients tell us is their state of physical and psychological exhaustion,” explains Marta de la Fuente Lago, health psychologist and director of training at the Área Humana Psychology Center in Madrid, a specialist in anxiety and stress disorders, and a member of Top Doctors. The expert explains that facing for the first time a situation in which one experiences such a lack of control in so many areas puts people in a situation of continuous uncertainty that leads to anguish and hopelessness that are very difficult to manage. In this sense, a good management of mental exhaustion and uncertainty would be key to face the new implementation of restrictive measures or a possible second confinement.

A still latent ’emotional deregulation’ that would affect resilience.

Society has faced an emotional turmoil that has been alleviated by the lack of restraint and vacations, a new air, a return to old routines and a greater number of social encounters that allow us to feel vestiges of a pre-covid state. However, with the arrival of the resurgence, the return of restrictions and partial confinements, the alarm bells are ringing again. Maria Rosario Gomis Ivorra, psychologist specializing in Emergencies, EMDR clinician and member of PSICOEMERGENCIAS CV and Top Doctors, participated in several psychological care lines of the Valencian Community during the confinement. “At the beginning, most of the calls were from women between 50 and 60 years old, with dependents and with small dwellings. But then we were joined by people of all genders, social status or personal situation, such as those who were isolated and had no one who could help them. In 65% of the cases they presented depression, and anxiety in 27%”.

The expert assures that the population is currently experiencing problems of emotional dysregulation, trying to restore normality to their lives, and that a hypothetical new confinement would quickly aggravate mental health. “Those effects that we all suffered progressively during the first confinement would emerge faster and stronger. Our resilience would be affected by the fatigue caused by the first emotional dysregulation,” he explains.

Multiple personal and family situations with different sequelae

During the confinement, the population has had to face many changes in their lives. In the consultations, the experts have mainly observed the following situations:

• Life crises. Adults with anxiety disorders aggravated by confinement, who question their lifestyle and are motivated to change their interpersonal and emotional relationships and their time management and quality of life.
• Grief and emotional loss: relatives of those who died from Covid19, experiencing the beginning of the grieving process, “with different peculiarities, such as guilt for not having been able to accompany their relative in the last moments of their life and a feeling of unreality, given the impossibility of performing the usual farewell ritual” explains Dr. Luisa Fernanda Yágüez Ariza, clinical psychologist specializing in family and child psychology, and member of Top Doctors.
• Reactivation of traumas. People who show anxiety and a feeling of reliving traumatic situations suffered in the past, almost always during childhood and adolescence, “because the pandemic makes them experience an extreme existential situation in which the feeling of helplessness, lack of control or impossibility of defending themselves from a real threat predominates,” says the doctor.
• Phobic and paranoid reactions. These are related to the fear of contagion of oneself or the people under one’s care, to which one reacts with obsessive-compulsive crises of cleanliness, OCD, superstitious behaviors and sleep disorders (nightmares and insomnia).
• Couple breakups. Acute emotional crises as a result of breakups in couple relationships, where the inability to assume the reality of the situation, emotional dependence, low self-esteem and unbearable feeling of abandonment predominate.
• Family communication problems. According to expert data, in recent months 40% of couples have been seeking therapy to improve their communication with both their partners and their children.
• Parents and children immersed in conflictive divorces. Usually given in couples with previous poor communication. The confinement exacerbates their inability to adapt and to make agreements regarding visitation or communication with the children more flexible, which leads to a serious increase in conflict and a tendency to prosecution, affecting the children and adolescents involved, who develop anxiety crises and psychosomatic symptomatology.
• Lack of job and personal control. Uncertainty regarding the employment situation leads to a continuous feeling of insecurity and vulnerability with respect to the economic situation, resulting in anxious-depressive symptoms. Another cause of stress was the need to work and take care of the family at the same time, which affected the quality of family relationships.

Acceptance and application of what was learned

However, according to data extracted from Top Doctors.es, up to 7 out of 10 of the patients are grateful for the situation and the way they have been able to live during the confinement that began in March, accepting the circumstances and coping with them in the best possible way. The Spaniards have been gradually adapting to the circumstances and assure that they could now better apply what they have learned. Next, our specialists offer us a series of tips to psychologically cope better with the new restrictions that appear with the new outbreaks that have occurred:

1. Organize your day in such a way that you always know what you are going to do, in order to gain a sense of control. Always with flexibility, if there is no time to finish something, I will finish it tomorrow.
2. Try to do things that until now you couldn’t do because of lack of time. Now that you have it, you have to enjoy it.
3. Repetition forms a habit to increase the feeling of control and security. Routine application of safety distance, hand washing and masks will become normalized and integrated into our daily lives.
4. Keep in touch with the people around us and establish new ways of giving and receiving affection, so that physical distance does not imply affective distance. It is important to learn to express emotion with the gaze, to be aware of the tone of voice, and to put into practice gestures that indicate to others our empathy, solidarity and closeness.
5. Try to make time for physical exercise, even if it is indoors.
6. Try to make sure that staying informed is not the only motivation for the day.
7. If you have children, try to convey calmness and control, always telling the truth if they a
   sk.
8. Ask for and accept help. New psychological symptoms will gradually emerge, and with them the need to receive emotional support and containment, especially from family and friends, but psychological care will also be necessary in those cases in which anxiety and irritation burst and produce an overflow that is impossible to contain.

The WHO recommends, in general and to combat depressive states:

1. Do aerobic exercise, in sunlight hours, at least 50 minutes a day.
2. Eat a healthy and, if possible, Mediterranean diet.
3. Sleep, horizontally, about 8 hours more or less.