A more hidden, more far-reaching and protracted "secondary disaster" of COVID-19
Written by | Chen Xiaoyan
Source | "Medical Community" public account
Hostility spread as fast as an epidemic. This is the strongest feeling chen yao who lives in Baoshan, Shanghai, in recent days. Since the lockdown on April 1, the residents of the community have not left their homes for more than 20 days. At first, the community was relatively stable, but in recent days, the sound of people arguing can be heard almost every day.
Early last week, when corridor volunteers were notified to do antigen examinations, they were scolded and cried by an elderly resident. Some residents insisted on going downstairs to walk their dogs, and they had a conflict with the police who came to dissuade them, and attacked the police. Sometimes, the noise crossed the silent neighborhood: "Come, fight to the death." She heard someone shouting provocatively. Chen Yao realized that after the extension of the sealing period, the negative emotions accumulated by people may have reached some peak.
Community residents appealed for understanding of the volunteers
Mental health issues under the epidemic are like reefs under the water. Compared with the direct impact of the epidemic, the impact of mental health is a more hidden and more protracted "secondary disaster".
Kevin Xu, a former associate professor at Peking University and ph.D. in clinical psychology and a psychiatrist, expressed his concern to the "medical community": "No disaster, as complex as today's COVID-19 pandemic, has swept the world, causing lasting and serious impacts. ”
In his view, the new crown epidemic is a bit like a chronic disease, repeated over and over again. The extent to which the pandemic will ultimately affect is still difficult to assess, "but there is at least one consensus now – the pandemic must have had a huge impact on human mental health." ”
Under the epidemic situation,
Why do people become sensitive and irritable?
Since the outbreak of COVID-19, China has been implementing the strictest epidemic prevention measures. Dr. Kevin Xu told the "medical community": "The ban on the community and the disruption of the living state will definitely cause a strong negative impact on people's psychology." "Unrestricted activities, normal work, and the companionship of intimate relationships are all important foundations for people's mental health. But the pandemic has destroyed all that.
Jiang Changqing, director of the Department of Clinical Psychology at Beijing Anding Hospital, was one of the first experts to be exposed to the mental health problems of the epidemic. In his view, under long-term control, anxiety, anger, and depression are the most common emotional problems.
Some special groups of people, such as the sick or people who have died in their homes, will also have obvious stress reactions, such as self-isolation, inability to eat, sleep, and non-contact with people. Others will fall into a state of excitement, become talkative, and lose their temper easily. In the most serious cases, suicidal tendencies will also occur.
The ubiquitous negative information also made Chen Yao, who was in Shanghai, feel breathless. The number of new infections on the Internet every day, the news that some patients cannot seek medical treatment, and the pleas for help issued by vulnerable groups have become message pushes that constantly bombard her mobile phone. For a while, she was unable to concentrate on her work, falling into a sense of confusion and despair, rejecting all news about the epidemic.
Dr. Kevin Xu believes that a large part of the psychological trauma caused by the epidemic is a sense of loss of control and powerlessness. Ordinary people who are exposed to negative news but are unable to reverse the status quo will fall into anxiety and depression, and even "alternative trauma". (Alternative trauma is when a person does not experience a traumatic event in person, but simply witnesses or hears about symptoms similar to the person.) ）
Therefore, Dr. Xu suggested that ordinary residents, especially those who are not in a good psychological condition themselves, should try to avoid contacting this information and only pay attention to the epidemic prevention instructions and notices issued by the government.
Director Jiang Changqing also suggested that you should pay attention to the news, but do not pay attention to the news at all times. During the epidemic in Wuhan, experts called on ordinary people to pay attention to the news for no more than 10 minutes a day. In addition, Director Jiang believes that negative emotions such as anxiety should be regarded as normal things, and accept it, rather than trying to get rid of it. The more you want to get rid of it, the greater the psychological burden.
Collapse, sudden death, suicide, why do they happen so frequently?
On the afternoon of April 12, Qian Wenxiong, a cadre of the Shanghai Hongkou District Health Commission, died at the age of 55.
On April 14, Chen Shunping, a 71-year-old Violinist in Shanghai, was overwhelmed by illness and committed suicide.
In addition, it is rumored that a woman in Shanghai asked for help from a delivery man to deliver food to her father 27 kilometers away, and committed suicide after encountering online violence.
Why are there lives dying in places that are not directly threatened by the new crown virus?
Dr. Kevin Tsui has written that under great pressure, people will become crazy and unable to think rationally. Under the siege of negative information and emotions, only the problems and dangers are seen, and the possibility of solving the problems is not seen, so that hasty decisions are made.
"No matter how strong psychologically and physically strong, under long-term pressure and danger, people will lead to physical and mental exhaustion, and there will be more serious physical and psychological collapse." Dr. Xu wrote.
Kevin Xu, founder of Da Ru Psychology, Doctor of Clinical Psychology, Psychiatrist.
In the current Shanghai epidemic, there have also been front-line epidemic prevention personnel who have had similar situations. At noon on April 12, Zhang Zhen, secretary of the General Party Branch of Yongkang Residential Area, Tianping Road Street, Xuhui District, received a call from Mr. Yu Lao, a resident, who was unwell, but lacked medicine and food at home, wanted to go to the hospital to do CT, and reflected with the neighborhood committee for a long time without a response.
In the face of the old man's dissatisfaction, Zhang Zhen also became out of control: "I am also very anxious, I am also very angry, I am also very angry, but we can't do anything... Maybe one day I can't bear it, I quit first. ”
After media interviews, people learned that Zhang Zhen had been stationed in the territorial community since March 12 and had not returned home for more than 30 days, unable to meet with his parents, wife and daughter in Pudong. Before receiving the elderly's request for help, Zhang Zhen was also urgently transporting a pregnant woman to take care of the aftermath for the elderly who had passed away.
Dr. Kevin Tsui observed that frontline anti-epidemic personnel often face the problem of excessive pressure. In the Shanghai epidemic, many front-line anti-epidemic personnel are local, they are victims of the epidemic, and they need to work under high pressure for a long time, and they will also face emotional collapse and energy exhaustion, and their own state is precarious.
This has long been a lesson in Wuhan in 2020. At that time, after the outbreak of the epidemic, Zhang Hui, secretary of the party committee and director of the Hunan Provincial Health and Family Planning Supervision Bureau, has been on the front line of prevention and control, leading teams to major hospitals for fever clinics, stations and docks, CDC, highway intersections, checkpoints and other places to supervise epidemic prevention and control measures. In the early morning of February 1, due to overwork, Director Zhang Hui died of a sudden heart attack and ineffective rescue at the age of 56.
Dr. Xu believes that it is necessary to ensure the rest of the frontline anti-epidemic personnel and give sufficient support and protection, because only by helping the frontline personnel can they better help others.
And for ordinary residents in lockdown, what should be done to maintain psychological health as much as possible?
Dr. Kevin Tsui believes that an important and effective way is to establish a "sense of connection" with people. He explains: "Although you have experienced terrible things, you are not alone, you have the support of family, friends, and community. ”
This has been verified in the post-disaster psychological assistance work in Wenchuan. Dr. Xu Kaiwen and Zhu Changzhen, a reporter of Dahe Daily, followed 10 families who had lost their independence in Yingxiu and Dujiangyan for a decade. Of all types of psychological trauma, loss of independence is the most serious. Kevin Xu observed that in order for people to get out of this huge trauma, in addition to government policy assistance, they also need social support from friends and relatives and their communities.
During the epidemic in Shanghai, community leaders and corridor volunteers have maintained the living supply and order of community residents. Neighbors who did not know each other in the past began to watch out for each other and once again experienced the warmth of neighborhood relations. In Dr. Kevin Tsui's view, this is a very helpful behavior for mental health. He is also thinking about how to let people in the community do some activities through non-contact ways to promote community unity and understanding and support.
The psychological impact of the epidemic is still difficult to assess
The pandemic is completely different from other disasters.
Dr Kevin Tsui pointed out that first, the vast majority of disasters will end in a short period of time, but the epidemic has lasted for more than two years, and when it will end is still unknown; second, disasters are usually localized, and no disaster has swept everyone around the world like the new crown. Moreover, a general catastrophe will not bring about a drastic change in the way of life of humanity as a whole, but the COVID-19 pandemic has done so, which has given it the character of "collective trauma". Outside of the affected area, people who are not infected can also be depressed by collective trauma.
In the view of Director Jiang Changqing, from 2020 to the present, for most people, the epidemic has slowly evolved into a "chronic stressor" and become a potential and long-term precipitating factor for mental health problems.
In the consultation that Director Jiang Changqing recently received, there was a patient who had a broken source of income due to the epidemic, shops could not be rented out, there were few deposits at home, and there were mortgages and car loans to be repaid every month. Under the pressure of the economy, he suffered from major depression.
After 2020, signs of a sharp deterioration in people's mental health are emerging. Dr. Xu cites the World Health Organization report to illustrate this: the epidemic has led to an increase of about 0.53 billion people with depression in 2020, an increase of about 27.6%, and in addition, the epidemic has led to an increase of about 76 million people with anxiety disorders in 2020, an increase of about 25.6%.
Dr. Xu found that after the epidemic, the suicide rate of adolescents was two or three times that of previous years. Such problems are still being studied.
How big is the psychological impact of collective trauma on humans? Director Kevin Xu believes that this issue is still difficult to assess and lacks sufficient research and discussion. Because the epidemic is not over, it is far from the problem of healing collective trauma.
From the perspective of regulating anxiety and depression, Dr. Xu pointed out that the first thing to do is to adjust your mindset. Accept the fact that the epidemic may exist for a long time, and then see if there is a chance to change, do not imagine that the epidemic will suddenly disappear one day, life will completely return to normal, the stronger this expectation, when it can not be achieved, the greater the frustration will be. Without controlling what cannot be controlled, only by accepting anxiety can we eliminate anxiety.
Jiang Changqing, director of the Department of Clinical Psychology of Beijing Anding Hospital
(According to the interviewee's request, Chen Yao is a pseudonym)
Source: Medical community
Editor-in-charge: Zheng Huaju
Proofreader: Zang Hengjia