Wednesday, October 27, 2020, will Emmanuel Macron announce a reconfinement? Possible. And for some, the psychological impact is likely to be severe … We take stock and we organize ourselves, to better protect ourselves.
The rumor swells and swells: extended curfew, confinement on weekends, even re-containment short … Hard for our morale, already tested by a year of Covid. The objective of these measures remains essential: to protect the health of all, above all, the most fragile. But be careful not to prioritize one aspect of health to the detriment of others … As the World Health Organization reminds us, it is defined as "a state of complete physical, mental and social well-being and does not consist only of the absence of disease or infirmity." However, this mental health was severely tested during the first confinement, between March and May 2020. How to manage the idea of a re-containment, or even its application?
The French at their wit's end
Since the arrival of the pandemic in France, Santé Publique France (the national health agency) is taking our pulse. Through its CoviPrev survey, it monitors not only the evolution of behavior (barrier gestures, confinement, alcohol and tobacco consumption, diet and physical activity) of the French, but also of our mental health (well-being , psychiatric disorders …). And according to this survey, there is currently an increase in symptoms of anxiety and even depression. Faced with which we are not equal.
After analyzing the agency's data, the newspaper Le Monde notes potentially aggravating factors. Among them, the fact of being "a woman, a parent of child (ren) aged 16 or under, and to declare a difficult financial situation". Living conditions also have an impact such as "Telework during confinement and have a loved one sick or who has had symptoms of Covid-19". Finally, precarious people, but also caregivers are finally more exposed to a deterioration of their psychological state, as are the inhabitants of certain areas, very affected by the epidemic. Among the regions with high anxiety rates during confinement (up to 30%): Île-de-France, Grand Est and Bourgogne-Franche-Comté. Depressive states also increased enormously at the end of March, amounting to a quarter of the population of the Grand Est.
Be careful, however, not to darken the table. Astrid Chevance, psychiatrist and researcher in clinical epidemiology at CRESS (Center for Research in Epidemiology and Statistics) qualifies as follows: "In this study, the symptoms are self-reported, and therefore do not necessarily sign the presence of a constituted disorder. Here, no formal diagnoses, which require that we see a doctor or a psychiatrist. But the suggestive signs detected can arise from an anxiety or a contextual depression which, for their part, are probably on the rise. " If there is an increase in, among other things, depressive symptoms, this does not necessarily mean that there is an increase in depressions as such. On the other hand, the pandemic does have an impact on general morale, and the period in which a containment could occur is not neutral.
The end of 2020, a particular context
According to Dr. Chevance, there is no such thing as a crystal ball, only several assumptions about the situation ahead. "As we are in unprecedented situations, no one can predict their impact with certainty, specifies the psychiatrist. As doctors and / or scientists, we adapt, but just in time. " Still, the study of the context makes it possible to anticipate. On the positive side, the French have already experienced confinement. We can therefore estimate that many of them will know how to (re) create a routine. On the negative side, and the results of the CoviPrev survey show, everyday life is harder for some, who can expect to feel a form of exhaustion and anxiety.
The specialist also notes that it is the end of the year. A re-containment as Christmas and New Year looms can weigh on morale … "As the holidays approach, the reality principle is going to be harsh, estimates Dr Chevance, and even greater resilience resources will have to be mobilized. It's winter too, and as the light dims, seasonal depressive symptoms reappear. At the individual level, everyone should therefore pay particular attention to their mental health, so that the chronic stress of uncertainty ".
Last particularity: a gloomy news, marked by the looming economic crisis, as well as by the count of patients and victims of Covid. To get out of this anxiety-provoking and depressing tunnel, it will therefore be necessary to adopt the attitude of a marathon runner, with precise training.
In case of re-containment, anti-depression tips
The rule to follow, according to Astrid Chevance: remember that you must take care of your physical AND mental hygiene. "The sinews of war: sleep, appetite, physical activity", she details. Three pillars around which we will organize our routine against spleen. To begin with, the psychiatrist invites you to regulate yourself emotionally, difficult in such a context but essential to keep up a marathon. The basis: identify your emotions, that is to say, manage to objectify your emotional, mental and psychic states that you are going through, so that they do not turn against you or against those around you. A little tip from Astrid Chevance, valid for teleworking as when we re-fine with several people: "wondering if it's the other one or the situation that infuriates us." To be clear about your emotions, nothing better than meditation. If this is not your thing, a lot of advice is available on Santé Publique France.
Once you've managed to connect to yourself, feel free to identify everything that feels good to you, then create little rituals, schedule at fixed times to feel even more grounded. e. A hot bath, a book, a series, a good meal … "As long as we notice that certain things do us good, without being dangerous for our health in the medium or long term", we let go, encourages Astrid Chevance.
Finally, since the season is not playing in our favor, we can consider light therapy, effective against depressive symptoms and sleep disorders. The ideal: schedule the sessions 30 minutes after getting up, with a suitable device.
What if it doesn't work?
When you feel yourself slipping into a state of stress, anxiety or depression for more than 8 days, it is worth discussing the matter with a doctor. The criteria for identifying a state of depression? The alteration, for more than 15 days, of the mood, but also the loss of pleasure, sleep disorders with nocturnal awakenings, the inability to go back to sleep or even having trouble concentrating, reminds Dr Chevance.
The psychiatrist also warns about addictive behaviors that can occur during confinement: cigarettes, food, taking anxiety … "Be careful not to lose control, she explains, and if so, there is no shame in asking a doctor for help ". It is also important to monitor children's mental health: changes in behavior, including irritability, anger, profound silence or withdrawal.
Who to discuss the matter with? In the first place, it is possible to consult your general practitioner, who can then redirect to a psychologist, a psychiatrist or a psychotherapist. The difference between these three professions: a psychologist has a master's degree in psychology and has the ability to deliver psychotherapy; a psychiatrist is a doctor, authorized to deliver diagnoses and drugs; a psychotherapist has state-recognized training in psychotherapy such as hypnosis, for example.
Finally, Astrid Chevance warns: in the event of recurrent suicidal ideation, you must consult as quickly as possible, because there is a psychiatric emergency. "We must not trivialize these suicidal ideas and behaviors", insists the psychiatrist. Whether the next few days are marked by an extended curfew, a new confinement or quite simply, the extension of the limitation of social life, the goal remains the same: the care of oneself and those close to them.