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The coronavirus pandemic has forced the Italian population into forced isolation within their homes, and there is no doubt that this quarantine has caused conditions of psychological distress.

Why has the isolation, now known to all as lockdown, resulted in a state of mental illness?

The reason is related to theimportance ofsocial relationships in human beings.
Social relationships are indeed the basis of the evolution to an increasingly complex society, such as the present one: the sudden and totally unexpected deprivation of interpersonal relationships has deprived human beings of the most meaningful aspects of their lives.

Restrictions assumed by various national governments in order to contain the spread of the pandemic have caused people to be unable to meet with friends and relatives or to have access to venues such as theaters or restaurants.
Instinctive manifestations, such as simply “shaking hands,” came to be missing.Social distancing itself was felt to be a barrier to the individual’s freedom.

Mental health problems are a common response to pandemic COVID-19; symptoms such as anxiety and depression increased from 16 percent to 28 percent, while stress conditions were found in 10 percent of cases.
Also related to stress are sleep-wake rhythm disturbances with frequent night waking and poor sleep.
Among the most at-risk groups are the elderly, pregnant women, people with pre-existing conditions including mental illness, out-of-home students, the homeless, and migrants.

Psychological stress can manifest itself, in addition to sleep-wake rhythm disturbances, in different forms, which may include:

  • concern for their own health and that of their loved ones, including the unpredictability and severity of the illness;
  • Fear of losing the security acquired over time (work, affections, friendships etc.);
  • Attention and concentration deficits;
  • feeling of loneliness and boredom;
  • Increased use of alcohol, tobacco and other psychotropic substances;
  • Worsening of any pre-existing chronic diseases.

Theeconomic impact related to COVID-19 and the anxiety of losing available resources also contribute to the malaise.

How to deal with this state of malaise?

The following is a list of strategies aimed at reducing epidemic-related stress:

  • accurate information to the public in order to minimize responses such as“panic” about the disease and its transmission; for example, the use of specific preventive measures, such as handwashing, has partly mitigated the occurrence of mental disorders;
  • Improving social support;
  • maintaining as normal a life as possible, even in the presence of security measures;
  • Use of available psychosocial services, particularly online services;
  • training of teams of qualified specialists to deal with emotional distress and the need for adequate training of health personnel;
  • Use of online surveys to assess the extent of mental health problems;
  • provision of online counseling and self-help services, and in particular seek to bring mental health services online;
  • Development of telemedicine services for diagnostic and counseling purposes;
  • Improving linkages between community and hospital services.

Such strategies offer the hope that mental health services can be provided in a more easily accessible way without any increased risk of infection. However, the above strategies are crucially dependent on the availability of adequate personnel and infrastructure.

In a very recent study (Banerjee et al, 2020), the central figure of the psychiatrist is particularly emphasized, with six key roles attributed to him or her:

  1. (a) educate the public on the most common psychological effects of a pandemic;
  2. (b) motivate the public to adopt strategies for disease prevention and health promotion;
  3. (c) integrate the services of Mental Health Departments with available health care;
  4. (d) teach problem-solving strategies to cope with the current crisis;
  5. (e) Empower patients with COVID-19 and their caregivers;
  6. (f) provide mental health care for health care workers.

Finally, some simple tips for dealing with the symptoms of stress:

  • Try to respect the usual sleep-wake rhythms by going to rest and feeding at the usual times;
  • Continue taking medication for any other conditions;
  • Keeping one’s home in order;
  • Avoid the use of alcohol and drugs;
  • Try to get some physical activity even if it is simply by moving around inside your home;
  • try to do activities that keep one’s brain engaged such as reading, crosswording, cooking, etc;
  • maintain contact with their friends and relatives, trying not to talk exclusively about pandemic issues;
  • if physical complaints arise, such as alterations in sleep-wake rhythm, feelings of apathy or disinterest in surroundings, or anxious state, contact your doctor.

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