As we face all manner of new pressures and uncertainties each day, it is natural that dealing with crises and roadblocks has amped up levels of anxiety and depression. To get some insight into how we can manage all this, we turned to Prof. Dr. Abdel Nasser Omar, Professor of Psychiatry and Neuropsychiatry and CEO of Al Mashfa hospital.
CWM: Dr. Abdel Nasser, have you noticed a substantial increase in anxiety-based cases in the past few months?
Yes, definitely with the Covid-19 issue the rate of anxiety has increased in both my patients and the general population. Buts let’s differentiate between anxiety and depression symptoms and anxiety and depression disorders. Anxiety increases with people who are already predisposed to it. The main problem with Covid-19 is uncertainty. We are faced with tremendous stress. A lot of people first went into denial, saying it is some sort of conspiracy, that it doesn’t exist, but this has quickly been followed by anger and resentment at having to endure lockdown and social restrictions. This has been followed by depression, and now a phase of acceptance, with the widespread wearing of masks and social distancing. The realization has hit people that it is an equalizer, that it makes no difference how wealthy or influential you are, you can still contract Covid-19 like anyone else, so they are looking at a different meaning in their lives.
We must differentiate between anxiety symptoms and anxiety disorders, and depressive symptoms and depressive disorders. We are actually seeing an increase in the symptoms of anxiety and depression, not in the actual disorders. It is mainly the people who are predisposed to anxiety or OCD who will manifest the chronic stress symptoms.
Which issues are uppermost in people’s minds?
Apart from the actual virus, people are undergoing financial hardship, grief and a lack of social activity. Social interaction has always been a great lubricant for dealing with stress, where people can find relief from a bad marriage or difficult children by enjoying relaxing with friends. Now everyone in the family is locked down together, with no way to escape. So beyond the fear of the virus and fear of death, there is also the burden of social hardship, monetary pressures and marital discord.
How dangerous are anxiety and stress in terms of general health and the immune system?
Both anxiety and stress are very serious conditions. In order to have proper immunity in life you have to have the right mood. Our advice to people suffering from cancer, diabetes and other conditions is to maintain good spirits in order not to be impacted too much by the disease. The presence of anxiety and depression really affects the immunity of the body and its ability to heal. This can mean psychiatric disorders and other illnesses. Our psyche is well prepared to handle acute stress, but the problem lies in chronic stress, which is very debilitating to our physical and mental health, especially when we don’t know when it will end. When your immune system is weakened by chronic stress you are inviting many sorts of physical disorders. You can have a lot of disturbances in your blood glucose, your blood pressure, and develop complications in a variety of chronic conditions.
How does stress usually manifest?
When you are suffering from chronic stress you may see symptoms like heart palpitations, hand tremors, increased sweating, bowel problems like irritable bowel syndrome, breathing difficulty, and a disturbed sleep pattern. Other than these physical symptoms there may be edginess, irritability, a negative outlook and gloominess, a loss of focus and concentration and apathy in meeting challenges. While social interaction has always been considered a source of happiness, now it is linked with fear and anxiety, with people worrying about how to avoid contracting the virus, how to protect themselves and loved ones. People must make a conscious effort not to fall into this type of stress. With this interruption to normal face-to-face interaction, there can also be a level of paranoia. Critical situations can arise when people are dependent on WhatsApp and telephone calls, so misunderstandings can arise more easily.
How important is it to seek professional help when anxiety disrupts normal life?
You need to see a psychiatrist or psychologist when the symptoms you are suffering from affect your functionality. That means your social functionality, your mental functionality and your occupational functionality. Everyone can go through moods, but if you are starting to lose your grip with your work and social functions, you need to see a psychiatrist.
What are the dangers of self-medicating?
This is a serious problem, as Egyptians are known for self-medication. Medications available are safe when prescribed by a doctor, but there has to be a diagnosis first. A person cannot self-diagnose, it requires professional help. You shouldn’t take medication for psychiatric symptomatology; it is prescribed when needed for psychiatric disorders. By using medication without being under a doctor’s supervision you are risking turning yourself into a person dependent on medication, with a psychiatric disorder. Care must also be taken in the use of any substances like alcohol to cope with anxiety and help in falling asleep. In reality, alcohol can make things worse by increasing depression and anxiety. The same goes for marijuana and hash. They can create severe depression and cause amotivational syndrome, which creates lethargy, and a lack of motivation and direction. Heavy use of these substances can result in alcohol or cannabis psychosis which manifest as becoming very paranoid and suspicious of people around you, with associated delusions. Sleeping pills are another problem. You start with just one, as needed, and then it can become a habit.
What positive steps can you take to keep anxiety to a healthy level?
It is important to accept the stress and the situation and find tools to deal with it in a normal way. Try to live as usual, and go out, but with the social distancing guidelines like handwashing, wearing of masks and staying the required number of meters away from others. Recent studies have shown that around 60% of people who caught the virus were already staying at home.
There are many positive aspects to social distancing, so make the most of your new leisure time. Make a wish list, catch up on books you never had time to read and movies you wanted to watch, and consider it some sort of partial early retirement. By all means, do some exercise at home or go out for a leisurely walk, wearing your mask and keeping a safe distance. Relax, and don’t push yourself to work and be overly productive unless you absolutely must. It is not a competition! The chance to spend time at home can be a gift, even if you have financial pressures through the Covid-19 situation. You can avoid the expense of going out, travelling and shopping, which means of course be careful about online shopping temptations.
Prof. Dr. Abdel Nasser Omar is CEO and Managing Director of Al Mashfa and Professor of Psychiatry, Neuropsychiatry Dep. Faculty of Medicine, Ain Shams University.
Tel: 0120 000 0603/0100 642 2220 | 0100 008 3561 / +20 5544 00922