How to survive self-isolation without harming the psyche?
Experts Reveal How To Survive Social Isolation
Reflects and advises psychiatrist Leonid Israelit
«When the quarantine ends, millions of schizophrenics will take to the streets with clean hands». This kind of dark humor about the coronavirus pandemic can be found these days on Facebook and other social networks. But seriously speaking, doctors are sounding the alarm in connection with the deterioration of the mental state, not only in people suffering from various kinds of mental disorders, but also in those who consider themselves healthy..
How to maintain mental health in conditions of self-isolation and quarantine? We addressed this question to an experienced psychiatrist, MD, Dr. Leonid Izrayelit.
Leonid Izraelit was born in Leningrad. He also graduated from the First Medical Institute there, and received specialization first in neurology, then in psychiatry and narcology. In 1992 he moved to the USA. Passed the medical license exams and completed four years of residency in psychiatry at Long Island Juish Medical Center. He worked in several hospitals. For the past 16 years he has worked in his private medical office in Rigo Park, Queens, New York..
Correspondent of the Russian Service «Voices of America» talked with Leonid Izraelit by phone.
Oleg Sulkin: You also switched to home mode?
Leonid Israelit: Yes, I switched to telemedicine, I talk with patients on video, prescribe drugs remotely.
OS: Who are your patients by ethnicity? How many Russian speakers are among them??
L.I .: About 25 percent. There is a large community of Bukharian Jews living in Queens. Russian-speaking patients from Brooklyn and Manhattan also come to me. In general, a colossal variety of nationalities! Latinos, Italians, Chinese, Koreans, Africans, Arabs, Portuguese. Surprisingly interesting! Different cultures and traditions, different views on life.
OS: Now the situation is compared to a war, because life has changed dramatically. Do you find a military analogy appropriate??
L.I .: We are indeed in a new reality. True, the beginning of wartime is somewhat erased, implicitly. When Pearl Harbor happened, it was clear to everyone that this was the watershed. We somehow gradually began to slide into a strange, incomprehensible life, refracted into a dystopia. People who don’t close their eyes or hide their heads in the sand really find themselves in a new reality.
OS: For you, as a psychiatrist, what turned out to be the most difficult in this situation?
L.I .: People have largely lost what in the US is called the social support system. This can be translated as «social support of the individual». Contacts with people, exchange of information, spending time in a certain social group, that is, everything that creates psychological comfort for a person, has ceased or sharply decreased. Now everyone is at home, in a confined space, and for many it is very difficult to endure. But not everyone.
OS: Who do you mean?
L.I .: Those who, in a situation of self-isolation, experience relaxation and comfort. For these introverts, the outside world has always been frightening and unpleasant..
OS: In this regard, I remembered a visual joke from Facebook. Two identical photos of an unshaven bumpkin lying on a sofa in home clothes. And signatures: before quarantine – malicious bummer, during quarantine – an exemplary citizen. That is, it turns out that changes in the external world have also changed the role function of the individual.?
L.I .: Of course, because role functions depend not only on us, but also on changes in society. In different eras, the same human behavior was perceived in completely different ways. So it is here.
OS: What do patients most often complain about in connection with the self-isolation regimen??
L.I .: The most obvious consequences of being imprisoned in four walls – increased anxiety, depression and irritability, manifestations of depression. An interesting observation. Those who in the ordinary world experienced increased anxiety tend to keep this anxiety more under control today, in times of crisis. A catastrophe has occurred, and he, a neurotic, suddenly gains confidence in his own adequacy, in the soundness of his mind..
OS: Are there not cases when a pandemic intensifies fears and panic among those who were previously prone to increased anxiety? There are reports in the press about cases of inadequate reaction, manifestations of violence and attempted suicide.
L.I .: Yes, of course, there is such a thing. A person is not a machine, he does not have one hundred percent the same reaction. But still the hardest part – deal with people for whom everything that happens defies explanation. They are most susceptible to panic and fear. Depressive reactions are typical for people prone to paranoia. Such a person may be fascinated by conspiracy theories that help him explain the hostility of the outside world. What have I not heard enough? – who launched this virus and why. By the way, the love of conspiracy theories is characteristic of the Russian-speaking community. It, of course, exists everywhere, but in our environment it is much more common to find a person who knows exactly who brought the coronavirus into the world and for what purpose. This is probably a common tendency of the former Soviet mentality: to explain our troubles by intrigues «abroad» or internal enemies.
OS: Many are very depressed by uncertainty. When will the pandemic subside, when will it end? According to your observations, how long is critical if the quarantine is delayed?
L.I .: People are ready to wait a month, well, two. But if the quarantine lasts a longer period and there is no positive dynamics in the fight against the virus, this is fraught with an exacerbation of psychotic and neurotic disorders..
OS: What is in your medical arsenal today??
L.I .: If the patient has the right antidepressants, anti-anxiety drugs, stabilizers, and so on, he or she will respond much better to the current crisis. Medication and psychotherapy must go together.
OS: Judging by social networks, many consider them to be almost the main means of fighting loneliness and depression. This is true?
L.I .: I consider physical activity to be the most important tool. Dumbbells, isometrics, aerobics, whatever suits you. Exercise with loads on different muscle groups promotes the release of not only endorphins, which cause a feeling of joy, but also neurotransmitters, that is, serotonin, dopamine and other substances that regulate mood and anxiety levels.
OS: What do you think about social networks? Some consider them a panacea, others see them as a source of stress and fear..
L.I .: As the famous poem says – «everyone chooses for himself». People who are well versed in the global network can reasonably choose their «bubble», your niche, your friends. People have a craving for dramatic news, see how many «likes» collect news about disasters, accidents and so on. People love to scare themselves, which is why horror films are so popular. I may be wrong, but I think social media in general plays a positive role. They discourage isolation, which can be very painful for many. I believe in bioenergy, and I see how communication in social networks helps to recharge, increase vitality.
OS: There are those who suppress the alarm with alcohol. This is bad from a medical point of view.?
L.I .: You need to be careful if you are taking medication. Some drugs do not work well with alcohol, which increases side effects. It’s another matter when a person can keep alcohol consumption under control, then, say, one or two glasses of brandy are unlikely to do harm..
OS: Another picture from Facebook. The frowning wife says to her husband: «You can blink more quietly!?». And adds a strong word. How to maintain psychological compatibility in the family in isolation?
L.I .: The main thing here – create their own personal space for everyone. When people go to work, they take a break from each other. Under quarantine, these relationships require thoughtful restructuring..
OS: Are there any differences in the response to the pandemic of Russian-speaking and English-speaking patients?
L.I .: If they are, then only some of the older generation. People from the former Soviet Union, who have gone through the war, repression, famine, devastation, say something like this: we have experienced it, and we will survive it