Anxiety, isolation, winter and the prospect of the holiday season separated from loved ones could further weaken the general mental health situation, warns an expert as France goes into a second lockdown.
With public morale already flagging from the combined onslaught of the health crisis, economic recession and the approaching winter, France entered a second nationwide coronavirus lockdown on October 30.
Following the first lockdown from March 17 to May 11, France eased restrictions over the summer. But with Covid-19 cases spiking sharply in mid-October, a second nationwide lockdown – expected to last until at least December 1 – has been imposed. The French have been plunged once again into an era of isolated telecommuting and “attestations” (permits to leave home), in addition to the dismal prospect of the pandemic dragging on into the new year.
In an interview with FRANCE 24, Astrid Chevance, psychiatrist and researcher in epidemiology at the Paris-based Centre of Research in Epidemiology and StatisticS (CRESS), discussed potential mental health consequences of the second lockdown.
FRANCE 24: This second lockdown promises to be a new ordeal. Should we fear greater psychological effects on the population?
Astrid Chevance: It’s very difficult for scientists, and even more so for doctors, to make predictions because we are living in a new situation. However, unlike the first lockdown, mental health surveys – such as the one carried out by Santé Publique France [the French national health agency] – show that the population today is particularly tired. Depressive symptoms are already very marked and could rapidly increase in the future. Public morale is not good.
During the first weeks of March, a form of exhilaration was observed among certain social classes. The situation was unprecedented and some, even though they’re in the minority, may have seen this period as a kind of opportunity. Today, we are obviously no longer in this situation. People have become aware that we are faced with a phenomenon that is not totally controllable and whose outcome we do not know. So there is a general anxiety linked to all these uncertainties.
In addition, we were already forced to change our habits during the first lockdown, which may have been an ordeal for many. Despite these efforts, we now see that they were not enough. So there’s a general psychic wear-and-tear because we don't see the end of this health crisis.
F24: Can winter aggravate this trauma?
AC: Seasonal depressions typically occur in November. The prospect of having to stay locked up at home during this period and reducing our social contacts will obviously not help. The holiday season is usually difficult for people suffering from psychological disorders and for those who feel lonely and are in situations of social isolation.
But the end of 2020 may be even more complicated for everyone, as family reunions may not be allowed. Many families still find this prospect hard to digest.
F24: Who are the most vulnerable and likely to suffer more from this second confinement?
AC: The people most at risk are first of all domestic violence victims and those confined with their aggressors – that’s mostly women and children. Even in this particular context, these people should not stay at home with their aggressors. They must protect themselves and contact associations that may be able to help them. [The French domestic violence hotline is 3919 and 119 for child protection services.]
Another demographic at risk are those suffering from chronic illnesses, psychiatric or not. These people may feel abandoned in their follow-up care due to overloaded medical systems. However, they must not be allowed to discontinue their medical care. Students could also suffer more. Many find themselves isolated and far from their families, in a situation of profound uncertainty about their future.
Finally, another segment of the population may be even more vulnerable: those who experienced pathological bereavement during the first wave [of the Covid-19 crisis].
Many people who lost a loved one in the spring were unable to experience a conventional grieving process. Some were unable to attend funerals or visit loved ones before they died. The social rituals and funeral rites that surround mourning enable us to be in a transitional phase. But some people today are still suffering from not having had that opportunity. This is no doubt one of the reasons why the government relaxed certain restrictions [cemeteries are open and visits to relatives in nursing homes are permitted in the second lockdown, unlike the first].
F24: What’s your advice to help people cope better during this period?
AC: It may seem difficult because we don't all have the same material conditions, but you have to be able to diversify your activities as much as possible. Because when we are stuck in one mode of operation, we cut ourselves off from the rest of the world. However, if the symptoms of anxiety are too severe, you should not hesitate to contact your doctor.
More generally, we need to help the people around us and keep in touch with the people who help and support us at difficult time. It is also essential to maintain contact with the most fragile people, and to monitor those who are not doing well. Also keep a regular daily rhythm: don't disrupt your sleep cycle, eat at regular hours, try to maintain physical activity.
Finally, it’s important to limit practices that could aggravate our condition (alcohol, drugs, etc.) or our anxiety in the long run. When anxiety levels rise, human beings try to drift, to forget their state of stress. They can then engage in behaviours that relieve them at that moment but which, in the medium or long term, will be harmful. For example, avoid spending too much time on social networks or 24-hour news channels. They can undermine our equilibrium when there is already a great deal of uncertainty.