Mental illness is poorly understood. Since mental illness, which affects our mood, thinking and behavior, is less tangible, people tend to believe that a broken leg or a kidney stone is more serious. Because entities, such as neurosis (or coronavirus) are invisible, some deny their existence until their lives are fatally touched by them. It is only then that they realize the folly of disregarding what they are unable to see.
Types of mental disorder include anxiety disorders, mood disorders, schizophrenia, and psychotic disorders. All of them are just as serious as physical ailments that have more visible manifestations. Like the coronavirus, the exact cause of mental illness is largely unknown. The best guess is that it is the result of a combination of biological, psychological, and environmental factors.
Certain people are more vulnerable to mental illness than others. No one knows why some are able to dodge bullets on the battlefield without blinking an eye while others crumble when their kitchen sink starts leaking.
In Spain, confinement has now lasted a month. It is becoming crystal clear that quarantine will be prolonged into May though the government is desperately trying to sugarcoat the unpleasant-tasting medicine by focusing on all the agreeable things that will happen when restrictions are progressively lifted.
The wife of Neanderthal man, who lives across the hall, yelled to me from the threshold of their apartment that the government could not keep us locked up forever. One cannot know what happens behind closed doors but on the other side of the hallway, domestic bliss is being severely tested.
All over the country, enforced confinement, which initially began with good humor and a stiff upper lip, is now starting to develop a few cracks. People are now not quite as upbeat as they used to be. What people thought was going to be short stroll has now become Mao’s Long March.
Stressful situations are thus arising, which the vulnerable find difficult to cope with. In desperation, people have begun grasping at the few straws provided by the daily government press conferences. This allows them to preserve the agreeable fantasy that the nightmare will soon end.
This absence of light at the end of the tunnel is hardest on people who abhor solitude because they have never been friends with themselves. Others who are accompanied are thinking about separating because they have discovered that enforced 24/7 togetherness is far from being the ultimate romantic dream.
Finally, there are the walking wounded who have lost a loved one or even various loved ones to coronavirus. Unable to say good-bye to them, they must mourn for them alone, and sometimes they are unable deal with the grief. This is the explosive cocktail that is triggering the current proliferation of mental disorders in Spain
My son, the psychiatrist (temporarily recycled into intensive care), will soon be returning to the psychiatry ward, where all beds are now full. The ward has been divided into two sections. The first is for psychiatric patients with coronavirus. The second is for psychiatric patients without coronavirus. His hospital is the only one in Madrid with a ward for the first group.
He told me that patients suffering from both mental illness and coronavirus are extremely difficult to treat because the protection equipment, shield, and glasses worn by the psychiatrist are a barrier to communication. Since the patients cannot recognize the psychiatrist’s face or eyes, and the mask muffles his voice, it is impossible to establish a dialogue with them. The protection equipment prevents any meaningful doctor-patient interaction.
Although their coronavirus symptoms can be treated with medication, their psychiatric condition must be treated with a delicate balance of pills and psychotherapy. In such circumstances, psychotherapy is impossible. Since my son cannot talk with his patients, he can only give them medication and cross his fingers.
The other beds in the ward are occupied by the usual suspects (people with mental conditions before the coronavirus pandemic). However, a high percentage of them are occupied by new patients, with no previous history of mental illness. They have fallen prey to anxiety and depression stemming from extended confinement. Many have suicidal thoughts or have actually attempted suicide. He must try and convince them not to. He must persuade them that their life is worth living and should not be thrown away.
Not surprisingly, suicides are increasing. This was corroborated by my daughter, who is a forensic doctor here in Granada. In the USA, her job would be a hybrid of a medical examiner and a coroner. When people die under strange circumstances, she has to certify their death and investigate exactly what happened. She also gives expert testimony in cases of rape, murder, domestic violence, etc. She likes her work and is very good at what she does.
One of her pre-coronavirus cases was a murder/suicide involving a man who had a heart attack while being stabbed or while stabbing himself (that was the question). A family member improbably claimed that it was suicide, but the final decision will ultimately depend on the DNA samples taken. Everyone is still waiting for the verdict. In real life (unlike in the CSI television series), DNA results are not available within the hour.
At the beginning of the coronavirus confinement, she had less work than usual. There was a lull (like the eye of the hurricane). There were so many people dying in hospitals and old age homes that the rest of the population seemed to have momentarily forgotten about killing themselves and/or others. Not that Granada is Los Cabos, Caracas or Detroit, but there is the occasional murder though the weapon is rarely a firearm (never an AK-47).
After the calm, there has been an upsurge in suicides. This is in line with the predictions of psychologists who have warned that extended confinement could lead to anxiety disorders, panic attacks, and depressions. In Granada, a coronavirus patient recently jumped out of the window of his hospital room. He did not survive the fall. Another patient used the curtain cord of his room to hang himself. They killed themselves because they were afraid of dying. Paradoxically, excessive fear of death can also lead to death.
In Madrid, the coronavirus is providing my son and his colleagues with more psychiatric patients than they can handle. They are fighting a battle against a powerful enemy. Not content with devastating the body, Covid-19 also attacks the mind. It is not even necessary to be infected by the disease in order for it to destroy one’s mental balance. And my daughter and her colleagues must deal with the patients who finally fall through the cracks, the ones whom the psychiatrists are unable to save.
