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Revista de la Facultad de Medicina

Print version ISSN 0120-0011

rev.fac.med. vol.69 no.2 Bogotá Apr./June 2021  Epub July 23, 2021

https://doi.org/10.15446/revfacmed.v69n2.97128 

Editorial

Mental health during the COVID-19 pandemic

La salud mental durante la pandemia por COVID-19

Álvaro Rodríguez-Gama1 

1Professor, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, D.C., Colombia. Executive Secretary of ALANAM (Association of National Academies of Medicine of Latin America, Spain, and Portugal), Bogotá D.C., Colombia. arodriguezg@unal.edu.co


COVID-19 is an infectious disease caused by the new SARS-CoV-2 coronavirus and, since its emergence in December 2019, millions of people have been infected and thousands have died. This disease has also had a significant physical and mental impact on those who have survived its severe phases.1,2 Colombia is currently one of the countries most hit by this pandemic.

The most important biosafety measures that have been implemented to fight this new coronavirus and have been effective in preventing its spread are frequent hand washing, mandatory use of face masks in public places by the general population, physical and social distancing, and confinement of the majority of the population in their homes. However, these actions have seriously affected the mental health of people since they have modified their daily behavior.

In this context, the COVID-19 pandemic has provoked anxiety, depression, suicidal ideation,3 uncertainty, fear, claustrophobia, agoraphobia, irritability, sleep and eating disorders,4 family conflicts, excessive ideas and attitudes regarding hygiene and cleanliness, and even consumption of alcoholic drinks and narcotic drugs among the general population, leading to a significant increase in the number of consultations with the psychology and psychiatry services.

It is worth mentioning that activities in all areas have also been affected by the abovementioned protection measures and that, consequently, people have had to face various economic, academic, and labor difficulties.

Each person reacts differently to adversity using their own adaptation mechanisms. Thus, although many have been able to manage positively the situations around the pandemic and others have developed behaviors of solidarity with those most affected, some people have not dealt with the new reality in which we must now live.

It should also be taken into account that the conditions have been different for everyone and that they vary depending on sex, age, personality, educational level, occupation, socioeconomic status, family composition, quality of health, access to information and communication technologies, the place where they live, the size of and amenities available in their homes, experiences with close people who have fallen ill or died, exposure to risks of contagion, the possibility of exercising and engaging in leisure activities, among other aspects.

Individuals with schizoid personality have endured better the confinement, while those who used to have a fairly sociable life have been more affected. Similarly, claustrophobic people have felt particularly overwhelmed, and the psychological and family problems of addicts, smokers, and alcoholics have worsened to the point where many have experienced withdrawal syndrome due to the lack of access to the substances on which they are dependent because of the lockdown. However, some people have been able to turn to activities such as arts, reading and writing to maintain their mental health balance.

During the pandemic, many working women had to stay at home to care for their children and take on tasks such as cooking and housekeeping; for some women, this was favorable, but for others, it represented overwhelming burdens that have had a negative impact on their emotional stability and physical health.

Affective relationships between family, friends and partners have also been severely affected, resulting in estrangement, frustration, anxiety, depression, and conflict, which has in turn led to an increase in domestic violence. Fortunately, other families have been able to strengthen their ties, even through virtual means, so this is not the norm.

The elderly are another demographic group that has been touched by the pandemic since many of them have lost their limited social activities and are living difficult conditions including sedentary lifestyle and isolation, a situation similar to what some children and young people have experienced.

Regarding work, people who have lost their jobs or whose income decreased have faced economic hardships that have also impacted their personal and family lives. The outlook is no better for those who continue to telecommute, as they have had to learn to perform under these new conditions by taking on new tasks and adapting their work environment. However, some financial businesses and workers or entrepreneurs increased their income and, incidentally, their emotional well-being.

For their part, students who have continued to study online face the limitations and frustrations of this type of education, as those who do not have good connectivity experience highly stressful moments when they are unable to attend classes or submit assignments on time. However, for many, not having to take public transportation to get to school has been a relief.

The experience of mourning the death of loved ones is another important aspect that has affected people's mental health during the COVID-19 pandemic, as it has not been possible to accompany the sick in hospitals during their final moments or during cremations, preventing traditional funeral services from being carried out. This has resulted in feelings of remorse for not being able to bid the dead a proper farewell.

It is also worth noting that most patients with underlying conditions have become chronic patients and their health has deteriorated because they refuse to visit health care centers due to their fear of infection, thus missing their medical check-ups5. Furthermore, it is worth mentioning at this point that people's lack of awareness of the issue, as well as the misleading information that has been disseminated, has resulted in a significant percentage of the population refusing vaccination, limiting effective immunization and delaying disease control.

With the emergence of COVID-19, health care workers have experienced highly demanding, stressful, and exhausting moments6 that have been especially overwhelming for those who directly care for infected patients. Therefore, mental health, not only among the general population but also among health workers, has been affected by the negative impact associated with the pandemic. Furthermore, even in medical settings, topics such as suicide and suicide attempts have become taboo. Finally, the COVID-19 pandemic has been the ideal scenario to promote telemedicine, with some services, such as dermatology or psychiatry, adapting better than others that require the patient to be physically present to provide them with adequate care.

Given the implications of the pandemic on people around the world, orientation courses on the maintenance, promotion and recovery of mental health have been beneficial to teach the basics of what can be done to cope with the psychological burden arising from the current situation. Thus, more health and social actions are needed from government agencies to help the population continue to fight this cruel disease.

References

1. Cifuentes-Faura J. Infection, treatment and virological features of SARS-CoV-2. A brief overview. Rev. Fac. Med. 2021;69(1):e90245. https://doi.org/gf39. [ Links ]

2. Ballesteros P, Salazar E, Sánchez D, Bolaños C. Spatial and spatiotemporal clustering of the COVID-19 pandemic in Ecuador. Rev. Fac. Med. 2021;69(1):e86476. https://doi.org/gf4b. [ Links ]

3. Ramírez-Ortiz J, Castro-Quintero D, Lerma-Córdoba C, Yela-Ceballos F, Escobar-Córdoba F. Mental health consequences of the COVID-19 pandemic associated with social isolation. Rev. colomb. anestesiol. 2020;48(4):e930. https://doi.org/fb2k. [ Links ]

4. Escobar-Córdoba F, Ramírez-Ortiz J, Fontecha-Hernández J. Effects of social isolation on sleep during the COVID-19 pandemic. Sleep Sci. 2021; Ahead of Print. [ Links ]

5. Escobar-Córdoba F, de Borba Telles LE, Hernández-Yasno M. Pseudo-COVID-19. A new mental disorder? Rev. Fac. Med. 2021;69(1):e91032. https://doi.org/gf4c. [ Links ]

6. Echeverry-Raad J, Navarro-Vargas JR. Ethical and clinical challenges when providing medical care during the COVID-19 pandemic in Colombia: A global perspective to contribute to the local context. Rev. Fac. Med. 2020;69(1):e89474. https://doi.org/gf4d. [ Links ]

Rodríguez-Gama A. Mental health during the COVID-19 pandemic. Rev. Fac. Med. 2021;69(2):e97128. English. doi: https://doi.org/10.15446/revfacmed.v69n2.97128.

Rodríguez-Gama A. La salud mental durante la pandemia por COVID-19. Rev. Fac. Med. 2021;69(2):e97128. English. doi: https://doi.org/10.15446/revfac-med.v69n2.97128

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