Psychological vulnerability in subjects with major (or unipolar) depressive disorder in the quarantine period
In people with depression, the health emergency from Covid-19 only heightens the sense of inadequacy and closure towards the world. How can these patients be helped to get through the quarantine period?
Advertising message Italy, our country, has been acting for several months now as an emblem and warning about the consequences that a State could, and in our case is forced, to face in order to face the organic, economic and psychological problems of which the the virus in question, Covid-19, is the cause. Among the many psychological pathologies, mood disorders are extremely common. These consist of emotional alterations, of such magnitude as to cause, to the subject who experiences them, serious problems and persistent dysfunctions, accompanied by a marked maladaptation to normal environmental conditions of life. The loss of the minimal and simple tasks of everyday life, aggravated by the contingent situation, make the depressive disorder an atrocious condition. But what is depression?
The term depression is used in a generic and extensive way in colloquial language in reference to a feeling of slight discomfort or momentary sadness triggered by an event or by a thought capable of causing, in the subject who experiences it, a state of transient malaise. However, wanting to get out of the common inaccuracies, it is good to know that the unipolar disorder refers to a pathological state of melancholy, lasting approximately more than two weeks. Although the main identification symptoms are clear, the causes, which are still imperfectly known, are not as clear. How do you make a diagnosis of the disorder?
The most used diagnostic criteria are those that refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM), drawn up by the American Psychiatric Association and now in its fifth edition (DSM 5 – APA, 2013). According to the criteria of the current DSM 5, to make a diagnosis of Major Depression the patient must have at least five or more of the following symptoms for a period of at least two weeks (diagnosis criterion A). In the five or more symptoms, “depressed mood” or “loss of interest or pleasure” should appear. Symptoms listed in DSM 5 include:
Still referring to DSM 5, the other two criteria that need to be met in order to make a diagnosis are:
So how can people with depressive disorder be helped in this quarantine period?
Advertising message As previously mentioned, the causes underlying the origin of the disturbance are not clear; more recent theories tend towards an etiological model that considers the interaction of some elements such as biological and character vulnerability together with stressful life events, such as the presence of multiple traumatic events in the course of life. In this regard, the general discontent due to the mandatory state of quarantine does nothing but heighten the sense of inadequacy and closure in depressed subjects, which overlapping the already acclaimed pathology creates a sort of double trauma.
Furthermore, the lack of work, especially for some categories of citizens who are unable to perform their usual duties even from home, and the low socio-economic level represent other factors of malaise. In such situations, the presence of the therapist is therefore necessary, albeit from a distance, but not only, since having adequate social relationships, as well as the support of those family members who live within the same nucleus, are of fundamental importance. of the depressed subject, who now more than ever needs to receive the right encouragement, support and help from the people closest to him.
The commitment and constancy of loved ones in providing support is very important, since it represents a source of hope towards a possible recovery and a sense of utility for the relatives of affection. This is because depressive decompensation does not only cause suffering and malaise to the person who suffers from it, but usually presents negative consequences also towards family members and those around them. In fact, it is common experience of subjects close to the depressed person to be “infected” by his bad mood.
Unfortunately, it must also be said that many individuals affected by the pathology experience a deep sense of shame that often leads to difficulty in admitting that they are affected, further exacerbating their situation in a sort of vicious infernal circle. Therefore the first step at the base of the recovery consists precisely in accepting the pathology, considering it as a now widespread and common problem. Those who accept their condition are more able to find the most suitable mechanisms and solutions, capable of facing it and ending it.