Maria Laura Avignolo
01/15/2021 11:51
Clarín.com
Society
Updated 01/15/2021 11:52 AM
"Depression Covid 19" is an allegory of joy.
A cover in yellow, with blue and red letters and the word fatal in black.
Color and hope in
the darkest days of the epidemic that controls the planet
.
Dr. Juan David Nasio is publishing his book number 25 in the middle of the pandemic and has baptized it that way.
And he adds a question: "Can everyone fall into depression?"
This
Franco-Argentine psychiatrist and psychoanalyst
, who came to France in 1969 to study with Jacques Lacan, today is a teacher, with his books translated into 14 languages.
Professor for 30 years at the University of Paris VII and with a seminar at the Ecole Freudiane in Paris, then he founded the Paris Psychoanalytic Seminars.
In 1999 the French government decorated him with the Legion of Honor, under the rank of Knight and he is Doctor Honoris Causa of the University of Buenos Aires, Rosario and the 21st Century in Córdoba.
In his office facing the Seine and in the midst of the epidemic, Dr. Nasio
discovered how his patients are increasingly distressed and depressed
, in the midst of the health crisis and in step with restrictive measures.
In this context, he decided to baptize the new phenomenon as "Covid depression" and began to write.
His conclusions were discussed in a long talk with Clarín, in his study in Paris.
- What have been the mental health effects of Covid 19?
- More than the effects on mental health of Covid 19, they are the effects of the health crisis produced by Covid 19. A curious phenomenon has happened to me.
I receive the patients and I see that all those who have been depressed in recent months, it is for the same reason: a strong accumulation of anguish.
And that made me baptize this very particular depression with the name "Covid 19 depression".
This depression is an unprecedented variant of classic depression.
Q: What are the characteristics of this epidemic depression? How is it different from classic depression?
- Classic depression is a disease characterized by an impoverishment of emotions.
Emotions are all asleep.
It is characterized by a tenacious sadness and a critical, denigrating withdrawal in itself.
The depressed person is thinking about him all the time and becomes depressed.
And it is criticized, it is denigrated.
It is also characterized because the person is tired, all the time tired.
She sleeps a lot, wakes up and is tired.
Physically tired and morally dull, she doesn't feel like anything.
This is what characterizes classic depression.
The sadness in Covid 19 depression is sadness with anguish, it is an anxious sadness, it is a tormented sadness and it is also an irritable sadness, it is angry.
"Why is he angry?"
--The depressed Covid 19 is an angry depressed, because he feels that he is mistreated, frustrated, deprived.
He can no longer deal with the anguish, caused by frustrations and deprivations, due to all the measures that are being taken to stop this virus.
And he is angry with the world and above all, he is angry with the government, because he feels it incompetent.
And now, with the vaccines, because they repeat what already happened with the masks.
Actually now with vaccines we are behind in France because there are no vaccines and because there are no freezers for vaccines.
So the depressed Covid 19 is critical, he recriminates.
It is recriminating.
He is also against doctors, who are on TV all the time and have somewhat hypocritical and false positions.
The depressed Covid 19 no longer believes in anything.
"Is it like a psychiatric" yellow vest "?
--Exactly.
He feels that he is threatened and sad because he can't take it anymore.
That is why I say that in Covid 19 depression, sadness is an anxious sadness, it is a tormented sadness and an irritable sadness.
Q: You say: "Anguish becomes corrosive and in the face of the anguish of the health crisis, that person becomes 'vindictive'. Afterwards, he is physically exhausted and morally falls into depression." How are those steps?
--This is very important.
The phenomenon that occurs is first the health crisis, reality.
There is a reality that exists.
That reality, for those very sensitive people, is produced through anguish, which accumulates, is amplified.
And the anguish is going to be such that it comes as a paroxysm of anguish and there it transforms into exasperation.
Second, the person already has fits of anger, is angry with the world.
Suddenly, in a third stage, he gets tired, exhausted.
She is disenchanted, she has lost all illusion, she has lost all hope.
And after that, depression.
Then, health crisis, frustrations and deprivations of the health crisis, anguish, exasperation, lassitude, and then depressive sadness.
Juan David Nasio, in Paris.
He has just published a book on the impact of Covid.
Photo Noel Smart
--What are the four anguishes of the Covid?
--The Covid 19 anguish has four reasons.
First is the anguish, the fear of illness, of being sick and above all, dying alone in the hospital.
Because this is not just being sick.
It is also that they die without the family being able to get close.
So the anguished is afraid of dying alone or sometimes of contaminating someone in the family or a friend.
--And then?
--The second anguish of Covid 19 is the problem of confinement, of isolation.
It is the anguish of being isolated.
We are confined today.
There has been confinement, then unconfinement, then reconfinement.
We are in a situation where between the confinement of the first time and the reconfinement, this reconfinement is totally different.
The first confinement we went out at 8 o'clock at night to applaud the people.
It was a quiet, resigned confinement.
This new refinement is deeply unruly.
We are in rebellion against this confinement.
We are wrong, we are lost.
Because it is a reconfinement that shows that the illusion that we had that this epidemic was going to end, we discover that this epidemic continues.
--And what effects is that going to have mentally in the long term?
- I think that the human being is wonderful, because we know how to adapt.
The difference between humans and all other animal species is that we have survived, because we adapt.
This is an old idea from Darwin.
The consequences that are going to be there is that we are going to readjust.
But at the moment it is a struggle between the adaptation that we have to do and the pain of having to make the effort to adapt.
Then the isolation, the anguish of being isolated.
It is the other way around, that being confined, there is the anguish of being with the other very close.
I have patients who call me and say: "I can't take my partner anymore, he's on top of me all the time."
Or "He wants to make love all the time" or "He wants to go to the kitchen", "I'm not used to living with him that long."
I mean, there is no distance, no privacy.
`` There is no privacy.
So either the other is missing or the other weighs us down.
That is the second type of distress.
The third type of anxiety of Covid 19 is the anxiety of economic uncertainty.
That is to say: we do not know what will happen, how the work and the company will evolve.
How will the country even evolve economically.
So there is fear that work will be absent or that my work will be taken from me.
- And the fourth anguish?
- For me it is the deepest: it is the anguish that a future is missing.
There is no horizon line, there is no defined horizon.
We live in a time when we cannot project anything.
We don't know what will happen in five weeks.
We do not know if there will be a holiday or not in February.
We cannot project.
There are companies that have development projects, mergers with other companies.
There are very important projects at the urban level, at the country level.
There is a difficulty in being able to project into the future because there is no future, there is no future line.
So those are the four major anxieties.
-How do you experience these restrictions on movement? Are they considered an attack on freedom?
`` It is true, there are many people among us who do not support restrictive measures.
There is no anguish, there is indignation.
They feel indignant, angry, rebellious against any measure that is an attack on freedom.
They feel that they are treated in a childish way and that they are deprived of the natural freedom of the human being, which is also in all the constitutions.
These restrictive measures have been experienced and are experienced by many of us as an attack on privacy and the decisions one can make.
"Is there another option?"
- There is probably no other option because you will have to adapt, even if it is painful.
I myself have to adapt to putting on the mask to receive my patients and I have to be at a certain distance.
I consider myself a psychoanalyst very close to my patients.
I've even written that I feel very close.
Now I have to get away.
Because you have to respect the barriers.
--And this sadness generated by Covid, is it going to be incorporated or temporary?
It is an anxious and irritable sadness, tormented.
But it is a sadness that does not last all the time.
It lasts as long as the health crisis lasts.
That is the difference with classic depression.
Classic depression is a depression in which the sadness lasts, it is permanent.
Sometimes it can last three weeks, a month without moving, despite antidepressant medications.
I think that when the health crisis is over - and we hope we are on the threshold of the end of this epidemic with vaccines, there we will return to a normal state.
- What attitude should be adopted when faced with a Covid depressed person, how to accompany him?
- I have many patients who are not depressed themselves, but the woman is depressed, the brother.
And they ask me: "Doctor, how to do? You don't want to consult and I don't know how to help you."
I propose five things.
First I ask you please: "When you go to be with your brother and talk to him and listen to him, you are well, do not be anxious, try to be in a calm state, go calm." Because the tranquility in you you are going to convey to him. He needs to be able to speak, complain and complain to someone who is okay. Show yourself well and be okay about everything. "
Serenity is transmitted.
I think that a person who is going to listen to a depressed family member has to be relatively well, not to be distressed.
--And later?
When you speak to him, remember that the words are not what is important.
What is important is the way of saying them.
Let him feel that you say them with conviction, that you say them with your whole body, that you speak with a voice in which the voice carries all the presence.
Another piece of advice that I give is to try to go to his story.
The depressed is a being who is drowning in the present.
He cannot think of the future and he cannot even think of the past.
Live in a difficult, horrible, heavy present.
Then get it out of the present.
Take him out of that relationship that he has with a permanent threat and take him as far as possible, with intelligence, tact and respect.
Take him so that he can talk about some significant, important moments in his story.
Sometimes, as I do with many of my depressed patients, I ask them to bring a family photo or several photos, to tell me about the photos, explain the photos to me.
And you don't have an idea of the extraordinary effect it has.
I lead the patient to come out of that threatening present and have a moment of rest with the past.
--Must his past be remembered so that he can somehow build a future?
--So is.
Exactly.
You need to go back to the past so that he realizes that, from the past, until today a life has been built and that there is a future that awaits him.
But of all the recommendations that I give, there is one for me that is the most important: it is to know when you are going to listen to someone that the most important thing is you, how you open your emotions.
That is what helps you fundamentally.
Not what he does or what he says but what he is and what he feels.
-It is going to have to be very little dogmatic to treat the depressed of the Covid: neither Lacanians nor Freudians. How is the technique?
- You have to be yourself.
You do not have to make a theory or a dogma, with everything you learned, with all the experience, with all the books we have read.
Or if it is a person who is not professional, with all the experience that he learned in the analysis or in the therapy that he is doing.
To be oneself in the depths of oneself and to feel that being that same is what allows the other to share with me what they live and to be able to pacify it.
--How does Covid depression affect children and adolescents?
It's as if they are more confident and less afraid than us adults.
They come with a chinstrap sometimes and I have to ask them to take it off because I need to look at their faces.
But the child is calm, and so are the adolescents.
Adolescents are as if they said: "Well, we have other problems to solve: the school problem, the problem with a friend or the problem of the girlfriend or the problem of such a contest. But about the epidemic, I can tell by listening to my parents and the adults around me, that we are indeed living a very difficult time. "
- Another point is vaccines. For many people, a hope and for other people a denial. In France only 56% want to be vaccinated. Why?
Before vaccines came, most people were not going to get vaccinated.
Once the vaccines arrived, people agreed to get much more vaccinations.
I'm sure that if we make a statistic today, the number of people who want to get vaccinated goes to 80%, especially more influenced by the other countries where vaccines are applied.
But there is a curious phenomenon, that once we decide: "We are going to get vaccinated", we discover that there are no vaccines in the country.
And above all that there are no fundamental freezers for certain types of vaccine, like the one from Pfizer.
The vaccines have not arrived, there are no vaccines.
We are living the same as we live with masks.
When they said "don't wear the masks", but in reality there were no masks.
Today they say that people do not want to be vaccinated, but what happens is that there are no vaccines.
-The infectologists and virologists have spoken, has the time come for psychiatrists and psychoanalysts to speak?
- I think that we psychologists, psychiatrists, psychoanalysts, have a very important role at this time of the health crisis.
We are progressively going to have an increasingly indispensable role, more essential.
Because human beings are experiencing catastrophes that are increasingly difficult to bear.
We are experiencing something absolutely unprecedented in the history of humanity.
Not even the ancient pests of the Middle Ages or those of the 18th or 19th century are compared to what we are experiencing.
Today the pandemic is being experienced by the entire planet.
--And what do you attribute it to?
There are two answers.
A hypothetical answer and a second answer a bit mystical.
The hypothetical answer is that this pandemic is like a "response" to globalization.
It is as if God were saying to us: "Ah, you want to travel all over the world and you want to dominate the entire planet."
Well, the whole planet is going to get sick.
I think in this allegory that I say of God.
There is some truth, which is that we are learning extraordinarily by living a great humility.
For me, the humility that we have to have now is fundamental, to feel human, smaller than nature.
Nature is powerful.
We are going to defend ourselves, but obviously this is a nature that prevails.
--This structural change speaks of a new society, with other values and with other forms of consumption ...
- It seems to me an evidence that after a catastrophe like this, new patterns of social life will appear.
They are already appearing now: the importance of the numerical, new guidelines in the way of relating, in a different way than usual.
My forecast is that we will return to the same social habits.
There are going to be changes in communication.
But the important thing I would like to say is that today, with the health crisis, the message is "Let's not get close."
The message is that, after this epidemic, let's not be afraid to get closer.
We need to get closer, we need love.
It seems as if this epidemic forced us to say "Separate, do not love each other, do not touch, do not see each other."
It is awful.
It is totally opposite of the love instincts, which are in each one of us.
The drive of the human being is a gregarious drive.
We need the others.
What are the lessons of the pandemic?
- For me the essential are four vital things, which will follow later.
One, the vital thing, is the body.
A healthy body that does not prevent us from living.
Second, love.
It is the affectionate presence of the other and my affectionate presence for him.
The vital thing is to love, to be loved and to feel loved.
And the third vital thing that we are going to continue to have later is to act, to do.
The fundamental thing is action: it is to be in action, it is to fulfill a task.
I am assigned a task, you are assigned a task.
The important thing is that I feel that I do what I have to do.
Even if I'm suffering, even if I'm tired, but at least I know that I'm there, acting.
And the fourth, probably the most important of all and that has to do with the future that I was saying, is to feel expected.
They are waiting for me, someone is waiting for me.
I live and I feel like myself, because each one of us and each one of those who are reading this interview, knows that for him the fundamental thing is to feel expected.
Paris. Correspondent
ACE
