Carlos Gómez Restrepo, dean of the Javeriana University School of Medicine, spoke with El Espectador about the first results of the study that seeks to measure the health status of young adults. The survey was conducted from May 25 to June 22.
“Being with others, feeling them, talking and looking into their eyes is something that is obviously necessary.” With this phrase Carlos Gómez Restrepo, psychiatrist, psychoanalyst, clinical epidemiologist and dean of the Faculty of Medicine of the Javeriana University, described one of the main causes of the increase in depression and anxiety in young Colombians: quarantine.
This was revealed by a survey that analyzed anxiety and depression in young people between 18 and 24 years old, carried out by the departments of Psychiatry and Mental Health, Clinical Epidemiology and Biostatistics of the Faculty of Medicine of the Javeriana University. In it, 68% of the thousand respondents presented various symptoms of depression. According to Gómez Restrepo, who leads a research on resilience, most young people feel that the pandemic affected them and changed their lives and they see a near future full of uncertainties and not very encouraging.
Why did the need to carry out this first survey of depression and anxiety in young people in Colombia arise?
This survey comes as part of another study, OLA, that I am conducting on youth resilience. It is a study that is carried out with the Queen Mary University, London, in Colombia, Argentina and Peru. With the onset of the pandemic and quarantines in the countries, it seemed important to a group of colleagues from Latin America and Colombia, especially Dr. Miguel Uribe Restrepo, director of the Department of Psychiatry and Mental Health at the University, to include this study in the context of our countries. We want to know how isolation measures influence mental health and the factors associated with the presence and evolution of symptoms that will give us very important answers at the Latin American level.
Why was the age range of 18-24 years chosen? Is there anything that needs to be taken into account from that developmental period?
Of this age range few results were known about depression or anxiety and nothing about their behavior during a quarantine. In addition, much more has been said about the elderly and the same about children, but little about young people. We usually believe that young people can be more flexible and resistant to change and we realized that this might not be the case. For this reason, we believe that monitoring of this population is very important for the country, especially for young people, most of whom are in technical or university education processes, who are working and handle countless relationships and circumstances that affect them. they make a vulnerable group.
One of the most telling results showed that the degree of depression in women (70.3%) is higher than that of men (63.4%). Why?
Women are more vulnerable to depression in general terms. The proportion of depression, in global data, is more or less than 60% in women and 40% in men. In the various surveys in Colombia, this result is maintained and has to do mainly with the fact that women have greater vulnerability due to biological, hormonal, life course factors and sometimes due to what they have suffered historically.
Why was anxiety included in a study on depression? Are the two connected?
Because they are two of the most frequent problems in the country. In the National Study of Mental Health, which we coordinated in Javeriana in 2015, it was shown that depression, anxiety and alcohol consumption are the most important disorders in the adult population and this group of young people is within that population. Uncertainty and various anxieties were present among the consequences of the quarantine, so we had to ask about anxiety. But it is also clear that many cases of depression can start from anxiety or cases of anxiety can start from depression, that is, they are two groups of entities that often converge or are comorbid. In the survey we found that 29% of young people had mild anxiety, 18% moderate and 6% severe. Many young people had depression and anxiety.
The study identifies three types of depression: mild, moderate, and severe. How to identify them and what should be the treatment of each one?
It has usually been classified this way by the severity of the symptoms and the number of those that are present. Symptoms can start with a feeling of sadness and little interest and pleasure in things. If you have felt this in the past thirty days you may be experiencing an episode of depression. Then come a series of questions about whether the appetite has decreased, libido, if it is slowed down, if it sleeps badly, if it is irritable, with difficulties in relationships, feeling of guilt, fatigue, or if there are thoughts or ideas of disability, sometimes death, among other symptoms. As more symptoms are experienced, it goes from mild to moderate and from moderate to severe. The survey showed that the majority of people have mild depression, with a total of 29%; 22%, moderate, and 17% —which is a very high percentage— were severe.
If mild depression is the most common among young people, what recommendations can you give them to feel better?
This type of depression can be seen by a general or family doctor, and in principle there is no need to go for a consultation by a specialist. One of the main recommendations is to maintain the affective and interpersonal relationships that one has, remembering that it is important to respect physical distancing, but without forgetting social relationships. We must continue in contact with friends, the partner, the affective life as far as possible. This helps a lot in mild depression. Another important aspect is to exercise for at least twenty to forty minutes a day, three to four times a week. Maintain study habits and hobbies: reading, watching movies, painting, dancing, etc. In the survey we could see that with the quarantine, people stopped doing activities that they did before and took refuge in routines that lead them to become depressed.
When talking about the difficulty of maintaining interpersonal relationships, it is striking that it is young people, those most connected in social networks, who lose that interest. Are you having trouble getting used to a primarily virtual relationship?
We know that physical contact is very important. Being with others, feeling them, talking and looking into their eyes and experiencing what only physical contact generates is something that is obviously lacking. However, for now, we can substitute this communication in some way with the virtual, and we must think that it is temporary, despite the fact that something is missing. But the most important thing is to understand that isolation is something that will last only a while longer and it is something that we have to do, because we are in a pandemic and we have to take care of each other. When the survey asked young people what they did when they were able to go out, 20% answered that they went to visit a friend or relative.
How to comply with these recommendations taking into account the different socio-economic contexts?
According to their context, people have different activities that they could privilege. We can all exercise in some way, have some virtual contacts, have fun, read or do enriching activities. Obviously, according to the age group, there are diverse interests that range from playing, in children, to reading or doing hobbies, in adults. Now, activities such as mindfulness exercises can be used to integrate into the various activities we do. Around this we made a small video with the university that teaches some of these possibilities.
Returning to the topic of virtuality, one of the main causes of this depression is information overload. How to avoid it if the main distraction is the social networks that publish this content?
Regarding social networks, what we propose is that one must have certain limits in their use, social networks indigestible and also have to know that not all information is real and fake news do enormous damage that we call infodemic. This was one of the first factors we identified when the quarantine began: people shocked by excess information. At the Javeriana University we did a free course in EdX called “Communicate without harm”, in which we precisely spoke to communicators and journalists so that they understood their health promotion work. People have to limit their use of these computing resources, they can’t go to bed watching the news and get up early to see what’s new. We have to propose to do a certain “news diet”. A fair means.
Another important issue is the consequences of feeling depressed or anxious, since concentration is generally lost and in young people who work or study this affects performance. What to do?
Usually when you are depressed or anxious, your cognitive processes get blocked. You can’t be as effective as you were before. This can have some repercussions in the way of studying and here I speak as a teacher, one has to explore how pedagogical strategies change or adapt when teaching virtually. It is necessary to take into account the difficulty of some students to concentrate on virtuality and for this reason it is necessary to implement strategies that favor attention and better learning. Likewise, let’s not try to take the same face-to-face classes to the virtual. Let’s see different ways of learning, innovative models.
It is starting and the best efforts are being made. There are many circumstances going on in time and decisions have to be made according to the moment. I think the time for mental health is coming. What is happening now in mental health is what some call the fourth wave and others call the second wave. That is, all the psychosocial consequences derived from the pandemic, and everything that we are and will be living in the personal, family, work and social life. In this sense, we must educate and accompany much more in mental health, many people do not have equitable access to health services. Other professionals must improve their empathy for the mental, other people may not recognize their mental difficulties, or if they do, they do not go to the health service due to stigma, fears of the pandemic or other circumstances that we have to avoid. We must propose ourselves in an effective and purposeful way so that we all intervene in health care, that we be careful with ourselves and others. Mental health is and must be a commitment of all, where all people and institutions must carry out part of this accompaniment. For now, the Javeriana University has been carrying out various projects that seek to improve the conditions of young people and the entire community where we operate. Finally, I think that accompaniment in mental health exceeds what the Government can do, and must improve some areas, it is a social commitment, a responsible commitment of all of us.