"The definition of mass hysteria is suitable": the chief psychiatrist of Moscow on the consequences of COVID-19 and anti-vaccination

- Georgy Petrovich, earlier, more than once, there was evidence that those who had recovered from COVID-19 sometimes suffer from mental disorders.

How common are these side effects?

And how long do they usually last?

- In psychiatry, one can conditionally distinguish the concepts of disorder and disease.

A disorder is, for example, when a person in a stressful situation has disturbed sleep, anxiety appears, but over time everything goes away.

The disease is a chronic condition that can be compensated for with therapy, but usually cannot be completely cured.

In patients who have undergone covid, certain disorders occur, during which several phases can be distinguished.

Firstly, during the infectious disease itself, when a toxic load occurs, hypoxia, a number of autoimmune processes - all this can cause changes in the mental state.

At this moment, rather severe disorders are possible, with a clouding of consciousness.

There may be hallucinations, it may seem that someone wants to harm.

But this is a temporary phenomenon.

Typically, this condition can develop in intensive care patients.

• Georgy Kostyuk

• © Ekaterina Kozlova

Unfortunately, in the first wave of the pandemic, when not everyone understood that this was possible, there were even isolated tragic cases.

However, these disorders are nonspecific, they are not associated specifically with covid, and can manifest themselves in other infectious processes.

The second phase is the exit from the disease, the period of convalescence.

It is always accompanied by a certain asthenia, weakness, which is also associated with a toxic load on the nervous system, on the brain.

It is the brain that is most difficult to recover.

Patients have even coined the term covid fog for this condition.

And now the exit from the coronavirus disease is accompanied by more severe and longer-lasting phenomena than even after the flu.

A person cannot concentrate for a long time, mental performance is greatly reduced, memory and attention deteriorate.

- Some covid survivors complain of hallucinations, what can you say about this?

- Rather, these are still not hallucinatory phenomena, but illusory ones.

It is as if, for example, a raincoat is hanging on a hanger in the dark, but it seems that this is a person.

Hallucinations are when you see something that is not.

And illusions are when there is a sound or an object, but perceived differently.

In general, the effects of covid are different from those of other infectious diseases.

Even if the covid proceeded in the form of ARVI, without pneumonia, and in these cases, the way out of the disease is still more difficult.

- And therefore, depression is possible, if we speak not in a clinical sense?

- Why, you can speak in the clinical.

Many scientists, neurologists, psychiatrists suggest that those who have suffered from COVID-19 may experience an accelerated onset of neurodegenerative diseases.

For example, in theory, this could lead to earlier dementia.

But so far this is only a pessimistic forecast.

There is another group of disorders, which is associated not so much with the impact of the virus itself, but with the informational atmosphere in which we all find ourselves, starting from March last year, when there was the lightning of the first wave of the pandemic.

At the first stage of the pandemic, when it was already raging with might and main in Moscow, we still did not know how to work with it correctly, there were no verified drug therapy schemes.

Guidelines for patient management were just being refined.

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• © Evgeny Odinokov

Unfortunately, with the arrival of the virus, a lot of conspiracy theorists appeared, who said, for example, that masks and other restrictions were supposedly the way to a digital GULAG.

Of course, all this created confusion in the minds.

In addition, people lost loved ones, all this formed a very serious informational pressure, which in itself caused a significant increase in stress in the population.

- That is, even those who were not sick suffer?

- Including.

This pandemic is distinctly two-pronged.

It is infectious and informational.

Serious population studies were carried out, which showed that, although at the beginning of last year the disease really spread quickly only in Moscow, and in the regions it was epidemicly calm, the level of stress in people was recorded the same throughout the country.

The incidence rate was different, and the information agenda was common for everyone.

This can be indirectly judged by the data on the sales of antidepressants, which are absolutely reliable.

In April 2020, there was a sharp jump in sales through the pharmacy chain.

By the summer, these indicators had subsided a little, and if everything had been limited to the first wave, everything would have ended there.

But then came the second wave of the pandemic, it was the longest, and by the New Year, sales of antidepressants rose again.

And if at first anxiety disorders predominated in the structure of stress response, then by the end of 2020 the depressive component began to prevail.

- What is the difference?

- Anxiety is a universal reaction of our psyche to any unforeseen changes or their expectation.

This is a normal adaptive reaction, anxiety mobilizes us - for example, thinking processes are accelerated before an exam.

But only when it is moderate and short-term.

When it is constant and pronounced, it leads to disruption of the functioning of the body.

Long-term anxiety can lead to cardiac problems, or stress ulcers, the manifestations can be different.

Each person has his own weak link in the body - locus minoris resistentiae (lat. “Place of least resistance.” -

).

And when the stressful situation is prolonged, depressive disorders begin to form - more formidable and persistent.

Separately, it is worth talking about vaccination, and it is in the context of mental health.

It would seem that three vaccines were developed in Russia, and we were the first to register a vaccine.

And this created an advantage for us, should have become a guarantee of peace.

However, unverified information resources were able to convince part of the population of the most ridiculous theories that are still circulating in society.

Not old, famous people die, and then it turns out that they succumbed to a general panic and bought a vaccination certificate.

- Have there been any attempts to scientifically analyze the mechanism of spreading dangerous myths?

And what happens to the human psyche when he begins to believe in speculation about "chipping"?

What is this - mass hysteria, or something else?

- Probably the most appropriate definition of mass hysteria.

You cannot literally call it psychosis.

This is a combination of a number of factors.

On the one hand, the conviction of one's own intellectual superiority over others.

On the other hand, there is an initially protest attitude.

A tendency imposed on many of our compatriots to criticize their country in any situation.

I have even heard such statements: how Russia, which is not able to sew a shirt, can develop such a high-tech vaccine.

- At the same time, in other countries, for example the USA, the anti-vaccine movement is also very active ...

- Everywhere there is its own motivation.

For example, opponents of vaccination say that allegedly the Russian Federation could not develop a vaccine in three months.

But in fact, this drug has been dealt with for many years.

And it so happened that exactly in time for the COVID-19 pandemic, it was practically developed.

All that remained was to synthesize the protein S specific for this coronavirus in order to integrate with the adenovirus.

It was a long, painstaking work of several research teams.

Yes, there are cases when vaccination does not lead to the formation of sufficient immunity, but they, firstly, are understandable, and secondly, fortunately, they are extremely rare.

However, public attention focuses only on them, and ignores many millions of other cases when everything goes well.

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• © Maxim Blinov

- When you talk to anti-vaccine people, you get the impression that they have some kind of psychological block.

They don't hear any arguments.

Why?

- Because for various reasons, some people have already formed stable stereotypes.

For example, when Alexander Gintsburg (director of the Gamaleya Center -

) said that it was possible to determine whether a person was vaccinated or not by a special label, supporters of the theory of "chipization" began to say that he allegedly "confessed" himself.

Although, in fact, this "label" is just antibodies to adenovirus.

They are produced when we introduce the vaccine, and by their presence it is possible to understand whether a person has been vaccinated, even if by the time of testing he has already become ill with COVID-19.

- Can you somehow convince opponents of vaccination?

- When a person has already formed some kind of solid structure in his consciousness, he hardly leaves his convictions. Nowadays, in many ways, people's ideas are formed with the help of social networks, where they have their own authorities. At the same time, they often refer to the official agenda with amendments, looking for other sources that are more reliable from their point of view. And such information, refracted through a supposedly personal approach, is perceived much more willingly.

This property of the psyche can be deliberately used by those who launch various dangerous fakes in social networks, which form in people a belief in the correctness of certain false theories.

At the same time, there are those who are convinced all their lives that only he is right, in any situation.

At the same time, there is such a parameter - locus control, which determines whether a person is inclined to blame the result of his actions on himself or on those around him.

And this affects the conclusions that a person makes.

- That is, it is impossible to convince anti-vaccinators?

- Any processes in our life are a continuum of states, with forms extreme along the poles and intermediate ones in the middle.

There are probably a certain number of people at the poles with whom nothing can be done.

And the rest of them may still think better, this requires consistent information work.

- Has it ever happened that an irrational fear of vaccination exacerbated existing mental disorders?

- If we talk about patients who already have chronic mental illness, then strong external circumstances wedge themselves into their painful constructions.

Once it was talk about evil spirits, then about aliens.

Then there were "rays" that act through the TV.

And in the case of vaccination, our patients also begin to build this plot into their storyline.

But this is not specific.

There are no mental disorders specific to coronavirus.

However, there are still consequences, I stated them earlier.

I can add that there is also a factor of fear, when a person gets sick, he thinks he can die.

Fear of the development of the disease.

For example, I am now conventionally modeling, a person did not want to be vaccinated with "Sputnik" - it cannot be that a vaccine is done well in three months.

I waited for the vaccine of the Novosibirsk "Vector", waited.

No, he thinks, I'll wait a little longer, until a vaccine from the Chumakov Institute appears, then I'll get vaccinated.

Meanwhile, the people around them continue to get sick.

A person waits, isolates himself from the rest, is afraid.

All this creates conditions that are not very favorable for the psyche.

And in the end, let's imagine that such a person was never vaccinated and got sick.

And all this is superimposed - both fear and the effect of infection.

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• © Pavel Lisitsyn

Now cardiologists note that at the exit from COVID-19, patients also experience tachycardia.

An alarming background coupled with such a heartbeat is a prerequisite for a sharp increase in panic attacks.

We are already recording this growth.

Panic attacks are paroxysms of anxiety, very painful conditions that can literally invalidate a person, he is afraid to even leave the apartment.

And this is just the specificity associated with coronavirus infection.

To summarize, I will highlight a few points.

First, you need to understand that the informational aspect of the pandemic may be even more significant than the infectious one.

Especially when we are talking about mental health.

Second, the information component of the pandemic affects both those who are sick and those who are not sick.

Thirdly, the stressful state in which the entire population was located could significantly contribute to a decrease in critical perception of information - fake data that is disseminated on social networks.

I think that this also slows down the vaccination process and slows down the formation of population immunity.