Politicians initially gave into their usual impulses to reassure rather than inform, calling for “business as usual,” and “nothing to see here.” But it quickly became evident that the disease spread fast and could be life-threatening in a minority of cases. In response, federal and state entities called for “social distancing, “hand and surface washing, and “hands off the face,” all of which seemed reasonable. Then, as the news media sensationalized their coverage, public officials became anxious and fell back on their all-time favorite method of problem-solving: risk management. Emergency statutes and orders have mandated masks, closings, and in some states, curfews.
In our practices, we are seeing patients make health compromises that might increase their susceptibility to the viral scourge. Some have become so anxious or depressed, due to fear stoked by the media, that they are unable to work. One potty-trained four-year-old patient had a curious manifestation. In the last month, as her entire routine changed, she had daily unpredictable urination, or incontinence: probably a disorder driven by all of the media blitz, adult anxiety, and related disruption.
As a family physician and a psychiatrist with more than fifty years, collectively, of clinical experience, we are not the only ones to observe that the current intervention in the name of public health is so invasive and far-reaching that it has caused considerable amount of preventable mental illness in adults and children alike. Our colleagues are, no doubt, also spending considerable time treating patients’ mental health symptoms stemming from the government-caused crisis.
It is imperative to recognize these solonogenic harms so they can be treated properly by clinicians. It may not be possible to remove the mental irritant of public health orders right now, but their effects can be mitigated if we distance our minds from the parts of the guidance that irritate.
As physicians, we grapple with the same mental challenges as our patients. It is anxiety-provoking to be faced with the possibility of punishment if one does not practice medicine according to government edict, particularly when the authors of those directives are nonclinicians, remote, unaccountable, and concerned with the well-being of populations rather than individuals. Physicians beware: public officials will not be responsible for the clinical outcomes resulting from your compliance with their guidance!
How can lockdown panic syndrome be treated? Encourage patients to take back control over their own daily lives as much as they safely can. Tell patients that their own judgment about protecting themselves will be sound once they have vetted their information carefully and sought individualized guidance from their personal physicians. Patients can also be supported in taking the initiative to rebuild their own lives on their own terms, in safe and realistic ways, rather than waiting for the go-ahead from public officials.
Public officials and the media could stop lockdown panic syndrome in its tracks by allowing physicians to treat the clinical problems created by COVID-19, and empowering patients to use their individual judgment and take responsibility for themselves and their families. Unfortunately, it may be too much to ask public officials to shelve their partisan agendas, but the rest of us, practicing physicians and patients, can partner together to make America a healthy nation again, mentally, physically, and perhaps we can learn to put politics in places less central in our minds.
Craig M. Wax is a family physician. Robert Emmons is a psychiatrist.
Lockdown panic syndrome, and how to fix it
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