ROUEN, FRANCE – The panicked 22-year-old is taken to consulting room No.2, with its easy-to-clean floor and honeycomb mesh above the window. Behind her, the heavy double doors of the psychiatric emergency room – which could only be opened with a key from a staff member – slammed shut.
With anxious snaps of her white sneakers, she tells a psychiatrist on duty how the loneliness of the coronavirus lockdown and the anxiety of not finding a job in the pandemic labor market is contributing to her whirlwind of anxiety . She is baffled that she is starting to obsess over knives, fearing that her sanity will collapse.
“The lockdown – let’s not pretend otherwise – worries me,” explains the young woman through her surgical mask, while the psychiatrist, Irene Facello, listens attentively.
“I want to be reassured,” said the woman, “that I don’t go crazy”.
Forcing millions of people to stay at home again – cutting them off from families and friends, shutting down businesses they’ve invested in, college courses that nurtured their spirits, and nightclubs where they socialized – a, for the moment, began to roll back the new coronavirus push in France which pushed it in November beyond the dark milestone of 52,000 dead.
But the costs to mental health have been significant. While the number of French COVID-19 patients in intensive care is now decreasing, psychiatrists face a wave of psychological distress. The health authorities’ survey indicates the most acute depression among the unemployed, those in financial difficulty and young adults.
The Rouvray hospital center in the Norman city of Rouen is one of the places where psychiatrists are on the front line of the fallout from the pandemic on mental health. They fear a growing crisis of depression, anxiety and worse looms on the horizon as more livelihoods, futures and hope are lost due to the pandemic. Associated Press reporters spent 10 hours in the sprawling 535-bed facility, the day after French President Emmanuel Macron presented a plan extending through mid-January for the gradual lifting of restrictions on locking.
In the psychiatric emergency, as Facello sends the 22-year-old home with an anti-anxiety prescription and an appointment to see her again in two weeks, the double doors open again.
She’s another 25-year-old linguistics student. She is directed to consulting room # 1, where she sits silently in the dark as night falls.
On the department’s whiteboard, which lists patient names and details, an abbreviated initial diagnosis handwritten on a piece of paper uses acronyms to spell out how close she may have been to the irreparable. Over the past week, she said, she had suffered from “IDS” – suicidal ideation – and had imagined “IMV,” or voluntarily ingesting drugs.
The head psychiatrist of the service, Sandrine Elias, gently teases the student how the confinement has left her completely alone, classes being suspended.
This is not the only cause of his discomfort. Elias learns that the young woman had a difficult adolescence, with suicide attempts. The isolation during the epidemic only amplified the student’s distress. In a calm voice, she tells Elias that she “confronts us with ourselves”.
“I’m a stay-at-home type person, but this absolute constraint is a real burden,” she says.
Elias quickly decides to hospitalize her. Supervised rest and medication, Elias says, can help.
“You need a framework, to be supported. Alone, in your studio, this is not possible, ”explains the psychiatrist. “It’s very good that you came here. ”
Not everyone who seeks help has a psychiatric history. Mental health professionals say lockdowns and curfews have also unsettled people who, in less difficult times, could have overcome difficulties by chatting to family and friends rather than ending up in wards. psychiatric treatment.
“Being alone between four walls is terrible,” says Elias. “Stopping life like that affects people. It’s not good. ”
Nathan, a 22-year-old student, came to the emergency room two days earlier. The logbook shows that he was admitted at 5:20 p.m. and transferred that evening to a longer stay unit.
There, in room 14, he told psychiatrist Olivier Guillin that he had asked for emergency help “because I had the impression that my morale was declining very quickly, that I was on the verge of rocking, with suicidal thoughts ”.
Similar thoughts had first depressed him this summer, following France’s initial lockdown from March to May. They struck again when the country was contained for the second time from October 30. His university has closed its doors. His political science lessons have gone virtual. Rather than being alone in his student apartment, he returned to his parents’ place in Rouen, separated from his support network and ruminating on his uncertain future.
“The first lockdown didn’t really have much of an effect on me,” he tells Guillin, but the second “really sank me. ”
“Being confined again, always having to stay within a limited area, not being able to see my friends as often as usual, that bothered me,” he says.
The safety of hospitalization and medication quickly began to stabilize him. Resting on his bedside table was a Rubik’s Cube that he had solved.
Guillin, who runs several units at the hospital and has 200 medical staff under him, says they are seeing a surge in the number of young adults seeking help with issues of anxiety, depression, drug addiction and other difficulties. He is preparing for more.
“We will most likely see the crest of the wave in the coming months,” he says.
The pandemic has also had other mental health implications that are less obvious but no less devastating.
Guillin still mourns the death of a patient who committed suicide in the first lockout, 48 hours after what turned out to be their last date. She wore a mask at this meeting, to protect herself from the virus. This interfered with his reading of the depth of his distress, he says.
“She was a very expressive woman and there, with the mask, I misjudged things,” he says. “In retrospect, I tell myself that maybe, without the mask, I would have been more alert and done more.
Patients have also been hurt by the misappropriation of mental health resources to fight COVID-19.
The electroconvulsive therapy that had helped student Laura recover from her severe depression was destabilized when anesthesiologists – who are needed to put her to sleep while electrical currents flowed through her brain – were called in to treat patients infected with the virus.
“My morale deteriorated soon after, and the suicidal ideation returned,” she tells Guillin.
Laura says for her that therapy is “as urgent as COVID-19”. She says prioritizing patients with the virus “is kinda dumb and mean”. Now, instead of being released from the hospital in mid-November as she had hoped, Laura has had to stay.
In the emergency room, for the third time in two hours, another young woman enters through the double doors, dressed in black, looking hollow. As room 1 is already occupied by the 25-year-old girl, the 18-year-old high school student is presented in room 2. After her first interview with a nurse and a caregiver, she snuggles up in her chair.
The nurse, Sébastien Lormelet, and the caregiver, Anita Delarue, exchange notes in the staff room where the teenager’s name and admission time, 5:02 p.m., are written in black marker on the whiteboard.
“Lockdown has a lot to do with it, because she says the first one was difficult. With the second, now, if she could escape, she would, ”said Delarue.
“She wouldn’t resist a third. ”