Audionota: Danilo Belloni
Guillermo D. Rueda / [email protected]
“During the strict confinement we had to be very present, since the consultations were more than usual. It was clear: patients with bipolar disorders had gotten out of the routine and could no longer cope with stress ”.
Dr. Miriam Montes de Oca, a psychiatry specialist, said it about the consequences of the Covid-19 pandemic in people affected by mood disorders, as the professional herself was in charge of updating the term.
“That situation led to many relapses. And the worst is depression, “he said.
Dr. Miriam Montes de Oca, specialist in psychiatry and medical examiner of the Judicial Power.
“If it is the main consequence of the coronavirus? Yes, but the disorganization that has prevailed in their lives also had an impact, “added Montes de Oca, who is also, since 2011, a medical examiner for the Judiciary.
“These are patients who have fewer strategies to face confinements, or uncertainties, and social isolation, because what we always promote is that they interact with the environment,” he explained.
As for the imbalances due to disorganization, or lack of organization, he referred to not sleeping at certain times and staying in front of the screens – including streaming series – in an unlimited way.
“Order is very important, because they immediately lose their north. You also have to insist on the timing of meals and medication, something vital and essential to stabilize it, “he said.
“When this happens, you have to stop everything and start ordering, especially the hours of sleep, routines and doing gymnastics, even online, because mood stabilizers tend to cause weight gains,” said the professional from Bahia, in dialogue with The new one.
Montes de Oca, who worked at Penna Hospital from 2000 to 2011, also said that the key is not to break the therapeutic alliance.
“We are already returning to the presence and with all the care,” he said.
“Patients are rechecked knowing that there will not be a full waiting room and that all protocols are in place. That has been loosening them (sic) ”, he said.
“Now, we have to be present, as before, the therapists, psychologists and psychiatrists, to order the habitual until we reach that routine life,” he insisted.
Dr. Montes de Oca commented that bipolarity, as a disease, is the sixth leading cause of disability worldwide.
“It generally occurs in young adults, between 20 and 30 years old, which is when the diagnosis is made. The good thing is that it has treatment and that today, beyond the pandemic, there are no excuses to leave it, “he described.
“It is a disease that must be psychoeducated, both for the patient and the family. In general, bipolarity is a chronic, mental illness that cannot be cured, until now, but it can be stabilized. Like diabetes, for example, ”he explained.
“What happens is a disorder at the level of humor, which sometimes triggers and enters states of hypomania, or mania, where everything is up and more and the patient is very difficult to contain. He goes through his life at a high rate, and even with a certain danger, since in some cases he must be admitted to a psychiatric institution ”, he commented.
“The problem is when it goes down,” said Dr. Montes de Oca, who studied in La Plata and developed the specialty at the Oscar Alende Hospital, in the city of Mar del Plata.
“That is the phase that he does not like. It goes from the brightness of light to a well. It is a depressive phase, where the patient remains in bed for a long time and cannot do anything at all, “he said.
“These are very vulnerable patients, especially in situations of stress and uncertainty, as happened to us with the pandemic. And thus they begin to decompensate, when before that was controlled ”, he said.
The professional was trained with Dr. Alejandro Lagomarsino (now deceased), a reference in the country on bipolarity, who also formed the mutual aid groups concentrated in the Bipolar Foundation in Argentina (Fubipa).
“In Bahía Blanca I was working at the local headquarters of Fubipa, but finally the group disbanded. Today they move via social networks and people can follow the development of activities, “he said.
Treatment and virtuality
Regarding the continuity in virtual form of the treatments with patients with bipolar disorders, Dr. Montes de Oca said that it has its peculiarities.
“It is not the same to see the patient on a screen than when he comes to the office, we look at each other and talk to each other,” he said.
“Sometimes the screen even helps to mislead (sic) if it is an initial consultation,” he clarified.
“If I worked virtually? Yes, but for a short time, because I noticed that the patients were becoming unbalanced ”, he commented.