When mental illness reveals itself on summer vacation

Medexpress: Do psychiatrists observe the phenomenon of disclosure or exacerbation of mental disorders during the vacations? If so, how frequent does this occur and what might be the reasons?

P.W.: Indeed, we are seeing such a phenomenon. In recent years, we have been paying more and more attention to it. Many patients come to consult psychiatrists after vacations because they don't know how to rest. We work too much, are overworked and overly stressed. Many of us treat our vacation as another set bar and want to make the most of this time and rest. And it is impossible to rest by force. Many of the patients say that while on vacation they had a sense of guilt about not working during that time, worried about whether they were sure they were doing the right thing. For many of us, the vacation arranged in our heads wishfully, can become unsuccessful, because something, however, goes wrong on it. And this is the main problem.

Medexpress: Like in the movie "Groundhog Day," where the main character, going on vacation, kept repeating to himself, "At all costs I must rest."

P.W.: And you can't rest out of necessity. You have to prepare for it. I also want to say about sensitive things i.e. vacation does not protect at all from the appearance of mental disorders, nor from circulatory episodes. On vacation, many people experience numerous somatic or psychiatric illnesses. For a simple reason - external stress levels drop and cortisol levels suddenly decrease. Our body biochemically and immunologically "shifts" drastically, and therefore this is a sensitive period during which the percentage of psychiatric disorders can rise.

Medexpress: What are the most important, common symptoms we should look out for when observing, for example, the unconventional behavior of others while on vacation. What indicates a mental disorder rather than the effect of alcohol consumption or holiday fooling around?

P.W.: There is no answer to this. The most important thing is the interview and objectivity, i.e. we assume a hypothetical situation that we are going on vacation with our partner, husband/wife, and suddenly we see that he changes and behaves completely differently than before, for example, he becomes aggressive, more impulsive, or as he was talkative, he stops talking, withdraws socially, doesn't want to go out to people, suddenly drinks more alcohol, or says he won't drink at all. Such a quantitative change should worry us. Not to mention qualitative. Because if the first episode of psychosis on vacation is to become apparent, we will know it right away. It will be apparent when delusions or hallucinations appear. It is a qualitative, jumping variety. Often easily recognized as completely socially inadequate behavior, which is also a discomfort to those around, when someone behaves irrationally and differently from the accepted cultural and social norms. Then such a patient will more easily probably end up in the psychiatric care system. But the discrete onset of illnesses is most often insidious, these are quantitative changes - something is less, e.g. I'm sadder, I talk less, I can't sleep. Often we don't notice this on vacation, because we are absorbed in, for example, a trip, sightseeing, seeing new things. And in fact, this may already be the beginning of the disease.

Medexpress: Someone went to a dream destination and doesn't want to leave the room....

P.W.: And this is not uncommon at all. People who are overtired and overworked don't want to go out, but (qualitative change). If this happens suddenly, and it wasn't like this before, we should be concerned about it. Any behavior that deviates from the norm for a person, which prevails for most of the day or week during the vacations, should worry us. Because this is a change that is not an incident, it is already underway.

Medexpress: What should it look like to help a person experiencing a psychiatric crisis on vacation and in a country where getting professional help quickly is not easy? What to do and what not to do?

P.W.: First of all, relationship, conversation and not judging that person. We try to be helpful, we establish a relationship, but we don't judge and we are not firm in this message, we don't say that something is right or wrong. Often such a person, if we talk to him or her, will let us in and say why he or she behaved that way. And usually there is a second bottom. Then it's good to assure this person that we are ready to help him, we reduce the stress level by doing so, we make him start to feel safe in our company. We don't raise her anxiety level. We help as much as we can. But if psychosis appears, it will be difficult to help, because psychosis is a qualitative change. A delusional patient, with hallucinations, will not listen to us. But I assume that such cases are very rare. Most often, anxiety or depressive symptoms become apparent during the vacation. If we are close to such a person, let's try to ask him about a situation that happened recently. There may not have been an opportunity to talk about it before and the vacation may be such an opportunity, thus reducing, perhaps, the stress level in such a person. If something happens, let's try to be with this person to lower his stress level so that he feels our support.

Medexpress: What are the most common mistakes we make in terms of our own mental health during vacations, vacations?

P.W.: On vacation, we should return to good habits, i.e. to what we don't observe every day, such as sleep hygiene. Let's try to get enough sleep and eat well, systematically, do what we don't usually do because of the rush. Let's slow down a bit, try to do physical activity, increase movement, but not abruptly, but gradually. Let's get back to healthy habits. It is worth noting that on vacation we can afford to talk, relate and be with loved ones with whom we did not have the opportunity before. Support and good habits. And on a daily basis we don't do this, I see it from patients. We work too much and sleep too little, move too little, have a bad diet. Let's go back on vacation to habits that are healthy.