Marco Torrado was always very close to people, concerned with what they felt and what moved them since ancestral stages of their life path. He always wanted to take care of others and that is why he wanted to work in the Health field and, particularly, in Mental Health. His taste for writing and painting has re-emerged in recent years, but he still doesn't know what this might translate into in the future. Still, he says it "brings new colours to the journey!"
He is a clinical psychologist and psychotherapist. He obtained a Ph.D. in Human Development (Health Sciences) in 2013 from the Faculty of Medicine of the University of Lisbon (FMUL) and was a Ph.D. Fellow at the Foundation for Science and Technology. He has worked in various professional contexts, namely in psychosocial support institutions for vulnerable groups, primary health care, hospital services, intervention in addictive behaviours and advice on mental health in childhood and adolescence at the Ministry of Health.
He is currently Professor of Medical Psychology at the FMUL, since 2013, working at the University Clinic of Psychiatry and Medical Psychology. He is also Coordinator of the Psychology Specialty in the Neurosciences Centre at CUF Tejo Hospital. He is a member of the Social Bodies of the Portuguese Psychosomatic Society and of the FMUL Environmental Health Institute, as a researcher.
In this interview, we will address the theme of anxiety regarding returning to work and of students going to schools and universities, including the consequences of this disease, which sometimes manifests itself with small signs that we are not aware of.
What concerns can anxiety bring to people's lives? What physical and psychological influences might be involved? Due to the Covid-19 pandemic, will we have a change in social interaction? These are the main points that Psychologist Marco Torrado will address.
The anxiety of returning to work can cause a lot of worries in our lives. How should we manage this?
Returning to the usual routines after a holiday period (almost) always entails a time of adaptation, sometimes with some discomfort experiences, restlessness or even malaise. It is important to place it in what is a normative adjustment at a more demanding pace and it tends to be less lenient from day to day. Sometimes with some signs of resistance (ex: drowsiness, fatigue or even irritability), we end up adapting to the less relaxed rhythms of the post-holiday. It is important to tolerate the sadness that often follows periods of greater pleasure and relaxation without making it a problem or thinking it might be an indicator of disturbance. Most of the adjustments we make daily in the face of more or less significant stressors do not entail problems compatible with psychopathology. They are often transitory states of weakening or even withdrawal in order to better face the demands of resuming demanding routines, whether in the occupational or affective and family sphere, and it is important to gradually tolerate and accept them. Of course, it is important to be aware of more consistent difficulties in this recovery, for example if this malaise is prolonged or intensified for several months.
And do children and young people also suffer from this return to school after the holidays?
Sometimes children and young people also resist going back to school after the holidays, but I would say that 'suffering' only occurs in a very residual portion of situations. In younger children, for example, it may be more difficult to return to school routines, especially if, during holidays, part of the sleep, feeding or stimulation tasks routines have been more neglected. Or even when they spend longer periods with other significant affective figures (for example, grandparents), it is sometimes difficult to renounce such a frequent presence at the beginning of the school year. In young people, difficulties in restoring schedules, in 'normalizing' sleep times and discontinuing periods of socialization (which, more contemporary, often happen online and in the context of games or social networks), are more common. However, as I mentioned, they tend to occur for short, transitory periods without continuity. When dragged further in time, they can lead to less healthy or even problematic situations, but they tend to be associated with previous aspects of vulnerability, such as greater difficulty in regulating negative emotions, tolerating frustration or accepting change.
What physical and psychological influences can anxiety cause in the lives of adults and young people?
Anxiety, sustained by the basic emotion 'fear', arises in response to events, stimuli and happenings that are assessed by the individual (often unconsciously and automatically) as potentially threatening. At more controlled and non-disruptive levels, it is a good engine for us to face events perceived as more demanding, such as starting a new job or a new academic environment, taking an exam, or even the beginning of a new affective experience. However, this is not always the case, since this experience of fear, which is continuously lived, can over activate the body, as if it were always in preparation to act in the face of adversity. This action mobilizes responses at the level of multiple systems that aim to defend the individual against such adverse situations, whether globally from a logic of 'fight' and confrontation, or from a perspective of 'escape' and avoidance.
When experienced at higher and poorly controlled levels, anxiety can negatively interfere with various areas of individual functioning, whatever the age group. It can, therefore, promote slight and transitory changes or others that are more continuous over time and that often require clinical intervention due to the severe discomfort they cause. There are behavioural changes, feelings of inadequacy and avoidance in the face of new situations and contexts, marked social inhibition and restlessness, rituals, difficulties in concentrating and maintaining the attentional focus on certain tasks, in short, multiple manifestations sometimes accompanied by (or anticipating) other indicators of emotional distress, namely depressive symptoms.
Naturally, the expression of anxiety happens in different ways depending on the various phases of the life cycle. It is modulated by numerous factors, from contextual (e.g. family, educational...), psychological (e.g. personality traits, emotional states. ..), neurobiological and constitutional, which in turn interact in a complex and non-linear way. If each case is really a case, I think it is possible to highlight that both in the youngest and in adults, the issue of gradual dysfunctionality in multiple day-to-day tasks is central (which was not previously seen), with a significantly negative occupational, social and relational impact. This aspect usually signals an exacerbation of anxiety, with a clinical setting, which requires specialized therapeutic support.
One of the main concerns for young university students is the fact that they have to move to a new city and find a place to live. Can this worry complicate things?
The sudden or progressive abandonment of the life contexts that are more familiar to us that mean stability is a challenging and even exciting life event, but sometimes also an anxious one. It is naturally a promoter of enthusiasm for most university students who often leave their places of origin to go to other places to study, it is like a promotion for adult life and for their autonomy!
But precisely because of this it also entails the assumption of new responsibilities and adaptations, not previously immediately necessary due to the presence of the family network and friends. In most young people, this adaptation is done in a healthy way, not exempt from some 'ups and downs'. There are, of course, cases when this is sometimes accompanied by some suffering associated with uprooting and feelings of helplessness, especially if, over the course of the young person's development, some of these aspects were experienced and little internally transformed. In this confrontation with geographic change, they can be at some point revived or evoked. Within this minority, there are situations that are calmed with the creation of new social support networks, inside and outside the academic context, and with the support of the most significant affective persons. There are others who, having more difficulties in tolerating change processes, need additional support. In this context, it should be noted that the entire educational/academic community has an important role, not only in supporting (at various levels) the new members, but also in increasing health literacy, and particularly mental health, helping university students in their self-care and monitoring their well-being.
It's hard to get back to work and school after holidays. This year, with the pandemic, with the implementation of telework and online classes, we have people returning to the office after several months at home. Will social interaction change due to the isolation caused by Covid-19? Will we be psychologically and physically ready to go back to a work routine where we spend 7 to 8 hours in the office, in addition to time spent in transportation and traffic?
The pandemic times we still live in have required a sudden need to adapt to the imponderable. With the lockdowns and the necessary adjustment of life as a whole, individuals have faced the absence of stability that we so much need to guarantee our psychological and, I would even say, psychosomatic balance. It is certainly no coincidence that so many people in the clinical context mention nutritional abuse during the time they were teleworking, the problematic use of alcohol, a sedentary lifestyle even after the reduction of restrictions in view of the improvement indicators of the pandemic situation.
The psychobiological balance that means the inextricable articulation between physical and psychological aspects of our body was as if short-circuited by the demands of the COVID-19 pandemic, becoming naturally a stressor for a significant number of the population. The progressive adaptation made to a very distinct community experience, predominantly online for about 1 year and a half, at the expense of multiple 'crutches', naturally left wounds, especially in the field of social interaction, but which I consider to be repairable, as long as there is continuity in the mprovement of the pandemic scenario and reactivation of affective life and belonging groups.
Despite so many changes in so few decades, we continue to be eminently gregarious individuals, deeply motivated by the affective bond as a guarantee of our survival. I believe that this will continue to happen, despite the countless new channels that facilitate (but do not replace) full and profound human contact.
Of course, returning to the new pace will also require an adaptation, which must be done in as thoughtful and serene way, assuming in advance that these are transitory processes that demand tolerance and empathic capacity, with others and with us.
How can families prepare for this return?
I humbly admit that I don't have a prescription for this! I think, however, that the key to a good return to old/new experiential paces will always be consistent and continued investment in the affective contexts that feed the psychological balance of individuals. Without it, the possibility of cultivating and maturing the adaptive potential of the human being is endangered, and this has been decisive over these last times.
Creatively reinventing everyday life needs this affective side, an engine of hope built in the relationship with others and with oneself, in order to tolerate the multiple adversities we face daily and others of greater magnitude, which sometimes take away the feeling of stability and the support we so much need to avoid incurring physical and psychic allostasis. On the other hand, the dimension of self-care seems essential to me: the promotion and maintenance of our habits and routines, from eating, sleeping, affiliative life, among others. Taking care of ourselves, of our psychosomatic being, in which mind and body are the two sides of the same coin, is absolutely crucial for our feeling of completeness and for feeling vigorous and motivated to walk along familiar slopes and climb new mountains!
Therefore, I would say that returns are made with hope, stability, self-care and affective proximity. This possibility of having a rewarding place in our individual history, as well as that of our family and community, is absolutely essential to enter into and not fear the new paths of our journey.
Marco Torrado
Professor of Medical Psychology
In order to end this piece, it is worth mentioning a space dedicated to this topic that supports students, whenever they need it, at the Faculty of Medicine of the University of Lisbon (FMUL). Espaço S is a place where it is possible to approach the essential issues for the well-being of students, where professionals help them to understand themselves and to understand the problems. Where students can be themselves, without barriers, where what they think is important is what really matters.
An interview with Espaço S Psychologist, Rui Martins.
Students coming from other cities tend to experience greater difficulty integrating themselves. Could this difficulty worsen due to the pandemic?
Displaced students face more difficulties when starting higher education because, in addition to adapting to the degree and new and greater demands, they are forced to have a level of autonomy that they often did not yet have. These students end up having more risk factors for developing psychological disorders or adaptation problems. When the classes were entirely online, many of these students chose to stay at home, avoiding isolation. In periods when this was not possible, these students became more isolated, especially year 1 students, as they did not have the opportunity to socialize, which is so important in the first months of the academic year. All academic life, which is not just classes, was affected and naturally displaced students ended up suffering more from it.
What psychological consequences can this difficulty have on these students?
Young people who abruptly find themselves estranged from their parents and therefore forced into an “instant” autonomy process, tend to develop anxious psychopathology. Those who end up more isolated, and are prevented from pursuing pleasurable activities and social relationships, tend to develop depressive disorders. They also often become addicted to technologies, social networks, games and binge watching of visual content, that is, the compulsive watching of videos, films and series.
We must emphasize that psychological disorders are multifactorial and, therefore, we cannot say that they are caused by integration difficulties and isolation. Certainly there is a combination of other prior or concomitant factors that eventually precipitate the disturbances.
We are all further apart due to the pandemic. Can this generate new forms of anxiety?
I don't think these are new forms of anxiety. It seems to me that it is a new context, new challenges and new fears that lead us to the forms of anxiety that we already knew, that were already arriving at the consultations and that led to the request for anxiolytics, often without adequate follow-up. Distance, or social isolation, was already known as a risk factor, in a vicious combination: if isolated, I'm more exposed to psychological illness, if I'm sick, I isolate myself more.
Perhaps what is new for some generations is the fear of disease, the proximity to death and uncertainty, which they had not yet experienced in their years of life. There is certainly an increase in known and researched risk factors. It's certainly a tougher time for everyone.
Final note
It can be difficult for us to know whether what is going on inside us is a normal reaction to leaving the parents’ home, to a new, more demanding academic context or an emotional response adjusted to the pandemic and “social isolation”. But in health services, we find the answer to these questions and therapeutic support, if necessary. A psychologist, a psychiatrist and a family doctor can be very important. FMUL students can contact Espaço S, the psychological support service of the Student Support Office.
Rui Martins
Espaço S Psychologist
Leonel Gomes
Editorial Team
