Saturday, 29 December 2012

Greek Crisis Harms Nation's Mental Health

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Published: Friday, 28 Dec 2012 | 2:05 AM ET

By: Joshua Chaffin

Steve Allen | Brand X Images | Getty Images
For the past five years, Lisa Kalbari has observed the impact of Greece's economic crisis from an airy office on a quiet side street far removed from the teargas and tumult afflicting central Athens.

Dr Kalbari is a psychologist. Each day her couch hosts a procession of patients suffering from anxiety, sleep disorders, depression and other maladies - many of them exacerbated, she believes, by a crisis that has pushed the unemployment rate above 25 per cent while depriving Greeks of any certainty about the future.

"We have a lot of panic attacks," she says. "For the older generation, it's like a form of post-traumatic stress disorder. They have experienced war and poverty. For them, it's about dignity - they don't want to be humiliated again after reaching a high point."

The toll the crisis has taken on Greece's mental health tends to be overshadowed by more urgent concerns about hunger or poverty. Nonetheless, there is increasing evidence of the psychological strain on Greek society - from increased diagnoses of depression to an uptick in suicides - and the human wreckage it may leave behind long after the economy has been mended.

"All types of psychological disorders have increased - anxiety, depression, abuses, somatisation, antisocial behaviour," says Argyro Voulgari, a clinical psychologist at the Hellenic Centre for Mental Health and Research.

At the centre's office in Piraeus, a city that has been particularly hard hit by the crisis, the number of child and adolescent patients - who often suffer from their parents' psychological strain - increased 51 per cent between 2006 and 2011. The publicly-funded centre has not yet tabulated figures for adults, although Dr Voulgari suspects they would also show sizeable growth, particularly for young men.

"Even the people who have money are depressed," he says.

The most harrowing - and debated - measure of psychological strain may be the suicide rate. It rose 37 per cent from 2009 to 2011, according to the Greek ministry of public order.
Other figures vary - to the extent they are even available. Public health experts caution that reporting is often imprecise in Greece because of the shame attached to suicide. For example, the Greek Orthodox Church has been known to withhold funeral rites from its victims.

The country's shrinking health service has struggled to accommodate a flood of patients as people who once paid for private care seek free treatment at public hospitals. Waiting times for appointments now stretch to two months or more, according to psychologists.

"If you need a psychiatrist, good luck," says one former politician, who counts his family as "one of the lucky few who have benefited" from therapy.

Thanks to the crisis, the stigma against mental health treatment in a conservative, Orthodox society is rapidly melting away, he says: "Something that happened in the US 20 years ago is now coming to Greece."

From a psychological perspective, one of the most corrosive problems is the duration of the crisis. It has now produced five years of recession with no end in sight - an uncertainty is its own form of psychological torment, say doctors.

"It doesn't finish. It's always there," says George Christodoulou, a psychiatry professor at the University of Athens and the honorary president of the Hellenic Psychiatric Association. "This represents a chronic stress, and chronic stress is worse than acute stress."

Dr Christodoulou draws a distinction between depression - a medical diagnosis - and the more widespread sadness and anger that have permeated Greek society. As with any loss, the latter was to be expected, he argues, and could ultimately be productive.

"When you talk to people in-depth, there is an element of self-criticism that is arising gradually, and this is encouraging," he says.

Greeks appear to benefit from the unusually close bonds within families, which tend to create their own informal support network and blunt psychological blows. But there are other aspects of Greek culture that present their own problems.

Andrew Armatas, an Athens psychologist, believes the crisis has played on a typical Greek neurosis: an ever-present fear - communicated by overbearing elders who suffered Nazi occupation, civil war and famine - that disaster is just around the corner.

"That's the shocking thing: we always heard our parents telling us what they lived through," he says, noting the feelings of guilt and shame displayed by many of his patients.

Among others, Dr Armatas now counsels parents mourning children who have moved overseas to find work, as well as executives who have either lost jobs or are struggling to hold on to them.

"You can help someone with their emotions", he says, "but practically, you know they will be unemployed for a very long time."

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