Hotline santé

This web page comes in addition to the official website of the Government www.covid19.lu and of that of the Ministry of Health, which contains useful information about health in times of health crisis. All official communications, calls for volunteers, forms and official recommendations can be found on www.covid19.lu.

Looking after our mental health

What sort of psychological reactions are we likely to have when faced with the COVID-19 health crisis?

As we have never before experienced a situation like the current pandemic, there are many factors that may lead to stress reactions: fear of contracting the disease, fear of seeing our loved ones suffer, uncertainty about how long this crisis will last, fear of losing our job, feelings of loneliness, frustration, difficulty in coping with day-to-day tasks, etc.

The way in which these reactions express themselves may vary a lot from one person to another.

Stress: Stress is a normal physiological reaction to an abnormal situation. It helps us adapt to life’s challenges.
Anxiety: Anxiety is an emotional response to threatening thoughts that are hard to pinpoint. It may weigh us down, especially in a period of uncertainty.
Depression: Depression is a temporary state of sadness and lethargy. It is disheartening and may show itself in different ways (we cannot be bothered to do anything, we cry, we have no energy, etc.).

Certain people are more likely to suffer stress because of this health crisis:

Elderly people and people suffering from chronic conditions which entail a higher risk of COVID-19.
Children and teenagers.
‘Front-line’ staff dealing with COVID-19, such as doctors and other health professionals.
People suffering from mental disorders, including abuse of alcohol and other substances.

What can we do to keep our mental health in good shape during this crisis?

Take a sensible approach to our news intake

Ration our exposure to news.
Give preference to official sources of information.
Avoid polemics on social networks.

Organise our days

Get up and go to bed at fixed times.
Allocate set chunks of the day for working (working from home/schoolwork/household chores) and for relaxing.
Set up a routine with regular rituals (breakfast, housework, reading, lunch, going for a walk, telephone calls, evening meal, board games).
Share out the chores between all the people in the household.

Keep up physical activity

Alternate periods of ‘screen time’ with other activities.
Go out for a walk if the rules allow it.
Practise individual sports activities.
Do physical and manual activities that stimulate our senses (playing, cooking, tidying up, listening to music, dancing).
Try out new projects (painting, learning a new language, etc.).
Actively plan all the events postponed until the crisis is over (holidays, celebrations, concerts, meeting up with friends and family).

Look after ourselves

Get dressed and put on make-up as usual, rather than staying in pyjamas all day.
Make sure we have a balanced diet and avoid sugar, fatty food and alcohol.
Learn relaxation, meditation or mindfulness techniques and practise them regularly.

Stay in touch with our loved ones

Phone our friends and family to hear their voices, discuss things with them and hear their news.
Arrange regular virtual contact times.
Listen, comfort and support those we know who need help.
Express our concerns about the health crisis to other people, but not talk about it exclusively.
Join in initiatives showing solidarity and do the shopping for vulnerable people in our neighbourhood. Helping others may also be good for us!

Keep our spirits up

Actively acknowledge the emotions we are feeling (joy, sadness, anxiety, anger) and accept them.
Distinguish between what we can control (contributing to our own well-being) and what we cannot (the development of the epidemic, official instructions).
Avoid feeling guilty when we do not manage to achieve our daily goals.
Ask for help when we are feeling overwhelmed.

Seeking help from a professional

When should help be sought from a professional?

Our own inner resources normally enable us to overcome responses to stress, anxiety and depression. However, if the malaise continues or gets worse over a number of days, help from a professional may be of benefit – in the following situations, for example:

You lack energy and you find it very difficult to function normally.
You have negative thoughts that you can no longer control.
You have lost a great deal of weight and have lost your appetite.
You find it difficult to get restorative sleep (difficulty falling asleep, waking up frequently during the night, nightmares, etc.).
You worry so much about anything and everything that you are incapable of action.
You have panic or anxiety attacks (such as palpitations, breathlessness, numbness, nausea, a feeling of tightness in the chest area, etc.).
You are finding it difficult to cope with the death of a relative or a loved one.
You notice higher levels of anger and aggressiveness in yourself or in a close relative.
You have unusual recurrent thoughts which you know to be absurd but which you cannot get out of your mind.
You consider death to be a better option than life.
You find it difficult to stop thinking about a painful event which you have been through and which is dominating your everyday life.
You notice that you have increased your intake of alcohol, drugs or medication solely to help you relax and/or to deal with this particularly stressful health crisis.

If you (or those who are close to you) are experiencing one or more of the above responses, do not hesitate to ask for help. View your mental health problems in the same way as any other health problem: the more quickly you act, the greater your chances of recovering quickly – and you will be less likely to have a relapse in the future.

With whom can I talk about my problems and what benefits can I expect?

Luxembourg has an extensive assistance and care network. Do not hesitate to contact your family doctor, a psychologist, a psychiatrist or a psychotherapist.

Who are they? How can they help? What does it cost? How can you find them? You will find answers to these questions under « How about I talk to a shrink? »

It does not really matter which of these professionals you talk to – they main thing is that you should not be left on your own with your doubts, fears, sadness or anger.

Family doctors have experience with patients suffering from psychological problems and they are able to provide personalised advice, possibly prescribe tests or medication and recommend psychologists, psychiatrists or psychotherapists.

Psychiatrists are medical doctors specialising in psychiatry, i.e. the diagnosis and treatment of mental disorders. They can carry out a medical diagnosis, indicate (and even administer) psychotherapy and prescribe medication, further tests, and so on.

Psychologists are not doctors. Clinical psychologists may specialise in many fields including mental disorders. They can offer advice, support and guidance.

Psychotherapists are mostly either psychologists or psychiatrists who have undergone additional training in psychotherapy. Psychotherapy is fully-fledged form of treatment that has proved effective as a way back to normal behaviour. Depending on their approach and their methods, they help their patients to control their emotions, adapt their behaviour, calm their thoughts, improve their relations with others or their state of health, and so on.

Where can help be found?

Mental-health disorders are common and may affect anyone. Effective treatment is available and talking to a professional is often the best and sometimes the only way of obtaining it. You can talk to your family doctor, for example, or to a shrink (a generic term used to refer non-specifically to psychologists, psychiatrists and psychotherapists).

Hotline soutien psychologique [psychological support hotline].
SOS DETRESSE on 45 45 45. This on-line telephone service offers anonymous confidential psychological support. You can also contact SOS Détresse by e-mail if you log on to 454545.lu.
Psychological and school assistance service at 8002-9090. CePAS and SePAS school psychologists, who are specialized in the well-being and development of adolescents and young adults, are available to pupils, students, parents and teachers for listening, counselling and providing psychological support by e-mail and telephone https://schouldoheem.lu.
Kanner a Jugend-Telefon [telephone help-line for children and youngsters] on 116 111. This on-line telephone service is mainly aimed at children and teenagers who are in difficulty. Support can be provided anonymously and will in all cases remain confidential.
L’écoute parents (Elterentelefon) [telephone help-line for parents] on 26 64 05 55. This telephone service offers a listening ear and advice on how to bring up children and deal with problematic parent-child relationships.

Other support structures may be found under the heading ‘Getting help’ on www.prevention-depression.lu/en/.

What should I do if I cannot contact my medical specialist?

During the current health crisis, contacting a medical specialist may for various reasons be more difficult (he or she may be ill, may have to look after children, may be dealing with patients remotely, may be short-staffed, etc.). The vast majority of medical specialists (psychiatrists, child psychiatrists, etc.) are continuing to practise remotely, i.e. at a distance over the telephone or by videoconference. Remote consultation is often more time-consuming and only one call is possible at a time (which may partially explain why some doctors can no longer be contacted so easily). Furthermore, doctors’ receptionists are often less available to take your calls.

If you are finding it difficult to contact your medical specialist (psychiatrist, child psychiatrist, etc.), we encourage you to proceed as follows:

Be persistent and telephone your medical specialist repeatedly at different times of the day (you might leave a message on the answering machine or send one by e-mail).
If you are still unable to speak to your medical specialist, contact your general practitioner (GP) and see if he or she can help.
If that proves impossible, you can request an appointment for a remote consultation with another medical specialist by logging on to the e-health portal https://econsult.esante.lu/en/list/. All you need to do is state your choice of specialist and select the medical professionals available on the day in question.
If none of the above produces the desired result, you can check out our website: https://www.prevention-psy.lu/aide/soutien-psychologique-et-psychotherapies/

What should I do if I cannot contact my psychologist/ psychotherapist?

During the current health crisis, contacting a psychologist/psychotherapist may for various reasons be more difficult (he or she may be ill, may have to look after children, may be dealing with patients remotely, may be short-staffed, etc.). The vast majority of psychologists/psychotherapists are continuing to practise remotely, i.e. at a distance over the telephone or by videoconference.

Remote consultation is often more time-consuming and only one call is possible at a time (which may partially explain why some psychologists/psychotherapists can no longer be contacted so easily). Furthermore, their receptionists are often less available to take your calls.

If you are finding it difficult to contact your psychologist/psychotherapist, we encourage you to proceed as follows:

Be persistent and telephone your psychologist/psychotherapist repeatedly at different times of the day (you might leave a message on the answering machine or send one by e-mail).
If you are still unable to speak to your psychologist/psychotherapist, contact your general practitioner (GP) and see if he or she can help.
If that proves impossible, you can request an appointment for a remote consultation with another psychologist/psychotherapist by logging on to the SLP’s directory at: https://www.slp.lu/en/find-a-psy/. All you need to do is state your priority criteria and contact the professional in question.
If none of the above produces the desired result, you can check out our website: https://www.prevention-psy.lu/aide/soutien-psychologique-et-psychotherapies/

Managing your own and your child’s stress

How can you best support your child during this health crisis?

The current pandemic and the consequent lockdown may produce signs of stress or anxiety not only in adults but also in children. The national child psychiatry service at the Centre Hospitalier de Luxembourg (Luxembourg Municipal Hospital) has issued an excellent brochure for parents faced with the COVID-19 pandemic. It gives information about your child’s normal reactions and how you can help your child.

You can download the brochure here

How can you identify stress in children and teenagers?

Children and teenagers react to the emotions and behaviours they witness in their parents and other adults. The more you are thrown off balance by the crisis, the more likely it is that your children will be too. The best way that parents and adults can help them is to act calmly and confidently.

It is important that you as a parent identify any changes in the way your children behave and what is troubling them.

Here are some of the changes or complaints to look out for:

Excessive crying or irritability in young children
Becoming withdrawn or not saying anything for a long time
Regressive behaviour (wetting the bed, separation anxiety, etc.)
Being overly worried or sad
Irritability or impulsiveness in teenagers
Sustained lack of interest and loss of pleasure in things; sleeping problems
Difficulty in paying attention and concentrating
Unexplained headaches or body pains
Consuming alcohol, tobacco or other drugs

In most children, the usual reactions to distress ease off as time goes by. If your child keeps on being very disturbed or if their reactions are having a bad effect on their schoolwork or their relations with others, please do not hesitate to talk to a professional and encourage your child to do so.

You might also like to read the reply to the question: ‘Where can help be found?’

How can I talk to my child about the coronavirus and reduce its stress level?

There are a number of tools available to discuss coronavirus with your child. Below you will find a selection of websites, leaflets and information that we would like to share with you.

An illustrated leaflet entitled "Hello, I am Corona", available in 4 languages (LU, FR, DE, EN) helps to explain the facts about the coronavirus/COVID-19 to children. It teaches the basic rules of protection and how to fight negative emotions: download the leaflet here
8 tips to help you reassure and protect your children: UNICEF recommendations
Healthy Parenting in the time of COVID-19 - World Health Organization : To help parents interact constructively with their children during this time of confinement, these six one-page tips for parents cover planning one-on-one time, staying positive, creating a daily routine, avoiding bad behaviour, managing stress, and talking about COVID-19. Use them to your and your kids’ advantage, and have fun in doing so: www.who.int
COVID-19 - bien-être@home - Awareness campaign: How do I talk to my children? For further information, please visit the website www.schouldoheem.lu

If other supports have helped you to better manage this crisis with your child, do not hesitate to share them with us (info@prevention.lu).

Managing anxiety

Is my anxiety pathological?

Anxiety is a normal reaction to certain situations and has been experienced by everyone. It helps us to recognize, manage and avoid dangers and threats in everyday life. During this period of health crisis, it is normal to feel a high level of uncertainty, worry and stress with regard to the health and safety of the people close to us and the effects of the pandemic on our personal and professional lives. However, people also often show great resilience in times of crisis.

What is pathological anxiety?

Anxiety becomes a problem when it is intense and without basis and significantly affects a person’s life. It is then called clinical anxiety or anxiety disorder.

Typical features of anxiety disorders:

The anxiety is excessive in view of the situation.
The person suffering the anxiety finds it difficult to overcome on his/her own.
Situations that give rise to the anxiety are avoided.
The duration and frequency of the anxiety increase over time.
The anxiety causes considerable suffering or significantly restricts everyday life.

If you feel particularly agitated or anxious, don’t hesitate to seek professional assistance.

You will find a lot of additional information on anxiety disorders in the leaflet and by visiting the www.prevention-panique.lu webpage.

Please also don’t hesitate to read the answer to the question: "When does it become necessary to seek professional assistance?"

I am worried about everything and anything, even more so since the start of the health crisis. Is this pathological?

We are currently experiencing a period of unprecedented health crisis. Not knowing when the situation will come to an end may reasonably cause episodes dominated by strong feelings of stress, insecurity, helplessness and anxiety. Although feeling anxiety in response when facing a threat is a completely normal reaction, these fears become excessive in some people and may come to dominate everyday life.

A generalized anxiety disorder is characterized by frequent, intense, persistent and disproportionate fears and worries. These fears do not just occur in response to acute problems or during a period of crisis, but are more or less constant. People suffering from generalized anxiety disorder are constantly stressed and agitated and are often unable to concentrate and become quickly tired.

Common types of worries of people suffering from generalized anxiety disorder

(about themselves or the people around them):

If you feel particularly agitated or anxious, don’t hesitate to seek professional assistance.

You will find a lot of additional information on anxiety disorders in the leaflet and by visiting the www.prevention-panique.lu webpage.

Please also don’t hesitate to read the answer to the question: "When does it become necessary to seek professional assistance?"

What is a panic attack?

People suffering panic attacks experience episodes of intense anxiety, which start with great suddenness and reach their highest point in a few minutes. They feel helpless and afraid of going mad or dying.

Typical physical symptoms of panic attacks:

More than one person in four has already experienced a panic attack. It is less common to suffer more than one. People who go on to develop a panic or anxiety disorder are still less common. A panic attack may occur for a variety of reasons in different situations. However, it frequently occurs especially at a time of stress, such as during the pandemic we are currently experiencing.

You will find a lot of additional information on anxiety disorders in the leaflet and by visiting the www.prevention-panique.lu webpage.

Please also don’t hesitate to read the answer to the question: "When does it become necessary to seek professional assistance?"

How to manage a panic attack

Is it a panic attack or a different medical emergency?

The symptoms of a panic attack resemble the symptoms of a heart attack or other medical emergency to some extent. In this type of situation, we can’t know what it really is; only health professionals can find this out.

What to do if you are certain that you are suffering a panic attack

If an attack occurs, the best thing to do is to stay where you are and breathe slowly until the attack comes to an end. It is highly unpleasant, but not dangerous. Most panic attacks last between 5 and 20 minutes, less frequently up to one hour. The more you fight the symptoms, the more you increase the feeling of danger and the more stress hormones are produced by the brain, which will make things worse.

Don’t fight the attack
Stay where you are, if possible
Breathe slowly and deeply
Remember that the attack will go away
Remember that it isn’t dangerous

It is important for anxiety problems to be detected and treated quickly, as they have a major impact on the life of the person suffering them.

How to prevent a further attack

There is no sure way of preventing panic attacks. However, these recommendations may help.

Professional treatment: to prevent panic attacks from worsening or becoming more frequent, it is important to obtain treatment as soon as possible.
Physical exercise: regular physical exercise helps to reduce stress and tension.
Reduce consumption of stimulants: avoiding caffeine, alcohol, tobacco and sweet foods and drinks helps to reduce the occurrence of panic attacks.
Healthy lifestyle: it is recommended to have a calm and structured life with regular sleeping times and a healthy, balanced diet.
Relaxation: relaxation techniques such as mindfulness meditation and progressive muscle relaxation help to reduce anxiety, if practiced regularly.

These recommendations are of a general nature and should not replace medical advice and psychotherapy.

If you feel particularly agitated or anxious, don’t hesitate to seek professional assistance.

Please also don’t hesitate to read the answer to the question: "When does it become necessary to seek professional assistance?"

What are obsessive compulsive disorders?

The restrictions on community life associated with the COVID-19 crisis are a big challenge for everyone. The challenge facing people suffering from obsessive compulsive disorders may be several times greater, however. They may think that their compulsions have been confirmed, leading to a further increase in obsessive brooding, washing, cleaning and checking.

We all experience moments of fear that we have forgotten something important (to turn off the oven or lock the door, for example). It can make sense to play safe and check something twice in such situations.

There are people, however, who find the thought that they have forgotten something so intrusive and frightening that it ‘compulsively’ blocks out all other thoughts. Rechecking just once might then be insufficient to allay the fear, resulting in ‘compulsive’ repeated checks. ‘Compulsive’ thoughts and/ or ‘compulsive’ behaviour over a relatively long period may lead to an ‘obsessive compulsive disorder’, which can greatly impair quality of life. A further factor is that people suffering from such a disorder are frequently ashamed of their thoughts or behaviour and attempt to keep their compulsions secret. This, too, can be exhausting.

In an obsessive compulsive disorder, obsessive thoughts are continually repeated and are difficult to consciously suppress. They are usually felt to be useless and distressing and can take up a great deal of time. To relieve the fear and tension triggered by obsessive thoughts, people suffering from an obsessive compulsive disorder feel compelled to perform certain rituals. Their obsessive actions only reduce their fear for a short time, however, in a vicious circle, contributing to a worsening of the obsessive compulsive disorder over time. Obsessive thoughts then occur more frequently and become even more of a nuisance.

An obsessive compulsive disorder may be expressed in many different ways, for example as a compulsion to wash or clean, check something, tidy up or collect or count things. Some people also have a compulsive fear of behaving inappropriately, hurting themselves or others or sexually harassing someone. This certainly does not mean that they would engage in such behaviour, however!

I wash my hands 50 times a day. Is that normal now?

During the COVID-19 pandemic and the resulting protective measures, it is an understandable and, to some extent, natural and even desirable reaction to consciously think about the dangers of infection, avoid social contact and wash your hands more often. These currently sensible measures to contain the pandemic do, however, create a certain risk of producing or increasing obsessive compulsive disorders (especially with regard to washing), even after the end of the health crisis.

People suffering from a compulsion to wash have a constant fear of being contaminated by microorganisms, bodily fluids or dirt. If contact cannot be avoided, extensive washing and cleaning rituals are carried out. They normally follow a precisely determined sequence. If the ritual is interrupted, people suffering from the disorder must start again from the beginning, often until they are totally exhausted.

In the current situation, it can be very difficult to distinguish ‘normal’ from compulsive thinking and behaviour. The following question may be helpful in making such a distinction:

Do you have distressing thoughts that you would like to give up, but are unable to do so? For example, do your thoughts constantly turn around the possibility that you have been infected or have infected other people, even when there is no objective reason to suppose this?
Do you wash and clean excessively? For example, do you wash or disinfect your hands more frequently than is objectively desirable in the current situation or more often than other people?
Is your everyday life dominated by other measures to ward off the fear of infection? Do you have hardly any time or energy left over for other things (work, family hobbies)?
Do you check a lot? Do you feel that you have to recheck things (electrical appliances off, doors closed?), even when you should objectively have satisfied yourself of this when you first carried out the action?
Do you need a great deal of time to carry out everyday activities? Do you notice that you carry out various sequences of everyday activities in an almost ritual fashion and have to start them all over again if you are interrupted?

If you are unsure whether your thoughts and behaviour are now appropriate in view of the current situation and they are becoming increasingly distressing, don’t hesitate to seek professional assistance. The sooner the better.

Obsessive compulsive disorders are generally treatable.

Managing a depressive state

How to distinguish between simply feeling downhearted and being depressed

Often when we say we are feeling low, we mean that we are down in the dumps or downhearted because we have problems. We all feel sad from time to time, but this does not mean that we are depressed. A feeling of sadness of this type often disappears after a few days. It should then rather be referred to as feeling downhearted.

Depression consists in the same feeling of sadness, but with much greater intensity and over a longer period, of at least two weeks. Everyday functioning is significantly impaired and depressed people are no longer able to enjoy things that had previously given them pleasure. Depression is a genuine illness, which is frequently referred to as a mental health disorder. It is an illness that affects both the brain and the rest of the body.

In practice:
If you have felt different or anxious lately and that things have been getting on top of you more than previously or if something has upset you, your sadness might be a reaction to the situation and you might be suffering from a feeling of downheartedness.

If, on the other hand, you feel out of sorts, worried and sad to such an extent that you are prevented from living as previously and this feeling has lasted for over two weeks, you might be suffering from depression.

Don’t forget that depression can be treated, the sooner the better.

You will find a lot of additional information on anxiety disorders in the leaflet and by visiting the www.prevention-depression.lu webpage.

Please also don’t hesitate to read the answer to the question: "When does it become necessary to seek professional assistance?"

What are the medical characteristics of a depression?

The characteristics of a depression are as follows:

Loss of interest or enjoyment
Depressive mood (sadness, emptiness, hopelessness)
Loss of or increase in appetite
Disturbance of sleep
Agitation or psychomotor retardation
Fatigue or loss of energy
Feelings of guilt and worthlessness
Reduced ability to concentrate and pay attention
Thoughts of death, ideas of suicide

People are considered to be depressed if they show at least 5 of the above symptoms almost all day for at least two weeks. The 5 symptoms must include either or both of loss of interest/enjoyment or depressive mood.

Don’t forget that depression can be treated, the sooner the better.

You will find a lot of additional information on anxiety disorders in the leaflet and by visiting the www.prevention-depression.lu webpage.

Please also don’t hesitate to read the answer to the question: "When does it become necessary to seek professional assistance?"

Is there a way of testing for depression?

Yes, there is a test for depression. If you wish to test yourself, please complete the questionnaire that you will find on the www.prevention-depression.lu site and talk about it to a professional.

Don’t forget that depression can be treated, the sooner the better.

You will find a lot of additional information on anxiety disorders in the leaflet and by visiting the www.prevention-depression.lu webpage.

Please also don’t hesitate to read the answer to the question: "When does it become necessary to seek professional assistance?"

What can I do myself to reduce the symptoms of depression?

Changing your lifestyle can help to reduce the symptoms of depression. Some studies have actually shown the effectiveness of strategies we can all apply, in particular:

Doing light exercise helps to make us feel better by reducing anxiety and depression while improving cognitive performance in adults and children.
Eating a balanced diet rich in vegetables, fruit and fish (Omega 3) helps to improve performance and reduce the symptoms of emotional disorders.
Spending time in the countryside can enhance cognitive functions and wellbeing.
Taking the time to talk to people you trust and taking care of your relationships can spectacularly improve psychological wellbeing.
Regular relaxation and good sleep hygiene help to manage a depressive state.
Helping others (up to a reasonable point), especially at present, is also beneficial to physical and mental health. Altruism and generosity make us happier, while reducing feelings of worthlessness and guilt.
Following the treatment prescribed by your doctor or psychotherapist and speaking openly about your doubts to him or her will help you to feel better.

Together with the treatment you receive, these points will help you to manage your depression and get better.

Don’t forget that depression can be treated, the sooner the better.

You will find a lot of additional information on anxiety disorders in the leaflet and by visiting the www.prevention-depression.lu webpage.

Please also don’t hesitate to read the answer to the question: "When does it become necessary to seek professional assistance?"

Managing our sleep

Why is it important to maintain a good sleep pattern?

We spend about a third of our lives asleep. Sleep forms part of the vital functions of the organism, like breathing, digestion or the immune system.

While we are asleep, motor activity is reduced and we can save energy. Sleep allows the body to rest, gradually attenuating the main basic functions: the pulse and breathing slow down, blood pressure, muscle tone and body temperature fall. Sleep also helps us to commit to memory things that we have learned during the day, because the brain remains active during the night. Sleep also contributes to our growth and development by means of growth hormones secreted during sleep. Lastly, it plays a key role in regulating our emotions and our state of psychological wellbeing.

The Covid-19 health crisis is disrupting many people’s sleep patterns. Confinement has greatly altered our ways of life (reduced physical activity, being cooped up at home, etc.) and also our emotional states (fear of contagion or of being infectious ourselves, uncertainty about the future, etc.). Sleep deprivation can cause many health problems, viz.:

high blood pressure
cardiovascular diseases
psychological, psychiatric and neurological disorders
reduced production of growth hormones (particularly in children)
difficulties in concentrating when awake
attention deficiency
mood disorders and stress
difficulty in learning and remembering new things
premature ageing of the skin
etc.

Source: We would like to thank the CPATS (www.cpats.lu) for making the content of its brochure ‘Sommeil et troubles du sommeil’ available.

How can one maintain a good sleep pattern?

The quality of our sleep depends primarily on what we do during the day. A lack of physical effort, poor diet, unresolved conflicts or excessive stress factors during the day are all liable to disturb our sleep. General recommendations can be divided into those which apply to people themselves and those which apply to their bedrooms.

People:

The hours before sleep should ideally be devoted to tasks that are both mentally and physically relaxing.

Engage in a relaxing activity before bedtime (reading, music, etc.)
Do not go to bed if you are not tired
Do not stay in bed if have difficulty getting to sleep: get up, read (a magazine or book, etc.), avoid bright light
Avoid strong visual stimulation (TV, computer screens, laptop screens, etc.), strong acoustic stimulation (loud music) or excessive intellectual stimulation before going to bed
Do not continue your daytime (professional and/or private) activities in bed
Practise mental relaxation techniques to help you get to sleep
Do not engage in physical activity in at least the last hour before going to bed
Avoid eating too much in the evening
Avoid drinking alcohol: although it helps people get to sleep, it also tends to wake them during the night
Avoid the following stimulants before going to bed: coffee, tea, vitamin C, caffeinated soft drinks, cigarettes, energy drinks, etc.

Bedrooms:

Although we sleep with our eyes closed, it is important to ensure that the ambiance of the bedroom is agreeable and conducive to good sleep.

Is the mattress hard or soft? That does not matter so long as it allows you to sleep comfortably and to be restored by it
Make sure that your bedroom is dark
The ideal temperature for a bedroom is ambient or cool: 18 to 20°C
Avoid placing electrical equipment near your bed, because of the electromagnetic waves
Remove noise sources (watches, radios, TVs, etc.)
Do not use your bedroom as an office: do not work in bed
A double bed is fine, but, if you are sensitive to your partner’s movements, it should have two separate mattresses; otherwise use twin beds

Generally speaking, it is important to:

discover what sleep pattern suits you and stick to it
if possible, always get up and go to bed at the same times, even at weekends. Lie-ins can disrupt our sleep patterns, and should not be over-indulged in
adopt bedtime rituals which relax you, as they will help you to get to sleep more quickly
deal with the problems awaiting you in the near future by writing them on a piece of paper
wake up in the best possible way: light, shower, breakfast, etc.
avoid looking at your alarm clock or watch during the night

Source: We would like to thank the CPATS (www.cpats.lu) for making the content of its brochure ‘Sommeil et troubles du sommeil’ available.

When should you consult a doctor?

Even during the coronavirus period, it is important to consult a doctor if you have difficulty sleeping. Health problems caused by poor sleep can be more disabling and more problematic in the long term than Covid-19. Do not hesitate to consult your GP if you are in one of the following situations:

You have had difficulty in getting to sleep for several weeks
You wake up too early (at 4 or 5 o’clock), although your alarm clock is set for 7 o’clock
You have unpleasant sensations in your legs, which prevent you from sleeping or which wake you up
You are tired in the morning after a ‘normal’ night
You feel like sleeping during the day, and it is a struggle to remain active
People around you are disturbed by your snoring and have witnessed you stopping breathing while asleep
Your sleep is agitated
You move extravagantly while asleep
You wake up frequently to eat during the night
You wake up at night and have difficulty in getting back to sleep
You have the impression that your sleep is not refreshing you

Source: We would like to thank the CPATS (www.cpats.lu) for making the content of its brochure ‘Sommeil et troubles du sommeil’ available.

Keeping your alcohol consumption under control

Are we drinking more during the period of confinement?

The current situation involves changes of habits for many of us. Stress and anxiety in the face of the unknown, the risks to our health, the uncertainty of our financial situation, but also the boredom which sets in when one is cooped up at home, may influence our alcohol consumption.

The new fashion of the e-aperitif on social networks is one factor that may encourage the drinking of alcohol. Alcohol seems very prominent on social networks, and some people may be tempted to try to calm themselves down and escape by drinking wine, beer or spirits.

However, one should not forget that the current situation also affects the accessibility of alcohol. Bars and restaurants are closed, and alcohol is on sale only at food shops and service stations. This state of affairs could persuade some of us to take advantage of this period to reduce our alcohol intake or stop drinking for a time.

Here is our advice:

If you drink alcohol during confinement, we advise that you do so in moderation.

Source: We would like to thank Cnapa - Centre National de Prévention des Addictions for writing this text.

How should I control my alcohol consumption during confinement?

In response to the COVID-19 pandemic, our habits have changed. It is very important to strike a balance and adopt new habits in order to get through confinement unscathed.

Some people’s alcohol consumption may be high. We would advise you to respect the limits to your consumption at home too! You are responsible for yourself and other people.

Here is our advice:

Stay in contact with your friends and family.
Maintain a healthy life style– eat a balanced diet, sleep enough, practise sport, etc.
Avoid drinking alcohol to combat negative emotions. If you are distressed, call the hotlines that have been set up.
Take advantage of this period to engage in your favourite leisure pursuits or seek out new pastimes.
Do not leave bottles of alcohol within easy reach.

If you or people around you need assistance and additional support, you can consult the following website: https://sante.public.lu/fr/prevention/alcool/aides-utiles/index.html

If you want to drink alcohol during confinement, we advise you to do so in moderation.

For a healthy adult, a low-risk level of consumption is:

a maximum of 2 standard glasses per day for men
a maximum of 1 standard glass per day for women
refraining from drinking alcohol on at least 2 days each week

A standard glass is defined as a glass containing between 10 and 12 g of pure alcohol, e.g. beer (30 cl), wine (10 cl), spirits (4 cl).

You could take advantage of the fact that bars and restaurants are closed to reduce or stop your drinking.

Take a break!

Try to stop drinking for a time (e.g. for a month) so as to think about your own consumption and the place that alcohol occupies in your everyday and social life.

Source: We would like to thank Cnapa - Centre National de Prévention des Addictions for writing this text.

What risks are associated with high alcohol consumption at home?

and also for other people living in the same household:

More accidents in the home (injuries, falls, etc.)
Increased tension between members of the household
Violence between members of the household
Impaired vigilance, resulting in less compliance with the recommended physical distancing measures to protect yourself and others against the virus
Failure to comply with confinement measures

Source: We would like to thank Cnapa - Centre National de Prévention des Addictions for writing this text.

Coping with a close relative’s final days or actual death

What impact will the health crisis have on cases where death is approaching or actually occurs?

A close relative’s final days or actual death constitute critical moments that profoundly alter the lives of the surviving family members. Grief is something that we each experience and overcome in our own way. The current situation has placed barriers around the grief that we customarily feel.

Particular risks as a life nears its end

People with a close relative whose life is coming to an end must now accept social-distancing measures that make it impossible for family members to visit a dying relative. Although this ban on visits may help to limit the spread of the virus, it may in many cases seriously damage the quality of a family’s relationship with their relative during the final stages of his or her life.

Persons who are nearing the end of their life may not see their close relatives for a period of several weeks and may die in extreme solitude. For the relatives, being unable to visit their dying family member may be a source of frustration, anger and helplessness, and may make it harder for them to prepare for the coming loss.

Particular conditions in the event of death

Rituals are disrupted. If a person who has died in a care home or in hospital was infected with COVID-19, family farewell ceremonies before the body is laid in the coffin are to be avoided; in all cases, funeral masses will be postponed until after the crisis is over. Ceremonies may be held at the cemetery but must be on a very small scale: no more than 10 people may attend and they must maintain a degree of separation. Physical contact must be avoided.

How can we begin to grieve under the current circumstances?

Here are some ideas for overcoming the current difficulties:

Put the death in context. The grieving process is a long one. The circumstances in which a person dies are of course important, as is the funeral – but there is more to grieving than that. In any grieving process, what really matters is the relationship that we had with the departed whilst he or she was still alive. Come to terms with the conditions in which the deceased passed away by focusing on the memory of what you shared, on the legacy that your loved one has left in you.

Rituals have been postponed, not cancelled. The ‘lockdown’ period will not last forever. Once the health crisis is over, we will be able to organise funerals that cannot take place just now. There will always be an opportunity for the family to gather at the grave and honour the memory of their loved one.

Paying tribute to the deceased at home. Pending the end of the health crisis, those grieving for a loved one can devise home-based rituals: a place at which to honour the deceased with a photograph, a candle to be lit each day, some letters… In the words of Christophe Fauré (a French psychiatrist with an expert knowledge of grief), ‘There is nothing morbid about this – quite the opposite, in fact. Humans need something tangible and solid in order to be able to grieve. A purely intellectual approach is not enough’.

What should be done with children and teenagers?

When a loved one dies, it can be difficult for adults to find the right words and appropriate behaviours with children and adolescents.

The Omega 90 association has published a document "Attitudes to adopt with children and teenagers concerning Covid-19" (available in French and German), which will give you practical information on:

possible béhavioral changes,
how to act about it,
what adults can do,
what children or teenagers can do,
if death is caused by Covid-19

Who can we find support?

The Omega 90 association provides support for the dying and their families, and also for the bereaved. Consultations and support are available by telephone and via Skype.

Contact details:

Telephone number 26 00 37-1 (Monday to Friday, 8 a.m. until 5 p.m.)
E-mail address: info@omega90.lu

Plenty of information is available on the website www.omega90.lu and in the guide ‘Une personne est décédée... (in French) or "Wenn ein Mensch gestorben ist... Formalitäten, Rituale und Trauer nach dem Tod" (in German).

Detecting the signs of psychosis

What is psychosis?

The coronavirus pandemic spreading rapidly all over the world gives rise to a considerable level of stress and anxiety. Certain factors are likely to foster the emergence of psychosis, and stress is one of these.

Psychosis is a generic term used to describe a psychological disorder which leads to changes in the thoughts, feelings and perceptions of those affected; generally, these changes also affect their actions. In most cases, psychosis is a temporary condition during which the individual loses contact with reality in whole or in part. Delusions and hallucinations are typical signs of a psychotic state. Psychosis may severely destabilise the individual’s life and impair their ability to have or maintain social relationships, work, carry out everyday tasks and take care of themselves.

Schizophrenia is the most common psychotic disorder. The generally held view that the word ‘schizophrenia’ means ‘dual personality’ is incorrect; it comes from Greek and means ‘split mind’.

How to detect signs of psychosis?

The people who are around the individual affected are often the first to observe changes in their behaviour. The symptoms of psychosis evolve with the illness and vary greatly from one person to another.

Changes to look out for:

withdrawal, isolation, lack of interest in social relationships
loss of energy or motivation
sleep disorders and loss of appetite
neglecting personal hygiene
attention disorders and problems with memory
mood swings
unusual behaviour
disrupted perceptions or hallucinations (seeing, hearing, feeling things which are not there, above all hearing voices)
delusions (for example, the individual believes they are under surveillance by the police/their thoughts are controlled by external forces)
confused and incoherent thought patterns (for example, difficulty in following a conversation, disjointed speech, inventing words)

These signs are not necessarily associated with psychosis, but it is important to have them assessed by a doctor. If some of your relative’s speech or behaviour is unusual or hard to understand, take your feeling seriously. If you suspect psychosis, you should seek help and get a referral to a specialist. It is important not to wait. Psychotic disorders are illnesses which can be treated: the earlier the treatment starts, the more effective it will be.

See also the question: ‘When should help be sought from a professional ?’

AUTISM AND CONFINEMENT

What impact is the Covid-19 crisis having on the everyday lives of people with autism?

Among their other characteristics, people with autism are very sensitive to change, to unpredictable situations and uncertainty. The confinement currently imposed on us began rapidly, abruptly and without warning, and it is having an enormous impact on our everyday lives. Anybody may feel anxiety in this type of situation, and that feeling is all the stronger for people with autism.

To some extent, therefore, anxiety is a normal response to the unknown. However, if you (or your child) have difficulty in coping with such stress in everyday life (sleep disturbances, eating disorders, unusual behaviour, verbal / physical aggression, distress, persistent anxiety, etc.), it may be necessary to seek help to cope with the situation.

Source: We would like to thank the Fondation Autisme Luxembourg for writing this section.

I am a parent of a child with an ASD (Autistic Spectrum Disorder) – Why is he anxious?

Confinement, the suspension of schooling and of all kinds of support services, having to telework (or not being able to) for the parents, the impossibility of seeing one’s extended family, etc. – there is a whole range of changes that have disrupted your child’s routines, although he needs predictability, stability and clear and precise information about everyday life.

It is possible that your child may not understand the situation associated with Covid-19 and may be asking himself questions about the changes arising from confinement:
- Why am I no longer going to school / to the activity centre / to my therapist?
- Who will stay at home with me?
- What activities will I / can I engage in at home?
- What will happen if I fall ill (or my parents do) because of the virus?
He may also find it difficult not knowing:
- When school will resume
- When he will be able to see his grandparents and friends again
- When the shops / therapies / extramural activities will be accessible again

Source: We would like to thank the Fondation Autisme Luxembourg for writing this section.

I am a parent of a child with an ASD (Autistic Spectrum Disorder) – How can I help him at home?

To help your child, you can clarify the situation for him and structure his day by giving him information that is concrete, visual and appropriate to his level of understanding. For example:

Create a calendar indicating, each day, by means of a photograph the person who is to stay at home with him (father / mother / brother or sister) or a photo of the place where he will be going to be looked after (e.g. if he is looked after at an education and day care centre)
Structure time and places with him. Tell him clearly what activities he will be doing or will be able to do during the day, how long they will take and where they will happen:
- By preparing for the day games, school work or activities for outside, which are symbolised by an object that you, all together, put in a box which is set down in the same place every day.
- By writing a list of activities which he crosses out as the day goes on.
- If possible, tell him when the activity will be over (e.g. 3 pages of colouring, 2 cartoon films, filling the watering can twice to water the flowers in the garden, etc.)
- If it is not possible to tell him when the activity will be over in terms of quantity, try to show him clearly how long the activity/game/task will take (with a timer, an hourglass, etc.)
- If possible, assign a clear location to each activity in the house: the kitchen for eating, the office for homework, the living-room table for drawing and leisure activities requiring a table, the settee for watching TV, the bedroom for sleeping, etc.

It is possible that your child may engage in more repetitive behaviour than usual or may no longer display any interest in his favourite game or subject. This may be due to anxiety caused by confinement. Do not try to prohibit such behaviour but rather limit it if necessary by telling him where, when and for how long he can engage in it, etc.

If your child is nonetheless distressed, if his behaviour becomes difficult, or if you have any other questions as to how to help him or make confinement less troublesome to him, do not hesitate to contact a professional, who will be able to advise you and devise strategies, together with you, to tackle these difficulties.

Source: We would like to thank the Fondation Autisme Luxembourg for writing this section.

How can I explain the coronavirus to my child, who has an ASD (Autistic Spectrum Disorder)?

If you feel that it is necessary or if your child asks you about it, tell him what the Covid-19 coronavirus is, using simple, reassuring words and if possible pictures which will help him to visualise the information.

The association ‘Autisme Europe aisbl’ has put together on its website some useful resources and advice concerning autism, including social scenarios to explain coronavirus: https://www.autismeurope.org/blog/2020/03/20/the-autism-community-mobilizes-itself-to-face-covid-19/

Source: We would like to thank the Fondation Autisme Luxembourg for writing this section.

I have autism / Asperger’s syndrome – How can I cope with stress during confinement?

It is perfectly normal to be anxious at the moment, because our everyday lives and routines have been completely altered by confinement.

However, it is possible that this confinement may be difficult for you and that you may need assistance.

For example:

You have problems sleeping, difficulty in getting to sleep
Your eating patterns are disturbed
You feel sad or depressed
You do not know what to do during the day
You have difficulty in doing your shopping or obtaining basic necessities
You are very anxious and distressed: you cannot think about anything else
You have thoughts of suicide
Etc.

If you feel the need, discuss it with someone close to you (e.g. by telephone if you live alone) or contact a professional (see contact details in the section ‘Where can I get support?’), who will be able to discuss it with you and help you to find a solution.

The association ‘Autisme Europe aisbl’ has also put together on its website some useful resources and advice concerning autism, particularly resources for coping with stress and uncertainty: https://www.autismeurope.org/blog/2020/03/20/the-autism-community-mobilizes-itself-to-face-covid-19/

Source: We would like to thank the Fondation Autisme Luxembourg for writing this section.

Where can I get support and assistance for myself or my child?

The Fondation Autisme Luxembourg is still operating. The psychologists at its Support Service can be contacted either by telephone (+352) 26.91.11-1 or by email (autisme@fal.lu), and are available to support people with autism and their families. It is also possible to communicate by videoconference.

Source: We would like to thank the Fondation Autisme Luxembourg for writing this section.

Elderly people and the lockdown

What to do about relatives in an old people’s home

People living in nursing and old people’s homes are the members of our society with the greatest need for protection. To ensure their protection during the Covid-19 pandemic, visits to such institutions by families are prohibited at the moment, until further notice, in line with the safety regulations of the Ministry of Health.

And yet maintaining social contact and regular interaction with immediate and extended family is of inestimable importance in keeping people cheerful, now more than ever!

What you can do from home for your loved ones, as partners, children, grandchildren, relatives or friends:

Telephone regularly, write letters or, if appropriate, send emails. Be careful about your choice of words and try as far as possible to end conversations or messages on a positive, reassuring and confident note.
Use the possibility of video contact (e.g. skype or facetime) with your relatives. Many institutions have reacted to the ban on visits by tooling up with multimedia appliances and help their residents to use skype to talk to their families.
Encourage them to keep smiling through and help to manage the crisis, reminding them that the ban on visits is of limited duration and that visits will be possible once again in the foreseeable future.
Ask questions, to get a picture of how residents of homes are feeling. Remember that it takes time to get over a period of uncertainty, which can be marked by a great variety of different feelings, fears, thoughts and hopes. Speak openly with one another.
Don’t hesitate to make compliments or praise abilities, personality traits or behaviour that you value highly in the other person.
Contact the reference person in the old people’s or nursing home on a regular basis to find out about the general mental and physical wellbeing of your relative.

Links

http://www.servior.lu/2020/03/coronavirus-die-antworten-auf-ihre-fragen/

https://coronavirus.gouvernement.lu/en/citoyens.html

How to deal with loneliness in an old people’s home

Forced isolation faces us with completely new challenges. To get on top of this exceptional situation, there are tried and tested behavioural measures and psychological strategies that you can use for yourself. It is important to remember that everyone is different and you should adopt the strategies that are most suitable for you as an indivdual:

Adopt your everyday routine to the current situation. Don’t spend all day in your pyjamas, continue to follow your normal daily routine (meal and sleeping times) as far as possible.
Make a plan for each day, including an intellectual, a physical and a social activity. This will keep you moving in every respect and help you to maintain a feeling of wellbeing.
Focus on what is positive and think about your strengths. All the positive experience you have accumulated during your life and all the crises and problems you have overcome are your internal resources. Think about your strengths and use these internal resources.
Be a role model for others and show solidarity. Helping other people and showing friendliness and empathy can give a lot of energy!
Remember that the situation will pass. The isolation is of limited duration and is intended solely to protect you yourself and your fellow human beings.
Avoid uninterrupted use of the media, since the flow of information will not make you feel good! It is better to inform yourself in a structured way once or twice a day.
Don’t brood too much. In view of the current situation, it is quite normal to feel fear and uncertainty. Set aside a limited time in which to brood and use the rest of the time to think about your resources.
Talk about how you feel. It is important not to dwell solely on negative feelings. Talking to other people can be a great relief. If negative thoughts and feelings are gaining the upper hand and you can’t sleep or calm down, don’t wait, seek psychological assistance here: https://www.prevention-psy.lu/aide/soutien-psychologique-et-psychotherapies/

Domestic violence during the COVID-19 crisis

What is domestic violence?

The term ‘domestic violence’ refers to any act of violence that occurs within the family or domestic unit or between former or current spouses or partners, whether or not the perpetrator shares or has shared the same residence with the victim (Istanbul Convention, 2011).

Violence takes various forms:

psychological violence (verbal abuse, threats, etc.),
physical violence (blows, physical abuse, etc.),
economic violence (control, financial privation, etc.),
sexual violence (touching, forced sex acts, etc.),
stalking/obsessional control and cyberstalking (control, tracking, etc.)

Source: We would like to thank the Service d´information et de consultation pour femmes VISAVI de Femmes en détresse A.S.B.L. for writing this text.

What impact is the COVID-19 crisis having on domestic violence?

At times of crisis it is common to see an increase in violence.

Victims – whether they are concerned about the dangers of confinement in close proximity to other people, afraid of seeking outside help or uncertain about the capacity of the forces of law and order to intervene quickly – suffer anxiety: the family home is not a safe place for everybody.

National confinement measures do not mean that victims cannot escape from their homes if they are faced with recurrent violence or danger to life. Despite confinement, it remains possible for victims to move to refuges.

Isolation is one of the main strategies used by violent husbands. In the current situation of legally enforced confinement, a victim may be at a loss to know how to seek help.

As the psychological and physical consequences may become more serious at a time of confinement, it is all the more urgent to act quickly to help victims.

Source: We would like to thank the Service d´information et de consultation pour femmes VISAVI de Femmes en détresse A.S.B.L. for writing this text.

What should you do to help victims of violence?

As a witness to domestic violence (neighbour, friend, family member, etc.):

ask people who are living with violent husbands how they are,
show that you are willing to help in the event of a problem,
alert the police or emergency services in case of imminent danger,
contact organisations specialising in support to abuse victims:

- www.fed.lu
- www.violence.lu

Source: We would like to thank the Service d´information et de consultation pour femmes VISAVI de Femmes en détresse A.S.B.L. for writing this text.

Have you perpetrated domestic violence?

I do not want to hurt my children or my wife /my husband (by word or deed) and I do not know what to do to control my emotions. How can I avoid exploding? What can I do if I feel my tension mounting?

At a time of confinement, it is already not easy to be the perfect parent or partner. In such times, it is all the more important to look after yourself properly, so as to avoid saying or doing anything that you might regret later.

Do not hesitate to contact our service Riicht Eraus on: 2755 5800. Our counsellors are there to listen to you and advise you.

I have been excluded from my home for perpetrating violence. What should I do?

You are required by law to contact the service Riicht Eraus by telephone on 2755 5800. We shall offer you an opportunity to talk things over with us on the telephone, on a date and at a time that is convenient to you.

I have been excluded from my home for perpetrating violence. Where can I stay?

Call the service Riicht Eraus on 2755 5800. Together, we shall work out where you can stay while you are excluded from your home.

How are consultations with Riicht Eraus’s counsellors being held during this crisis?

Unfortunately, we cannot receive in person those people who wish to consult us. Our counsellors are nonetheless conducting all their consultations by telephone, by appointment. If you would like an appointment, you need only call 2755 5800 and arrange a date and time for the telephone consultation. Once the state of emergency is lifted, consultations at our offices will resume.

Source: We would like to thank Riicht Eraus, Service de consultation et d’aide pour auteurs de violence de la Croix-Rouge luxembourgeoise for writing this text.

Upcoming Q&A on :

Substance Abuse and Video Game Abuse
Relationship management during containment

Link to covid19.lu