In Idled Venezuela, Psychiatrists Work Overtime
www.nytimes.com By JUAN FORERO
CARACAS, Venezuela, Jan. 30 — They are the stressed and the nervous, the phobic and depressed, and on this day they filled the waiting room of Edmundo Chirinos, a psychiatrist well known here for having provided advice to President Hugo Chávez.
Under soft lighting and surrounded by the gentle gurgling of a miniature fountain, they sit shoulder to shoulder — an octogenarian nervous about the future, a young political aide worried about violence, an elderly couple concerned about their dwindling finances. Advertisement
"I am very depressed," Elena Dorante, 62, said. "That is why I'm here."
It may all seem normal for the office of a psychoanalyst. But these are not normal times in Venezuela. The streets are often filled with protesters, many businesses remain shuttered from a two-month general strike, the government is defiant and opposition leaders warn of an impending apocalypse.
Perfect conditions, in other words, for mental traumas of all kinds, Dr. Chirinos acknowledges with a smile, noting that business is booming.
"I do not think there is a country in the world that has so much stress, and so many neurotics, than Venezuela has today," he said, while adding that President Chávez himself did not appear to be showing signs of wear.
"I have doubled, tripled the number of patients," he said. "I do not know what to do with them."
This is Venezuela on the verge of a nervous breakdown, or at the very least a country gripped by confusion and gloom.
Psychoanalysts have long thrived in this sophisticated but chaotic and stressful city, offering soothing words to people dealing with troubled relationships, problems at work and repressed childhoods.
"But now we are seeing things that are completely different — anxiety disorders, panic disorders, post-traumatic stress," said Dr. Edgar Belfort, a leading psychiatrist here. "People are depressed more. We are seeing people depressed in ways that we cannot explain, even in a scientific way."
The reason for the high anxiety, analysts say, is deep uncertainty about the future. Daily, Venezuelans hear high-octane rhetoric from both sides in the lingering political standoff. Government opponents warn of massacres and the impending installment of Cuban-style Communism; Mr. Chávez pledges to defeat what he calls fascists arrayed against him.
All of it is replayed hour upon hour on an array of antigovernment television stations, leaving people unhinged.
"There is like a collective schizophrenia," said Cristel Lusverti, a psychologist. "People do not know what to believe. People feel bombarded from all sides, and that gives you all kinds of stress."
If that were not enough, a fraying economy marked by high unemployment, failing businesses and a falling currency adds to the angst.
"We are seeing an immense proportion of depression," said Dr. Chirinos, who wears a white doctor's smock and oversize tie. "We have people with insomnia, anguish, apathy, lack of interest. People who feel they can do nothing, who have a sense of depression and resignation."
Since not everyone can afford therapy, Venezuelans are increasingly seeking answers and advice wherever they can get them. Neighborhood groups in which people share their problems have sprung up. Others have found solace in the church, Afro-Caribbean religions or with astrologers.
"They pray more and take refuge in God, who is the friend of the sufferer," said the Rev. Adán Ramírez, a Catholic priest. "We are seeing — and other priests have told me the same thing — more people coming to Mass."
Others have turned increasingly to stress remedies or natural medicines, "even when nobody around here has much spare money," said Jorge Luis Hernández, a pharmacy employee.
The symptoms of the ailing are myriad: panic attacks are up, while sexual encounters are way down, psychiatrists say. Health problems seem to be on the rise, said some doctors, with an increase in hospital visits for everything from heart attacks to unexplained rashes. In serious cases, Venezuelans suffer all manner of phobias, often of public places where violence can erupt.
"There is an attitude of paranoia I have noticed, where people think they are being chased," Dr. Álvaro Requena said. "They feel that waves and waves of people are going to come rob them."
Dr. Requena said that the constant street protests and the growing participation of Venezuelans in politics had helped relieve stress for many people. Yet he and other psychiatrists said even those who suffered nothing serious were still affected.
María Cabrera, a physician, said she noticed that she had trouble concentrating. "If I am at home and doing three or four things, I cannot do something that requires concentration," she said.
Milagros Torres, a lawyer who makes it a point to talk with her sister, a psychologist, to relieve stress, said, "I never took a pill in my life, a tranquilizer, but now I am taking them."
In Dr. Chirinos's office, on a faux leather couch, Ms. Dorante explained how she was "terrorized and confused," and fearful that the poor masses that support Mr. Chávez would overrun her neighborhood. "I cannot sleep, and every time I hear a firecracker I think there is an uprising," she said in a low voice.
Dr. Chirinos, nodding as she spoke, cut in, "This is what we call xenophobia."
"It is a form of ethnic phobia," he went on. "And yes, I'm seeing more of that, too."