COVID-19 and Melancholia: Different Perception of the Concept of Stigma and Loss

Dear Editor,

Historically, Hippocrates said that if fear (phobos). Or distress (dysthymia). Persisted for a long time, melancholy would develop. He emphasized special temperament and constitution in this regard (1). Although such a conception of melancholy later underwent fundamental changes in its historical course, its "inward" view, of which black bile and phlegm were indicative, later manifested itself in various forms in psychiatric and psychoanalytic theories. Consideration of mourning as an understanding of the "world" as a condition of "poor and empty" and of melancholia as an understanding of the "ego" as a condition of "poor and empty" may be another perception of this "inward" concept in attitudes toward melancholia. This view took about 30 years to explain and was accompanied by a variety of interpretations, and even within it, feminist concepts. Thus, the word underwent numerous subjectivities (2).

Subsequently, the concept of melancholy emerged from a purely individual and intrapsychic experience and was explored in a social context. Considering this, the word melancholy in one of its original usages, was used in such a way that "there is no consonance between what the mourner understands his/her loss and how that loss is understood by others." In fact, melancholy is formed under these conditions (3). In such a way, in addition to individual understanding, social understanding of individual-related situations was also introduced in the formation of this concept. Thus, the concepts of cultural context and morality are also discussed here. The role of Judgments, emotions, and relationships between individuals and society is another aspect of this issue (4).

Such a concept, can be accompanied by anxieties and worries about taking "self" and "ego" into a public arena and outside the subject of "inward." Such a concept describes a painful phenomenon, reminiscent of the pain of childbirth, which experiences entering the crowd with a painful cry (5).

In recent months, the COVID-19 pandemic has affected the human mind at the individual and societal levels. The formation of a new concept of stigma in this context, in turn, had a significant impact on the formation of interpersonal interactions in this area (6). In the recent past, we have witnessed the formation of stigma at different levels in different communities and among communities. The danger of the formation of stigma in a quasi-melancholic sense, is a serious concern that can be addressed given the similarities between the 2 concepts. Stigma, classically, includes various components and can include cognitive and emotional components along with "status loss", and in addition to being deprived of social participation, it can be associated with distance from people's dignity (7).

The status loss in stigma, which means the loss of internal capital, is probably the most painful aspect of stigma in the current pandemic. During the COVID-19 pandemic, if quarantine involved external consequences, such as reduced social interactions (8) and stigma, in the current context and with an uncertain outlook for the future, somehow evokes a sense of perplexity in the inner and outer worlds. (9).

It can also have semantic similarities to that painful birth experience. The lack of consonance between this inner feeling of loneliness and its perception by others creates the same melancholy feeling that we see in a pathological grief. Thus, it seems stigma in the context of COVID-19 is a perfect example of a melancholy-like situation, with concepts beyond morality and social status. What seems to be happening is that the new concepts formed in the field of COVID-19 are significantly different from the old concepts in meaning, especially in the field of psychiatric issues and its relation to psychoanalytic concepts. This is especially important when it comes to rearticulating the “self” (10). The concept of stigma and its relation to self-altered in the new world conditions in the COVID-19 pandemic era is shaped by such an attitude.

Efforts to overcome this humanitarian crisis are possible only with the help of all the individual, social, and international facilities. Only by creating awareness, paying attention to cultural capacities, strengthening social capital (11), and community engagement (6). Can we hope to overcome this difficult field.