The 33 miners trapped in 600 square feet of space, nearly half a mile underground in Chile, face a catastrophic risk of mental illness, especially since rescuing them may take four months.
I have treated many men and women who fall victim to major depression in the aftermath of losing their jobs. One of the primary stressors is that they no longer can tap into the momentum of the day and the energy of co-workers around them. Without clear goals at work and without schedules, some find their moods plummeting and their anxiety levels rising precipitously. But they are at home, above ground.
The miners have not only lost their routine and work habits, they have lost the light of day. They have lost privacy. They have lost the chance to interact in any complete way with loved ones. They must remain in extremely close proximity to co-workers they may come into conflict with. They must live daily with the anxiety that their shelter could fail to support the weight of the earth above it.
The stresses the miners will face, not to mention the fact that several of them (given the prevalence of such conditions) probably struggled with depression or anxiety or alcohol dependence before this crisis, means that those managing it must do everything possible to prevent and treat major depression and panic disorder and psychotic disorders in this group. This may include the use of multiple psychiatric medications, as well as continuing to provide alcohol or even illicit drugs to the miners (to prevent withdrawal or help them cope with unbearable realities).
Rescuers have done the right thing by reportedly informing the miners that it could be Christmas before they are released. People cope far better when they understand the magnitude of the challenges they face, and are not continually frustrated by perceived delays and false hopes. The most potent way to dispirit human beings is to give them no insight into when their suffering might end. Any end in sight is something to focus on.
It would be wise to give miners bright light therapy devices (no bigger than a book, in many cases) that simulate the sun and be instructed to use them each day for one hour. They should be awakened at the same time each day and should have a time they think of as bedtime.
I would also recommend that the miners become organized into a cohesive unit, by electing a council of leaders. A system to resolve grievances should be put in place. Some number of miners should probably be anointed as "security" officers and others as "counselors." A miniature government may sustain these men better than a culture of "survival of the fittest."
Sadly, being rescued will only be the beginning of the "journey back" for some of these men, who will likely struggle with psychological effects of their ordeal for a lifetime.
Dr. Keith Ablow is a psychiatry correspondent for Fox News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life Through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be reached at firstname.lastname@example.org.