Amy Sullivan, PsyD, is the director of behavioral medicine and training, and chair of the Neurological Institute physician and caregiver engagement team at the Cleveland Clinic’s Mellen Center in Celveland.
Although the word quarantine was first used during the Black Death in Italy in the year 1127, the types of physical distancing and stay-at-home orders that came with the coronavirus pandemic are unprecedented in the living memory of Americans. Along with unprecedented experiences often come unexpected consequences.
According to a recent viewpoint published in JAMA Internal Medicine, one consequence we can expect to see is a wave of mental health disorders triggered by the trauma of
In a famous study from 2015, researchers reported that people who were lonely and isolated had about a 30 percent higher risk of death. If loss of social contact can be that damaging to your physical health, imagine the effects on the mind.
The authors of the JAMA viewpoint predict a substantial increase in anxiety, depression, substance abuse, and domestic violence. Research supports this warning. Most studies on the mental health effects of pandemic quarantines have found that people experience high rates of conditions such as post-traumatic stress disorder, anxiety, and depression. Those effects may be seen after just 10 days of isolation and can last even when the isolation is over. A Kaiser Family Foundation poll published in late April 2020, about two months into the stay-at-home orders for COVID-19, found that 56 percent of respondents reported at least one negative mental health effect, including symptoms like worry, stress, alcohol use, and changes in sleeping and eating. During April, calls to the U.S. Disaster Distress Helpline were up 1,000 percent.
Many of the feelings people report—fear, anger, grief, numbness, insomnia, exhaustion, irritability, and sadness—are symptoms of isolation-induced stress. Prolonged stress itself can cause both physical and mental health disorders. To make matters worse, social connections are the way many people deal with stress. People who already have a mental health disorder may be triggered by this additional stress, leading to relapse or a loss of control.
Loss of social activity and connection can get anyone down, but some people are at higher risk for significant mental health consequences, including those who are elderly or disabled, who live alone, who have a mental health disorder, who are financially insecure, and who are at home in unstable relationships.
It is normal for negative feelings to come and go during times of change and stress, but if they persist or interfere with your ability to make it through the day, you may need to talk with your physician or mental health provider. Watch out for these warning signs: deepening depression, constant anxiety or fear, inability to return to normal after isolation ends, loss of interest in daily activities, loss of control over anger, loss of control over the use of drugs or alcohol, any fear or actual physical abuse at home, or fear that you may be a danger to yourself or others.
Recognizing that COVID-19 is an unprecedented crisis affecting daily physical and mental health, the National Alliance on Mental Illness (NAMI) created a resource for help, support, and information. You can find it at https://nami.org/covid-19-guide. You can also call the NAMI Helpline at 1-800-950-NAMI (6264)
While no one knows how the coronavirus pandemic will unfold, it is possible that we could experience a resurgence this fall and winter. If another quarantine were to be ordered, use these tips to make it more manageable.
Structure your technology use. Virtual visits with friends and family became the new normal for many people. To harness the power of digital social connection, use it to replace lost routines and add structure to days of isolation. For example, try using it to check in with friends and relatives at certain times of the day. Participate in scheduled activities such as meetings, social events, religious services, support groups, and exercise classes.
Reduce stress. Make techniques like guided relaxation, deep breathing, and mindfulness meditation part of your daily routine. It is a good idea to limit the amount of media you consume.
Don’t ignore the importance of routine wellness. Eat healthy foods. Schedule time for exercise or physical activity most days of the week. Try to get seven to eight hours of sleep every night, and keep regular hours for sleeping and waking. Avoid boredom by learning new things. There are countless free resources online where you can learn languages, study art, or even take Ivy League courses. We like Harvard Health Publishing’s online course series. (Learn more here: https://www.harvardhealthonlinelearning.com/catalog.) Explore your creativity by drawing, painting, sculpting, writing, or trying new crafts.
Build resilience through gratitude and altruism. Even if you don’t have everything that you desire, be thankful for what you do have, whether that’s safety, support, or friends you’re looking forward to seeing. If you are sharing a home with family, cherish the extra time that you have with them.
Practicing altruism means stepping outside of yourself. Thank people who are working while you are sheltering. It could be your mailman, a grocery clerk, or a health-care worker. Instead of thinking that you are being forced into isolation or forced to wear a mask, think of it as something you are doing to protect others.