Published March 24th, 2020 at 11:38 AM
In just over a week, area residents have gone from life’s normal bustle to a clamp down.
Shut out of nearly all social activities, people typically surrounded by co-workers, friends and family could well find themselves suffering from a challenge typically relegated to the nation’s elderly: social isolation.
During normal circumstances, about 40% of older Americans report regularly feeling lonely and isolated from their communities. With the rest of the nation now forced into similar circumstances due to the coronavirus pandemic – in addition to economic anxiety, joblessness and a complete upheaval of daily schedules – this condition could become increasingly widespread.
Social isolation, over the long term, can lead to depression, sleep disturbance, cognitive decline and even premature death. In the month or two that local counties will likely be sheltering in place, more severe symptoms are unlikely. But it can be easy, in just a couple of weeks, to experience anxiety and depression.
“It’s normal to feel this way and it’s to be expected – there’s a sudden onset of feeling like the whole world has been turned upside down,” said Becky Franklin, an older adult educator with Tri-County Mental Health.
There’s no need to be stressed about minor mood changes, but major ones may be a sign that social distancing is turning to isolation. Fortunately, there are some simple steps to take to help stay mentally healthy while sheltering in place.
In anticipation of widespread stay-at-home orders, researchers recently analyzed the psychological impact of quarantine during the spread of SARS, Ebola and H1N1. In an article in The Lancet, they reported people under those quarantines reported isolation causing problems ranging from “low mood” and irritability to depression and post-traumatic stress disorder (PTSD) in more severe cases. People quarantined for greater than 10 days were more likely to experience symptoms.
During times of isolation anyone can struggle. But people more predisposed to do so fall into a few specific categories: the elderly and people with depression or anxiety.
For instance, a person with a compromised immune system may become more anxious because of their increased risk of complications from COVID-19. Extroverts, who thrive on personal connections, may have a particularly difficult time being cut off from social activities.
During such a dramatic change in lifestyle, few people are immune to stress. It’s not unusual to worry more about health – fearing a cold or allergies might be the coronavirus. Others may feel heightened anxiety just leaving the house. And still others will horde things like toilet paper to prepare for potential dwindling supplies.
But for some people, social isolation can lead to depression or anxiety. If this happens, there are some signs to watch that can signal that things are more severe.
Greg Nawalanic, clinical psychologist with the University of Kansas Health System, said to focus on four areas. The first is behavioral, like not answering texts or increasing use of drugs or alcohol. Next are physical problems like consistent stomach aches or headaches. People also may have cognitive problems like trouble concentrating or memory loss. And finally, monitor for emotional disturbances like extreme sadness or anger. It’s important for each person to know their own emotions and when they are triggered, Namalanic said.
It’s difficult to see the bright side of the pandemic. But Nawalanic said recognizing the importance of sheltering in place can improve mood.
“If we look at it as a case where everything is shutting down and feed into the fear of the unknown, we will have isolation fueled by anxiety and uncertainty,” he said. “In this day and age, quarantine is far less disruptive than it was 10 years ago.”
Notably, a lot of people can work from home. Students are continuing education and learning remotely. Netflix and other streaming services allow endless entertainment. And if that all fails to keep people busy, Nawalanic recommends going outside – walking, biking and running are allowed a safe distance from others.
There are also a handful of recommendations that can help improve mental health when sheltering in place.
Although personal routines are going to be very different than a couple of weeks ago, Franklin recommends implementing new ones while sheltering in place.
People working from home should perform the same morning rituals they did before. Don’t go days without showering and always change out of pajamas. Have meals at a consistent time and keep a rough schedule for things during the day. Also, try your best to get to bed at the same time each night. For children and teens, used to tight routines at school, particularly benefit from keeping schedules.
“It doesn’t have to be really rigid, just have a loose idea of when to eat breakfast, read, or do chores and maybe after lunch, do an online activity or virtual field trip,” Franklin said.
All those things people say they want to do if they had the time… the time is now.
David Cates, behavioral health consultant at the Nebraska Medicine Biocontainment Unit and the National Quarantine Center, recommends catching up on movies you haven’t seen, doing an art project, learning a language or trying new, interesting takeout food. Keep busy with those projects around the house that have been put off indefinitely.
During times of stress and uncertainty, people tend to turn to things that comfort them. It’s not unusual to overeat, increase alcohol intake, use drugs or overspend money. These things, Franklin said, provide instant, but artificial, gratification.
“It feels good in the immediate, but doesn’t sustain over the long term,” she said.
News and social media keep people informed, but Nawalanic recommends a diet. Take in COVID-19 updates on TV or the internet for about 30 minutes to an hour at the beginning or end of the day. Cates recommends having two sources of reliable health information – one national (like the Centers for Disease Control and Prevention) and one local (like the health department).
Franklin recommends doing things in “your best interest” now that can continue over the long term. Doing things like getting groceries for people who can’t get out can give a sense of purpose. Any kind of healthy movement is beneficial mentally. Laughter yoga is another tool she recommends to “lighten the mood and release endorphins.”
Cates suggests mindfulness training. Being in the moment helps relieve depression (thinking about the past) and anxiety (worrying about the future). He recommends PTSD Coach, an app that provides tools and exercises to encourage relaxation even if someone doesn’t have PTSD.
Restlessness, boredom and cabin fever will probably be the worst emotions that many people deal with while sheltering in place. If you are experiencing symptoms of depression – overeating or not eating enough; inability to sleep or sleeping too much; feeling hopeless or helpless; or not finding pleasure in things you used to enjoy – Cates recommends reaching out to a healthcare professional.
Teletherapy and video therapy are available and many mental health organizations will continue to have some kind of services available. Most also have 24-hour crisis hotlines for urgent needs. Tri-County’s can be reached at (888) 279-8188.
Tammy Worth is a freelance journalist based in Blue Springs, Missouri.