Homebound and Happy: Keeping Your Spirits Up in Quarantine
Research on past pandemics can help us battle both disease and depression.
Posted March 29, 2020
For many people, their home is a place of refuge. A place to regroup, relax, and recharge. A haven within which to escape the grind of work and wind down with loved ones.
During quarantine, however, the home is viewed a bit differently. Once known as the proverbial castle, for people taking contagion concerns seriously, it becomes a fortress. A sanitary, sterile, structure with strict rules. Family members, worried about having become infected the last time they were out and about, practice social distancing even inside the home, space permitting.
Packages delivered to the front door are requested to be left outside, and after a safe amount of time, are quickly dragged inside by a designated, gloved, masked family member, and thoroughly sanitized before opening.
Nonetheless, as the days pass, homebound occupants fall into a new routine. Teleworkers transform family room areas into remote offices, kids organize their bedrooms into makeshift remote classrooms. And life goes on, as we are reminded that this too, shall pass.
But even when a quarantine period is over, does the experience leave a psychological toll? Research has some answers.
Home Court Disadvantage
Laura Hawryluck et al. studied the experience of quarantine in connection to the severe acute respiratory syndrome (SARS) outbreak, which they note was ultimately contained successfully through worldwide quarantine measures.[i] Acknowledging the effectiveness of quarantine procedures for preventing the spread of disease, they examined its psychological effect on people who were confined.
They investigated the psychological impact of quarantine on a sample of 129 people in Toronto, Canada. Participants, who responded to an Internet survey, reported a high incidence of psychological distress.
Specifically, the researchers discovered reports of posttraumatic stress disorder (PTSD) symptoms and depression in 28.9% and 31.2% of respondents, respectively. They also noted that longer periods of time in quarantine were linked with a higher incidence of PTSD symptoms. People who had either direct exposure or acquaintance with someone who had a SARS diagnosis were also linked with PTSD and depressive symptoms.
Hawryluck et al. describe PTSD as “an anxiety disorder characterized by avoiding stimuli associated with a traumatic event, reexperiencing the trauma, and hyperarousal, such as increased vigilance.” They note that higher symptoms of PTSD were directly proportional to increased amounts of time spent in quarantine, perhaps suggesting that the experience of quarantine itself might be experienced as personalized trauma.
Money Matters: The Psychological Impact of Financial Distress
Hawryluck et al. noted that symptoms of both depression and PTSD increased as household incomes fell. But it was difficult to arrive at a definitive result in this area due to the methodology used. Because the survey was Internet-based, the authors note that respondents might have been more likely to be more affluent and educated, with access to computers. If true, they acknowledge that study results might be an underestimation of the psychological distress caused by quarantine.
They also note that most of the participants in their study did not report financial hardship, which was likely explained by the fact that over half of the respondents reported an annual household income of over $75,000 CAD.
Information as an Antidote for Anxiety
Notably, Hawryluck et al. reported that approximately half of respondents expressed feeling like they had not received enough information about methods of controlling home infection. And of those who at least had some information, apparently not everyone was following the recommendations.
The authors note that of particular interest, strict adherence to measures of infection control, including wearing masks more often than recommended, was linked with higher levels of distress. Regarding the reason for this finding, they note that without interviewing the respondents, it is impossible to determine whether people experiencing more baseline levels of distress were more likely to strictly follow methods of infection control, or whether following recommended strategies created higher levels of distress.
The Power of Information
There appear to be several take-aways from this research, which can potentially ease the discomfort of this disruption in routine. First, regarding the value of accurate information, knowledge is power, which can decrease anxiety when families have a working knowledge of precautionary measures that are effective and appropriate.
In addition, investing in good technology is money well spent when it can allow employees to work from home. Not only is this true for people who are self-employed, but also because not all employers can provide employees with the equipment necessary to work remotely.
The underlying theme is that when it comes to acquiring information, proactivity does not breed paranoia, but preparedness. Authoritative, sound advice from expert sources will allow families to shelter in place while remaining sane, and financially sound.
[i] Laura Hawryluck, Wayne L. Gold, Susan Robinson, Stephen Pogorski, Sandro Galea, and Rima Styra, “SARS Control and Psychological Effects of Quarantine, Toronto, Canada,” Emerg Infect Dis. 2004 Jul; 10(7): 1206–1212. DOI: 10.3201/eid1007.030703.