New research published in the Lancet reveals the negative psychological impact of quarantine. The review examines the psychological impact from quarantines involving SARS (11 studies), Ebola (5), the 2009 and 2010 H1N1 influenza pandemic (3), Middle East respiratory syndrome (2), and equine influenza (1).
Researchers found the most common psychological symptoms related to quarantine included depression, stress, low mood, irritability, insomnia, anger, and emotional exhaustion. Involuntary quarantine caused much more stress than voluntary quarantine. Also, researchers concluded that public health officials should stress the altruistic choice of self-isolating to help reduce stress.
People who are quarantined due to exposure to someone who tested positive report a wide range of negative psychological effects including fear, confusion, nervousness, anger, grief, numbness, sadness, guilt, and difficulty sleeping due to anxiety.
Here are the common stressors during quarantine. I offer my solutions below. Staying at home during this unprecedented pandemic is essential. By doing so, all of us are protecting each other's health and safety, and we are supporting our brave health care and essential workers who are on the frontlines fighting this battle for us.
Researchers found that the longer the quarantine, the harder it is. Symptoms of PTSD were greater in people quarantined over 10 days. With the COVID-19 quarantine recommendations being 14 days, we can expect and plan for more psychological stress after the 10-day turning point.
- Create a daily routine to add structure to your day so that you keep track of your stay at home on a calendar. Many of us who are working from home can benefit from defining more routine as the reality of having to stay home for more than a few weeks settles in. Try to keep your routine as close to going to work as possible, including wearing work clothes and changing at the end of the day to provide firm boundaries to the workday.
- Don't forget to take regular breaks throughout the day.
- Be self-compassionate. So many people I'm speaking with nowadays are being hard on themselves for not being productive or returning to old family dynamics at home, especially triggered by feeling stuck inside a home. Try to be kind to yourself and catch yourself when you're being mean. Ask yourself, is that how you would speak to a friend?
- Consider bookending your day with a daily morning and nighttime meditation.
Here is a free streaming breathing meditation from me and other free mindfulness meditations.
2. Fears of Infection
Uncertainty plays a large role in the fear—there are fears for one’s own health and fears of infecting others. Researchers found that women who are pregnant or those with young children need more support during this time as they may experience higher levels of fear and concern.
- Make a preparedness plan in which you identify health care providers you would call or local clinic telehealth lines if concerning symptoms did arise and write down their contact information.
- Avoid checking the news or going online at night before sleep. The blue light combined with the negative impact of news online can be harmful to preparing for sleep. Sleep is crucial for your immune system.
- While it is important to stay informed, try to limit the time that you spend online or social media if you're finding it making you more anxious and fearful.
- Learn what are important symptoms and health information from your local public health department or reliable sources.
- Anticipate that there will be a range in the levels of awareness and concern with your family and friends, and know that you may also sometimes encounter denial from others. Try to act with compassion, try active listening, and educate and support them.
3. Frustration and Boredom
Confinement leads to a loss of the usual routine, changes in social and physical contact with others, and an increased sense of isolation. This is made harder by the daily activities that are no longer accessible (e.g., going to the gym or yoga, seeing friends for dinner, shopping for food).
- Discover a new activity or revisit an old hobby while social distancing appropriately.
- Schedule a wide variety of activities and stay curious and don't judge yourself.
- Try activities that are solitary like cooking, playing music, baking, taking a hot bath, learning an online class, taking an online museum tour, drawing, journaling, or reading.
- Stay connected and keep social by calling friends and family. Make a list of people that you want to check in on. Write letters to people you might not have spoken with in a long time.
- Physical exercise is really important, though this may be particularly hard in urban areas, but consider jump roping, a seven-minute workout, yoga, or pilates from local online classes that are often streaming these now.
- Try to find one activity a day that feels joyful and give yourself permission to do that. Can't think of one? Try this exercise: "If I didn't have to be perfect, I would try ____" and list 20 things without judging yourself. You'll be surprised by what you'll find on that list!
4. Inadequate Supplies
Basic supplies like food, water, clothes, and having a place to stay were found to be associated with anxiety and frustration even four to six months after being quarantined.
- This is challenging because so many areas are low on food supplies or food delivery might be slowed (as it is currently in New York City). A helpful tip on stocking the pantry wisely is here.
- Be generous. If you have extra food or medical supplies (masks, gowns, hairnets, gloves, face shields, eye goggles), consider donating to local food pantries and hospitals, which are running very low right now.
- Check on your elderly neighbors or those who might not have resources to get enough food, water, or supplies.
5. Inadequate (or Inaccurate) Information
Hearing conflicting information from different health and public authorities can be stressful. Research found that participants who observed a lack of transparency or conflicting information led to more confusion and frustration.
- Find a reliable source of healthcare information from credentialed health care professionals and public health agencies.
Researchers also identified post-quarantine stressors including primarily financial losses from lost earnings as well as potential stigma.
What is healing in times like these?
A Sense of Community and Compassion
I believe that the most healing thing at the center of all of this psychological stress is to be connected to a sense of community and compassion—for each other and for ourselves. Know that you are not alone. Many of us are, have been, or will be experiencing some level of shock and distress from this unprecedented time. But know that we are all in this together, and we must continue to do what we can to help each other when we can.
At the roots of psychological wellness is the ability to care and be generous to others and ourselves. During this time when so many in my family and medical colleagues are on frontlines fighting this unthinkable battle, I have witnessed so much courage, compassion, kindness, and generosity—from brave healthcare workers on the frontlines to those in the community working so hard to support them. I have connected with new and old friends and witnessed the kindness of strangers and even corporations who rapidly are trying to donate food and supplies.
While we are all still weathering this storm, take comfort in the knowledge there is generosity, love, and compassion at the heart of all this—that is the hope and light amidst these dark, uncertain times.
Share with us what you're up to while staying at home and what has been helpful for you! I hope your families, friends, and loved ones all are safe and sound.
Marlynn Wei, M.D., PLLC © 2020
Facebook/LinkedIn image: Bogdan Sonjachny/Shutterstock