Psychlogical impact of quarantine

Ways to Recognize and Ease the Psychological Distress of Quarantine

This time of isolation and self-quarantine continues to drag on, leading to many different emotions and reactions in all of us.

A couple stuck at home together has to find space, time, and energy to create an adequate work environment. They have trouble focusing on their work, surrounded by the distractions of home. In the evening, they grow bored, and frustrated that they can’t just go out to dinner or meet up with friends. If one suggests a beer or glass of wine, the other concurs. This becomes a nightly routine.

Eventually, this couple might find themselves feeling lonely for the company of friends and family. They become easily irritated and fight much more than they were used to doing. Maybe one or both of them begins to have difficulty maintaining the energy to get through the day. They may even become hopeless or start to have nightmares or panic attacks.

We try to normalize these emotions and reactions. We think to ourselves, it makes sense to feel lonely, sad, bored, and irritated during these trying times. But it’s not just normal. It’s quarantine. According to research, quarantine has a negative impact on our wellbeing.

A recently released report in The Lancet reviewed quarantines throughout history and their effects on the communities and individuals involved (Brooks, et al., 2020). For those of us undergoing self-isolation and quarantine, there are certainly psychological impacts like those of the couple above, and like those identified in the study—but there are also ways to ease those impacts.

What to Expect: Typical Reactions to Quarantine

Anxiety, worry, or fear related to:

  • Health – your own and that of your family and loved ones
  • Work – time taken off and the potential loss of income and job security
  • Child and elder care – concern about being able to effectively care for your family and still work

Uncertainty or frustration about:

  • How long you will need to remain in this situation
  • What the future holds
  • How you should feel about the situation

A wide range of emotional reactions:

  • Loneliness associated with feeling cut off from the world and from loved ones
  • Anger if you think you were exposed to the disease because of others’ negligence
  • Boredom and frustration because you may not be able to work or engage in regular day-to-day activities
  • A desire to use alcohol or drugs to cope
  • Symptoms of depression, such as feelings of hopelessness, changes in appetite, or sleeping too little or too much
  • Symptoms of post-traumatic stress disorder (PTSD), such as intrusive distressing memories, flashbacks (reliving the event), nightmares, changes in thoughts and mood, and being easily startled

Quarantine Can Lead to Psychological Distress:

As the Lancet paper detailed, surveys of people who had been quarantined and reported symptoms of psychological distress have found these general symptoms to be the most common:

  • Emotional disturbance
  • Depression
  • Stress
  • Low mood
  • Irritability
  • Insomnia
  • Post-traumatic stress symptoms
  • Anger
  • Emotional exhaustion

Low mood and irritability each affected more than half of respondents.

Emotional Impact of Quarantine on Healthcare Workers:

One study reviewed in the Lancet paper followed hospital staff who came into contact with SARS. Those who were quarantined for 9 days after exposure experienced more symptoms of acute stress than their counterparts who were not quarantined. Their symptoms included exhaustion, irritability, detachment, and anxiety in working with sick patients to the point of considering leaving their jobs. 

Quarantine Can Lead to Post Traumatic Stress Disorder (PTSD)

Several studies in the Lancet review indicated that individuals who had to be quarantined were much more likely to later demonstrate post-traumatic stress disorder than individuals who were not quarantined.

  • Parents and children quarantined during an outbreak reported significant, trauma-related symptoms in 28% of respondents, as opposed to 6% of parents who were not quarantined.
  • Healthcare workers in another study were found to be more susceptible to PTSD three years later if they had been quarantined during an outbreak.

Long-Term Impact of Quarantine
Beyond symptoms of PTSD, one of the studies found that three years after the SARS epidemic, healthcare workers who were quarantined were more likely to suffer from alcohol abuse or dependency.

Stressors During Quarantine

  • Finances with job stability or loss
  • Food availability and access
  • Housing stability, paying rent
  • Childcare and/or assisting school-age children with schooling from home
  • Work, adjusting to changes in schedule, location, and demands
  • Interpersonal struggles with roommates or family
  • Loneliness and isolation from friends and loved ones
  • Change in routine, exercise, eating

Stressors Post-Quarantine

  • Finances, job stability or loss
  • Readjusting to new routine
  • Stigma of having been quarantined
  • Anxiety about encountering the disease again

Ways to Ease Distress During Social Distancing & Quarantine

  • Remember that distress is an understandable reaction in such circumstances.
    • If you find yourself judging your emotions or responses around the pandemic, remind yourself that they are normal and justified. Studies have found that pathologizing your responses by viewing them as “something wrong with you for reacting so strongly” actually increases your anxiety. Instead, say something nurturing to yourself.
  • Expect that you or your family member may have difficult time occasionally.  You are entitled to one meltdown a week.
  • Unplug, too much information can increase anxiety.
  • Reach out to friends and family.
  • Engage in healthy behaviors that promote wellness.
    • Maintain a healthy die
    • Obtain sufficient sleep when possible
    • Exercise
  • Go outside.
  • Avoid excessive alcohol, smoking, and vaping.
  • Maintain routines related to bedtimes, meals, and exercise.

This may be the most widespread incidence of quarantine as people around the world are experiencing the anxieties and stressors related to social distancing, disease, and isolation. The good news is that healthcare and mental health care professionals are recognizing these impacts and using their findings to advise community leaders and individuals alike. Couples who are struggling with the change in routine, the isolation, the increased anxiety and irritability are experiencing the effects of quarantine, and there are ways to get through it.

Dr. Irena offers online therapy  for couples in Texas and New York who are having difficulty being together during the quarantine. She uses research-proven method,  known as Emotionally Focused Therapy (EFT) to help couples develop and maintain the emotional connection and support each other through stressful times. She has helped highly distressed couples be available and responsive to each other, access their resiliency, and strengthen their relationships.

If you would like to schedule a session, email Dr. Irena for a free 10-minute video consultation:   [email protected] or call (281)-267-1742.

References:

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet395(10227), 912–920. doi: 10.1016/s0140-6736(20)30460-8

Other Resources:

Ellis, E. G. (2020). What Coronavirus Isolation Could Do to Your Mind (and Body). Retrieved from https://www.wired.com/story/coronavirus-covid-19-isolation-psychology/

Psychological effects of quarantine during the Coronavirus outbreak: What healthcare providers need to know. Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University. Retrieved from https://www.cstsonline.org/assets/media/documents/CSTS_FS_Psychological_Effects_Quarantine_During_Coronavirus_Outbreak_Providers.pdf

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