Quarantine and its Potential Psychological Fallout

As we all know, we are currently enduring an epidemiological crisis of potentially epic proportions as COVID-19 spreads across the planet. Quarantine has proven to flatten the curve of infection, promoting fewer infections and a quicker end to the pandemic. However, while imperative from the standpoint of disease control, quarantine carries significant psychological repercussions in its wake.

 

Denied human interaction in physical space, confinement to a small area such as mandatory isolation for an infected individual, worries about infecting others, and financial implications are a recipe for real psychological distress.

Some studies have shown that the psychological impact of quarantine causes confusion, anger, and post-traumatic stress disorder, sometimes lasting for up to three years after the quarantine has been completed. Other studies have shown that extended quarantines can cause confusion, frustration, boredom, depression, insomnia, anxiety, and fear.

Sensitivity and Compassion for the Most Vulnerable

While everyone’s psychological health is at stake, there are those segments of the population that are particularly vulnerable to enduring psychological distress. For those with a  history of psychiatric illnesses, quarantine can be particularly detrimental.

For example, those who are already suffering from anxiety, the sense of helplessness, and lack of control engendered by a mandatory quarantine will almost certainly exacerbate the anxiety. For someone who has claustrophobia, feeling locked into a small space may be unbearably stressful. And those saddled with suicidal ideation are at particular risk in this situation.

Being confined to their homes or facilities where infection can quickly spread without the proper precautions, makes the elderly especially vulnerable as well. Their higher risk for mortality requires that the quarantine for the elderly be complete. This complete quarantine, coupled with their higher dependency on others, only serves to exacerbate their helplessness resulting in elevated levels of anxiety and depression.

Those in hospitals or nursing homes are still being cared for by others. However, it can safely be assumed that caregivers in the current environment are overwhelmed.

Therefore family members must continue phoning, texting, emailing, and sending “snail mail.” Caregivers are often more attentive when they are aware that family is checking in on their loved ones, not to mention that patients who are isolated need to know that they still count.

Ways to Mitigate the Impact of Quarantine

 

Public Officials

1. Every attempt must be made to keep the quarantine as brief as possible, within the bounds of what is medically prudent. Studies have shown that psychological impact becomes increasingly negative as the duration of the quarantine is extended.

2. Research shows that people are better able to tolerate and comply with the quarantine when information about the nature of the epidemic is updated regularly and they are reminded regularly about the quarantine’s benefits.

3. Gaining consent as opposed to forcing the quarantine makes people feel that they are participants in the process and diminishes their sense of helplessness. When a person is faced with external pressures, giving the person control by allowing him to choose transforms the feeling of being a victim into that of being a survivor.

4. Education is critical. Providing people as much information as possible, even when it is negative, builds trust, and can reduce anxiety as the unknown is minimized as much as possible. Those in quarantine from COVID-19 have a dual fear. They are afraid of becoming infected or infecting others. Accurate information can alleviate some of that fear.

5. Quickly create whatever systems are necessary to keep the flow of adequate food, medicine, and other essential supplies. Craft backup plans to keep essentials coming to those in quarantine if the amount becomes too low.

Individuals

1. Decrease boredom by finding activities of interest, new things to learn about, or skills that you have always wanted to learn or master. Being in quarantine doesn’t mean that life needs to be on hold. But it does mean that life may need to be defined differently for the duration of the quarantine.

2. Remain connected to your social network, even remotely. Social distancing is only physical distancing. It is imperative to maintain and perhaps also grow your social connections. Maintaining social connectivity is key to protecting yourself from immediate anxiety and long-lasting distress.

3. Do your best to limit your checking on the news. Constant contact with what is going on may seem like you have more control but, in reality, is a recipe for anxiety.

4. Spend time creating something. Whether it is gardening, baking, sewing, or building, it doesn’t matter. Any of these and other similar activities give you a sense of control in light of experiencing so little control over the pandemic.

5. Maintaining structure in your life and schedule will help to relieve the sense of disorientation that most people feel when their lives are so heavily disrupted. Although your schedule may differ from before, it is crucial to establish a daily routine that allows for flexibility.

6. Get fresh air daily. Whether it is a walk alone or together with someone in your family, or even a virtual walking “date” with a friend, chatting on the phone as you walk, it doesn’t matter. Quarantine doesn’t mean that you need to be locked inside your house 24/7. It does mean that you need to exercise care per the recommendations of the government and health officials.