No less than one third of the world's people are currently in lockdown and quarantine. In South Africa lockdown affects 59 million people. In India the figure is a staggering 1,380 million, and in the United States 297 million. Whilst isolation obviously helps to protect us from COVID-19, it does also take a (sometimes high) toll on our psychological health. Quarantine researchers tell us that many are likely to feel the fallout during and / or after lockdown. Their findings from other lockdowns 'normalise' what so many people are now experiencing in this lockdown and during this far-from-normal time: stress, low mood, insomnia, anger, fear, sadness, frustration and emotional exhaustion. Whether alone or locked down with a partner or family, we are all potentially susceptible to lockdown-induced distress. On 26 February 2020 The Lancet published a 'rapid review' of 24 previous studies done on the psychological impact of quarantine scenarios in the world. These studies were done across ten countries in which people were quarantined for SARS, Ebola, H1N1 influenza, Middle East Respiratory Syndrome and Equine flu. All of these studies point to the wide-ranging psychological impact of quarantine and lockdown situations.
Of all the kinds of distress reported, low mood and irritability had the highest prevalence. The studies also suggest that people with pre-existing mood and anxiety difficulties are more likely to need support during times of lockdown. (Lancet: 2020:913-919) Some of the health disaster quarantine studies point to trauma-related symptoms. In one study, close to one third of parents quarantined with children (28%) qualified for a diagnosis of a trauma-related disorder, as compared with only 6% of parents who were not quarantined. (Lancet: 2020:913) It is sometimes only in the aftermath of lockdown that the adverse impact emerges. Avoidance behaviours, for example, have been reported in post-quarantine worlds following SARS, especially among health workers. Sometimes these behaviours were seen to persist in the work environment well after the lifting of quarantine restrictions. (Lancet: 2020: 914)
Dr Elke Van Hoof of the Vrje Universiteit in Brussel (2020) foresees that post-COVID-19 quarantine difficulties will be a "secondary epidemic of burnouts and stress-related absenteeism" that is likely to show itself later in 2020, some 3 - 6 months after lockdown. With advance warning of this possibility we can start to make room for it, rather than get sideswiped by an unanticipated showstopper. For Van Hoof, it would make sense to offer psychological help at an early stage. This approach has already been modelled in France more than 20 years ago. "International playbooks for disaster response", she says, "increasingly call for this two-tent approach: one for the wounded and one to treat the invisible, psychological wounds of trauma." (2020: 02) Researchers of quarantine experiences have found that some of the fallout for mental health can be mitigated by governments. They improve the prospects for our wellbeing when they communicate clearly; provide clear rationales for what is happening; explain duration, and preferably adhere to timeframes since extensions have been seen to have adverse outcomes for mental health; make it possible for people in lockdown to engage in meaningful activities; ensure basic supplies, and reinforce a sense of altruism in the population. (Lancet: 2020:919) Isolation is a very unnatural state of being for us because we rely on our inbuilt social engagement system to feel safe and calm. Concurrently with isolation and distancing we face hefty stressors relating to illness and suffering; death; loss and loneliness; adjusted working arrangements; shrivelled income; concern for our children and pets in restricted environments; fears for the safety of older relatives; the terribly fragile state of our planet; the dreadful plight of the under-resourced people in our country; the scope of our own resilience in relation to the present challenge. In the video below, Dr Stephen Porges explains why social distancing is hard for us, in terms of the workings of our nervous system. He tells us why we need to take actions that mitigate the effects of social distancing for the sake of our neural circuitry : https://www.youtube.com/watch?v=6FGTHm6R4pc
In the video that follows, Dr Bessel Van Der Kolk illuminates the traumatic potential of this COVID-19 era, in which we live under what he calls "a pre-traumatic cloud" of uncertainty and relative helplessness. He has some ideas for us about how best to navigate these precarious and challenging times:
References
Lancet 2020; 395: 912-20 The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Retrieved April 16, 2020, from
Van Hoof, E. Lockdown is the world's biggest psychological experiment - and we will pay the price. Retrieved April 16, 2020, from