Anxious, bored, frustrated and lonely are some of the emotions people have described since the COVID-19 circuit breaker first began in Singapore. These emotions are not uncommon as many around the world have reported similar feelings since COVID-19 reached pandemic proportions this year. There is now a growing body of research that demonstrates the effects of imposed isolation on psychological and physical wellbeing, and more importantly, offers ways of managing and countering its effects on our human psyche.
Brooks and her colleagues (2020) at King’s College London recently conducted a review of studies investigating the psychological impacts of quarantine adopted during the periods of Ebola, SARS, MERS and H1Ni influenza. Their review revealed that some of the common effects of long-term quarantine and isolation comprised anxiety, low mood, depression, stress, irritability, insomnia, and acute (and post-) traumatic stress symptoms. Factors that were observed to heighten people’s psychological distress included longer periods of quarantine, fears of infecting self and/ or others, loss of physical and social contact, loss of usual routines, having inadequate supplies, and lack of clear and adequate information from health and other government agencies. These effects were observed even three years after the quarantine and were most pronounced among those who had direct exposure to the high-risk situations (i.e., healthcare workers) or a history of psychiatric illnesses.
What might the reasons for this extent of psychological distress? Firstly, Slovic and Peters (2006) reported that certain factors are more likely to increase (perceptions of) fear such as when the threat is novel or unfamiliar, there is a lack of control over the threat, and when the threat involves a sense of dread. Further, Holman and colleagues (2014) described that while communication of information is essential and useful, we need to be mindful the amount and type of exposure to information because stress and anxiety can be exacerbated by too much media. Management of stress is therefore crucial (Garfin, Thompson, & Holman, 2018) especially since imposed isolation can increase the likelihood of negative psychological outcomes for individuals, especially if the quarantine period is extended or indefinite with no clear time limit (Brooks et al., 2020). Imposed quarantine can be an oftentimes isolating and lonely experience, with those who have strong social relationships 50% more likely to survive compared with their peers who have poor or insufficient social relationships (Holt-Lunstad, Smith, & Layton, 2010).
Given these facts, what might we do during quarantine you may ask? You may wish to observe the 3Cs of Choice, Control and Certainty in making this period of imposed isolation a little more comfortable..
Choice: Imposed isolation and social distancing is not a pleasant experience for most, so let’s instead choose a more helpful mindset – perhaps this can be an opportunity for reflection and taking a step back from the hustle and bustle of our daily lives, or a time to practice gratitude for the little joys and pleasures that we do have. Keep in mind that this sacrifice that we’re taking is one that will keep ourselves, loved ones and others in our community safe.
Control: Continue to exercise control over aspects of our lives that we reasonably can, such as picking up a new skill or activity, setting goals you can work towards during this period of working from home. Intentionally make varied and intentional choices when it comes to meal times in what you may cook or choose to takeaway or Grabfood. Don’t forget to control your intake of COVID-related news and limit it to reputable reporting sources.. keep a rein on that wandering mind and don’t let it catastrophise!
Certainty: Create a routine for yourself and stick to it – remember to include both achievement-oriented and pleasurable activities including exercise and leisure. Make dates with your loved ones, friends and family to Zoom or Skype, or to play Animal Crossing together, and consciously maintain your social support and friendship networks. Rest a little easier in the certainty and security that you’ve got your act together, and that life still goes on in spite of all the uncertainty around you.
So make realistic and flexible choices that allow you to maintain control and achieve certainty. Remember, we are all in this together.
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., et al. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395, 912-920. https://doi.org/10.1016/s0140-6736(20)30460-8
Garfin, D. R., Thompson, R. R., & Holman, E. A. (2018). Acute stress and subsequent health outcomes: A systematic review. Journal of Psychosomatic Research, 112, 107-113. https://doi.org/10.1016/j.jpsychores.2018.05.017
Holman, E. A., Garfin, D. R., & Silver, R. C. (2014). Proceedings of the National Academy of Sciences of the United States of America, 111(1), 93-98. https://doi.org/10.1073/pnas.1316265110
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A metanalytic review. PLOS Medicine, 7(7): e1000316. https://doi.org/10.1371/journal.pmed.1000316.
Horesh, D., & Brown, A. D. (2020). Traumatic stress in the age of COVID-19: A call to close critical gaps and adapt to new realities. Psychological Trauma: Theory, research, practice and policy, 12(4), 331-335. http://dx.doi.org/10.1037/tra0000592.
Netburn, D. (2020, April 29). Feeling drained by coronavirus quarantine? Science can explain why. The Los Angeles Times. https://www.latimes.com/science/story/2020-04-29/what-science-tells-us-about-the-psychological-impacts-of-coronavirus-isolation
Slovic, P., & Peters, E. (2006). Risk perception and affect. Current Directions in Psychological Science, 15(6), 322-325. https://doi.org/10.1111/j.1467-8721.2006.00461.x
Weir, K. (2020, March 16). Seven crucial research findings that can help people deal with COVID-19. Retrieved from https://www.apa.org/news/apa/2020/03/covid-19-research-findings
Dr. Daphne Goh