The psychological price in pandemics

As the COVID-19 pandemic spreads across the world, social distancing, lockdown, quarantine and isolation have become the norms of the day. The social animals that human beings are, this new lifestyle seems to be taking a toll on their mental health. In this article, Upasana discusses the importance of studying mental health during a pandemic, the psychological stressors involved, and the need for an appropriate support system.

With the COVID-19 pandemic, the latest word on our fingertips besides all the swear words is “quarantine”. A huge chunk of ongoing research is mainly focussed on the transmission and cure of the disease. But the disease currently being untreatable, people have been advised to practice social distancing. A tangential but costly effect of social distancing, either through quarantine or isolation, is seen on the mental well-being of people.

“Quarantine” was first used in Venice, Italy in 1127 in the leprosy outbreak followed by official implementation of the same in the UK in response to the plague. In the context of the recent outbreak of coronavirus, the nationwide lockdown has been implemented in many countries across the world due to its rapid transmission and fatal nature. While it is the most appropriate measure taken by any nation, we often forget to address its psychological impacts. There are very few reports discussing the repercussions of pandemics on mental health after quarantine and isolation were imposed in many countries during SARS, MERS and Ebola and H1N1 outbreaks.

Global evidence on mental health outcomes associated with such measures to prevent the spread of infection suggests that prolonged exposure to psychological stressors exerts disturbance in the mental health of not only common public but also in patients, healthcare workers and informal caregivers, the latter being the most affected. Psychological stressors are elements in our everyday life, physical or social, that challenge our mental balance – being separated from loved ones, financial loss, overthinking, etc. These could be as small as worrying about an exam, but we do have other options like being with a friend or family, taking a walk, etc. which help us in such instances.

Depending on the mental state of an individual and the length of quarantine or isolation, there are impacts during the quarantine: short-term impacts (a few months post-quarantine) and long-term impacts (2-3 years post-quarantine). Common stressors during quarantine are fear of infection, frustration and boredom, shortage of supplies and inadequate information. No matter how prepared an individual is, with each passing day these anxieties grow. In the longer run, studies have shown that these fears become so overpowering that they could still be evident years later particularly in the healthcare officials directly involved in treatment or care of the infected patients. The constant fear of contagious diseases and the associated risks have led people to avoid public places and transport and ignore other people as such. This does not fare them well and ultimately leads to loss of employment and finances.

It might seem that leading the life of an introvert would be a fair shot here, given the impression of lying alone in a room with coffee and books, but it is not true. A remarkable thing about psychological disturbance is that we fail to realise when it seeps in and gets rooted in us till we finally show any symptoms.

Social distancing is currently the most effective way, albeit a little harsh on mental well being, in controlling any pandemic. Nevertheless, there are ways to alleviate the psychological stressors like keeping the quarantine duration as less as possible, although under unavoidable circumstances it has to be extended. Keeping the public informed and providing necessary supplies are required to maintain peace. Special attention and encouragement have to be given to people working in healthcare for their current efforts and also further to reduce the long term impacts post-quarantine. Providing emotional support and compassion towards everyone would help in the struggles associated with the crisis. Digital intervention has paved a better way not only for patients with a history of psychiatric illness but also for the general public. It is currently the best method to reduce boredom and anxiety – thanks to meme-makers and YouTubers!

Overall, there is a compromise on the psychological aspect made by everyone up to some extent during the quarantine. For the best we can do now is to try to keep our minds happy despite the limitations.