What are the effects of social isolation and quarantine on people?

The COVID-19 outbreak, and its development as a pandemic throughout the last few months, has forced governments around the world to advice or enforce measures of social distancing and isolation on their citizens, including quarantining infected people, connections of infected patients or suspected cases of infection, and even whole populations. All this on a scale that the world has never seen before; it is assumed that the psychological effects of such measures can have an important impact on the mental health of the isolated people.

A review of academic papers on the psychological impacts of quarantine, published in March in The Lancet, highlighted the negative effects of confusion, frustration and anger on the mental health of quarantined people, which may even lead to post-traumatic stress. These emotions are triggered by a wide range of stressors, including loneliness, fear of infection, anxiety over the future, boredom, financial loss and inadequate supply of information.

Isolation and quarantine are indeed a drastic change of lifestyle for everyone affected, but what may seem as one general isolation measure is in fact many isolations, depending on the specific conditions of the people being affected. Is it a young person living alone? A couple? A family? Children? Elderly? People with special needs? There are certain populations for which these measures can have greater effects. Elderly people, for example, may suffer more chronic types of loneliness in isolation. Anja Machielse, professor of Humanism and Social Resilience at the University for Humanistic Studies in Utrecht, states in AD newspaper that chronic loneliness has a big impact on emotional and ultimately physical health. It is closely connected with depression and can lead to physical consequences like insomnia, restlessness and heart palpitations, which are more dangerous in older populations. Elderly people may additionally not have the social networks or the technological possibilities or knowledge to maintain close connections through the internet and social media like younger people would.

But the psychological effects of long-term isolation are not limited to loneliness. Anxiety can arise as well from having to coexist with a romantic partner, children and other family members in a confined space. Then, the problem becomes the opposite of isolation: the lack of personal time and space may result in conflict. In addition to this, external factors like fear of infection for the person or their loved ones, insecurity of economic stability, uncertainty about the future and an overflow of information (and misinformation) can vastly affect and magnify psychological distress in quarantine environments.

Although not everyone becomes depressed or is as strongly affected by isolation, the general impact on the population cannot be underestimated. Psychologist Gijs Coppens from Amsterdam conducted a survey among 365 Dutch people through his firm iPractice, and found that in the current COVID-19 social distancing situation in the Netherlands, 65% of the surveyed people reported a form of anxiety or stress, and 50% suffered feelings of gloom and despair since the Corona crisis began. Like in many other countries in times of isolation, people in the Netherlands are now feeling unusually anxious, and this is being represented in the increased numbers of people seeking psychological guidance in health institutions, which have implemented or expanded their online services. For example, Parnassia Groep, the largest mental health institution in the country, has seen a big increase of calls and consultations because of COVID-19, Trouw reported in March.

Advice by experts to deal with isolation anxiety includes taking breaks from distressing news (and avoiding information flows from unreliable sources), strengthening social networks and developing routines. These are included in a report released in late March by the World Health Organization, providing mental health guidelines with regard to COVID-19. Jaap van der Stel, professor of mental health at the Hogeschool Leiden, advices trying to create structure in order to remain mentally resilient in this crisis. It is through the development of routines that such a structure can be created. Rhythm provides guidance, and people need this in times of crisis, Van der Stel stated in Trouw. Additionally, the review paper published in The Lancet warns that the inability to activate a social network in isolation conditions is associated with immediate anxiety and long-term distress. The paper concludes that “the ability to communicate with one’s family and friends is essential. Particularly, social media could play an important part in communication with those far away, allowing people who are quarantined to update their loved ones about their situation and reassure them that they are well.”

Although isolation is always particular to each person experiencing it, in the end we are all connected by a collective experience that can be overcome by an equally collective feeling of recognition and resilience. In this way, we are all in the same boat together. Helping others whenever possible is another important guideline, according to the WHO report, to succesfully deal with isolation anxiety: “Assisting others in their time of need can benefit both the person receiving support and the helper. For example, check by telephone on neighbours or people in your community who may need some extra assistance. Working together as one community can help to create solidarity in addressing COVID-19 together.”

 Edition 10 April, by Juan Alvarez Umbarila