Following social distancing protocol is critical to slowing the spread of coronavirus, but being isolated from colleagues, friends and family, especially over long periods of time, can profoundly affect emotional well-being and overall mental health.
Brian Droubay, assistant professor of social work at the University of Mississippi, is an experienced psychotherapist in a range of settings, including prison systems, employee assistance programs and private practice. He offered insights on clinical symptoms that can develop in isolation and evidenced-based practice that can provide relief to those in need.
Also, Amy Fisher and Susan Allen, fellow licensed clinical social workers and associate professors in the Department of Social Work, helped compile local, state and national resources for those feeling emotional distress in the midst of the COVID-19 health crisis.
When people are somewhat isolated, what are some of the clinical symptoms that might emerge?
Some of the most common symptoms people may experience are worry and anxiety. They may find themselves ruminating – or even overthinking – about the situation. Others may experience a down or depressed mood or irritability.
People may experience appetite and sleep changes, psychosomatic symptoms such headaches or stomachaches, fatigue, and difficulty concentrating. Some may increase use of alcohol or other substances. For children and teens, this may manifest itself behaviorally; for example, acting out more.
Are there any groups who are disproportionately affected by isolation?
People with less social support, who are at higher risk – including the elderly and persons who are immunocompromised – or who have previous mental health or substance abuse histories may be disproportionately affected by isolation and related stressors.
Also, social distancing and sheltering in place could potentially be a dangerous scenario for those at risk of domestic violence. There have been anecdotal reports of increased call volumes to domestic violence agencies since the COVID-19 outbreak began.
Finally, being asked to leave campus and return home may be difficult for some LGBTQ+ students who have faced rejection by family.
What can people do to minimize those symptoms?
The Centers for Disease Control and Prevention has issued a number of good recommendations, including taking breaks from news about the pandemic and limiting time on social media. Of course, it’s important to stay informed, but it’s helpful to do so in doses.
Self-care is obviously important. Things such as eating healthy, getting adequate sleep, exercising, journaling and meditating are all common sense, beneficial activities. It is important to carve out time for intentional self-care. Intentionality is key.
When I worked in the prison system, with inmates who often had to spend copious amounts of time in their cells or housing units, we would also focus on maintaining a routine to establish some semblance of normalcy.
When maintaining physical distance from others, it is easy to inadvertently become socially and emotionally isolated as well. Individuals will find benefit from being purposeful in communicating with important people in their lives. Communicate about concerns and seek to connect.
In this case, media technology can be a positive in allowing people to stay connected even though they are physically distant.
What are some of the best evidence-based techniques for maintaining mental health during a time like quarantine?
The main thing I’d add to the CDC’s recommendation relates to acknowledgement and self-compassion. It is important to acknowledge the anxiety this pandemic – and its fallout – produces. People’s propensity to relentlessly seek out information – and even ways to cope – may actually be a manifestation of trying to grasp for certainty and control.
There is nothing wrong with staying up-to-date on information and seeking out coping tools, of course. But I think it is important to recognize the anxiety that is at least partially fueling those actions.
There is this idea that I really like that comes from acceptance and commitment therapy, which is that the more you try to control/avoid a thought or emotion, the more you paradoxically have it. This is why it is important to acknowledge that anxiety and then act in ways that are beneficial regardless. None of us truly know exactly how this will play out, and that can feel scary.
Along with acknowledgement, I think it is important to touch on productivity, particularly for students, staff and faculty at UM. A natural byproduct of anxiety is difficulty concentrating, which can make it difficult, if not impossible, to be as productive.
From an evolutionary standpoint, human beings are wired to pay attention to fear for survival. Thus, trying to “will” your way through anxiety into expansive productivity during this time may prove counterproductive. People may just burn themselves out. This speaks to the importance of showing compassion for yourself and others, including students and colleagues.
The reality is that everyone will experience this differently, and some will be more profoundly affected than others.
What can we do as community members to help each other in our mental health during times of crisis?
The first thing is to recognize that not everyone will be similarly impacted. Vulnerable populations will be harder hit in terms of mental health. Communicating with and offering emotional support for community members who are vulnerable – such as the elderly or disabled – or who may otherwise be isolated – including students from out of state or individuals who aren’t connected with a church group – would be helpful.
It’s also important to keep in mind that some of the most vulnerable may not have access to the internet or be tech-savvy. Sometimes making a phone call or sending a letter/card may be a more appropriate form of communication.
It is also important to recognize that mental health is integrally linked with physical resources. The recent unemployment claims highlight how many people are living precariously in terms of employment, housing, etc. Checking in with individuals whose livelihoods are being affected or who were already living in precarious financial circumstances is important.
By doing things such as donating to food banks and supporting small businesses, people can indirectly help with mental health.
For example, information about donations to the Ole Miss Food Bank can be found at https://foodbank.olemiss.edu/donate/.
And here is an example of ways community members are working to help those whose livelihoods will be disproportionally impacted by the disruptions to daily life: https://hottytoddy.com/2020/03/26/local-pizzeria-owner-establishes-restaurant-workers-relief-center/.
What kinds of resources can you recommend that people use – virtual or phone – for mental health wellness or crisis during this pandemic?
Resources for regular mental health care:
Efforts in social distancing may impact individuals’ ability to seek in-person mental health treatment. However, many clinics/practitioners are offering tele-mental health services in lieu of traditional face-to-face sessions.
Communicare, the Oxford Wellness Center and the University Counseling Center are examples of this. The latter offers services to Ole Miss students, staff and faculty. Visit https://counseling.olemiss.edu for more information.
If visiting a private clinic, individuals should double-check their insurance coverage regarding tele-mental health services. Blue Cross Blue Shield of Mississippi recently expanded its coverage in response to COVID-19.
Resources for people in crisis:
Individuals who are in crisis and having suicidal thoughts can call the National Suicide Prevention Lifeline at 800-273-8255.
The Trevor Project is an invaluable resource for LGBTQ+ students who are in crisis or having suicidal thoughts. Call 866-488-7386.
Resources for those in domestic violence situations include the National Domestic Violence hotline, telephone 800-799-7233, and the Mississippi Coalition Against Domestic Violence, online at https://mcadv.org.
The National Grad Crisis-Line is also available for graduate students in crisis at 877-472-3457.
UMatter has compiled a list of pertinent resources, including for emotional wellness, which can be found at http://umatter.olemiss.edu/covid-19-resource-information/.
The United Way of Oxford-Lafayette County also has compiled a list of resources, including information for those affected by COVID-19. See https://www.unitedwayoxfordms.org/coronavirus and https://www.findhelplafayettecounty.org/.
For Ole Miss graduate students, the In This Together! website has a number of helpful suggestions/resources at https://gradschool.olemiss.edu/in-this-together/.
Other wellness resources:
Finally, mindfulness and other meditative exercises may be beneficial for both acknowledging and managing anxiety and related emotions.
The Greater Good Science Center at the University of California at Berkeley offers a number of free mindfulness exercises, available at https://ggia.berkeley.edu/#filters=mindfulness.
A number of apps, such as Stop, Breathe and Think and Calm, that include mindfulness exercises are available either free or for a nominal fee. Other options include virtual yoga classes. For example, Southern Star Yoga in Oxford is offering free online yoga classes via Zoom.
By Sarah Sapp