Within the next few days, every Briton in an at-risk group will be told to stay at home for 12 weeks to protect themselves from coronavirus. Prime Minister Boris Johnson said yesterday that pregnant women, people over the age of 70 and those with certain health conditions should consider the advice “particularly important”.
According to ONS data from 2017, there are nearly 12 million people aged 65 and above in the UK, of which 5.4 million people are aged 75 and above. Of those 12 million, 3.8 million live alone – 58% of whom are over 75.
The isolation measures are designed to protect the most vulnerable groups in society from the spread of the virus. But what about the mental health impact of being in quarantine for potentially months, particularly for those who already live alone?
Research suggests that quarantine is often associated with a negative psychological effect. A study of people in quarantine during the SARS outbreak of 2012 showed that confinement, loss of usual routine, and reduced social and physical contact with others were frequently shown to cause boredom, frustration, and a sense of isolation from the rest of the world.
Steps that health officials should be taking to manage quarantine stress include telling people what is happening and why, explaining how long it will continue, providing meaningful activities for them to do while in quarantine, providing clear communication, ensuring basic supplies of food, water and medicine are available.
But what can we as individuals and communities be doing to help ourselves?
Basic supplies – have a plan to reduce anxiety
Having a strategy in place for receiving food and medical supplies over the isolation period will help to alleviate the anxiety of being stranded without means – this may involve booking slots for online food deliveries, having family or friends deliver food to your doorstep, or having medication delivered. Community Aid groups began appearing on Facebook over the weekend for many parts of the UK, aimed at providing support for people who are self-isolating, connecting them to people who can deliver necessities. Know your options, make a plan, and have back-ups.
Manage your news consumption – stay informed, but not misinformed, and don’t overload
Having access to good quality information about the virus can help you feel more in control. However, checking the news compulsively should be avoided, as this keeps your mind in a state of alertness and anxiety, and rumour and speculation can fuel this anxiety. WHO are urging people to only use trusted sources of information when needed and to “minimise watching, reading or listening to news that causes you to feel anxious or distressed”. Reliable, up-to-date information on the virus is available from www.nhs.uk, www.nhsinform.scot, www.publichealth.hscni.net, https://gov.wales/coronavirus-covid-19 and www.gov.uk.
Self-care – address your basic physiological needs as a priority
Eat well – regular meals incorporating a variety of fruit and vegetables can keep your blood sugar stable and make a big difference to your mood and energy levels.
Exercise – regular exercise helps to improve mood, reduce stress, and increase self esteem. The latest advice suggests that those in isolation will be able to get out for walks and exercise provided they avoid crowds. The World Health Organisation (WHO) also recommends learning simple daily physical exercises to perform in isolation to maintain mobility and reduce boredom – options for this could include exercise apps or videos on youtube, dancing, floor exercises, yoga, or using home exercise equipment, if you have it.
Sleep – getting the right amount of sleep, and having a regular sleeping pattern, is important for mood regulation.
Spend time outside – use your garden or balcony if you have one, or if you are able to, go for walks in nature away from crowds.
Routine – incorporate these basic things into a routine with other stimulating activities – WHO advise keeping your schedule as regular as possible, and including regular exercise, cleaning, daily chores, singing, painting or other activities. Writing out a plan for each week, including daily and weekly goals and a variety of stimulating activities, will help prevent boredom and restlessness.
Avoid using unhelpful coping strategies such as tobacco, alcohol or other drugs, which can worsen your mental and physical wellbeing in the long-term.
Stay connected – maintain your relationships using technology, and engage with online communities
Activating your online social network should be a key priority if you have to self-isolate – humans are social creatures and interacting with other people is fundamental to our wellbeing.
If you can, have friends or family over for visits – but take hefty precautions with distancing and hygiene. Matt Hancock told the BBC’s Andrew Marr Show on Sunday that people without symptoms would still be able to visit older relatives and friends as long as they stayed 2m (6ft) away from them.
Social networks such as Facebook, texting and video-chat services like Skype will be a valuable lifeline to the world if you’re in quarantine. Sharing hopeful images and positive stories about how communities are dealing with COVID-19 and control measures such as isolation is a positive and empowering way to use social media. Get creative with how you use different platforms – a social media-based book club could be a good way to be sharing common ground with friends and family members during isolation.
A number of charities are also setting up online platforms to help people feel connected over the coming months, as there is evidence to suggest that online support groups specifically for people who were quarantined at home during disease outbreaks can be helpful.
Creating meaning – plan your time to make it count
Actively plan your entertainment – although TV is a distraction, it is relatively mindless – instead, make a list of films, series and documentaries to watch, podcasts to listen to and books to read. Puzzles and games, or creative hobbies such as writing and crafts can help stimulate your mind and help keep you moving forward, reducing feelings of isolation and helplessness.
Feeling as though something has been accomplished during an isolation period is likely to be good for your mental health. The Guardian recommends setting daily and weekly goals and tracking your progress towards completion, with rewards for hitting each milestone.
The NHS guidance on mindfulness describes how anyone can take simple steps to be conscious of your thought patterns in order to avoid becoming entangled in streams of thoughts and feelings that you experience – this becomes particularly useful practice when we have to spend long periods of time alone with only our own thoughts for company, which by nature often tend towards the negative.
Developing this awareness of your thoughts will also help to identify signs of stress or anxiety earlier and deal with them better.
This article is designed as a general self-help guide for people who are self-isolating, or supporting others who are self-isolating. If you begin to see the warning signs of a decline in yours or others’ mental health, including a loss of interest in things you once enjoyed, feeling helpless or hopeless, having trouble getting out of bed, sleeping too much or too little, overeating or losing your appetite, or having trouble paying attention or making decisions, it is important that you seek professional help.