This week, the number of people infected with COVID-19 exceeded two million – this figure back in February was impossible to imagine. More than a third of the world’s population today is under the influence of quarantine measures or in self-isolation.
Of course, an event of this magnitude cannot but affect our psychological state: forced isolation, the inability to do many familiar things and see each other live with friends and family, news about the increase in the number of infected and dead, fear for oneself and loved ones cause alarm and stress even those who do not experience them the rest of the time.
Already today it is clear that COVID-19 will greatly change the world and our future: we are waiting for a large-scale economic crisis and changes in the labor market, perhaps we will reconsider how our relations are built (many of them switched to a distance format, even if the partners live in one city) and with new respect we will look at the work of doctors.
There is no doubt that the pandemic will also change ourselves: we will leave out of self-isolation like other people.
“Now quarantine will show who the real introvert is and who just show off”, “When it turns out that your usual way of life is called quarantine” – jokes that many people are comfortable without regular communication with other people go on the Internet from the very beginning of the self-isolation mode.
But the fact that a person communicates with a small number of people does not mean that he does not need communication in principle. In addition, coercive restrictive measures are not at all like a voluntary desire to sit alone at home.
The second is easy to interrupt at any time, and the lack of impressions – to compensate for a walk or a trip to your favorite place – and the very possibility to do so greatly changes the feeling of the situation.
Regardless of whether a person lives alone, with his family, partner or young children, most likely he or she already experiences the consequences of restrictions.
The situation when a huge number of people all over the world find themselves locked up in their homes is not very similar to other forms of isolation that are more familiar to “peace” times.
But here it’s hard not to draw parallels – with astronauts, employees of polar stations, former prisoners and other people who for a long time have been forced to limit movements and contacts.
For example, some former prisoners admit that once they are released they find it difficult to go outside – they may need the help of other people.
A former prisoner, Frank de Palma, who spent twenty-two years in solitary confinement (his total term is almost two times longer), says that in prison he developed agoraphobia – a fear of open spaces.
The last five years of his sentence, he did not leave the cell at all, although earlier, for example, he went in for sports in the prison yard alone.
“But once, when I was standing there, I felt as if the air around me were pressing,” he says. – I could not breathe. I started pounding on the door to let me in. I knew that I needed to get out of this open space. I ran back to the cell and after a few minutes I felt calm again.”
De Palma says that gradually his psychological state worsened – he began to have problems with his teeth, but he did not go to the doctor. He began to think less about loved ones and instead fantasize that he communicates with imaginary people.
Shortly before his release, specialists began to deal with him, who were supposed to prepare him for returning to society, – by this moment he almost did not speak. He had to gradually accustom himself to leave the cell and get used to other people in custody.
The case of de Palma is not the only one.
Studies show that prisoners who have been in solitary confinement for a long time (not as punishment in a punishment cell, but for a long time when a person is considered a threat to other prisoners or prison staff) have psychological consequences associated with this.
According to the social psychologist Craig Haney, in the long term, those who are deprived of communication with other people in prison experience anxiety, panic, paranoia, depression, aggression and insomnia.
Joel Dvoskin, Ph.D., a clinical psychologist and forensic psychologist, says some prisoners told him they were afraid they would behave with other people when they went free.
Another well-known example of isolation is workers at polar stations. Researchers have found that many of them have insomnia, depression, irritability, decreased cognitive abilities, and people become more withdrawn.
Professional assistance in such cases is rarely required, but researchers emphasize that we are talking about a group of people whose condition is often checked.
True, the psychological state of polar explorers should not be associated only with isolation: experts also associate it with seasonal affective disorder – polar explorers have been in harsh conditions for a long time and are faced with a lack of light.
Another well-known example of self-isolation, which led to difficult consequences, is the story of poker player Rich Alati, who arguably tried to spend thirty days in a bathroom in complete isolation and darkness for the sake of 100 thousand dollars.
In some ways, his conditions were even harsher – complete darkness, nothing but his own thoughts. On the other hand, he had a strong motivation – dispute and monetary reward. Moreover, his isolation was voluntary.
Alati delivered food, but at different times, so that he did not have the opportunity to count the time. Of the classes at his disposal were only a yoga mat, rubber bands for fitness, a massage ball and bath salts.
The test turned out to be severe psychologically for Rich: he began to hallucinate, his thoughts quickly became painful and gloomy – there was nothing to distract.
As a result, Alati interrupted the experiment after twenty days – they agreed to reduce the amount of the dispute from one hundred thousand to $62,400.
After the release, the poker player admitted that communicating with other people and how many actions are now open for him was a “cultural shock” for him – he knew how to act, but he seemed to forget.
Of course, both solitary confinement and the polar station are more extreme conditions than those through which most people go through self-isolation.
Nevertheless, studies of the psychological effect that the epidemic and quarantine measures have on people show that this experience can indeed be traumatic.
In March, the scientific journal The Lancet published a review of studies on the psychological effect of quarantine measures.
It is difficult to call the information in it exhaustive: the studies considered by the authors most often were small, far from all of them can be distributed to all people without exception (for example, if the studies were conducted on a group of young students).
Nevertheless, the authors come to certain conclusions: the psychological effect of isolation measures in an epidemic situation can be significant, it can be different and last a long time.
Most of the studies studied by the authors of the review note that quarantine negatively affects the psyche – they saw the participants of the research symptoms of post-traumatic stress disorder (PTSD), anger and confusion about what is happening.
Among the factors that make the situation more difficult for the psyche: the fact that quarantine is prolonged, fear of infection, a feeling of frustration or boredom, lack of supplies, lack of reliable information, financial losses and stigma – many of this is already well understood by those who are in isolation from for COVID-19.
Researchers advise the authorities not to prolong quarantine, give people clear explanations and justifications for the measures introduced, take care that people have enough supplies and also remind people of altruism and the common good.
The authors of the review emphasize that we are by no means talking about lifting quarantine measures: the consequences of the epidemic can be much more disastrous. It is only about making the situation psychologically more comfortable.
The authors of a small study on quarantine measures introduced in Canada due to an outbreak of SARS in 2003 suggested filling out an online questionnaire for those who were locked at home. 129 people took part in it. About a third of those surveyed had symptoms of post-traumatic stress disorder and depression.
These conditions were also associated with a situation where a person personally knew someone who had pneumonia, or met with such a person, risking infection.
Similar processes are noted by researchers and on the basis of the Ebola epidemic in Sierra Leone in 2014-2016. They concluded that a year after the outbreak, the population observed symptoms of PTSD and depression.
Post-traumatic disorder, or PTSD, is an anxiety disorder caused by a person experiencing a difficult, stressful, and terrible event. Events can be very different – for example, an attack, accident, illness or difficult childbirth.
With PTSD, a person again and again returns to a painful event through flashbacks or nightmares.
Of course, not everyone faced with quarantine measures will have PTSD – moreover, a pandemic, unlike, for example, a large-scale fire or catastrophe, does not fall under the formal criteria of this diagnosis.
Symptoms or signs of a specific disorder or depression do not mean that a person can be diagnosed.
Nevertheless, to deny that what is happening is a traumatic event both for individuals and for society as a whole, is becoming more and more difficult every day.
Already today, many of those affected by quarantine measures feel how this process affects the psyche.
Anna, who lives in France, says that she stopped reading the news about COVID-19, because they drive her into a state of anxiety.
“I try to go out as rarely as possible. The first month I did not go out at all, but now I realized that in order to maintain mental health I need at least some air, so sometimes I go out for groceries or to the pharmacy,” – she says.
Anna adds that each exit is not easy for her: it seems that life continues to go on its own, but it is worth looking up and see signs on the windows with the words “Sew for health workers, bring fabric” or a passer-by in a mask, the feeling of anxiety returns.
Anna does not yet imagine what will be the return to ordinary life and how soon this will in principle be possible.
“So far I can’t even imagine how I will again ride the subway or walk in crowded parks – and summer is coming soon. Of course, I understand that you can’t live in fear, but psychologically it’s very hard for me so far. I hope this feeling goes away,” – she says.
The question is also whether the psychological consequences of quarantine will be permanent or at least long.
The authors of a recent report on the psychological state of people during the COVID-19 pandemic, for example, note that after disasters, most people still recover from their experiences, and the consequences of the trauma are short-term and do not lead to a psychiatric diagnosis.
True, to say that after a pandemic everyone will be able to recover equally quickly also seems inappropriate.
Probably, the psychological consequences of COVID-19 will be stronger for those who directly faced the disease: patients, especially those who were in serious condition, as well as doctors and other medical personnel who were at the forefront.
Experts note that the situation when a person ends up in intensive care and faces the need for artificial ventilation of the lungs is very difficult psychologically – and many patients who have ended up in intensive care in the past exhibit symptoms similar to depression and PTSD.
Historically, PTSD has been associated with military action: it was diagnosed in former military personnel who were confronted with the consequences of psychological trauma in peacetime. Later, the disorder began to be detected in different people, including those whose injury occurred in peacetime.
Nevertheless, in a pandemic situation, it is difficult to avoid thoughts of hostilities – this is one of the frequent associations that arise in a conversation about the work of doctors and nurses.
Doctors and other medical staff are experiencing very serious overloads. They often face the death of patients, are forced to inform the relatives of the victims not only the tragic news, but also that they may not be able to say goodbye to their loved ones because of the risk of infection, they see how their colleagues get sick.
Many of them also face additional isolation – for example, they decide to live separately from their relatives, so as not to infect them.
Already known cases of suicides of nurses and doctors in different countries.
Dr. Michael Duffy, a psychotherapist specializing in work with trauma, believes that the psychological consequences of a pandemic for doctors can resemble the consequences of a large-scale tragic event like a terrorist act – in addition, they may not appear immediately, but after years.
Finally, people with mental and psychiatric disorders may be faced with the fact that the current stressful situation will seriously worsen their condition: anxiety and depression may intensify due to stress.
Eve has been living with anxiety disorder for many years and says that there were times in her life when she could not catch the train on the subway or spent days at home, avoiding contact with people.
Over the years, everything worked out, although sometimes she has panic attacks when she is faced with limited space or a large crowd of people.
“At the root of this panic is the lack of a sense of security – a siren suddenly starts yelling in my head, although there is no reason for it. It is very interesting that in the new reality of a pandemic this feeling of danger is now for everyone. The world has ceased to be a priori “good”, now it seems that a deadly virus lurks everywhere,” – she said. – This is a new global concept of thinking, and not a single living generation (except, probably, a few veterans of the Second World War) had to consider the world around it like that. It is very sad and scary. “
Quarantine Eve spends alone in a house in London – her neighbor urgently left home in the United States.
“I try to leave the house at least once every couple of days so that the hermit’s syndrome does not develop, because the further you sit at home alone, the more difficult it is to leave,” she says. – There was already a negative experience: in my local grocery, a guy was brandishing a knife, trying to steal something, and at that moment I went inside. I ran out and did not leave home, probably for a week.”
It is important to understand that today it is impossible to unequivocally predict which particular aspects of a pandemic will affect people more.
People’s fears are associated not only with the threat of infection, but also with financial losses. In addition, a reaction to stress can occur not directly during the event, but after a while, if the person has not received proper help.
For example, victims of Hurricane Katrina in New Orleans note that it is difficult for them to leave their homes to work during the hurricane season — it’s reminder of the past.