How to stay sane in a lockdown, quarantine
Dealing with lockdowns, quarantine and social isolation is a bit like being asked not to scratch your nose. It makes you want to scratch it all the more. Much like your suddenly itchy nose, sitting alone and uninterrupted in a room with a smartphone is sheer bliss until it is made non-negotiable. So when you’re told to stay quarantined, that is the one thing you will not want to do.
The real challenge, then, is to make people voluntarily accept being quarantined and isolated despite the inconvenience and anxiety associated with imposed restriction.
It needs to bit of convincing, but it can be done. “Explaining to people why it is needed, that it is for a short term, and the big difference their staying isolated will make to the community by ending a deadly new disease helps reinforce altruism and bring down anxiety. It is an opportunity to recognise how interconnected we are as a society, and how individualism will only bring collective disruption,” said Dr Samir Parikh, director, Mental Health and Behavioural Sciences, Fortis Healthcare.
No man is an island, said the poet John Donne, and if the infection persists in the community, no one is safe. “Every sanitiser or face mask you hoard is taking it away from someone else who needs it, and if that someone gets sick and infects others, you will not remain safe either. The focus should be on supporting government agencies and being socially responsible to end infection,” Dr Parikh said.
The uncertainty is exacerbated by not being able to follow your daily routine and fear about being infected or infecting others, especially children. “Fear, insecurity and anxiety is particularly high for those quarantined while waiting for test results. Isolation brings a feeling of being cut out from the living world, which may also be accompanied by fear for their own health or guilt of infecting others, including family and friends,” said Dr Rajesh Sagar, professor of psychiatry at the All India Institute of Medical Sciences (AIIMS). “We need concerted effort to cut down rumours and share factual information without getting emotional,” he said.
“Confinement, loss of routine, and reduced social and physical contact with others also leads to boredom, frustration, and a sense of isolation, but this can be offset with group activities in mass quarantine situations and rediscovering the things you enjoy, when you are home quarantined,” Dr Sagar said.
He gives the example of a retired person in his clinic who restarted playing a guitar after 50 years. “He had stopped because he didn’t have time, but never thought of going back to it when he retired and had the time. He is really happy he has gone back to it. Free time is a great opportunity to introspect and discover yourself,” he said.
Longer quarantine and lockdowns, like in parts of China and Italy, are associated with poorer mental health, with people showing post-traumatic stress symptoms, avoidance behaviours, and anger, according to a study in The Lancet.
But even in partial lockdown situations — like in Delhi, Kerala and Karnataka — there is growing anxiety because of uncertainty over where the epidemic is headed. Rumours and misinformation driven by ignorance or misunderstanding of health messages add to stress, as does financial loss during quarantine.
“Transparent and realtime sharing of information is critical in outbreak situations, and governments also must reinforce that there will be no shortage of basic supplies such as food, water and medicine during lockdown periods. Support groups on social media create a sense of collective effort, so individuals do not feel isolated and work with a group to reach the common goal,” Dr Parikh said.
Stigmatisation and rejection from neighbours and friends can be distressing for both people who are quarantined, health workers and other people in the frontline, who often find neighbours and friends avoiding them, withdrawing invitations or treating them with fear and suspicion. “It’s important for all of us to recognise that we need to be positive, aware and informed so people in the frontlines, like health workers and airport staff, feel empowered. Because if they get stressed stop caring, every one of us is in deep trouble ,” Dr Parikh said.