2021 MENTAL HEALTH TOOLKIT: The Effects of Isolation & Uncertainty

There’s no doubt that COVID has highlighted the effects of isolation and uncertainty on mental health, driving many people’s mental states towards depression, anxiety, and other mental health challenges. The range of its effects vary from one population to the next and showcases the spectrum of needs and issues being faced in society.

Depression & Anxiety

It’s clear that the main negative effects of isolation and uncertainty on mental health are depression and anxiety, which was previously evident in cases such as animals in captivity, prisoners in solitary confinement or the plight of refugees, immigrants, and asylum seekers.

At the hands of the pandemic, the effects can now be looked at in terms of what society is experiencing as a whole, with certain populations being predisposed to depression or anxiety.

Children

Children are at an important period of growth and social development and whether engaging in virtual learning from home, or attending school while following social distancing guidelines, they have swiftly experienced a shift in their socialization during the pandemic.

In addition to being reliant on schools and parents for socialization, they have far less agency to tend to their mental health needs and often a more difficult time expressing their anxiety. In small children, anxiety presents as rage, anger, and/or behavioral issues such as physical aggression, which all compound family stress being experienced due to the pandemic.

Additionally, the absence of extra reassurance at home during the pandemic often leads to depression and increased loneliness, which can have long-lasting effects in children (Mayo Clinic).

Depression and anxiety can also result in suicide, which has seen a dramatic increase among youth since the onset of the pandemic (CHOC).

On top of coping with their own experience of isolation, routine change, or heightened stress, children & adolescents are in a helpless position to absorb their parents’ or caretakers’ stresses, such as financial burdens, economic hardships, and constant news updates.

Elderly

The elderly population has largely been affected by COVID in regards to their susceptibility to sickness, but also their limited social interactions. Whether in a nursing home or distancing from an independent living situation, prolonged isolation has resulted in loneliness, poor sleep quality, and physical inactivity (Nature Public Health Emergency Collection). It’s important to note that limited ability to use modern technology has left many without an avenue for virtual socializing, which has been a lifeline for younger generations during these times.

Adults

Adults have certainly not been spared from the anxiety or depression resulting from isolation and uncertainty, with an unprecedented amount of people suffering from economic hardship and poverty. To compound the difficulties of meeting basic needs, unemployment and diminished social interactions, adults are often sandwiched between elderly and the youth as the main caregivers – a demanding task indeed.

According to the CDC, “Two out of every three caregivers in the United States are women, meaning they provide daily or regular support to children, adults, or people with chronic illnesses or disabilities. Women who are caregivers have a greater risk for poor physical and mental health, including depression and anxiety.”

As informal – yet primary – caretakers during these times, adults are under greatly increased pressure to mentally support the elderly and children through their unique circumstances, as well as tend to their own mental health.

Substance Use & Addiction

Since the onset of the pandemic, isolation, increased or compounded stress, uncertainties, changes in routine, and limited social interactions have led to an increase in alcohol & substance use, as well as an increase in addiction and overdose.

Alcohol Use

Over the course of the pandemic, states have enacted various laws regarding the sale of alcohol, closing bars and restricting sale hours in order to slow the spread of COVID and keep alcohol out of the equation when maintaining social distance. Alternatively, there has also been an increase in alcohol sales and excessive consumption privately in homes.

The National Institute on Alcohol and Alcohol Abuse states, “We know from previous disasters, such as 9/11 and Hurricane Katrina, that the stress of the events and anxiety about the future can increase drinking and exacerbate symptoms of alcohol use disorder. We also know that feeling socially isolated, a possible effect of physical distancing, can worsen symptoms of anxiety or depression, which may encourage more alcohol intake.”

Substance Use & Overdose

While social distance, isolation and quarantine have been essential measures to help stop the spread of COVID, these strategies are associated with negative emotions, such as irritability, anxiety, fear, sadness, anger, or boredom, which are known to trigger relapse or intensify drug consumption (Psychiatry Resource).

While overdose-related deaths were on the rise prior to the pandemic, the Center for Disease Control reports that there have been an acceleration of deaths since its onset. Some facts:

• Overdose deaths involving cocaine increased by 26.5 percent
• Overdose deaths involving psychostimulants, such as methamphetamine, increased by 34.8 percent
• Synthetic opioid related overdose deaths increased by 38.4 percent from the 12-month period leading up to June 2019 compared with the 12-month period leading up to May 2020. During that period:
  • 37 of the 38 U.S. jurisdictions with available synthetic opioid data reported increases in synthetic opioid-involved overdose deaths.
  • 18 of these jurisdictions reported increases greater than 50 percent.
  • 10 western states reported over a 98 percent increase in synthetic opioid-involved deaths.

Inaccessibility to Addiction Support

With the closure of public spaces and limitations on in-person meetings, those suffering from addiction or substance use disorder during COVID have lost crucial lifelines such as group meetings, in-person treatment, and syringe service programs, which offer clean syringes, disposal, and testing / treatment for infectious disease (CDC).

The pandemic put a halt to meetings and group settings, which can give members substantial support that is necessary to cope with impulsivity and negative emotions associated with addiction, which may be heightened due to isolation. The absence of these support groups makes it difficult for those suffering from substance use disorders to seek help or keep up with a treatment regimen.

Personal Development and Increased Mental Health Awareness

On the positive side of isolation and uncertainty, there are also those who are embracing introspection and personal growth, perhaps experiencing a clarity of purpose or a renewal of hobbies. Some have been able to fit more meditation or exercise into their routine or been more proactive about their diet. Additionally, with the marker of ‘essential’ and ‘nonessential’ workers, it’s clear how one might have an existential questioning of the value of their work within a given context and awaken to new ideas through this forced shift.

Technology & Flexibility

People who were able to work virtually during this time of uncertainty may have been afforded the opportunity to reimagine where they’d like to live, and tap into a new vision of homeostasis. Early on in the pandemic, it became clear that many wanted to transition away from city life, with an increased demand for suburban & rural housing, and migrations out of the cities.

This new flexibility may change the workplace forever, opening alternatives for people when it comes to living situations, commuting, caretaking, etc., easing stresses that may have been burdensome prior to the pandemic. It’s also possible that this new flexibility may also unlock new outcomes for engagement and productivity for individuals (Human Resource Executive).

Nature & Healing

It could be called the COVID-19 Gardening Boom, with the spring of 2020 seeing a rise in retail and building material sales. With more time to spare in insolation, more people were busy getting their hands in the dirt, starting gardens and giving their attention to something within controllable means.

Spending time in nature and growing your own food has long been linked to increased life satisfaction, mindful living, and offered therapeutic benefits. Click here to read more about how nature therapy is increasingly being prescribed as treatment for covid-related stresses, anxiety, depression, mental illness, and addiction.

What You Can Do to Care for Your Mental Health During Isolation

• Consider meditation or exercise
• Reach out to friends or family by telephone, email, or video chat
• Keep a gratitude journal
• Spend time in nature
• Practice moderation when consuming alcohol or other substances
• If you are struggling with substance use disorder, call SAMHSA’s National Helpline: 1-800-662-HELP (4357)
• If you are having suicidal thoughts, call National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

Sources Include

Center for Disease Control: Alcohol and Substance Use
Center for Disease Control: Overdose Deaths Accelerating During COVID-19
Center for Disease Control: Women, Caregiving, and COVID-19
CHOC: The Link Between COVID-19 and Suicide: What Parents Should Know
The National Institute on Alcohol and Alcohol Abuse: Alcohol poses different challenges during the COVID-19 pandemic
Human Resource Executives: How COVID-19 Will Redefine Workplace Flexibility Forever
Home Alone: The Mental Health Impact of COVID-19 Isolation on Infants, Children, and Adolescents
The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment
Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations