How to Cope With Quarantine

Quarantining yourself at home can play an important role in preventing the spread of infectious diseases. But this doesn’t mean that coping with the disruption in your normal routine is easy. Taking care of your mental health is essential, even if your time in quarantine is relatively brief in the grand scheme of things.

The coronavirus (COVID-19) outbreak has led people to engage in social distancing as a critical way to help “flatten the curve,” or contain the spread of the illness to help keep infection rates as low as possible. Quarantine is recommended in cases where a person has been exposed or potentially exposed to others with coronavirus (COVID-19).

How Quarantine Affects Mental Health

The Centers for Disease Control and Prevention (CDC) defines quarantine as separating and restricting the movement of people who have been exposed to a contagious disease to see if they then become ill. Because COVID-19 can be contagious even if people do not yet have symptoms, this step minimizes the spread of the illness during the asymptomatic period.

In addition to the uncertainty and stress of the global outbreak, spending time in quarantine can take a serious mental toll. Part of the reason for this is the impact that quarantine has on three key elements of mental health:

• Autonomy
• Competency
• Connectedness

The isolation imposed by quarantine frequently leaves people feeling that they have no control over the situation. They also feel cut off from the rest of the world and unable to perform their usual duties.

As schools close, workers opt to telecommute, and other social events are canceled, the prospect of being confined to your home because of quarantine can be daunting. Time seems to creep by much more slowly after you've been at home for a long period of time. Even if you are home with other family members, the sense of isolation and cabin fever can be powerful.

The American Psychological Association reports that social isolation carries a number of health risks. Feeling isolated can lead to poor sleep, poor cardiovascular health, lower immunity, depressive symptoms, and impaired executive function. When executive function skills are impaired, you may find it more difficult to focus, manage your emotions, remember information, and follow directions.

Effects of Past Quarantine Measures

While each circumstance is unique, looking at past events can provide a look into the psychological impact that quarantines may have. 

Between 2002 and 2004, more than 15,000 people in Toronto voluntarily went into quarantine due to exposure to severe acute respiratory syndrome (SARS). SARS, like COVID-19, is a contagious respiratory illness caused by a coronavirus.

For a period of around 10 days, these individuals were asked not to leave their homes, not to have visitors, to wear face masks around other family members, to avoid sharing personal items, and to wash their hands frequently, among other measures. Later research indicated that quarantined individuals experienced a range of both immediate and short-term psychological consequences.

In addition to the feelings of social isolation during quarantine, participants reported longer-lasting psychological distress for around a month afterward. Almost 29% of participants displayed PTSD symptoms, while 31.2% had depressive symptoms.

Stigma can also create mental distress following a quarantine. One study found that 29% felt that other people avoided them after they had been in quarantine.

Possible Mental Health Effect of Coronavirus Quarantines

A 2019 review in The Lancet analyzed the results of past studies to get a better idea of how COVID-19 may impact those who are quarantined. The review found that psychological distress is common both during and after periods of quarantine. People commonly experienced:

• Fear
• Sadness
• Numbness
• Insomnia
• Confusion
• Anger
• Post-traumatic stress symptoms
• Depressive symptoms
• Low mood 
• Stress
• Emotional disturbance
• Irritability
• Emotional exhaustion 

There is some evidence that there may be longer-term consequences as well. Substance and alcohol dependency was more common up to three years after quarantine.

While individual reactions to self-imposed or mandated isolation will vary, you may be likely to have feelings of loneliness, sadness, fear, anxiety, and stress. Such feelings are normal given the circumstances. However, there are steps you can take to protect your mental health and well-being while coping with a quarantine.

Factors That Influence Coping

It is important to remember that everyone copes with stress differently. Some people may be better able to weather a quarantine for a wide variety of reasons including factors such as resilience and overall personality. Some factors that might play a role:

Your Current Mental Health

Previously existing mental health conditions, including depressive and anxiety disorders, can also impact an individual’s ability to cope.

How You Deal With Stress

If you tend to be fairly resilient in the face of stress, you may have coping skills that will allow you to manage being quarantined without many negative effects.

Your Personality

Personality differences might have an effect on how you cope. Extroverts, for example, may struggle more with the feelings of loneliness that isolation brings. Extroversion is characterized by a high need for social interaction. Extroverts may experience more loneliness or find staying home more difficult.

This doesn’t necessarily mean that extroverts need to be constantly immersed in social situations, and there are ways to fulfill the need for interaction among even the most outgoing personality types. Online communities can be a great way to maintain connections and talking on the phone can provide much-needed socialization.

People with more introverted personalities tend to enjoy solitude, so they may have an easier time coping with reduced or limited social interactions. Introverts tend to feel drained after socializing, so they may actually cope pretty well during quarantine—at least for a time. Even introverts need social contact, so finding ways to connect with others in some way is still essential. 

How Long You Are in Quarantine

The duration of quarantine is a key factor in determining how well people cope. Research suggests that minimizing the length of quarantine can help. The longer restrictions last, the more pronounced the effects are.

While there may be a minimum time period required in order to mitigate potential disease spread, such as the recommended 14-day self-isolation to minimize the risk of spreading coronavirus, prolonging quarantine beyond the recommended time may cause greater detriments to mental well-being.

Things You Can Do to Cope

Researchers suggest that there are steps that may help mitigate some of the negative mental health effects of quarantine.

Establish Routines

The disruption in your normal daily routines can be one of the most difficult aspects of quarantine. This can leave you feeling directionless as you try to figure out how to fill all the hours of the day. 

If you’re working from home, it can be helpful to structure your time much like a regular workday. This can be a challenge, however, if you're at home with other family members, including children, who are now home all day as well. Left without the structure of a normal school day, kids can be left feeling just as out-of-sorts as adults.

If you’re trying to keep small kids entertained while stuck in the house, or even trying to keep working amidst it all, it’s important to find a routine that works for you. Plan out activities that will keep everyone busy so you can get some work done. Try creating a daily schedule, but don't get too wrapped up in sticking to a strict routine. Make your own routines and break up the day in order to stave off monotony.

Be as Active as Possible

Even relatively short periods of physical inactivity can have an impact on your health, both mentally and physically. One study found that just two weeks of inactivity could lead to reductions in muscle mass and metabolic effects.

Fortunately, there are plenty of at-home workout ideas that can help keep you moving even when you are stuck inside the house. Your quarantine may be brief, but staying active may help you feel better and maintain your fitness levels. It’s also a great way to help combat the sense of malaise and boredom that can come from being stuck inside day after day.

Combat Frustration and Boredom

Some of the distress of being quarantined stems from boredom and frustration. Finding ways to stay occupied is important, so try to maintain as many of your routines as you can. Keep working on projects or find new activities to fill your time, whether it’s organizing your closet or trying out a new creative hobby. 

Getting things done can provide a sense of purpose and competency. It gives you something to work towards and something to look forward to each day. So make a plan, list some things you’d like to accomplish, and then start checking a few things off your list each day.

Communicate 

Staying in contact with other people not only staves off boredom, but it is also critical for minimizing the sense of isolation. Stay in touch with friends and family by phone and text. Reach out to others on social media. If possible, join a support group or discussion board specifically for people who are in quarantine. Talking to others who are going through the same thing can provide a sense of community and empowerment.

Stay Informed, But Not Overwhelmed

People tend to experience greater anxiety when they feel like they don’t have access to the information that they need. On the other hand, however, is the sense of panic that can stem from being immersed 24/7 in reports that focus on inaccurate or overly negative information. Rather than spend your time watching cable news, focus on getting helpful information from trusted sources. Sources such as the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), state and local health departments, and your doctor can all be helpful. 

Remember That Kids Are Stressed, Too

Research has found that children who had been through quarantine had exhibited PTSD symptoms at four times the rate of children who had not been quarantined.

The CDC recommends that parents and other adults talk to children about the COVID-19 outbreak in a way that is informative, age-appropriate, and reassuring. Focus on maintaining a sense of structure at home and model healthy, positive behaviors. Managing your own anxiety can help calm the fears of children in your home.

Remember Why You’re Doing This

When you are feeling frustrated or cooped up, it can be helpful to think about the reasons why you are quarantining yourself. If you have been potentially exposed to coronavirus, avoiding others is an altruistic action. You minimize the chance that you might unknowingly spread the illness to other people, even if you are currently asymptomatic. 

By doing your part to prevent the spread of the disease, you are protecting others and making sure that those who are sick are able to have greater access to available health resources. Reminding yourself of these reasons can sometimes make your days in quarantine a little easier to bear.

How to Find Professional Support

Fortunately, there are ways to find someone to talk to without leaving the house. Telehealth options increasingly allow people to talk to doctors online and there are a number of online therapy options that allow people to speak with a professional therapist online, by phone call, text, email, or through a video call. It can be a great way to get extra support during a difficult time.

The CDC recommends that anyone with a preexisting mental health condition should continue their existing treatment.