7 minute read
Emerging from the Shutdown Cocoon
BY KIMBERLY BROUILLETTE
When President Trump declared an emergency for COVID-19 on March 13, most Americans had no notion of the lengthy and extreme measures they would endure as a result of the virus. Even after Governor Cooper announced a statewide stay-at-home order on March 29, relatively few cases and resulting deaths had impacted our region. However, understanding of the situation soon changed as everyone but essential workers were limited to their homes, unless they had to go out for items, such as food and other necessities. However, once the restrictions were imposed, it didn’t take long for reality to set in.
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As of the writing of this article, it’s been nearly two months since those restrictions were imposed, which have only been partially lifted. As of May 14, over 885,000 people have filed unemployment in North Carolina alone, with many more on furlough or only partially back at work. Some items normally in abundance, such as toilet paper and ground beef are difficult to locate in the stores. Students are still at home, which is expected to continue through the end of the school year. Of course, none of this is new to anyone.
In addition to the worry of contracting the virus through social contact, thousands are concerned how they will be able to recover financially, or even simply get through the end of the month. As a result, anxiety, depression and many other mental and physical stresses are growing throughout the world, especially in older adults.
Even prior to this crisis, “the U.S. was a clinically anxious place. According to the National Institute of Mental Health, just over 19% of all American adults will experience at least one anxiety disorder over any 12-month period,” Jeffrey Kluger wrote for Time Magazine. “As its name suggests, generalized anxiety disorder (GAD) involves a pathological response to everyday challenges like worries over money, work deadlines, and parenting. For people with GAD, those common woes produce disabling pain, and coronavirus is surely having an impact.”
In a press release by the American Psychiatric Association, “Nearly half of Americans (48%) are anxious about the possibility of getting coronavirus, COVID-19, and nearly four in ten Americans (40%) are anxious about becoming seriously ill or dying from coronavirus, but far more Americans (62%) are anxious about the possibility of family and loved ones getting coronavirus.”
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According to a recent Kaiser Family Foundation poll, “nearly half (45%) of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the virus.” This is compounded in those who already face severe anxiety disorders and other mental and physical health issues.
As evidence of the impact on the local community, many people have responded to this publication’s social media posts regarding how the crisis has affected them. Many responses focused on inability to work at their jobs, seeing their loved ones, or simply feeling trapped in their homes. Others were concerned about their children missing out on school, or the fact they were having to do more “homeschooling” as a result, which they felt ill-prepared to do. One woman expressed that she feels anxious every time she leaves the house and always is hyper-aware of those near her in the store. Another said that she has become germaphobic, using hand sanitizer frequently and wiping down every surface in her house with bleach cleaners.
Depression, anxiety and frustration permeated the responses. No matter what the specific reason is, our mental health is being impacted through this difficult crisis. Therefore, it’s better to be mindful of the issues and be prepared to fight them, than to be caught unaware and face harsher consequences as a result.
I don’t often focus on my own experiences when I write for these articles, however, I realized it was these experiences that I needed to do some research on. A few weeks ago, I started feeling the effects of long-term isolation from my community. Every time I would run an errand, or go pick up some take-out from a restaurant, I would feel unusually tired as soon as I got home. Even participating in a lengthy online conference meeting
with several others would make me drowsy. In one instance, I could barely keep my eyes open and had to lay down for a two-hour nap due to extreme exhaustion. Things that never caused me to grow tired previously were having significant impact on me, although I wasn’t doing anything strenuous.
After doing some research, I realized that being isolated from others for so long is a milder form of what people experience with long-term isolation in extreme circumstances, such as intensive care units (ICU), prison, isolation wards, and even polar or space exploration. In these conditions, stimuli are reduced considerably compared to those in normal daily lives. Under stimulation is referred to as “sensory deprivation.”
In the medical article, Psychological Factors in Exceptional, Extreme and Torturous Environments, for the US National Library of Medicine National Institutes of Health, John Leach addresses these issues. “Isolation involves both the restriction of environmental stimuli and the reduction in the quantity and the quality of stimuli that are psychologically and socially meaningful. Often it is the reduction in social interaction that is the more problematic… As human beings we rely on social contact to inform our perception of the world, the environment, ourselves and of reality… The symptoms associated with sensory deprivation and perceptual deprivation have been well-documented and replicated across various studies.” Leach goes on to state that studies show virtually universal effects, which include “increased susceptibility to suggestion, instability of belief and attitude change, increased compliance, anxiety and depression, apathy, lethargy, reduced stimulation-seeking behavior, disorganized planning and eventually depersonalization which causes some people to lose touch progressively with reality,” as well as others in more extreme cases.
Too little or too many sensory experiences can be harmful to the body. Leach also discusses that additional effects can be felt due to “sensory overloading.” These occur when someone is inundated with sounds, smells, sights, crowds, and any number of stimuli they aren’t used to. Sensory overload, or overstimulation of the body from physical stimuli in the environment can cause mild to severe effects.
Z.J. Lipowski writes in Psychosomatic Medicine and Liaison Psychiatry: Selected Papers that a study was conducted by Japanese researchers of Tohuku University in the early 1970s. “Subjects who were exposed to intense auditory and visual stimuli showed changes in their mood such as sadness, anxiety and aggression. These studies concluded that symptoms of sensory overload include irritability, withdrawal, over-excitation, bright light hypersensitivity (cover eyes when there are bright lights), and inability to complete tasks, muscle tension, restlessness, fidgeting, fatigue, sleeplessness and angry outbursts. Because of these, some researchers try to find links between sensory overload and generalized anxiety disorder, or GAD.” Lipowski also states that not all subjects experienced the entire gamut of reactions, however those with more severe mental illnesses and disorders were affected more severely.
So, what does this mean? In essence, isolation forces everyone to adapt to a new abnormal environment, however long-term exposure can have extensive and negative impact on mental health. One aspect seemed to stand out in light of my own experiences — sensory deprivation. Living in an isolated separation during the shutdown has caused a reduction in environmental stimuli, much like those who have experienced other forms of extreme isolation. In contrast, once people leave there homes to run errands, or even go back to work, they may experience many of the effects similar to that of “sensory overload.” Basically, these forms of physical and mental stresses could easily explain my own experiences with extreme fatigue after only short outings. It is important to keep this in mind as you begin emerging from your own homes. Take things slowly, and don’t try to overdo it.
What are some things to do if you find the anxiety and stress are too much?
Dr. Ifeanyi Olele, DO, MBA, MS, a board-certified psychiatrist who sees adolescent and adult patients in the greater Washington DC metropolitan area at Genesis Psychiatric Solutions, states there are several things that can help deal with anxiety and stress associated with the COVID-19 shutdown.
1. Meditate, yoga, or use other relaxation techniques to help reduce stress.
2. Exercise to release tension and boost your mood. Riding a bike, taking a walk, or otherwise participating in some form of exercise can reduce stress, anxiety, and depression that may be interrupting your happiness.
3. Talk things out. Speak with others about any anxiety you feel. Often, you will get answers that reduce the “fear of the unknown.”
4. Ask for help from friends and family if you feel overwhelmed.
5. Stay positive! If you feel like everything is horrible and the situation is terrible and there is no hope, or if you simply cannot get past the negative thoughts, seek professional help to ease your mind.
