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Well-being Guide for Quarantine and Self-isolation

For many weeks now, our city has been living under a shelter-in-place mandate, and some of you may have already begun home quarantine or self-isolation even before the official requirement was announced.
 
With so many vulnerable people at risk of coronavirus exposure and infection, it’s essential that we work as a community to prevent the rapid spread of COVID-19. Self-isolation and social distancing are the responsible things to do right now. But, even those precautions come with their own health concerns.
 
Rates of anxiety, stress, and depression are expected to rise as consequences of quarantine. [1] And, these conditions are further fueled by money worries and concerns about our health and the health of loved ones.
 
To help you address the potential emotional impact of self-isolation, we’ve compiled a guide to help you:

  • Recognize mental health issues in yourself and others
  • Prevent or alleviate anxiety and stress in yourself and your family
 

Recognizing mental health issues in yourself and others

Some people are particularly susceptible to stressors during this crisis and might respond to them more strongly:
  • Those at higher risk for COVID-19, who include older people, and people with existing chronic respiratory disorders, diabetes, or auto-immune deficiencies
  • Children and teens
  • Health care providers and first responders
  • Substance abusers
  • People with existing mental health conditions[2]
 
Signs to look out for:
  • Trouble sleeping or concentrating
  • Changes in eating patterns
  • Increased use of tobacco, alcohol, or other drugs
  • Worsening chronic health problems
  • Excessive worrying about your own health and the health of others.
 
In children, the following changes in behavior are also indicators of stress:
  • Excessive crying or irritation
  • Returning behaviors that they had outgrown (e.g. bedwetting, toilet accidents)
  • Difficulty concentrating
  • Increased irritability in teens
  • Use of tobacco, alcohol and other drugs.[3]
 

Tips for reducing stress and anxiety around COVID-19

  • Only pay attention to information from reliable sources.
    We depend on social media to keep in contact with our friends and family at this time. However, social media is also where much misinformation is spread. Fear generated by alarming rumors or lies can elevate stress and anxiety.

    If you’re unsure about the reliability of something you see on social media or elsewhere online, fact-check the source. Snopes, has a page dedicated to debunking misinformation spread online and in popular media.

    You can also do your own research. At BronxDocs, we turn to reliable sources such as the World Health Organization and the Centers for Disease Control and Prevention, as well as advice from certified medical professionals, to ensure that we share accurate information with our patients.

  • Make information part of your protection against COVID-19.
    Confusion caused by contradictory information about our situation may make us feel out of control, powerless, or even hopeless.

    To counter those feelings, consult trustworthy information sources for advice on how to protect yourself against COVID-19. Knowing you are taking positive action will empower you and your family.
     
  • Talk to children about the virus in an age-appropriate manner.
    Even if you are not talking to your kids openly about the virus, they will sense the changes around them.  They will hear scary news stories, and they will pick up on cues from conversations you have with them and other people.[4]

    • Address the issue and ask open ended questions. Psychologist Madeline Levine recommends opening the conversation by asking , “I’m sure you’ve noticed things are different around here, do you have any questions?”[5]
    • Young children won’t be able to understand the extent of the threat posed by COVID-19. You can reassure them that it mostly affects people who are old or already sick, and that most people who get the disease will get better.
    • If they express concern for elderly or sick relatives, be honest, but then follow up with reassuring advice. For example, you may say, “It can be very serious for some people, which is why we are careful to wash our hands properly and stay at home.”
    • Teach them about healthy habits, such as how to thoroughly wash your hands. Show them how you’re cleaning and involve older children in the process of cleaning and disinfecting the house.[6]
       
  • Limit watching, reading, or listening to news stories.
    It’s important to keep informed about the latest national and local developments and advice on COVID-19, particularly in New York. However, repeatedly hearing news about the pandemic throughout the day can be upsetting. Be aware of what children of all ages are seeing and hearing. Limit screen time if necessary and explain that some of what they see online is misleading.[7]

Tips to reduce stress and anxiety while in quarantine or self-isolation

  • Keep a routine
    Try to maintain a normal routine. Have structure to your day. Wake up at a set time and prepare for your day as you normally would.[8]

  • Start and end your day with a personal hygiene routine. Even if you’re not planning on leaving the house, the simple act of brushing your teeth, washing your face, and showering will give you a sense of normalcy and dignity.
  • Include exercise in your routine. 
    Exercising helps keep you healthy mentally, as well as physically. Moving your body is proven to reduce levels of cortisol (the stress hormone) and increase endorphins (the body’s natural pain killers and mood elevators).[9]
    On YouTube, you’ll find free at-home exercise classes, such as aerobic and strength workouts, and yoga sessions. Kids can get involved too: in the UK, teachers are assigning online physical Education classes provided by YouTuber and Fitness Coach, Joe Wicks.[10]

  • Eat well 
    As always, it’s important to keep yourself properly nourished. Healthy eating positively impacts your brain chemistry and, in turn, your mood. Eva Selhub MD, contributing editor of the Harvard Health Blog, explains, “Serotonin is a neurotransmitter that helps regulate sleep and appetite, mediate moods, and inhibit pain. Since about 95% of your serotonin is produced in your gastrointestinal tract, [...] it makes sense that the inner workings of your digestive system don’t just help you digest food, but also guide your emotions.”[11]

  • Avoid alcohol and drugs The idea of “unwinding with a glass of wine” isn’t completely unfounded. In the short term, alcohol is a sedative that depresses our central nervous system, essentially numbing the physical effects of stress and anxiety. However, if used excessively or too frequently, you can build a tolerance to the destressing effects of alcohol and, at the same time, develop a dependence on alcohol that makes you feel even more stressed and anxious.[1

  • Take time to unwind
    Dedicate some time every day to do something you enjoy.
    You can use relaxation techniques to calm down your body’s fight or flight response to anxiety. Some research shows that meditation may reduce symptoms of anxiety and depression.[13]
 
  • Keep in touch with friends and family via phone, videocalls, emails, social media.
We are social animals; it’s a human need. As Matthew Lieberman, Professor at the UCLA Department of Psychology, Psychiatry, and Biobehavioral Sciences told the Scientific American, “we suffer greatly when our social bonds are threatened or severed.”[14]

Not only will a friendly chat with a loved one lift your spirits and provide emotional support, keeping in touch with friends and family reassures you that they are ok.
 
  • As Mr. Rogers would say “Look for the helpers! You will always find people who are helping.”[15] In New York, 52,000 healthcare workers signed up to volunteer during the pandemic.[16] It can be reassuring to see the community selflessly in action.

    Volunteering may also be good for your mental well-being.[17] If you are young, healthy, and not considered at high risk of contracting the virus, there are several ways for you to help at this time.
    • Offer to help an elderly or otherwise vulnerable neighbor
    • Donate blood
    • Research food drives in The Bronx. Food Bank NYC has accepts food donations.
    • Remember, this won’t last forever. There is a light at the end of the tunnel.
       
If you’re struggling to cope, or you know someone who is, New Yorkers can call the COVID-19 Emotional Support Hotline at 1-844-863-9314.[18] You can also call your BronxDocs primary care provider to discuss your anxiety or other emotional concerns.
 
Further information on all of the topics discussed here can be found in the list of sources for this blog.

 

 

Citations

[1] Brooks, S. K., et al, “The psychological impact of quarantine and how to reduce it: a rapid review of the evidence” RAPID REVIEW | Vol 395, Iss.10227. March 19 2020 pp912-920. Retrieved from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext Mar. 2020.
[2] Centers for Disease Control and Prevention, “Coronavirus Disease 2019 (COVID-19): Manage Anxiety & Stress” Retrieved from:  https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html Mar. 2020.
[3] CDC “Coronavirus Disease 2019 (COVID-19):Manage Anxiety & Stress” Mar. 2020.
[4] CDC, “Talking with children about Coronavirus Disease 2019: Messages for parents, school staff, and others working with children” Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/talking-with-children.html Mar. 2020.
[5] Levine, M talking to Bell, B. in “'No, we aren't all going to die': experts on how to talk to kids about coronavirus” Guardian. 24. Mar. 2020. Retrieved from: https://www.theguardian.com/us-news/2020/mar/24/coronavirus-kids-how-to-talk-to-children-death-virus-expert-guide Mar. 2020.
[6] CDC, “Talking with children about Coronavirus Disease 2019: Messages for parents, school staff, and others working with children” Mar. 2020.
[7] CDC, “Talking with children about Coronavirus Disease 2019: Messages for parents, school staff, and others working with children” Mar. 2020.
[8] Victoria State Government Health and Human Services Department, “Quarantine at home - coping tips” (2015) Retrieved from: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/quarantine-at-home-coping-tips Mar. 2020.
[9] Harvard Men's Health Watch, “Exercising to relax” Harvard Health Publishing (Feb. 2011) Retrieved from:
 https://www.health.harvard.edu/staying-healthy/exercising-to-relax Mar. 2020.
[10]BBC News “Coronavirus: Joe Wicks keeps children fit with online PE classes” Retrieved from: https://www.bbc.com/news/av/uk-52015767/coronavirus-joe-wicks-keeps-children-fit-with-online-pe-classes Mar. 2020.
[11] Selhub, E. MD. “Nutritional psychiatry: Your brain on food” Harvard Health Blog (2015) Retreived from: https://www.health.harvard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626 Mar. 2020.
[12] Cherney, K. & Jewell, T., “Alcohol and Anxiety,” Healthline (2016) Retrieved from: https://www.healthline.com/health/alcohol-and-anxiety#alcohol-effects Mar. 2020.
[13] National Center for Complementary, Integrative Health, “Meditation: In Depth) Retrieved from:   https://nccih.nih.gov/health/meditation/overview.htm Mar. 2020.
[14]Lieberman, M. Talking to Cook, G, “Why We Are Wired to Connect” Scientific American (22, Oct. 2013) https://www.scientificamerican.com/article/why-we-are-wired-to-connect/ Mar. 2020.
[15] Schulten, K. “Look for the Helpers” The New York Times (30, Aug. 2017) Retrieved from: https://www.nytimes.com/2017/08/30/learning/look-for-the-helpers.html Mar. 2020.
[16] New York State Department of Health, “NY State on PAUSE” Mar. 2020.
[17] Watson, S., “Volunteering may be good for the mind” Harvard Health Blog (26, Jan. 2013) Retrieved from: https://www.health.harvard.edu/blog/volunteering-may-be-good-for-body-and-mind-201306266428 Mar. 2020.
[18] New York State Department of Health, “NY State on PAUSE” Mar. 2020.
 
 
Posted: 5/1/2020 10:27:48 AM by


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