How to Manage Depression During Quarantine

Quarantine is generally defined as the isolation and restricted movement of people who've been exposed to a contagious disease. With regard to COVID19, the kind of quarantine the population is using is not only to isolate children and adults who are ill, but to protect non-sick people from catching the illness and preventing further contagion.

The word quarantine — or rather quarantino — was first used in Italy over 700 years ago to deal with the Bubonic Plague. Though genetic science hadn't been on the radar back then to explain the mechanics of viral infections, medieval Italy understood enough about the Black Death to organize the world’s first anti-contagion approach.

Previous studies involving mandatory quarantine have shown that there are a variety of things children and adults experience. Here is a list of the most common:

• Aches and pains
• Amplified risk perception
• Anger
• Boredom
• Cardiovascular stress
• Changes in eating habits
• Compromised immune functioning
• Confusion
• Contagiousness anxiety
• Counterphobic reactions
• Depressive symptoms
• Difficulty concentrating
• Emotional exhaustion 
• Fear and apprehension
• Financial worries
• Frustration
• Helplessness
• Hoarding
• Hopelessness
• Impaired executive functioning
• Insomnia or hypersomnia
• Irritability
• Numbness
• Overuse of drugs, alcohol
• Physical exhaustion
• Post-traumatic stress symptoms
• Sadness and despair
• Somatic experiences
• Stigma concerns

Studies have shown that psychological responses to infectious disease disasters are not a one-size-fits-all experience. In fact, subjective perceptions regarding the degree of danger to which one is being exposed can differ widely among individuals.

What research does report is that those of us who've have pre-outbreak traumatic experiences are more prone to have post-outbreak depression. And though evidence-based data explains completed suicide rates tend to be reduced during disasters, we must remain vigilant to vulnerable children and adults with severe depressive symptoms that include suicidal thinking.

To cope with quarantine when you live with depression, consider these 5 tips: 

1. Plan. Having a plan to gather supplies and necessities will help maintain predictability during a most unpredictable time. Aim for at least a two week's supply for food, water, and other essentials. If you cannot go to stores to do so, try online shopping or using delivery services like FreshDirect, Instacart or Peapod. Local community and religious outreach programs can also help with supplies if you are financially strapped. When it comes to having medication, consider moving your prescriptions to insurance based home delivery services. If this can't be done, most local pharmacies offer free delivery to your home.
2. Limit media. While it's vital to stay informed as we move through COVID19, avoid spending time in front of the television, on computers or cell phones. News stories can deepen feelings of hopelessness and despair when you live with depression. Studies suggest that a quick update in the morning each day (about 15 minutes) will give you enough daily information. Remember that most media outlets work from a fear-based approach — where creating sensational stories gets higher viewership. The greater the audience numbers, the more media organizations can charge higher amounts of money for advertising. 
3. Mix it up. Staying at home can feel restrictive. You can begin to experience boredom. A monotony may also take hold. To help minimize these feelings, consider shifting the textures of your environment every few days. Variety will ease the restlessness that comes with quarantine. Listen to music for a few days. Then light a scented candle for a few days thereafter. Shift and read a book for a few days. Sit outside for lunch if the weather permits for a few days. Move from there and do some cleaning and reorganizing. Indulge in self-care treatments, like a long bath or a hot shower, meditate or try some yoga. Go for a walk in the rain. Changing the focus of your days will stimulate your mind, body, and soul and help ease depressive mood swings.
4. Use mindful words. It's easy to fall into pessimistic thinking during quarantine. The way you see the world and the future can become an all-or-nothing experience. "I'm stuck at home." "This will never get better." "Life will never be the same." These are some of the sentences many people think or say aloud. However, being resilient during trauma requires a cognitive shift  - and choosing positive words can redirect your perspective from helpless to hopeful. This is called semantic restructuring. Consider these phrases as antidotes to the previous ones: "I am safe at home." "Things will get better in time." "Life will be different but I can cope with that." 
5. Work your treatment plan. When you live with depression, ordinary days can be challenging. So it becomes even more vital that during quarantine that you make sure you follow your treatment plan. Things like taking medication daily, tending to self-care, sleeping and eating well, exercising, using holistic approaches to ease depressive symptoms and keeping your scheduled telemedicine therapy sessions. As mentioned, those of us with pre-existing mental health disorders are more prone to post-disaster relapses. This is why maintaining your treatment plan is significantly important. Finally, if you're having a difficult time during quarantine, share this with your mental health professionals. Additional sessions can be scheduled and medications can be adjusted to help you move through this crisis.

By Deborah Serani, Psy.D.

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