Many governments across the world have ordered their people to stay home amid the coronavirus pandemic. The virus, which has affected nearly two million people, can easily be transmitted to one person to another. Thus, it is highly significant to avoid huge crowds and maintain physical distance with people. In countries that have implemented a complete lockdown or living under some kind of quarantine, people are only allowed to go outside for food, health reasons or essential work.
These new rules and regulations mean that many people are spending a lot of time at home and many of our regular social activities will no longer be available to us. However, this isn’t as easy as we thought. The pandemic is already taking a toll on people’s mental health as seen in how countries are addressing the generalized fear and fear-induced overreactive behavior by the public. For instance, the National Health Commission of China recently provided guiding principles of the emergency psychological crisis interventions to reduce the psychosocial effects of the COVID-19 pandemic.
The Mental Health Toll of the Pandemic
The World Economic Forum, an independent international organization committed to improving the state of the world by engaging business, political, academic, and other leaders of society to shape global, regional, and industry agendas, reported that an estimated 2.6 billion people or one-third of the world’s population is under some kind of lockdown or quarantine. India has the highest number of people on enforced lockdown due to the pandemic with 1,380 million, followed by China (760 million), the US (297 million), and Bangladesh (165 million).
Now, experts said that people who are under quarantine are very likely to develop a wide range of symptoms of psychological stress and disorder. This includes low mood, insomnia, stress, anxiety, anger, irritability, emotional exhaustion, depression, and post-traumatic stress symptoms. The connection between viral pandemics and psychological stress isn’t new. Previous studies have already seen the connection decades ago.
Researcher Karl Menninger linked the 1918 Spanish flu pandemic with changes in psychiatric complications. While the influenza virus commonly affects the respiratory system, the burden on neuropsychiatric diseases has also become evident. A 1920 study in the US was able to determine the impact of the influenza pandemic of 1918 on subsequent rates of suicide. The researchers found out that the pandemic caused an increase in suicide.
Aside from that, a 1994 study published in The Journal of Crisis Intervention and Suicide Prevention found out that people diagnosed with HIV in the wake of the HIV/AIDS pandemic were more likely to die by suicide. According to NBC News, an online site that covers breaking news, videos, and the latest top stories in world news, business, politics, health and pop culture, experts said that it is possible suicide rates will go up although no recent data can confirm or refute this.
"This is an unprecedented event for the vast majority of people. It is certainly reasonable to expect the risk of suicide increasing secondary to the economic and social fallout," Dr. Shailinder Singh, a psychiatrist working in a psychiatric emergency room in a New York City hospital, said.
The mental health impacts of quarantine are already being reported in China. In one study, about 28% of quarantined parents warranted a diagnosis of “trauma-related mental health disorder” and almost 10% of quarantined hospital staff reported “high depressive symptoms.” Some of the reasons for stress during quarantine include fear of becoming sick or of losing loved ones, risk of infection, and the prospect of financial hardship.
Who’s More At Risk?
Rhiana Holmes, a trauma therapist specializing in disaster psychology out of Denver, Colorado, said that there’s been an increase in people reaching out about their mental health during this crisis. “My private practice has seen a huge uptick in new clients because people are feeling really anxious. Interestingly, many of them don't necessarily relate it to coronavirus— but if someone has pre-existing conditions like anxiety or depression, stress is likely to bring out problematic symptoms in light of the pandemic,” Holmes said.
A recent poll conducted by the American Psychiatric Association revealed that 36% of Americans reported having serious impacts on their mental health because of the pandemic, while 31% said they’re sleeping less because of coronavirus-related anxiety. According to Forbes, a global media company focusing on business, investing, technology, entrepreneurship, leadership, and lifestyle, remote therapy services like Talkspace and Brightside have seen increasing demand. Talkspace reported a 65% increase in customers since mid-February, while Brightside has seen a 50% increase in new users since the start of the year.
Holmes said that the coronavirus pandemic and resulting quarantines are prime for mental health upheavals because depression and anxiety “thrive on social isolation and disruption of routine.” But, out of all people, those who have a history of mental illness are most at risk. “Much like how we don’t know how many asymptomatic coronavirus carriers are going to manifest into needing care, we’re seeing the same thing in mental health,” Brightside cofounder Mimi Weinberg said.
Dr. Fumi Mitsuishi, director of the UCSF/ZSFG Division of Citywide Case Management in San Francisco, said that people living with psychiatric disorders such as schizophrenia, bipolar disorder, or depression at a higher risk of being affected by the pandemic. “We’re talking about a population that struggles with being housed, being able to feed themselves, being able to take care of medical issues, having enough of an income,” Mitsuishi said.
Experts said that social distancing and isolation are triggers for people with a mental health issue. According to Healthline, an American website and provider of health information, people with mental illness have lifestyles that increase their risk of contracting the new coronavirus. At the same time, they also have more underlying health conditions that raise their risk for developing more serious cases of COVID-19.
The National Alliance of Mental Illness said that there could be an increase in suicide cases in this pandemic, especially if these people have experienced substance abuse, intoxication, medical illness, stress, have access to firearms, or suffered recent tragedy or loss. "Economic instability and unemployment have been linked to an increase in suicide. However in the past few years, we have seen a rise in suicide despite economic prosperity,” Dr. Ken Duckworth, chief medical officer of NAMI, said.