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How will you cope?
Mental Health Factors in self-isolation

Picture
8 things affecting your mental health in the lockdown
 
Silvia Purdie is a Presbyterian Minister in Christchurch
 
According to the Ministry of Health it is “normal to feel stressed or lonely when self-isolating” (website: ‘COVID-19 – Self-isolation’). But why do we find it so hard? Each person brings a unique mix of situation, skills and responses to this experience, as well as stressors and challenges in common. Here are eight factors that could shape your experience of lockdown, and some tough questions if you’re up for it.
 
1. Personality
Some people enjoy solitude more than others. Introverts welcome space alone. Extroverts are more likely to find solitude hard work; they thrive on external stimulation. As my husband (a strong extrovert) puts it “You don’t know what you are thinking because you haven’t talked about it. You are bored because there is not enough input. It feels empty.”
 
Are you bored already? If so, you’re probably an extrovert, and you’re going to need as much social interaction as you can get! But this is also a great chance to stretch yourself. Try being alone, properly alone and quiet, even for just 5 minutes (don’t check facebook!). Let yourself feel bored and wait it out, see what happens next. You might just find yourself thinking or feeling or imagining things which surprise you.
 
2. Love language
“All we need is love” sang the Beetles. Humans are communal creatures, and mental health requires a sense of belonging, knowing we are valued by others, social connection and family. How we express and receive love becomes a critical issue when cut off from normal ways of social interaction. Those who typically use words to connect with others may cope better with isolation, able to make the most of written or phone conversations. However those who rely on physical touch to show love could well find distancing painful and frustrating. The other ‘love languages’ of giving and receiving gifts, acts of service, and spending quality time with others, can be adapted for self isolation, with some creativity. Order someone a courier gift. Agree to hang out online for half an hour. Email someone a picture of a cup of tea, even if you can’t make it for them.[1]
 
How do you show love? What specifically can other people do that makes you feel loved? How can you keep doing those things in lockdown? It’s possible that the people around you don’t actually know what you really appreciate – try telling them!
 
3. Attachment
Your ability to hold a sense of yourself as loved and significant no matter what circumstance you’re in is a major protective factor against mental illness. Attachment theory describes how children develop emotional stability from early bonds with key adults in a baby’s life. A child who is cared for consistently and warmly learns that they are safe and loved whether a parent is in the room or not. A child who is neglected becomes anxious and either clingy or rejecting. These early childhood experiences of security continue to affect us through life. The challenge of self isolation is to continue to sustain our love for others despite being separated from them.
 
Who are you missing most at the moment? Find ways to connect with them. Pray for them.
How does it make you feel to be cut off? Be honest with yourself. Write about it.
If you have a religious faith or sense of spirituality, how does this help you feel connected outside your isolation?
 
4. Confinement
Being ‘cooped up’ in one physical space has typically been used through human history as a form of punishment. While self isolation is not the same as being imprisoned there is an echo in terms of mental health effects. International research shows that “imprisonment increases vulnerabilities and heightens mental ill health”.[2] In our jails, the most extreme form of punishment is solitary confinement; “isolation can be as clinically distressing as physical torture”.[3] A review of research into solitary confinement found that it is especially damaging for people with prexisting mental health conditions. “The stress, lack of meaningful social contact, and unstructured days can exacerbate symptoms of illness or provoke recurrence.”[4]
 
You might get sick of your own four walls after four weeks. Do you get panicky about being enclosed? Do you get angry about this outrageous loss of freedom? The challenge is keeping calm. If you’re having anxious thoughts, draw them or write them down. Seeing them on paper in front of you helps you choose whether they are true or not, and if not what you can remind yourself so that stress doesn’t get on top of you.
 
5. Trauma
A person’s experience and interpretation of trauma has become a central question for understanding mental health. Basically we are all in a global sea of trauma brought on by pandemic. For a person who is self isolating with suspected Covid-19, trauma may be triggered by fears of the illness and the potential for it to be fatal. Trauma may also be triggered from past events, and you may have had previous panic attacks. Our ability to manage trauma is closely related to our inner security systems, which are significantly influenced by our social supports. Being cut off from human intimacy (such as hugs) reduces our ability to cope with anxiety and flash-backs.
 
The key is to recognise the signs of trauma reaction (Christchurch people know all about fight-flight-fear post earthquakes & shootings!). Basically, you can’t think straight. Be nice to yourself if you are going all foggy, or really tired, or can’t sit still.
 
What do you notice about your own brain? How do you spot that you are getting stressed? What practical things can you do to step back down the trauma reaction ladder?
When you are in a calm safe space, let yourself remember what sets off your stress response. Put a red flag on memories that still distress you. How are you going to stop yourself replaying them over and over? Can anyone else help you with that?
 
6. Coping strategies
Everyone learns ways to manage distress – our coping strategies. Those who struggle with poor mental health and addiction may have less helpful ones. Now we are stuck in self isolation we have little access to activities and relationships (other than through our computer screens), so will be cut off from many of our normal coping strategies for reducing mental and emotional distress.
One coping strategy that is readily available during lockdown is alcohol; unfortunately this is a notoriously ineffectual coping strategy for emotional distress!
 
Several spiritual traditions teach that people have a ‘shadow’ side, a darker or ‘false’ self which is hidden beneath the busyness of everyday life but whose emotional needs drive us in unconscious ways. The practice of going on a silent retreat is designed to expose the shadow self, precisely because a retreat strips away the activities and relationships that obscure and distract, in a safe calm environment with wise counsel and disciplines of prayer. Without these supports people could be less equipped to creatively encounter their shadow self when they are deprived of their normal coping strategies.
 
What would you say are your coping strategies? If you feel like crap what do you turn to?
Have you stocked up on booze? If so how you protect the people with you from paying the price for your drinking?
Could you embrace the opportunity for a ‘silent retreat’, even for part of a day? What spiritual practices could help you?
 
7. Pressure-cooked relationships
The most harmonious of couples and patient of parents can struggle with being exclusively in each other’s company all the time. Family members’ habits and coping strategies are not all compatible, and experiencing distress and anxiety inhibits our ability to care for others. The Christian tradition teaches the value of a servant heart, of putting the needs of others before your own; no better time than lockdown to practice that.
 
As the country enters lockdown groups dealing with domestic violence warn of increasing abuse, both physical and emotional. “Factors that can exacerbate these numbers include added financial pressures that come from loss of income, the sudden close confinement of families and a narrowing of broader community contact.”[5]
 
How is the emotional tone in your ‘bubble’? You’ve heard the calls for everyone to be kind and patient … when might that be easier said than done?
Now could be a good time to read up on parenting or relationships or conflict resolution, try out some new ideas or remember what used to work. Remind yourself of your skills.
If you get freaked out by your own or your partner’s anger, call for help.
 
8. Inequality
Last and by no means least, isolation has a different effects on mental health because of social inequality. The NZ Government Inquiry into Mental Health and Addiction reported that “People saw poor mental health and addiction as symptoms of poverty, social exclusion, trauma and disconnection. They talked about threats to basic needs such as affordable and safe housing, quality education, meaningful employment, adequate income, social connectedness, freedom from violence and reliable social support. They explained how this leads to chronic stress on families, whānau and individuals and compromises wellbeing.” “Poverty goes hand in hand with [poor] mental health.”[6] Low income families have an increased risk of contracting viruses and suffering poor mental health for a host of reasons, including more people living in smaller, colder houses.
 
Global pandemic affects all of us financially. Given that there’s little you can do about it at the moment, it is probably better for your mental health to focus on gratitude rather than financial loss. What can you be thankful for?
All our welfare agencies will be working as hard as they can to aleviate poverty, both here and around the world. If you can, give money to help resource them. Generosity also helps your mental health, and reminds us that we are all in this together.
 
Every challenge is an opportunity. Four weeks of isolation will be difficult, but it is also space for you to make of it what you will. You can fill your time with the telly or you can let yourself be alone and see what emerges.
Kia kaha. Grace and truth be with you.
 
 
 


[1] Gary Chapman, The Five Love Languages: The Secret to Love That Lasts.
 

[2] Cherie Armour, “Mental Health in Prison: A Trauma Perspective on Importation and Deprivation”, International Journal of Criminology and Sociological Theory, Vol. 5, No.2, August 2012, 886-894.

[3] Jeffrey L. Metzner and Jamie Fellner. “Solitary Confinement and Mental Illness in U.S. Prisons: A Challengefor Medical Ethics”. Journal of the American Academy of Psychiatry and the Law Online, 38, 1 (March 2010): 104-108.

[4] ibid

[5] Alex Casey, “Where do domestic violence victims go during the Covid-19 lockdown?”, article on The Spinoff, (25 March 2020) https://thespinoff.co.nz/society/24-03-2020/where-do-domestic-violence-victims-go-during-the-covid-19-lockdown.
Casey quotes Holly Carrington, policy advisor for domestic abuse charity Shine:
“It can very quickly get a lot more dangerous because the vulnerable person has nowhere else to go and no time in the day to escape to their work or office. Frankly, we’re worried about the severe physical violence that nobody will have eyes on, because women won’t be interacting with enough people for them to intervene or even notice.”

[6] He Ara Oranga, November 2018, the Government Inquiry into Mental Health and Addiction.
https://mentalhealth.inquiry.govt.nz/inquiry-report/he-ara-oranga/chapter-2-what-we-heard-the-voices-of-the-people/2-5-social-and-economic-determinants-of-health

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Written by Silvia Purdie 

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