what quarantine and self-isolation is doing to your mental health

early studies show that mental health is likely to suffer due to the covid-19 pandemic in canada, supporting the concerns of mental health professionals who warn that some of these problems could be here to stay even after the crisis subsides.although there have been multiple reports that crisis lines are experiencing a substantial increase in calls, there have been limitedsurveys that measure the extent and depth to which canadians are grappling with physical distancing measures coupled with the stress and fear of the pandemic itself.but early data from wuhan, china, shows that worse mental health is highly likely to be an outcome of the pandemic, particularly connected to the lack of control of the situation, and a low degree of predictability about the future.and combined with research related to past epidemics, showing longer-term mental health impacts from isolation measures, it gives some insight into the mental health challenges that could develop in the weeks, months and years ahead.“it’s too early yet to have done any population-based studies here in canada,” said dr. maureen whittal, co-founder of anxiety canada and a psychiatry professor at the university of british columbia. “but right now, the world is experiencing one giant precipitating event, and when this is all said and done, i think what we will see is an increase in the prevalence rates of anxiety and depression.”national survey data from china — assessing stress and anxiety, depression, sleep, workplace wellness and social cohesion — found mental health was markedly worse in wuhan compared to the rest of the country where travel restrictions and physical distancing measures had not yet been enacted.“we caught it early enough that we could actually see the rates of outcomes like depression and sleep disturbance were the highest in wuhan, second in the larger province of hubei, and the lowest in the rest of china,” said keith dobson one of the investigators for the study, the spokesperson for the mental health commission of canada, and a university of calgary psychology professor. “so, we were actually able to capture the spreading effect of the virus on mental health as [government] measures really hit people.”these results echo warnings from studies on past epidemics, such as sars, that looked at the effects of quarantine and isolation measures, including being separated from loved ones and the loss of freedom. a recent review of these studies found a prevalence of negative psychological effects, including post-traumatic stress symptoms, confusion and anger, with some researchers suggesting long-lasting effects.“my prediction is that we will see increased levels of depression associated with social isolation and being physically separated, and then later, increased levels of anger associated with the way the government did or didn’t appropriately respond to the crisis,” says dobson. “when people get frustrated they begin to lash out sometimes, which is a response to feeling isolated.”these results suggest that health officials need to attend to not only the physical and direct effects of the covid pandemic, but also to the mental health of canadians.“people can spiral down,” says mark tremblay, senior research scientist at cheo, a pediatric health centre in ottawa. “they’re afraid to go out or can’t go out, they stay indoors, they get more anxious, and things get worse and worse, and then they could end up with mental health challenges that for some, would far exceed the consequences of catching the coronavirus.”in the short term, governments and support networks are adjusting where they can. the province of ontario, for example, has increased its emergency funding for mental health, providing an extra $12 million to immediately expand online and virtual mental health supports, and $2.6 million to hire new psychologists and other mental health workers.but health officials will also need to brace for longer term impacts, particularly as economic woes escalate.according to the international monetary fund, the world economy in 2020 will likely suffer its worst year since the great depression of the 1930s, as many as four million canadians are expected to apply for the canada emergency response benefit (cerb) due to virus-related unemployment.“my suspicion is that as some of these economic impacts start to become realized, that’s when depression and suicide rates will increase even further,” says dobson. “i hope that doesn’t happen — and i think our governments are doing what they can to reduce these risks — but that’s a worry i have for sure.”research linking economic conditions and health has found that recessions can lead to long-lasting declines in mental health, especially for some sociodemographic groups, including low-income earners.“i think it’s going to have a differential impact for different people. with people that have resources, or have good emotional support, they are less vulnerable to longer-term poor mental health outcomes,” says dobson.most psychologists and other experts point to the importance of developing and sticking to new routines, keeping contact with family and friends, practicing good hygiene, and regular exercise.“if it was a few days or a week, you could treat it as a holiday, but if it’s going to be several weeks, or months, then you need to make changes and start a new routine,” says dobson. “once we hit month two, and then maybe month three, the problem’s going to get worse, and the longer the self-isolation measures last the worse the impacts are going to be.”katherine monahan is a social scientist in ottawa and a fellow of global journalism at the university of toronto. follow her @katmonahan2