This paper explores the two major preventive concepts of the unpredictable life-threatening viral infection caused by Coronavirus that is ravaging the entire world from the beginning of the year 2020, as it pertains to mental health. Through scientific consultations, the expectation is that effective vaccine for the Coronavirus disease-2019 (COVID-19) may not come into the market this year. Two (among others) preventive measures, namely Social Distancing and Quarantine are suggested by the World Health Organization (WHO). Using the principle of explorative research, this study established the flipside of quarantine and social distancing from the metal health perspective. It was discovered that there is a relationship between a long period of self-isolation and a high probability of concerned persons having anxiety, stress, and depression, which gradually leads to mental and emotional health issues. Consequently, mental health affects the overall health and affects how we handle different situations during the Covid-19 pandemic. By considering this important matter, this article recommended different ways to improve mental health during the pandemic in the quest to keep oneself away from psychological issues arising due to the Covid-19 situation.
Academic Editor: Elbaih zico, Associate Professor of Emergency Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Checked for plagiarism: Yes
Review by: Single-blind
Copyright © 2020 Jainish Patel, et al.
The authors have declared that no competing interests exist.
The COVID-19 virus is a newly discovered virus belonging to the same family of SARS; Severe Acute Respiratory Syndrome viruses, as well as a couple of common cold viruses. On 11th March 2020, WHO announced the emergence of COVID-19 as a pandemic. Following this declaration, the world is faced with lockdown for which everyone is expected to stay indoors, alongside the fact that all educational institutes, recreational places, and malls are closed. Data from WHO reveals that Coronavirus has infected 15,117,078 people with 620,033 deaths worldwide as of 22nd July 2020 and continues to spread across the globe 1. Early efforts have been intensified into the clinical course of Covid-19, counting severe cases and treating those who are already infected. With no cure or vaccine yet to be developed for COVID-19, the best way to prevent this highly contagious disease and limit its spread among the people is by observing social distancing. Lockdown and stringent restrictions can have more impact on the mental health of humans. However, maintaining social distancing away from friends and social life has created lots of disturbance in man’s daily routine. This is because movements are restricted, and is affecting both the physical and mental health adversely 1. Therefore, this study aims to expose the impacts and effects of the preventive measures of COVID-19 on the psychological and mental state of concerned persons. At the same time, seek to explore various lifestyle adjustments necessary to help keep mental health stable during this pandemic.
Effects of Quarantine and Social Distancing on Mental Health
Many researchers investigate the adverse effects of self-isolation, commonly known as quarantine, and social distancing on mental health 2. The researchers found out that self-isolation i.e., quarantine is related to the high occurrence of mental disorders such as anxiety, stress, depression, and other related diseases. This is because the long period of quarantine and social distancing gradually leads to loneliness, which is the leading cause of psychological issues 3. In checking the psychological impacts of Covid-19, the result of the recent research conducted in 194 different cities of China that included 1210 defendants’ showed that 54% of defendants were suffering from mental health issues, where 29% reported against mild to severe anxiety indications and 17% showed severe depressive signs, thus proving that the COVID-19 pandemic is causing specific mental health issues 4.
COVID-19 Preventive/control Measures: Self-isolation and Social Distancing
Self-isolation and social distancing are considered as the ultimate way of controlling and reducing the record of positive cases of the coronavirus infection across the globe. Besides affecting the physical activities, quarantine has a prodigious result on mental health, and it so has negative adverse effects on the psychological state of the people 5. Research studies conducted showed that the effects of quarantine could vary from intermediate to moderate on mental health 6. Quarantine causes and produces petulance, antagonism, confusion, distress, lonesomeness, repudiation, anxiety, depression, hysteria, misery, and generates suicidal thoughts 7. The social distancing effects can be intensified by the person suffering from the disease or doubt about the disease development, inadequate source of basic life necessities, unsupportive family, and improper communication methods 8. As a result, the following manifestation of mental illnesses may be recorded.
Anxiety is the most common concern of mental illness amongst the general public. Due to the current epidemic situation, it is on its increase amongst the general public, both youngsters and adults. The increasing rate of anxiety in adults is due to the lockdown situation. All work and social activities such as the educational institutes are closed and replaced with distance learning and staying at home 9. The research was conducted in different regions including South-Eastern Asia, Southern Europe, Southern, and Northern America and Western Europe on both males and females, varying between 25-60 out of 1091 and 974 (89.3%) maintaining social isolation and 823 (75.4%) were suffering from anxiety. This rate is considered alarming 10.
Post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) can result in patients that are already suffering from anxiety issues 11. People suffering from OCD could develop invasive thoughts regarding the virus; thus, constant checking of temperature, extensive washing, and sterilization can occur, which increases the results of fears in the patients 2. Most of the Covid-19 patients and health workers developed the symptoms of PTSD. Among the 714 Covid-19 patients from the hospital in Wuhan, China, the results of PTSD manifested 12. Whereas, children locked up in their homes away from the educational activities and friends have also developed the symptoms of PTSD. A research study in the town of Wuhan showed that 30% of school-going children showed the symptoms of PTSD 13.
Stress is also one of the common and lethal mental issues emanating during the pandemic as it causes several effects. It can occur for many reasons, including the fear of contracting the disease, loss of a job, and financial issues 14. Stress can lead to,
Bad sleeping and eating habits
Lack of concentration
The excessive use of drugs
It can even deteriorate other mental and health problems adversely 12
Everyone responds differently against stress, and it depends on certain factors, including background, friends, family, partner, financial status, health, and society. However, people who are suffering from mental health issues already featured as homeless, having financial instabilities, disabilities, living in a minor group, children, teens, and front health line workers may react very strongly to the stress because of certain features affecting their mind 15.
Depression affects both mental and physical health. Besides changing the eating and sleeping patterns, it also affects the thoughts; it changes the person's perspective to see the world. According to WHO, 264 million people worldwide are suffering from depression because of the current pandemic. The condition is getting worse because people suffering from such mental health issues are more prone to contracting the disease, whereas getting the proper medication is also the main issue. After all, living in quarantine is preventing the sessions and other activities 16. People with depression due to Covid-19 have feelings of hopelessness and uncertainties regarding their future or finances. Ultimately, the fact that there is no proper treatment or vaccination against Covid-19 is causing more distress. 17
Causes of Mental and Emotional Health Issues due to Covid-19
There are a lot of causes behind the mental and emotional health issues arising from Covid-19. These are uncertainties generated in public, leading to stress, anxiety, and depression. Some of these issues are fears of:
Contracting the disease and transmitting it to others
Loss of job, poor financial state and its impact on the household
Not getting proper health treatment
Limited food supply
Powerlessness and helplessness
Staying away from a loved one(s) and the inability to protect them
Education (as the schools and universities are closed, and admissions are postponed)
Boredom and loneliness because of social distancing 19
How to Cope with Mental Issues during Covid-19?
There are specific ways to improve mental health during the pandemic to keep oneself and loved ones away from psychological issues:
Stay Active Physically
As most of the physical activities are reduced and also gyms, parks, etc. are closed. Efforts to remain physically active would help boost immunity, reduce blood pressure, control weight, and reduce the chance of strokes, diabetes, and several other diseases that have more chance in the case of persons already infected coronavirus 20. Opting for light, intense physical exercises such as walking, jumping, stretching, and lifting accompanied by yoga, aerobics, and mediation would further increase flexibility, increase muscle and balance, and improve bone strength. Adding exercise to daily routine would improve mental health and an excellent way to fight against stress 21.
Take Care of your Mental Health
Due to the pandemic, movements are restricted. People are working, teaching, learning and studying from home, lack of physical contact with friends and family, no social gatherings and activities, and temporary unemployment has burdened the mind, which in return results in several mental issues 22. Therefore, employing the following can help in taking care of mental health:
Make a Routine
Make a routine and try to add all the activities from exercise to reading, from watching movies to cooking. Make sleep patterns better by sleeping early and getting up early. Schedule work routine along with the home routine and take proper rests at intervals. Make room for things you enjoy; read books, watch movies, and listen to music. Similarly, adding exercise and meditation in daily routine can help 23.
Keep Oneself Updated
Watch official news channels on the television; reading verified news from official websites like that of WHO, CDC, can help keep the mind aware of all the information regarding the virus and precautions to take from time to time. But if watching such news makes a person feel distressed or uncomfortable, then it is recommended that watching such news be discontinued 24.
Avoid Illicit Drug use and Drug Abuse
Using excessive drugs can further increase the chance of getting infected with the virus as it weakens the immune system 26. Avoid taking any drug, including tobacco, alcohol, etc., to reduce stress or depression. This is because if any problem or emergency arises due to the use of such drugs, the hospitals may not be accessible since hospitals are already not considered safe in such a time as this 25.
Reduce Screen Time
Working, studying, and learning has increased screen usage, which is not a healthy sign for the body as it affects proper eyesight and can cause memory issues. Therefore, maintaining a gap when using the screen is essential. Also, its usage should be limited 27.
Read, Watch and Play
During quarantine, it is good to seize the time to increase in knowledge by reading books and articles. This will also help in remaining stress-free. Watching movies with good morals also serves as the right way of reducing stress 28. Playing video games is also an excellent way to feel less distressed and relax the mind while sitting at home 29.
Sustaining Nutritious Diet
Maintaining a healthy, nutritious diet would improve the body's ability to fight against certain diseases by boosting the immune system. Healthy dieting is considered one of the primary sources of prevention against Coronavirus 30. There are several essential tips for maintaining a healthy diet. Here are some of them:
Add a fresh variety of vegetables and fruits to diet, especially those containing vitamin C.
Take proteins in the form of meat, eggs, milk, and fish.
Intake of natural probiotics like yogurt will help to recover from GI problems.
Also, taking wholegrain such as wheat, maize. Proper intake of rice and lentils is also necessary 31.
Across the world, schools are closed. Kids are at home and are affected more than adults as they feel more isolated, lonely, bored, and can develop certain types of fears. Hence, parents must find out ways to keep their kids out of these unhealthy situations. Engaging them in activities and discussions regarding the virus and other matters could be helpful. Also, tell kids specific stories and encouraging them to read books 32.
Limitation of the Study
No limitation was encountered during this study.
During the pandemic, as the world is suffering from physical and mental health problems, we should take care of our family and friends balancing with your mental health because mental health presents the overall health and affects how we handle different situations Covid-19. Try to be a stress reliever and help the community get out of their stress. Provide social support and financial support to those who are needy by helping others and making a healthy community. Even in this time of social distancing, when you are away from your family keep you are self-connected through video calls, by social connection, your loved ones will feel less lonely, and they would also be able to share their worries. Hence by doing exercises, mediation, and yoga, keep yourself busy in certain activities. This would help to cope with the stress and depression during the quarantine.
There is a need for a renewed commitment to the fight of this scourge called Covid-19. Hence I recommend that there be an increased call for participation by all stakeholders, including the general public. For those already infected, maximum arrangements should be made to allow them to interact with family and friends through technology like the use of different internet communication applications.
- 1.Mental health and COVID-19. (n.d.). Retrieved (July20,2020),from.https://www.who.int/teams/mental-health-and-substance-use/covid-19
- 2.D L Reynolds, J R Garay, S L Deamond, M K, Gold W et al. (2008) . Understanding, compliance, and psychological impact of the SARS quarantine experience. Epidemiology & Infection 136(7), 997-1007.
- 3.T A Kato, Sartorius N, Shinfuku N. (2020) Forced social isolation due to COVID 19 and consequent mental health problems: lessons from hikikomori. Psychiatry and Clinical Neurosciences. 1-2.
- 4.Cullen W, Gulati G, B D Kelly. (2020) . Mental health in the COVID-19 pandemic. QJM: monthly journal of the Association of Physicians 113(5), 311-312.
- 5.G J Rubin, Wessely S. (2020) The psychological effects of quarantining a city. Bmj,368. https://doi.org/10.1136/bmj.m313
- 6.S K Brooks, R K Webster, L E Smith, Woodland L, Wessely S et al. (2020) The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet.
- 7.Robertson E, Hershenfield K, S L Grace, D E Stewart. (2004) The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. , The Canadian Journal of Psychiatry 49(6), 403-407.
- 8.Maunder R, Hunter J, Vincent L, Bennett J, Peladeau N et al. (2003) The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. , Cmaj 168(10), 1245-1251.
- 9.Qi H, Liu R, Chen X, X F Yuan, Y Q Li et al. (2020) Prevalence of Anxiety and Associated Factors for Chinese Adolescents during the COVID‐19 Outbreak. Psychiatry and Clinical Neurosciences. 1-2.
- 10.Limcaoco R S G, E M Mateos, J M Fernandez, Roncero C. (2020) Anxiety, worries, and perceived stress in the world due to the COVID-19 pandemic. Preliminary results. medRxiv.https://doi.org/10.1101/2020.04.03.20043992
- 11.Hawryluck L, W L Gold, Robinson S, Pogorski S, Galea S et al. (2004) SARS control and psychological effects of quarantine. Emerging infectious diseases , Toronto, Canada 10(7), 1206-1212.
- 12.Altena E, Baglioni C, C A Espie, Ellis J, Gavriloff D et al. (2020) Dealing with sleep problems during home confinement due to the COVID 19 outbreak: Practical recommendations from a task force of the European CBTI Academy. , Journal of Sleep Research 29(4), 1-7.
- 13.J, Bao Y, Huang X, Shi J, Lu L. (2020) Mental health considerations for children quarantined because of COVID-19. , The Lancet Child & Adolescent Health 4(5), 347-349.
- 14.R G Maunder, Leszcz M, Savage D, M A Adam, Peladeau N et al. (2008) Applying the lessons of SARS to pandemic influenza. , Canadian Journal of Public Health 99(6), 486-488.
- 15.CDC.Mental Health and Coping during COVID-19. Retrieved (July20,2020),from.https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
- 16.Dresden D. (2020) Depression and COVID-19: Tips on management and how to cope. Retrieved(July20,2020)fromhttps://www.medicalnewstoday.com/articles/depression-and-covid-19.
- 17.Y T Xiang, Yang Y, Li W, Zhang L, Zhang Q et al. (2020) Timely mental health care for the 2019 novel Coronavirus outbreak is urgently needed. , The Lancet Psychiatry 7(3), 228-229.
- 18. (2019) Guidelines for mental health and psychosocial support in emergency settings. , Retrieved(July21,2020)from.https://www.who.int/mental_health/emergencies/9781424334445/en/
- 19.Takieddine H, S A Tabbah. (2020) . Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental Changes, and the “New Normal” During and After COVID-19.https://doi.org/10.36811/ojda.2020.110005 .
- 20.Jiménez-Pavón D, Carbonell-Baeza A, C J Lavie. (2020) Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Progress in cardiovascular diseases.https://dx.doi.org/10.1016%2Fj.pcad.2020.03.009.
- 21.World Health Organization. (2020) . Mental health and psychosocial considerations during the COVID-19 outbreak, 18 .
- 22.A, Toner E, T V Inglesby. (2020) Priorities for the US health community responding to COVID-19. , Jama 323(14), 1343-1344.
- 23.Greenberg N, Docherty M, Gnanapragasam S, Wessely S. (2020) Managing mental health challenges faced by healthcare workers during covid-19 pandemic. bmj. 1-4.
- 24.Pfefferbaum B, C S North. (2020) . Mental health and the Covid-19 pandemic. New England Journal of Medicine. DOI: 10.1056/NEJMp2008017 .
- 25.Wang C, Pan R, Wan X, Tan Y, Xu L et al. (2020) Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International journal of environmental research and public health. 17(5), 1-25.
- 26.J M Clay, M O Parker. (2020) Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis? The Lancet Public Health. 5(5), 259.
- 27.A G Rundle, Park Y, J B Herbstman, E W Kinsey, Y C Wang. (2020) . COVID19–Related School Closings and Risk of Weight Gain among Children. Obesity.https://doi.org/10.1002/oby.22813 .
- 28.Liu S, Yang L, Zhang C, Y T Xiang, Liu Z et al. (2020) . Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry 7(4), 17-18.
- 29.Hammami A, Harrabi B, Mohr M, Krustrup P. (2020) Physical activity and Coronavirus disease 2019 (COVID-19): specific recommendations for home-based physical training. Managing Sport and Leisure. 1-6.
- 30.Naja F, Hamadeh R. (2020) Nutrition amid the COVID-19 pandemic: a multi-level framework for action. , European Journal of Clinical Nutrition 1-5.
- 31.Muscogiuri G, Barrea L, Savastano S, Colao A. (2020) Nutritional recommendations for CoVID-19 quarantine. , European Journal of Clinical Nutrition 1-2.