Anxiety and Depression in Confinement: 13 Tips

In these times of confinement, anxiety and depression can affect you, here's some advice from mental health experts on how to cope with this unusual situation.

Coronavirus and containment don't mix

     Are you worried? You should know you're not alone. The outbreak of the coronavirus COVID-19, first reported in Wuhan, China, has spread to more than 100 countries around the world in a short period of time.

     To curb the contagion, the government has put in place many restrictive measures: school closures, compulsory teleworking and the closure of many services deemed non-essential are just a few examples.

     Normal' life as we knew it has been confinement. The watchword is "social distancing". Most of the time, confined to the home.

Extreme stress during confinement

     "A significant percentage of the population suffers from mood or anxiety disorders: they are the most likely to have difficulty coping with extreme stress," says Dr. Victor M. Fornari, Vice President of the Department of Child and Adolescent Psychiatry at Zucker Hillside Hospital in Glen Oaks, New York.

     Other people, who have never been diagnosed with depression or anxiety, may also be at risk.

     Either because of financial instability caused by the COVID-19 pandemic, fear of getting sick, or fear that friends and family members will be affected by the disease, Dr. Fornari adds.

     Knowing the warning signs of depression allows you to act quickly and avoid the vicious cycle of negative thoughts, adds Brittany LeMonda, senior neuropsychologist at Manhattan's Lenox Hill Hospital.

     "Feelings of sadness, difficulty getting out of bed, sleep disturbances (insomnia or the urge to sleep all the time), poor eating habits (under- or overeating), use of drugs, alcohol or tobacco, self-isolation and extreme distancing (much more than is recommended) are all warning signs," adds Dr. LeMonda.

     Other signs to watch out for include: outbursts of anger, obsessive or self-destructive thoughts, feelings of hopelessness, or helplessness.

     "It's important that family members, friends, or colleagues pay attention to these warning signs in vulnerable people."

Give yourself a break

     It's normal not to be well right now," says Robin D. Friedman, a psychotherapist at Lotus Psychotherapy in White Plains, New York.

     You may feel desperate and have difficulty imagining a future beyond the current situation, she says. "Feelings are fluctuating. There are ups and downs: in difficult times, you can draw strength from family members, friends, or neighbors, who can be an inspiration to you."

Organize a virtual happy hour

     Yes, you can harness technology to organize virtual meals, a coffee break, or synchronize online games for your kids and their friends.

     "Just because we have to practice social distancing doesn't mean we have to be socially isolated," Friedman explains. "Use technology and be creative!"

Volunteer, help your neighbor

     Seniors are more likely to be socially isolated. In addition, many of them do not know how to use new technologies and may not even be connected to the Internet.

     Dropping off a meal, books, or small gifts at their door, writing them a kind word and putting it in their mailbox are altruistic gestures that can make all the difference, especially putting a smile on their face," suggests Friedman.

Meet with your psychologist by videoconference

     Many therapists offer consultations online or by phone," says Friedman, who now sees all his patients via videoconference.

     Even if you don't have a therapist right now, you should be able to find one who offers online support, she says. "Mental health professionals are still working - despite the situation - and many of them are accepting new patients."

     In some cases, medication may be necessary, to complement psychotherapy, she says.

Get some exercise

     According to the American Psychological Association (APA), exercise stimulates the secretion of endorphins - hormones produced naturally by the body - which act as a powerful stress reducer.

     "If you're not in quarantine, but in confinement, you can go for a walk, jog, or bike ride," Friedman says. Getting some fresh air is good for your health, as long as you keep a distance of two meters from other people.

     LeMonda adds:   "Online courses on YouTube or via applications are also a great way to stay in shape, strengthen your immune system and feel good about yourself on a daily basis.

Breathe

     There are different applications you can download to practice breathing, as well as mindfulness techniques," says Dr. Fornari.

     "Even if you're not used to practicing mindfulness, it may be helpful to include it in your daily routine during times of stress," he says.

     There are many choices: deep breathing, listening to music, or learning to meditate. Find the one that's right for you.

Avoid self-destructive behavior

     Drinking alcohol, smoking, using illegal drugs, or even eating too many foods high in fat and sugar - while comforting - makes the situation worse.

     "Those who generally find it difficult to cope with change may, unfortunately, see the use of alcohol, tobacco, or drugs as a way to alleviate their negative feelings.

     Those who tend to isolate themselves in difficult situations may also be more likely to develop depressed feelings," says LeMonda.

     "Other people may tend to change their healthy lifestyle habits in the face of stress: they may eat more - and too much - or not enough, which can interfere with their sleep. These people are more likely to suffer from depression."

     Maintaining a healthy diet, getting a good night's sleep and being physically active every day are the best ways to stay healthy, both physically and mentally, during this difficult time," she adds.

Take a break from the news

     "Continually the following information can aggravate feelings of anxiety and depression," says Dr. Fornari. It's important to stay on top of the news, but there's no reason to leave the TV on all the time.

     APA suggests identifying a few trustworthy sources of information, such as government or municipal resources and serious news media, and ignoring the rest.

Be indulgent with yourself

     

     Now is not the time to blame yourself for any behavioral errors you may have had in relation to the coronavirus," says Dr. Fornari.

     "You may have let your child attend a party or an event and then someone ended up being diagnosed with COVID-19," he says. "We're not perfect and everyone tries to do the best they can."

Put away your cupboards

      Use your time at home to your advantage," says LeMonda. She suggests that "activities that increase your sense of efficiency are far better than just taking your mind off things by watching TV," she adds.

     "For example, reorganizing your closet, cleaning your kitchen, sorting through old papers, reading, doing crosswords, choosing a new hobby, such as knitting, or cooking new recipes are all activities that provide a sense of satisfaction.

Stick to your routine

     Disorganization does no one any good, Dr. Fornari explains. "Get up at the same time as if you had to go to work, get ready for telework and follow a regular schedule," he says. 

     "Take a break once in a while and don't skip lunch." This positive attitude is as important for you as it is for your children, who are also housebound.

Stay calm for your children

     Parents need to be careful what they say and how they say it," warns Dr. Fornari. "Children hear everything and are like sponges: Parents must set an example with a calm, organized attitude." Listen to their concerns and offer a sympathetic and reassuring ear. 

Don't make things worse

     

     Avoid sharing - on social media - scary headlines," says Samantha Boardman, a psychiatrist in private practice in Manhattan. Instead, Dr. Boardman suggests sharing calming content such as the Cellist Yo-Ma's Comforting Songs series or Tom Hanks and Rita's Quarantunes Playlist.