The mental health toll of the coronavirus epidemic

“The 360” shows you diverse perspectives on the day’s top stories and debates.

What’s happening

Around the world, governments and health experts are scrambling to limit the spread of the coronavirus. Urgent public awareness campaigns are being used to inform the public of the severity of COVID-19, the disease caused by the virus. Social distancing measures — some voluntary, some imposed — have been put in place in countries around the globe.

These drastic steps are necessary to avoid potentially millions of deaths globally over the next few months. The ultimate concern is the health and well-being of those who are vulnerable to the virus. But pursuing these measures could bring about a less obvious, but still significant, threat to the mental health of people who may themselves never become infected.

Why there’s debate

The mental health impacts of the outbreak will vary among individuals, but experts say the most pervasive issues are anxiety and loneliness.

It’s easy to understand why anxiety would spike during a crisis. Wall-to-wall news coverage and changing messages from political leaders can cause stress and uncertainty in average people. For the estimated 40 million Americans with underlying anxiety disorders, these triggers can bring about overwhelming feelings of fear and lack of control. That can lead people to make unhealthy decisions as they struggle to differentiate between the very real dangers of the virus and the imagined risks brought on by their anxiety.

Another major driver of mental health risks is the isolation brought on by social distancing. Humans have an evolutionary desire to be part of a group. When we’re deprived of social contact, it can have dramatic effects on both mental and physical health. Loneliness was already a pervasive problem before the outbreak. Weeks of extended isolation enacted to control the spread of the virus could have significant and lasting health impacts. Loneliness has been shown to have a health impact equivalent to smoking 15 cigarettes a day.

The effects on mental health could endure long after the virus has been contained. People impacted by the SARS epidemic in the early 2000s reported mental health issues for up to four years after the epidemic ended.

What’s next

Mental health experts say there are ways to combat the psychological toll of the coronavirus pandemic. The most common advice includes avoiding sensationalist news coverage, interacting with people over the phone or internet, getting outdoors while avoiding close contact and making digital appointments with mental health professionals.

Perspectives

For some, the mental health risk outweighs the risk to physical health

“There is real risk, but for the vast majority of us, the risk is not commensurate with the degree of obsession and panic coverage of the virus has bred, both in people who are panic-prone and those who are not.” — EJ Dickson, Rolling Stone

Isolation will exacerbate an epidemic of loneliness that already exists

“Across the country, people are being asked to work from home, universities are switching to virtual classes and large gatherings are being canceled. These are key strategies to prevent transmission, but they can come at a social and mental-health cost: furthering our sense of isolation from one another, and making us forget that we’re in this together.” — Abdullah Shihipar, New York Times

Uncertainty is a major trigger for anxiety

“The uncertainty that exists right now is hard for people to manage. We prefer predictability and like to be able to anticipate what is going to happen as it increases a sense of safety. When that is not present, people try to find it; then when the information is unclear or contradictory, this can sometimes create even more ambiguity resulting in increased stress and fear.” — Therapist Holly Sawyer to Philadelphia Inquirer

Humans need social interaction just as they need food or water

“If we think about loneliness as this adaptive response kind of like hunger and thirst, it’s this unpleasant state that motivates us to seek out social connections just like hunger motivates us to seek out food.” — Psychologist Julianne Holt-Lunstad to Business Insider

The effects of isolation are more pronounced in older people

“Social isolation leaves elders vulnerable to negative health outcomes such as cognitive decline, heart disease and depression, which suppresses the immune system.” — Stacy Torres, San Francisco Chronicle

People could lose access to mental health professionals

“Preventative measures such as social distancing and quarantines can also inhibit access to vital health care for people with serious mental illnesses.” — Anagha Srikanth, The Hill

The psychological impacts of the outbreak are underappreciated

“We’re now officially in a pandemic. But we’ve also entered a new period of social pain. There’s going to be a level of social suffering related to isolation and the cost of social distancing that very few people are discussing yet.” — Sociologist Eric Klinenberg to Vox

Mixed messages from leaders contribute to anxiety

“Contributing to anxiety is confused and confusing pronouncements from elected officials. ... When reassurances ring hollow, anxiety spirals.” — Sharon Begley, Stat

The mental strain can cause a long list of symptoms

“Reactions to the crisis can include feeling overwhelmed, fearful, sad, angry and helpless, according to experts. Some people may have difficulty sleeping or concentrating. Fear of contact with others, travelling on public transport or going into public spaces may increase, and some people will have physical symptoms, such as an increased heart rate or upset stomach.” — Jessica Murray and Harriet Sherwood, Guardian

The impact will be worse for people with preexisting mental health challenges

“Some mental health experts think coronavirus fears may cause people with anxious tendencies to topple into a full-blown illness.” — Bonnie Berkowitz, Washington Post

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