Staying sane at home in the time of the coronavirus

In this blog, originally published on Inspire the Mind on 25 March 2020, Paola Dazzan, psychiatrist and Institute of Psychiatry, Psychology and Neuroscience (IoPPN) Vice Dean (International) discusses how we can stay sane whilst staying at home during the coronavirus outbreak.

This is day 14 of my working from home because of the COVID-19 crisis. I have had to start early my social distancing habits, according to Public Health England guidance, as I am living with two vulnerable people.

Everything I do that increases my chances of getting the virus, might pass it on to them, and for them, the risk of a deadly outcome is much much higher than it is for me. 

They are my family, my most loved ones. I cannot bear the thought of losing them. And the thought that this may happen because I was not careful enough, or because I exposed them unnecessarily to the virus is excruciating.

However, I am aware that this way of thinking is dangerous because what we are fighting, we can’t completely control. And we are used to control in many aspects of our lives — certainly I am.

We decide what book we read, which movie we see, which friends we go out with, which job we prefer and even which city we would like to live in. 

Suddenly, we find ourselves stuck in a situation over which we have little control left. 

And our brains are not wired to tolerate uncertainty, but rather to evaluate the threat and decide what actions to take. 

The COVID-19 crisis has forced us at home because of social distancing (avoiding unnecessary contact with other people) in the best case scenario, or because of self-isolation (not leaving home, other than for exercise), or worse, because of quarantine (staying separate from society until it is certain we don’t have the virus). Whatever the reason, we need to make sure we protect our mental health, as well as physical health, during this threat.

Credit: Jordan Hopkins on Unsplash

As a psychiatrist, I think about protecting mental health all the time, for my patients, for my team members, my friends, and of course for myself. 

But COVID-19 is different: is about managing the anxiety of a major, invisible threat in a situation where we cannot put in motion our tried-and-tested stress coping skills. 

And suddenly we may feel deprived, locked in, ineffective, powerless, hopeless, with no control over our present, and end up with more anxiety, more low mood, more obsessive and compulsive symptoms.

So what shall we do? Well, I do not have that silver bullet, but if you keep reading, you will perhaps find some understanding of how you can make it work for you.

We need social interactions to maintain good mental health, as Aristotle said, “man is by nature a social animal”. 

But now we are separated from our friends, family members and work colleagues. Luckily, modern times have brought us new ways to interconnect. Over 3 billion of us are using social media, and digital tools, such as video calls and instant messaging, to stay in touch. 

While we have heard many times that these means, especially when used excessively, may lower our mood, damage positive interpersonal relationships, or disrupt our sleep, they may turn out to be helpful in feeding the needs of our social nature while home-bound.

And yet, many in our societies will not have access to these means. 

My 80-year old mother barely knows how to use her mobile to call her relatives and friends, let alone to share photos or videos with them. So let’s not forget about those digitally-shy people who may still rely on a landline call for contact, and make an effort to make that call, or to drop a card on their doorstep.

While it is under our control how we use social media and digital means to keep in touch, it’s also easy to lose control over them, and let them dominate our day. 

At this time of crisis, we may end up searching the press compulsively, for news on that vaccine or treatment, and instead find the same upsetting headings repeated over many sites, with a less than reassuring result. Again, anything to reduce the uncertainty we can’t tolerate. 

The WHO recommends that we limit the times we check the news, be rigorous, and refuse to be constantly distracted by media. As Rosie Weatherley, spokesperson for the mental health charity Mind said recently: 

And Daniel Freeman, a professor of clinical psychology at the University of Oxford, recently suggested in The Guardian:

“We have to come to terms with such uncertainty… it is best to concentrate on what is meaningful in our lives.” 

So, time to let go, accept we have little control over this new situation, and instead control and select what we look at and when.

And shall we let go of the nice structure we had for our days? Well, maybe let go of how we used to do it, and find a new way. Now, this is something we can control!

Yes, we cannot go to the gym or our pilates classes, and our friends in some countries cannot even go out for a run, but there are many other things we can do to exercise. Many exercise apps have made some of their usually paid-for-services available for free, with a great choice of workouts, yoga, and anything that can give us both mental and physical benefit. 

Credit: Antonika Chanel on Unsplash

Because at the end of the day, this is about controlling how we spend our time, we decide when to do it and with which teacher!

Let’s not let our working day slip into our evenings, protect the time we previously had blocked for yoga or theatre, and replace it with something equally pleasurable, or start that online course we never had time to do. In fact, we have control over this, just need to let go of our old habits.

And if we are staying home for a while, we better stay connected with ourselves, in many practical but highly symbolic ways, looking after our self-care, getting dressed and not just staying in our PJs all day.

While I am writing this, I am finding it as difficult, as I am sure you all are, to think about how and whether this really represents control, or just letting go of it. Can I keep this going for weeks on end, and how different is this from my normal life?

Let’s keep reminding ourselves that, if we just manage to have some control over how we fit this new, unfamiliar crisis into our lives, while protecting our mental health, we will all find each other again on the other side of this.

And we will be stronger, and even more able to savour the normality of our everyday life. 

During these months, my friends in Italy have sent me many videos about responsible behaviour and staying positive and well during this crisis. 

One that has made me shed tears ended by saying:

“One day we will say, do you remember those months during the coronavirus crisis? Let’s get to that day as soon as possible.”

And stay healthy in the meantime.

Inspire the Mind is an online blogging community started by the Stress, Psychiatry and Immunology Laboratory (SPI Lab) King's College London, which is led by Professor Carmine Pariante. The blogs hosted on Inspire the Mind aim to use writing and creativity to open up a conversation about wellbeing, to teach and disseminate the science behind mental health and to encourage others to do the same.

If you're interested in writing a blog post, please contact: inspirethemind@kcl.ac.uk

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