Behavioral Health During Times of Social Distancing, Quarantine, and Isolation

In the event of an infectious disease outbreak, local officials may require the public to take measures to limit and control the spread of the disease. This article provides information about social distancing, quarantine, and isolation. The government has the right to enforce federal and state laws related to public health if people within the country get sick with highly contagious diseases that have the potential to develop into outbreaks or pandemics:

• What is social distancing? Social distancing is a way to keep people from interacting closely or frequently enough to spread an infectious disease. Schools and other gathering places such as movie theaters may close, and sports events and religious services may be cancelled.
• What is quarantine? Quarantine separates and restricts the movement of people who have been exposed to a contagious disease to see if they become sick. It lasts long enough to ensure the person has not contracted an infectious disease.
• What is isolation? Isolation prevents the spread of an infectious disease by separating people who are sick from those who are not. It lasts as long as the disease is contagious.

This article describes feelings and thoughts you may have during and after social distancing, quarantine, and isolation. It also suggests ways to care for your behavioral health during these experiences and provides resources for more help.

What to Expect: Typical Reactions

Everyone reacts differently to stressful situations, such as an infectious disease outbreak that requires social distancing, quarantine, or isolation. People may feel

• Anxiety, worry, or fear related to
  • Their own health status
  • The health status of others whom they may have exposed to the disease
  • The resentment that friends and family may feel if they need to go into quarantine as a result of contact with you
  • The experience of monitoring yourself, or being monitored by others for signs and symptoms of the disease
  • Time taken off from work and the potential loss of income and job security
  • The challenges of securing things you need, such as groceries and personal care items
• Concern about being able to effectively care for children or others in your care
• Uncertainty or frustration about how long you will need to remain in this situation and uncertainty about the future
• Loneliness associated with feeling cut off from the world and from loved ones
• Anger if you think you were exposed to the disease because of others' negligence
• Boredom and frustration because you may not be able to work or engage in regular day-to-day activities
• Uncertainty or ambivalence about the situation
• A desire to use alcohol or drugs to cope
• Symptoms of depression, such as feelings of hopelessness, changes in appetite, or sleeping too little or too much
• Symptoms of post-traumatic stress disorder (PTSD), such as intrusive, distressing memories; flashbacks (reliving the event); nightmares; changes in thoughts and mood; and being easily startled

If you or a loved one experience any of these reactions for two to four weeks or more, contact your health care provider or one of the resources at the end of this tip sheet.

Ways to Support Yourself During Social Distancing, Quarantine, and Isolation

Understand the risk.

Consider the real risk of harm to yourself and others around you. The public perception of risk during a situation such as an infectious disease outbreak is often inaccurate. Media coverage may create the impression that people are in immediate danger when really the risk for infection may be very low. Take steps to get the facts:

• Stay up to date on what is happening, while limiting your media exposure. Avoid watching or listening to news reports 24/7, since this tends to increase anxiety and worry. Remember that children are especially affected by what they hear and see on television.
• Look to credible sources for information on the infectious disease outbreak. Sources for reliable outbreak-related Information include the Centers for Disease Control and Prevention (CDC) at Link opens in a new windowhttps://www.cdc.gov/coronavirus/2019-ncov/index.html or the World Health Organization (WHO) at Link opens in a new windowhttps://www.who.int/emergencies/diseases/novel-coronavirus-2019.

Be your own advocate.

Speaking out about your needs is particularly important if you are in quarantine, since you may not be in a hospital or other facility where your basic needs are met. Ensure you have what you need to feel safe, secure, and comfortable:

• Work with local, state, or national health officials to find out how you can arrange for groceries and toiletries to be delivered to your home as needed.
• Inform health care providers or health authorities of any needed medications, and work with them to ensure that you continue to receive those medications.

Educate yourself.

Health care providers and health authorities should provide information on the disease, its diagnosis, and treatment:

• Do not be afraid to ask questions—clear communication with a health care provider may help reduce any distress associated with social distancing, quarantine, or isolation.
• Ask for written information when available.
• Ask a family member or friend to obtain information in the event that you are unable to secure this information on your own.

Work with your employer to reduce financial stress.

If you're unable to work during this time, you may experience stress related to your job status or financial situation:

• Provide your employer with a clear explanation of why you are away from work.
• Contact the U.S. Department of Labor (DOL) toll-free at 866-487-2365 about the Family and Medical Leave Act (FMLA), which allows U.S. employees up to 12 weeks of unpaid leave for serious medical conditions, or to care for a family member with a serious medical condition.
• Contact your utility, cable, and internet providers (as well as other companies from whom you get monthly bills) to explain your situation, and request alternative, bill-payment arrangements as needed.

Connect with others.

Reaching out to people you trust is one of the best ways to reduce anxiety, depression, loneliness, and boredom during social distancing, quarantine, and isolation. You can try these ideas:

• Use telephone, email, text messaging, and social media to connect with friends, family, and others.
• Talk "face to face" with friends and loved ones using Skype or FaceTime.
• If approved by health authorities and your health care providers, arrange for your friends and loved ones to bring you newspapers, movies, and books.
• Sign up for emergency alerts via text or email to ensure you get updates as soon as they are available.
• Call your employee assistance program (EAP) or a local helpline if you feel lonely or need support.
• Use the internet, radio, and television to keep up with local, national, and world events.
• If you need to connect with someone because of an ongoing alcohol or drug problem, consider calling your local Alcoholics Anonymous (Link opens in a new windowhttps://www.aa.org) or Narcotics Anonymous (Link opens in a new windowhttps://www.na.org/meetingsearch) offices. NA offers virtual meetings at Link opens in a new windowhttps://virtual-na.org.

Talk to your doctor.

If you are in a medical facility, you may have access to health care providers who can answer your questions. However, if you are quarantined at home, and you're worried about physical symptoms you or your loved ones may be experiencing, call your doctor or other health care provider:

• Ask your provider whether it would be possible to schedule remote appointments via Skype or FaceTime for mental health, substance use, or physical health needs.
• In the event that your doctor is unavailable and you are feeling stressed or are in crisis, call a hotline number like the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) for support.

Use practical ways to cope and relax.

• Relax your body often by doing things that work for you—take deep breaths, stretch, meditate or pray, or engage in activities you enjoy.
• Pace yourself between stressful activities, and do something fun after a hard task.
• Talk about your experiences and feelings to loved ones and friends, if you find it helpful.
• Maintain a sense of hope and positive thinking; consider keeping a journal where you write down things you are grateful for or that are going well.

After Social Distancing, Quarantine, or Isolation

You may experience mixed emotions, including a sense of relief. If you were isolated because you had the illness, you may feel sadness or anger because friends and loved ones may have unfounded fears of contracting the disease from you, even though you have been determined not to be contagious.

The best way to end this common fear is to learn about the disease and the actual risk to others. Sharing this information will often calm fears in others and allow you to reconnect with them.

If you or your loved ones experience symptoms of extreme stress—such as trouble sleeping, problems with eating too much or too little, inability to carry out routine daily activities, or using drugs or alcohol to cope—speak to a health care provider, your EAP, or an appropriate hotline for a referral.

If you are feeling overwhelmed with emotions such as sadness, depression, anxiety, or feel like you want to harm yourself or someone else, call 911 or 988, the Suicide & Crisis Lifeline. (The former number, 800-273-TALK [800-273-8255] still works also.) You can also visit the website at Link opens in a new windowhttps://988lifeline.org.