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The emotional toll of social distancing

As the number of novel coronavirus cases climbs, countries are increasingly taking social distancing measures to curb the virus’s spread. Social distancing means avoiding settings where you might come into close contact with others, as well as mass gatherings, and staying at least six feet away from others when you can, according to the Centers for Disease Control and Prevention.

Music festivals and sporting events have been postponed or cancelled altogether. Companies are encouraging employees to work from home. Some wonder whether we should also forego restaurants, gyms, and yoga studios. The thing is, so many of us have relied on these social gatherings to cope with a world that was already falling apart before coronavirus reared its head. And now, even the simplest, purest of human gestures, the ones we crave most in times like these — a hug or squeeze of our hand, reassuring us everything will turn out okay — now carry risk. Social distancing might physically protect us from coronavirus, but is it also emotionally isolating us? And how will all that isolation affect our mental health or overall mood?

Both the World Health Organization and the CDC cite social distancing as a strategy to slow the transmission of the novel coronavirus. Epidemiologists say that this, in turn, could prevent a spike in cases, which would overburden the healthcare system in the United States, per Vox. Many physicians also assert that, in big cities where illnesses can spread fast, keeping a 3-foot bubble of space between you and other people in public is crucial during a growing pandemic. But mental health experts say that such precautions may come at a psychological cost.

Right now, even the simplest, purest of human gestures, the ones we crave most in times like these — a hug or squeeze of our hand, reassuring us everything will turn out okay — now carry risk.

“In order to stay physically healthy, we’re doing the exact things that are evolutionarily not good for us in other ways,” says Jonathan Kanter, a research associate professor at the University of Washington’s Center for the Science of Social Connection. “Especially when we’re in a time of threat or danger, we naturally want to connect with each other.” Hugging and other forms of physical affection are especially important, he adds, soothing us at a physiological level by reducing levels of the stress hormone cortisol.

What’s more, social distancing adds to worries that already plague us about living in the midst of what the WHO declared a pandemic on Wednesday. “When people are isolated from each other, they feel more anxiety and threat, just as a general evolutionary fact,” Kanter tells Mic. (We’re social animals, after all, hardwired for connection.) He adds that social isolation is associated with worse immune functioning, which may have implications for our risk of infection.

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Research on people under quarantine can also provide a glimpse into the mental health effects of social isolation. A recent review of previously-published studies identified confusion, anger, and post-traumatic stress symptoms as possible psychological effects of quarantine.

Much of these are predicated on whether the quarantined individuals have access to new, reliable information, says Frank Ghinassi, president and CEO of Rutgers University Behavioral Health Care — that is, non-alarmist and not the “endlessly repetitive information” that often pervades the 24-hour news cycle, which can worsen stress.

Other stressors include a lack of food and other basic necessities, as well as financial loss, such as that experienced by people who aren’t compensated for not coming into work. The stigma felt by those under quarantine is another one. “They feel like they’re to blame,” Ghinassi says. “They’re labeled as somebody who needs to be avoided.”

The extent to which social isolation affects us also depends on our baseline social connectedness.

Whether the quarantine is voluntary or involuntary also makes a difference. People feel less in control under involuntary quarantines, like those enacted in China and Italy, and if governments don’t explain that the mandate is for the general good, “it can feel a little like punishment,” Ghinassi says. “Humans like to be in charge of our own activities.”

The extent to which social isolation affects us also depends on our baseline social connectedness, Ghinassi says. Those who are well-connected to their communities might feel some anxiety, loneliness, and frustration. Social isolation might have a greater impact on seniors — for whom social distancing is especially crucial, due to their a higher risk of serious illness and death from coronavirus — since they often rely on others for their day-to-day needs. The same goes for people who are single, introverted, and have few in-person interactions.

Millennials are also vulnerable. Despite often having a bunch of followers on social media, “many of them report feeling isolated, and a lot of that is because the majority of their face-to-face time tends to be at the office,” Ghinassi says. “They’ve begun to mistake Twitter and Instagram counts for friendship, and it really is several degrees of linkage away.” Work-from-home policies, on top of other social distancing measures, strip away the few in-person interactions millennials had to begin with, which could make them feel even more isolated “There’s a lot of research that live, human, face-to-face contact is unquestionably better for us than digital contact,” Kanter says.

That's not to say you can't maintain meaningful relationships online. Quality matters more than quantity; Kanter notes that focusing on a few close relationships might actually be more helpful in times of need. In other words, now is probably a good time to re-connect with that sibling or best friend you haven’t spoken to in a while, Ghinassi says.

Research also shows that reaching out and supporting others has mental and physical health benefits, such as increased happiness and lowered blood pressure, even though we tend to turn our focus toward protecting ourselves and our families in times of uncertainty, Kanter says. So sure, go ham stocking up on toilet paper — “but then distribute them to your neighbors or the homeless.”

Social distancing and other precautions related to coronavirus are prompting us to consider when the cure becomes worse than the disease, Kanter adds. Although he won’t go so far as to state that this is the case, “we do have to understand that the impacts of social isolation are real,” he says.