The novel coronavirus outbreak and pandemic have forced governments to introduce social restrictions and closures as containment measures. According to reports, the current global pandemic of the new crown pneumonia epidemic and the ensuing mandatory quarantines and physical closures have affected every aspect of people's lives around the world. The pandemic response has greatly increased the anxiety and fear associated with contracting the virus, getting needed medical supplies, timely access to medical assistance, and access to basic necessities and food. Threats to safety and security have been further exacerbated by governments abruptly halting social activities, economic production, education and recreational opportunities during the pandemic. Mandatory orders to work from home disrupt daily work and schedules, and place additional stress on an individual's mental health. Work-from-home orders have also led to a separation of family and work responsibilities. The consequences of the pandemic have been catastrophic for society, increasing mortality and morbidity, social isolation, and economic instability and employment hardship.
From the results of relevant studies, it is known that the incidence of mental disorders has increased in the new crown pneumonia epidemic due to social isolation, impaired basic needs, economic instability and fear of the virus. New cases of anxiety and depression have been on the rise, as have pre-existing mental disorders and chronic illnesses.
Which groups are most vulnerable to COVID-19 quarantines?
The elderly, children, health care workers and individuals with pre-existing mental health issues, who have limited access to mental health support services during the lockdown, are the most affected by epidemic control measures and the resulting social distancing. Pre-existing chronic diseases in the aging population are exacerbated by disruptions in health care delivery. Health care providers are also experiencing negative impacts from the pandemic, including work-related stress, long hours of fatigue, constant fear of contracting and spreading the virus, and life-or-death ethical dilemmas. At the same time, to prevent self-harm due to epidemic restrictions, vulnerable groups with pre-existing physical or mental disabilities and limited access to health care services and community resources must be identified and assessed.
During the COVID-19 pandemic, even those with no history of mental health reported high levels of stress. As a result, maladaptive behaviors have increased, including eating disorders, physical inactivity, substance use, and excessive addiction to social media and the Internet. Social distancing requirements, acute substance dependence, and maladaptive behaviors increase adverse effects on an individual's mental health.
When experiencing emotional distress, people with impaired well-being may experience catastrophic misinterpretation of events, negative self-talk, blaming oneself and others, black-and-white thinking patterns, impaired rational reasoning, and negative tendency to conclude. Therefore, the adverse consequences of epidemic measures, such as social distancing, must be addressed to reduce their negative impact on individual mental health, including anxiety disorders.
Anxiety disorders in the context of the isolation of the new crown pneumonia epidemic
Anxiety disorders are the sixth leading cause of disability globally, and the Covid-19 pandemic has brought unprecedented stress related to uncertainty and security concerns. Although specific symptoms of anxiety disorders vary by diagnosis, anxiety disorders have important transdiagnostic features, including overestimation of threat, intolerance of uncertainty, and underestimation of an individual's ability to cope. The study found that people with pre-existing anxiety or mood disorders experienced higher levels of stress associated with COVID-19 isolation compared to people without mental disorders. This suggests that the COVID-19 pandemic has affected individuals with pre-existing mental health problems to varying degrees.
Given that people with anxiety disorders overestimate the potential for threat and harm, people with anxiety disorders have a stronger response to stressors such as COVID-19, which poses a real and imminent threat to a person's health. One of the hallmarks of an anxiety disorder's intolerance of uncertainty is the need for predictability, which is often accompanied by excessive information seeking and difficulty in decision-making. In the context of the COVID-19 pandemic, intolerance for uncertainty has been shown to have a direct negative impact on mental health.
Although our understanding of the COVID-19 outbreak has improved considerably since the World Health Organization declared it a pandemic on March 11, 2020, with the emergence of interesting virus variants and changing safety restrictions , the situation is constantly changing. Therefore, even seeking reliable and accurate information cannot provide a guarantee. For people with anxiety disorders, changing information may promote compulsive behavior.
Why does the COVID-19 quarantine have adverse effects?
Widespread community closures and uncertainty about the spread of the COVID-19 pandemic have reduced an individual's psychological resilience and ability to cope with stress. Anxiety and fear are normal human responses to a pandemic environment. Individuals with high levels of resilience and physical and mental health are better able to cope with the additional stress of life and may return to normal baseline levels as soon as possible after a pandemic with minimal to no residual trauma. However, the unprecedented security threat of the pandemic has severely compromised individual resilience and ability to respond. The COVID-19 pandemic has created higher levels of anxiety, physical and emotional insecurities, and fears related to expected, potentially harmful, or adverse consequences of the pandemic. Additionally, the study assumed that quarantine-related symptoms could persist for at least 3 years.
Previous studies have found that individuals report increased anxiety symptoms, worsening work performance, worsening existing mental health conditions, heightened fear, difficulty concentrating, and increased insomnia, irritability, and isolation. And the constant updates of information provided by social media further exacerbate anxiety and stress and impair people’s ability to cope effectively with everyday life.
How to deal with the impact of the new crown pneumonia epidemic isolation?
First, adequate support for those affected by COVID-19 quarantine should be encouraged to ensure adequate psychological support for those who witness exposure to COVID-19. In addition, healthcare professionals should be provided with training in the basic management of COVID-19 and treatment, in-person or online, and healthcare facilities should ensure regular comprehensive screening and occupational health monitoring for symptoms of PTSD , to ensure the well-being and timely treatment of healthcare professionals.
In addition, appropriate psychological support must be developed to help those affected by the COVID-19 quarantine to cope with the challenges of the COVID-19 pandemic. Among them, psychological interventions for post-traumatic stress disorder in health care professionals should include two aspects: (1) provide adequate information related to the new coronary pneumonia epidemic, training and personal protection; (2) provide psychological support for health care professionals , to improve their ability to effectively deal with psychological problems.
At the same time, provide information to the general population on the essential elements of the COVID-19 outbreak to reduce traumatic stress, including increased safety, connectedness, promotion of calm and self-awareness, collective efficacy and hope, and possibly reduced COVID-19 isolation Effective methods for adverse effects.
During the quarantines and lockdowns associated with the COVID-19 pandemic, with social interactions disrupted, studies have shown that individuals receiving cognitive behavioral therapy have significantly less anxiety and fear about the COVID-19 outbreak than those not receiving cognitive behavioral therapy.
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