Last night I dreamed that I was trapped inside a strange house. I ran down coiled staircases through shadowy hallways, past room after room with locked doors or frozen-shut windows. There was no escape.
I woke up in a panic, anxiety from the dream still thrumming in my chest. Reflexively, I checked my phone for the time and everything else: emails, texts, social media likes, comments and shares — the hot and cold shimmers of information we miss out on when we're sleeping. I wanted to plug back into the world immediately to free my mind of the unease the dream had unleashed. But no number of notifications could drown out the nagging question in my mind: "How am I going to survive the COVID-19 winter?"
It's a question I feel guilty for even thinking given how relatively easy I have it. Because of COVID-19, millions of Americans have fallen into poverty, over 350,000 have died from the virus, and restrictions are tightening up across the country.
In the midst of all this tragedy and unrest, my little life looks pretty good: I'm in fine physical health, I have steady income (though a lot less of it than in 2019) and a wonderful partner. But sheltering in place hasn't been without its challenges. In March, my husband and I became surprise caregivers to my mother as her senior government housing complex was ravaged by COVID-19.
To help keep her safe, my husband and I seldom leave the house. Though he's managed to conduct a semblance of a social life online with Zoom hangouts and Skype sessions, I've gone full introvert. It's less my personality type and more my mental illness type, if you will. I have an anxiety disorder and major depression that cause me to self-isolate even when there isn't a pandemic going on. I take medication as prescribed to treat these conditions, but I've been out of therapy since my income dropped off earlier this year.
I worry that extended isolation over the winter months will push me over the edge. I'm not sure what that would look like, but I have a feeling it'll be about as fun as last night's nightmare.
If you’re feeling alone, you’ve got company
There are valid reasons for concern. Research shows that social isolation can trigger or worsen depression and/or anxiety, and the CDC recognizes that social isolation can increase the risk of dementia, heart disease and stroke in people ages 50 and over. Isolation can be detrimental in and of itself — but isolation because of a global pandemic is shaping up to be its own deadly beast. Mental health experts worry that the worst is yet to come.
"Many believe that we in mental health are facing a tsunami of need in terms of what lies ahead," said Dr. Saundra Jain, a psychotherapist and member of HealthyWomen's Women's Health Advisory Council.
"Recent data tells us that one in five of those recovered from COVID-19 will develop a mental health disorder like anxiety, depression, PTSD and OCD. Sadly, even pre-COVID there weren't enough mental health clinicians to meet the need, so we are going to be faced with some real challenges."
And the weather isn't helping matters.
"The winter season remains dark so much of each day that it can feel like we wake up in the dark, go to work all day, leave in the dark and then retreat to isolation," said William Schroeder, a therapist who specializes in cognitive behavioral therapy. "When you remove social opportunities from the mix that people used to engage with pre-COVID, we metaphorically spin our wheels desperate for connections."
Though some groups are more at risk for the ill effects of social isolation (the elderly, for example), nobody is immune to loneliness — and loneliness is so commonly tied to social isolation, organizations like the CDC tend to use the terms in tandem.
"It's worthwhile to address ways to combat loneliness to prevent an overwhelming sense of isolation," Schroeder said. "We are wired for connection as humans. We feel isolated and lonely when our need for connection is not being met. It can result from actual isolation (i.e., being ordered to shelter in place) or feeling cut off emotionally from those we are with (i.e., engaging is social-distant living for most of 2020)."Short periods of isolation and/or loneliness usually aren't a big deal, but as we now know all too well, pandemic lockdowns are fairly long-term affairs. Even after the COVID-19 vaccines are widely available, Dr. Anthony Fauci emphasizes that we'll still need to socially distance and wear masks for the foreseeable future.
Coping with isolation and loneliness
Fortunately, there are ways to cope with isolation and the loneliness it might induce. The number one trick is to build a daily routine that centers on self-care.
"Part of adapting to this pandemic is accepting the uncertainty and then proactively engaging in wellness-enhancing practices like exercise, mindfulness meditation, optimized sleep, social-connectedness, and optimized nutrition," Jain said. "We know that these practices improve depression and anxiety ... and improve wellness."
People who are struggling with isolation should also work to become aware of their thoughts, specifically the bad ones.
"Watch out for ANTs or Automatic Negative Thoughts," Schroeder advised. "All of us are guilty of this at various times but it is easy to allow ourselves to become monsooned in negative thought cycles. This is challenging during stressful times in life but if you can start to recognize what triggers it or makes it worse, you can then try and slow or stop those thoughts before they get too much momentum."
Dr. Athena Robinson, an adjunct clinical associate professor at Stanford's School of Medicine pointed out that feeling lonely right now is normal, so there should be no shame in accepting it. We're experiencing loneliness "because we care about one another and our communities," Robinson said. She vouches for self-soothing measures such as deep breathing and meditation, but notes that sometimes we just can't fight loneliness by ourselves.
"If you find loneliness is impacting to you to the point where it's difficult to get out of bed, concentrate, or to engage in daily activities, then it's time to consider reaching out for additional support," Robinson said.