Helping Give Away Psychological Science/Coping with social isolation

What this is: This page organizes resources and general information about coping with social isolation and the loneliness and stress that it can create. The topic is especially important as we deal with quarantines and social distancing as ways of responding to the coronavirus outbreak.

What this is not: We have another page focused specifically on the COVID-19 pandemic. There are also a variety of other teaching resources about COVID-19.

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= What do we know about social isolation =

Physical distancing slows down the spread of contagious diseases, flattening the curve of new cases. It also changes our social routines, and it is easy for physical separation to turn into social isolation and loneliness. Less social connection often means less sense of support, and worsens the stress and anxiety.

There are many things we can do to avoid feeling cut off from other people.

=Mental Health Resources= Many people feel some degree of anxiety when thinking about the outbreak of infectious diseases. The resources in this section may be helpful for reducing these worries.

Coping with anxiety
The American Psychological Association provides the following 5 tips for people coping with anxiety related to the 2019-nCoV virus outbreak:

Keep things in perspective
Take a deep breath, and remember that the number of confirmed infections in the U.S. is extremely low compared to number of people in the country. The fact that there is a great deal of news coverage on this issue does not necessarily mean that it presents any threat to you or your family. There are other things that are statistically more likely to be dangerous (such as car accidents) that are not getting major news attention.

Get the facts
It is helpful to adopt a more clinical and curious approach as you follow news reports about the virus. To that end, you will want to find a credible source you can trust. The U.S. Centers for Disease Control and Prevention has a webpage dedicated to information on the coronavirus outbreak. You may also find useful information from local or state public health agencies or even your family physician. We have gathered a lot of these together on a page for the corona virus/COVID-19 here.

Communicate with your children
Discuss the news coverage of the coronavirus with honest and age-appropriate information. Parents can also help allay distress by focusing children on routines and schedules. Remember that children will observe your behaviors and emotions for cues on how to manage their own feelings during this time.

Keep connected
Maintaining social networks can foster a sense of normality and provide valuable outlets for sharing feelings and relieving stress. Feel free to share useful information you find on governmental websites with your friends and family. It will help them deal with their own anxiety.

Seek additional help
Individuals who feel an overwhelming nervousness, a lingering sadness, or other prolonged reactions that adversely affect their job performance or interpersonal relationships should consult with a trained and experienced mental health professional. Psychologists and other appropriate mental health providers can help people deal with extreme stress. These professionals work with individuals to help them find constructive ways to manage adversity.

Coping with Obsessive-Compulsive Disorder (OCD) or Germ Phobia
The news can feel stressful or overwhelming. It can be even harder to keep in perspective if we already were anxious, and especially if we were anxious or obsessed about germs. It is a challenge to balance realistic steps for safety versus doing things to keep a sense of control and progress dealing with anxiety. The following tips come from Shala Nicely, LPC, Kimberley Quinlan, LMFT, and Reid Wilson, PhD:

News
It’s tempting to check news constantly to see how the situation is developing. To combat compulsive checking, restrict your news intake to a frequency and duration that works for you. For instance, you might only check once a day for a maximum of 5 minutes, or once a week you might watch the evening news, or you might decide not to check news at all. Do whatever is most useful for you (and not for OCD).

Travel
If you’re planning to travel to a region affected by the virus, identify dates by which you need to make travel decisions and whether travel providers might waive change fees. It’s likely that the information you’ll need to make decisions will be information released just prior to your decision-making dates. Therefore, give yourself permission not to constantly check the news or ask others’ opinions to try to “figure out” which way the situation will go, as frequent checking and reassurance seeking can cause more anxiety without an increase in useful information.

If it seems like OCD is trying to make your decisions and you’re travelling with someone whom you trust who doesn’t have OCD, you could observe how that person is making decisions and try to follow their lead. While your travel companions may also have anxiety, if they don’t have OCD, they are going to be more likely to make decisions based on current facts, not on OCD “what ifs?”

Contamination concerns
Many people in OCD treatment are trying to reduce compulsive cleaning rituals, and those in recovery may have handwashing and other cleanliness routines that are less stringent than the average American because they are trying to keep contamination compulsions in check. However, because of the present situation, give yourself permission to follow current guidelines being recommended by authorities such as the World Health Organization (WHO) or the Centers for Disease Control and Prevention (CDC).

The CDC and the WHO have the knowledge to be making these recommendations. OCD, no matter what it says, does not. Your goal is to restrict yourself to following valid recommendations (again, that counts out OCD). For instance, you could wash your hands as directed by the CDC/WHO but no more than that. OCD isn’t going to like this, so following the recommendations becomes your exposure and response prevention (ERP) exercise. Further, the feeling of dirtiness/grossness/contamination may still linger even after you’ve done the recommended wash, giving you an opportunity to practice allowing those feelings to be there without doing compulsions.

Here’s a way to frame these exercises to keep this whole situation in perspective. If you were a medical professional who had contamination OCD, you would still follow your profession’s procedures for germ prevention, even if you were in OCD treatment. But to keep your OCD in check, you’d want to do no more than what your profession says you’re supposed to do. Medical professionals with OCD work to manage this every day, and we’re joining them while valid authorities tell us these protective measures are necessary.

Self-compassion
Recognize that if you’re anxious about coronavirus, that’s normal and you’re not alone. The situation is making many people fearful, even people who don’t have OCD. Allow yourself to feel anxious and realize that your anxiety might not go away while the situation is still unfolding.

Be compassionate with yourself if you’re experiencing an increase in OCD symptoms. It’s not your fault! Do what you can to keep your compulsions in check without trying to be perfect. If you need support, schedule a booster session with your therapist or reach out to a support group like the International OCD Foundation’s My OCD Community.

You can do this!
The coronavirus situation is scary because there’s so much about it that’s uncertain. But if you’ve done ERP for OCD, you have above average skills in managing uncertainty and anxiety. You’re actually more prepared to handle all the unknowns than people who haven’t done ERP. While you may be scared and OCD may act up, remember that when it comes to anxiety and uncertainty, you’ve got this!

= Helping children and teens during social isolation =

Children with developmental needs
Children with developmental needs experience extra difficulty with transitions due to the change in day-to-day activities. This section focuses on a broad array of resources that parents can use

1. Reminders for parents

 * 1) Keep a structured routine. Include opportunities to be active in preferred activities, intertwined with less preferred tasks. Also, maintain existing daily care routines, like sleeping and mealtime.
 * 2) Plan gradual transitions. These steps should meet the pace of your child's needs.
 * 3) Visual supports. Those can be used to communicate routines and daily activities.
 * 4) Provide sensory "breaks". Those include opportunities for sensory input, movement, or sensory breaks.

2. Stopping germs / Washing hands

 * 1) Handwashing Song
 * 2) Stopping the Spread of Germs
 * 3) * English / Spanish
 * 4) Washing your hands
 * 5) * English / Spanish

3. Social stories

 * 1) Pandemics and the Coronavirus
 * 2) List of social stories relating to pandemics and COVID-19
 * 3) No School Today
 * 4) We Have To Stay Home

4. Visual Schedules / Transitions

 * 1) Visual Schedules: Practical Guide for Families
 * 2) Applied Behavior Analysis (ABA) educational resources
 * 3) Building Blox

=Mental health wellness tips=


 * 1) Maintain a routine. Maintaining consistent nightly and daily routines can be helpful in taking care of your mental and physical health. Try your best to go to sleep and wake up at a reasonable time every night. Keep your days varied and remember to make time for self-care.
 * 2) Dress to be social, even if you’re not! While it might be easy to lounge around all day in your pajamas, taking a shower, getting dressed, and getting ready for a new day can have a positive impact on your mood.
 * 3) Get some fresh air and a change of scenery. Going for a walk or just sitting outside and getting some fresh air can help improve your mood and help you to feel awake and energized.
 * 4) Get moving. Whether you decide to go for a walk around the block or join a Zumba class online, find ways to get your body moving every day.
 * 5) Reach out to others. Lean on your loved ones for support by video calling, texting, or planning a socially-distanced hangout with friends and/or family.
 * 6) Stay hydrated and eat well. Make sure to have a healthy diet balanced with a healthy intake of water. A fun way to continue this habit is by learning to cook a healthy meal
 * 7) Develop a self-care toolkit. Self care kits can come in many forms! The best way to create a self-care kit is to include all of the 5 senses (smell, sight, touch, taste, sound). For kids, the kits can come in any form and include fun items to keep them engaged while partaking in self-care
 * 8) Give everyone the benefit of the doubt, and a wide berth. Staying inside can be difficult. Individuals can sometimes become more stressed when forced to stay in a constant environment. It is important to practice patience during this time and understand that everyone is doing their best. Together we will get through this.
 * 9) Everyone find their own retreat space. There’s no better feeling than knowing that a specific space is yours. It may be beneficial if everyone creates a space they can go to whenever they want time away or wish to focus on themselves
 * 10) Expect kids to act out, and respond gently. Kids are the most susceptible to responding in a less than ideal way. Their schedules have been interrupted and things are constantly changing. It’s important to practice patience with them at this time and help them adapt to the constantly changing society.
 * 11) Focus on safety and attachment. These are scary and unpredictable time for children and a focus on connection is important. Strengthening your connection with your kids can be done through physical touch, playing with them, and through verbal reassurances.
 * 12) Lower expectations and practice radical self-acceptance. The current moment is laden with fear and stress. There are no roadmaps for times like these, so do the best you can knowing that things will get better.
 * 13) Keep conversation surrounding COVID to a minimum, especially around children. There is extensive information on COVID-19 available and constantly changing. The information in the media is often sensationalized and negative. Find a few reliable sources that you can check in with.
 * 14) Notice the positives in the world. Take a break from the overwhelming and scary information regarding the pandemic. Make sure to read the inspiring and hopeful stories as well.
 * 15) Help others. Find different ways to give back and help others. Whether it be small or big, it will make a significant impact and give you a sense of agency.
 * 16) Find something in your control, and control it. Turn to small things in your life that you can control when overwhelmed with things you can't. This can be as simple as organizing your house, cleaning out your closet, creating something...etc.
 * 17) Get involved in a long-term project. Take this time to take on new tasks and develop new skills. Learn how to play an instrument, read a book, learn to make clothes, whatever interests you that will keep you busy, engaged and distracted.
 * 18) Move. Engage in repetitive movements and left-right movements. Doing activities such as knitting, coloring, jump rope and running can be effective at calming in moments of distress.
 * 19) Be creative. Engage in art or some portal of releasing your feelings. It’s relieving to ourselves when we enable our creativity to flow. This can take place by coloring, journaling, or painting, etc.
 * 20) Find humor. It makes sense that we are worried, but we need to take care of our mental health. Counterbalance the negative and anxious feelings that makes you laugh: whether that’s talking to a friend or watching funny videos!
 * 21) Reach out for help - You have a community who is there for you, whether it’s friends or family or other supportive platforms. You aren’t alone in how you feel, and there are people who care about your wellbeing. It shows strength within you for reaching out and wanting to receive help.
 * 22) Baby Steps. There is not an exact timestamp of when the pandemic will end, but continue pushing through. Reward those small and big steps because they show progress!
 * 23) This is temporary. Remind yourself of the resilience you showed by pushing through the pandemic. Remind yourself that the pandemic is temporary and that your resilience will pay off.
 * 24) Find a positive. The pandemic has created all kinds of feelings that can be difficult to process. One way to handle this is to find and remember the positives in your life. Remind yourself of what this pandemic has taught you about yourself and your community.

For more mental health tips, visit: https://www.intermed.com/content/uploads/Mental-Health-wellness-during-COVID-19-advice.pdf

Some fun and helpful links:

Tiny Desk Concerts From NPR -  the ones featured in the link are supposed to help with calm, which we could also use a little of right now: https://www.npr.org/2020/03/19/818079150/5-tiny-desk-concerts-to-calm-your-mind

=Incident-Specific Information= The following section contains information specific to specific national or international health crises, organized by name.

COVID-19
On January 30, 2020, the WHO declared an outbreak of a novel designated SARS-CoV-2 (also known as 2019-nCoV). The disease caused by the virus has been named COVID-19. The epicenter of the outbreak was the city of, in the Hubei Province of China, though cases now have been reported worldwide. The has an interactive tracking site, showing updated information about cases around the world.

Helpful Links

 * General Info on COVID-19
 * Who is at higher risk of getting very sick.
 * How COVID-19 Spreads
 * Advice for the public (includes short videos and simple, downloadable graphics; available in multiple languages, including Spanish)
 * World Health Organization statement on 2019-nCoV
 * Questions and Answers (Q&A) about coronaviruses and COVID-19
 * Situation Reports
 * IFRC: information about the IFRC's efforts to combat COVID-19 including background information about the virus and its spread worldwide
 * APA: podcast about Coronavirus Anxiety
 * Johns Hopkins University: The hospital is maintaining a coronavirus resource page with daily status reports and information about how to protect yourself from the virus
 * USA Today: article about airlines waiving change fees; many hotels, vacation rentals, and other companies are also offering a lot more flexibility in canceling or rescheduling travel.
 * Johns Hopkins University: The hospital is maintaining a coronavirus resource page with daily status reports and information about how to protect yourself from the virus
 * USA Today: article about airlines waiving change fees; many hotels, vacation rentals, and other companies are also offering a lot more flexibility in canceling or rescheduling travel.

Infographics
COVID-19 general tips, information, and resources

=References=