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Keeping your mental health sharp during a prolonged quarantine

North Kitsap Herald - 8/31/2020

When the COVID-19 pandemic began in March, many of us thought a quick economic shutdown with health and safety guidelines in place would have been enough to defeat the virus and ensure a normal life once again.

Boy, were we wrong.

The pandemic has now reached six months, leaving many to wonder how long it will take to approve an effective vaccine or get a handle on the number of cases that steadily increased in Kitsap County through July. With uncertainty all around us, many people are still stuck at home quarantining, out of work, and trying to figure out the best way to make the most of this situation while keeping our sanity.

Identifying the symptoms

The mental health conundrums caused by the crisis can vary in the symptoms that are shown, said Dr. Britt Gounselin of Bainbridge Mental Health, PLLC. In order to see the symptoms others could be showing, she said you need to know how to identify the signs, which can be difficult.

Bainbridge prepares

Gounselin is part of the Psychological First Aid team called Bainbridge Prepares, an educational nonprofit that works with the city and fire department. The team leads training for citizens that encourages emotional support to friends, family and neighbors during the pandemic.

"One of the first things that we do, either as a community member or a physician of practice, is we have to get skilled at looking for signs of stress in ourselves and in others," Gounselin said. "Stress manifests differently for different people, even within the same age range. It can change our thought patterns; we might find ourselves thinking differently. Those can range from greater anxiety to more depressive thought patterns. Some people might flip and do the reverse where they're overly optimistic with some denial."

The second area of pattern that Gounselin looks for in her patients is behavior, dealing with the coping strategies that individuals might display.

"Some people might engage in adaptive coping strategies, which looks like more exercise, getting out in the garden or going for a morning walk," she said. "Obviously, there's more maladaptive behaviors people can get into, and those can range from avoidance of daily tasks, daily chores to full-blown patterns like over-consumption of alcohol or other substances to kind of try and numb yourself. There's distinguishing between adaptive and maladaptive behavior, and you can see those changes when people are under stress."

Lastly, physical signs are another good indicator of someone struggling with mental health, Gounselin said.

"We look a lot at physical signs like what your body is actually doing in response to this chronic stress," she said. "A lot of typical health problems crop up like higher blood pressure or an aggravation of any preexisting health conditions. Our cognition can be impacted when under prolonged stress."

Effects on children

As you might imagine, this pandemic is having different effects on different age groups from small children trying to understand and grasp this complex situation, parents who are attempting to juggle raising children during a time of crisis with their own work schedule, to young adults who often think they are invincible to the varying effects of the virus.

Looking at young children and the mental health symptoms that age group might show during a prolonged quarantine, Gounselin said they often will display more "outward signs behaviorally" like tantrums and aggressive behavior. Gounselin also pointed out that some children might show inward signs where they "internalize all of their stress," becoming quieter, avoidant, and could seclude themselves in their room for hours.

"I think kids are unique from adults in that they tend to have more of a wide range of behavior that can crop up and be kind of normal," Gounselin said. "With the pandemic, I think what we're seeing is a lot more chronicity and development of more chronic symptoms. This is where it becomes really important to start working within families to reroute some of those stress responses and build resilience."

Gounselin recalled speaking with a friend recently who said her young grandson was having an imaginary conversation with a scientist on "another planet" who was trying to tell him how to solve the virus so we all could go back to our normal lives.

"I think a lot of how younger children process this … is through fantasy," she said. "You might see it start to play out in their play scenarios. It's really the only way they process, truthfully. You're not going to be able to sit down and have a logic-based conversation with a child who is in kindergarten or younger. It's just not going to register. Having a parent that's feeling settled is going to take care of about 80 percent of that kid's needs."

Parents overwhelmed

On the flip side, parents have been shouldering a monstrous load during this pandemic and living in this "impossible scenario," Gounselin said, referring to the never-ending tasks that many mothers and fathers are experiencing with their kids at home.

She stated that families have even started forming "very small pods" with other families so kids can get some sense of summer while playing with their masks on. Gounselin also mentioned that some parents are doing "flipped schedules" where one parent takes care of the children in the morning while the other works from home, before switching roles in the afternoon.

"I think it's very individual, and it depends on each family's situation and depends heavily on where each person in the family has a little wiggle room," Gounselin said when asked about mental health coping strategies for parents. "Because this is such an ever-changing situation, people are still trying to figure out what is that balance? Where do I find some sense of balance in this new normal? A lot of families are choosing different approaches, and I think it's based on where they personally can find a sense of more balance."

Elderly most at risk

Perhaps the most at-risk age demographic when it comes to the COVID-19 pandemic is the elderly. With many living in fear and afraid to leave their households due to the underlying health conditions they might have, Gounselin said it is critical for that age group to find activities that keep their minds at ease, such as board games or projects around the house.

Gounselin also said it can be beneficial if older adults are "tech-savvy," since it will provide them an alternative avenue to connect with old friends or a group they're part of.

"If you are a senior or know a senior who is not well connected through virtual means, then I think it does become a bit more challenging," she said. "That's where I think communities do well to kind of look out for their neighbors and get to know who in your neighborhood might benefit."

Young adults

The young adult demographic is undoubtedly the most difficult age group to control from spreading COVID-19 because the virus doesn't personally affect that group as much as older adults or those with underlying health conditions.

"There is a way to be a young person and still function within the bounds of a community-level response for this situation," Gounselin said. "Finding a place of comfort within one's self about what is my individual need and then what is a way I can meet that individual need but still take care of the community.

"I do have knowledge and awareness of people who are also feeling like the pandemic's put the kibosh on dating and things like that," she went on to say. "What I tell people is [to] slow down, take your time. In some ways, this pandemic is kind of encouraging all of us to slow way down, and I know that's not always what your body's telling you to do when you're young."

Anti-mask wearers

Gounselin stated she has dealt with patients who have had issues with wearing mandated masks and encourages people to take a look from a perspective that is different from their own to try and understand one's decision.

"I think this is a time when we're being asked to look at things through different lenses," she said. "There's the lens of individualism, and there's the lens of public health and the community perspective. There's validity in the view from each lens that we choose to look through to analyze our situation. No one can tell anyone else how to think or what to think. As someone who has training in medicine and public health, I just want to say this is a time for each individual to try on those different lenses and ultimately make a decision."

As community members, "it's our job to have compassion for all of us," Gounselin went on to say. "We're all trying to navigate this as best we can and, in the end, I think what matters is compassion and resilience. We can help each other build that. That's key."

For details about the team's training, go to: bainbridgeprepares.org/psychological-first-aid/.