How To Manage Your Mental Health & Cope With Isolation During Quarantine - A Therapist's Advice

Quarantine in its most literary definition implies ‘restriction’. In an extremely unusual turn of events, in order to curtail the spread of the deadly Coronavirus-induced COVID-19, the Government of India has imposed a 21-day state-authorised lockdown which has made it mandatory for everyone (barring essential-service providers) to quarantine themselves. One of the aspects that we often tend to ignore when it comes to extraordinary situations like this is our mental health and how the situation is affecting us covertly. In order to understand the internal processes better and to know how to deal with the situation whilst mentally strong and healthy, Homegrown spoke to Mumbai-based Psychotherapist Dr Rizwana Nulwala who practises at Krizalyz Counselling and Psychotherapy and has an experience of over 15 years. Here’s what she had to say about quarantine and mental health.

Recognising Your Response

Dr Nulwala says that conceptually, ‘quarantine’ stands for curtailment, restriction, and loss of a sense of control or power over oneself and the environment. On losing control, a sense of helplessness creeps in. In these times, when our control has been restricted to the four walls of our home, these senses are heightened more than ever.

Ordinarily, people respond to this loss of control in three prominent negative ways:

i. Aggression: When one doesn’t know how to deal with an imposed loss of control, they suddenly don’t know how to react anymore. They begin to rebel and go against the grain because it seems like a legitimate way to feel ‘in control’. This can go on from confrontation and verbal abuse to physical fights.

ii. Denial: “It won’t exist if I don’t acknowledge its existence”, quite a few of us choose to ignore the reality and subconsciously choose to live in denial mode because it seems like an easy thing to do. One often ‘freezes’, not knowing what to do.

iii. Fleeing: The other part of the knee-jerk ‘fight or flight’ reaction contains ‘fleeing’ to find escapism in substance or alcohol abuse or anxious overeating.

Dr Nulwala refers to the Kübler-Ross model of ‘five stages of grief’ popularly referred to as DABDA. In 1969, Elizabeth Kübler-Ross had described five popular stages of grief: Denial, Anger, Bargaining, Depression, and Acceptance.

Once the initial direct response stages have passed, comes acceptance. However, we can very well choose to actively respond positively and cope with an extraordinary situation in a positive way.

Responding Positively

Healthy ways of responding basically include accepting and adapting to any given situation. At this point when it’s difficult to see the end of the tunnel, isn’t is utterly useless to think about the long walk that there is to the end?

Dr Nulwala says, take one day at a time. It’s always useful to be flexible and instead of thinking about how nice things were in the past or how fearful things might turn out to be in the future, focus on today and only today.

Break your day into chunks: While some of us might prefer dividing our day into three parts– eight hours for work, eight for sleeping and eight for recreation, some others might choose to divide their day in mini-chunks, allotting different chores or activities shorter durations. At a time when time appears to be fluid, one can make it more structured with careful planning. Dr Nulwala says, “Keep working as per your daily routine even as you don’t have anywhere to be. Shower, have breakfast, read something, even if it’s reading something on the phone, slot in other activities. Tell yourself how you will get up and finish all the work.” To-do lists also always help. However, go easy and avoid activities or routes of thought that create panic or aggravate anxiety.

Those of us who don’t have the need or facility to work from home due to the nature of their work, it might be useful to create work. Dr Nulwala says, “Sort your cupboard, take up stitching, do that deep cleaning you had been postponing for so long.

More than anything, enjoy what you do and do what you enjoy. Read, watch films or TV, listen to music or podcasts, or do your cleaning, even if it means cleaning the same place multiple times!

Plan time for solitude and reflection. Dr Nulwala recommends practising active mindfulness. Actively notice the little achievements and the little things you would otherwise never have the time to notice and celebrate. For instance, Dr Nulwala says, even if you are sweeping the floor of your house or doing the dirty dishes, think about how important it is and how you derive joy out of making the place where you inhabit slightly better. Set a disengagement hour to practice mindfulness and deep breathing. Since virtually all of the conversations and for a lot of us, all our work will require you to use your phone and computer, you might find it useful to set a switch-off hour where you could not look at your screen. During that hour, you could try breathing exercises and focus on your mind and body. If not that, plan a self-care evening. It can look different for everyone, but a self-care evening could just be you doing what relaxes you the most, ranging from playing your guitar to lighting a scented candle and reading to just dancing out loud.

Reconnect with yourself and your loved ones. Seek out positive social connections. Remember the school friend you haven’t spoken to in ages? Call her up now. It will be a little awkward at first but your lovely memories will wash it away soon and by the end of it, you would have found your little friend and perhaps a little part of yourself again. Dr Nulwala recommends video calling and just talking to people because unlike before, now everyone has the time to. Use this time to put down your creative ideas and business plans and do everything you have been stalling so far.

For Those With Chronic Illnesses or Anxiety Issues

We asked Dr Nulwala to tell us what to do if we are someone with a chronic illness (physical or mental). For a lot of us, life in the mundane can seem quite daunting, so what when put in such an extraordinary situation?

She suggested:

Creating a Worry Window And Shelving Your Worries

Dr Nulwala explains, “ What do you do with your winter clothes during summer? You put them in a shelf and only take them out when you need them again the next year.” Similarly, tell yourself every time stressful thoughts strike that you will set aside a couple of minutes to ruminate over them at the same time every day, post which you will ‘shelf’ them and think again the next day at the same time. Tell yourself that you will lock it up and not open it until tomorrow. Dr Nulwala further suggests, “Don’t set yourself for more sadness. Recognise that the cause behind your stress could be the uncertainty emerging out of the current situation. Put things in perspective and manage the uncertainty by using the aforementioned methods.”

For those of us with clinical conditions, she recommends continuing with therapy or taking up online therapy. There is absolutely no shame in seeking help.

Giving Support To Those Around Us

At this point, quite a lot of us are stuck with our family members whom we love but it can just feel stifling to be locked up with the same people 24x7 for days together. For some of us, our family members might also be suffering from anxiety or other mental and physical issues that we might not know how to address.
Dr Nulwala says that in these times, it’s always useful to de-escalate issues. It’s always useful to remember that things are never as big as they seem to be.

It’s important to listen to your family. Advising is not the same as supporting. Asking questions like ‘I hear you. What can I do?’ or ‘What is happening? How can we work through this?’ might be more useful. It’s also important for us to develop a mental health plan for ourselves and constantly keep checking in with ourselves. Have people give you feedback on your mental health and behaviour and acting on their advice.

Factoring The Spiritual Arch

It’s also important to be self-vigilant and gauging how you are feeling. One of the recommended ways is to find a spiritual or emotional anchor. It’s not the same as being religious but it’s useful to be able to hold on to a strong belief system.

Restrict Social Media Consumption

Social media is a big black hole and we all know it. Don’t create panic and avoid forwarding frightful messages. It can be very easy to get influenced by messages that sometimes sound true but lack authenticity. Only depend upon reliable sources of information and remember to always check your sources before passing anything on. Instead, consume some form of humour for at least a few minutes every day. It actually helps. Follow people who are able to find humour in tough situations. Don’t overcharge.

Think Of It As An Incubation Period

Dr Nulwala says that she doesn’t prefer using the word ‘quarantine’. Instead, using the word ‘incubation period’ might help us feel that we are cocooned at the moment. It’s important to realise that we are protected at the moment, slowly working on ourselves and by the time we come out of it, we would have developed into better people.

Overall, it’s really about taking one day and one breath at a time and keeping positive about the situation.

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