Beyond Blue during Covid-19: Cabin Fever, Sadness, and Depression
By Irem Choksy
Licensed Mental Health Therapist
Los Angeles, CA
As new restrictions are enforced, many people are feeling more frustrated, fearful, and worried about their health and finances. Seclusion isn’t a natural state for many. For the most part, we are social animals. That’s what can make apart for extended periods of time a struggle. Oftentimes, people may experience cabin fever – a range of emotions and distressing symptoms while feeling isolated and cut off from the world while being confined at home. This intense feeling of isolation can include symptoms like sleep disturbances, where the person gets too much or too little sleep, feeling lethargic, seeing a decline in motivation, feeling restless, impatient and irritable.
Here are some coping techniques to deal with cabin fever:
1. Checking in with family and friends via phone and trying out different ways to stay connected through apps and video platforms to chat is a great coping tool and a beneficial way to reduce isolation.
2. It also helps to have a routine—to create a new “normal” and find time to engage in creative activities. Take a few minutes to place a few relaxing activities throughout the day.
3. Limiting exposure to news and social media, and allowing a certain limited amount of time each day, can reduce overexposure to worry provoking news and can help with managing anxiety.
4. Self-care is integral, especially at this time. Promoting adequate restful sleep, healthy meals on time, and some physical activity can be beneficial tools to manage anxiety and stress.
5. Take a glimpse into your past and evaluate how you have coped with past stressors – be it cooking, music, reading, or art, and tap into those.
6. Explore a new hobby! There are several apps and websites offering free usage — trying doodling, deep breathing, and journaling can be cathartic.
7. Lastly, the power of positive thinking has a vital role. Visualize positivity in the present and for our collective future to reduce negative thoughts.
How is depression different from cabin fever? Many times people question whether they are feeling a normal sense of worry, distressful sensations caused by feeling isolated during shelter in place, or depressed. It is normal to have feelings of sadness. Most people go through periods of feeling sad, especially after experiencing loss or during and after a stressful period, like Covid-19. Clinical depression, however, is more constant –the sad or empty feeling does not go away after a couple of weeks, and everyday activities that were a routine become a struggle to accomplish; everyday routines like eating, sleeping, working and socializing are impacted.
Depression has traditionally been viewed as an issue faced by women; however, depression is a health issue faced by both genders. Per recent estimates by the World Health Organization, 264 million people are affected by depression globally. Per National Institute of Mental Health, depression is one of the most common mental disorder in the US. Depression can affect children, adolescents, and adults.
People who experience depression describe it as an agonizing pain that cannot be shaken. They often verbalize feeling trapped, reporting feeling numb, empty and hopeless. Some depressed people may suffer to an extent where they may contemplate suicide. Almost all people suffering from depression express decrease of pleasurable activities, a reduction of energy, feeling disconnected socially, having trouble with sleep (sleeping too much or too little), and an overall persistent feeling of sadness. Sufferers of depression experience either an increase or a decrease in their appetite, which is sometimes accompanied by weight fluctuation. A large portion of people suffering from depression report that their symptoms are exacerbated in the morning.
Below are some symptoms of major depression (from National Institute of Mental Health). It is not necessary for a person suffering from depression to experience all the symptoms noted below; some may experience a few, while others may experience several. For a depression diagnosis, a low persistent low mood is accompanied by some persistent symptoms noted below:
• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Many people often ask what causes depression. Although there isn’t a conclusive understanding of the causes of depression, there are several risk factors, including genetic features such as history of depression in the family, changes in the brain’s neurotransmitter levels, severe trauma/stress, major life changes, physical illnesses, as well as psychological and social factors. Although depression can occur at any age, it’s onset of symptoms are most often seen beginning during adulthood.
Despite seeming like an unchanging constant sorrow, even the most severe cases of depression can be treated. Depression is treatable and managing symptoms, depending on the severity can fall into two categories: psychotherapy and drug treatment.
Psychotherapy also known as mental health or talk therapy for depression includes Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT). Both have an excellent success rate with helping people manage depressive symptoms. For some forms of depression, psychotherapy is usually the first line of treatment, while some people respond better to a combination of psychotherapy and medications. A good relationship with the mental health therapist can improve outcomes.
Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) are the two main types of psychotherapy for depression. Cognitive behavioral therapy has been shown to help significantly with managing depressive symptoms. CBT helps evaluate and change negative thinking patterns associated with depression. CBT is a structured, time limited therapy treatment that aides with building coping tools for symptom management.
Interpersonal therapy (IPT) is another therapy that is successful with depressive symptoms; it focuses on improving problems in personal relationships and other changes in life that may be contributing factors of the symptoms. IPT, like CBT, is often time limited.
Psychoeducation is also useful and involves teaching the person about depression, how to identify symptoms, manage them, and recognize signs of relapse. Family psychoeducation can be helpful for family members who want to understand what their loved one is experiencing.
If you or someone you know needs help with depression or is experiencing stress due to feeling isolated during shelter in place, reach out – both are treatable. Managing the symptoms can have a profound impact on health, individual, and family quality of life.
(IremChoksy is a licensed Mental Health Therapist. She is currently offering free non-emergency, after-hours mental health support to California residents. Irem can be reached on www.iremchoksy.com or via phone at 408 782 7836)
References:
“Depression.” World Health Organization, World Health Organization, www.who.int/news-room/fact-sheets/detail/depression.
“Depression.” National Institute of Mental Health, US Department of Health and Human Services, 28 Feb. 2018, www.nimh.nih.gov/health/topics/depression/index.shtml.
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