Social Isolation And Loneliness Attributed To COVID-19

By Cori McMahon, Psy.D, NCCE, Vice President for Clinical Services, Tridiuumdepressed senior on side of bed

The challenges we have faced as a society during the COVID-19 pandemic are many, and some of them are yet to be fully evaluated for their potential impact. Often underestimated, social isolation and loneliness are serious public health risks that disproportionately affect the older adult population yet are currently impacting everyone, regardless of age. While “social isolation” and “loneliness” are two different concepts, they often overlap, Social isolation can be defined as the objective state of having few social relationships or infrequent contact with others, while loneliness is a subjective feeling of being isolated, which one can experience even in a crowded room or while among loved ones.

Studies around the world are measuring the psychological impact of COVID-19 on our kids and are finding, unanimously, that social isolation is having a negative impact on mood functioning, sleep, and overall behavior.

Considering the youngest members of our society, children and adolescents have experienced an upheaval of daily routines, academic expectations, and the essential interpersonal connection they are able to enjoy while with their peers in-person at school. Studies around the world are measuring the psychological impact of COVID-19 on our kids and are finding, unanimously, that social isolation is having a negative impact on mood functioning, sleep, and overall behavior. One online questionnaire that was administered in China to more than 3,600 children and adolescents revealed that approximately 22% of youth had scores indicative of clinical depression as compared to 13%—the estimated national prevalence. In another survey, over 8,000 junior and senior high school students completed the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scales. Results indicated the prevalence of depressive symptoms was 43.7%; anxiety symptoms was 31.3%; and both depressive and anxious symptoms combined was at 31.3%. (Wagner 2020)

depressed school girl on sofa

Multiple additional studies have resulted in similar findings, and a systematic review conducted by Loades et. al. summarized 83 different articles on the same topic (Loades 2020). Authors note concern that children and adolescents are probably more likely to experience high rates of depression and most likely to experience anxiety during and after the end of enforced isolation. The review shares both considerations for intervention and a call to action, explaining that strategies to prevent the development of mental health problems like these in youth should be an international priority.

With approximately 46 million Americans (14% of the population) over age 64, this group is at greater risk for both physical and psychological complications during this challenging time.

According to a report from the National Academics of Sciences, Engineering, and Medicine, in the US, approximately one-quarter of community-dwelling older adults are considered to be socially isolated and 43% of them report feeling lonely (National Academies Press). Stay-at-home orders and visitor restrictions during COVID-19 have only served to increase that number. With approximately 46 million Americans (14% of the population) over age 64, this group is at greater risk for both physical and psychological complications during this challenging time. Koma et. al. found one in four adults over 65 reporting anxiety or depression during most weeks since the onset of the pandemic, and increase from one in 10 older adults who reported anxiety or depression in 2018 (Koma 2020). Combining an increased likelihood for health issues such as cardiovascular disease, respiratory illness, or diabetes, which raise the risk of severe COVID-19 and the potential for isolation or cognitive decline, older adults are positioned to fare worse than the rest of the population. Further, an article in Public Health Nursing notes while adults over 75 comprise only 12% of the US population, they have some of the highest suicide rates, accounting for 18% of suicides annually. The authors explain that the pandemic has heightened the risk for “deaths of despair.” (Troutman 2020)

Intervening to decrease the impact of social isolation

While it may remain necessary to physically distance for some time to come, it is increasingly important to focus on social connection. Research has shown that depressive symptoms may be reduced by increasing social support and that the negative impact of physical distancing can be mediated by maintaining the structure, quality, and quantity of social networks. (Gong 2020) Knowing that loneliness is connected with mental health challenges in youth, it is important to help children and adolescents experience social rewards, to feel part of a group, and to know there are others to whom they can look for support. It is important for parents to look to strike a balance between concerns for too much screen time on social media with the benefits of social connectedness.

Recommendations for mental and physical health in older individuals are focused similarly, in that strengthening social connectedness is key (Sepulveda-Loyola 2020). Whether one leverages technology to connect via video chat, internet apps or the telephone, it is essential to remain engaged. caregiver showing senior gentleman how to use tabletCaregivers also play a critical role in supporting the well-being of the older person. They can help reduce anxiety by engaging loved ones in adapted daily activities as is possible, by providing clear information and thinking about exposure to sensational media, and, if needed, by employing health education and counseling to focus on resiliency. Yes, we are, in theory, “all in this together,” however, it takes concerted effort to remain socially connected in this unprecedented time. Our health depends on it.

 

References

Gong, X, Ni, Z, Wu, B. The mediating roles of functional limitations and social support on the relationship between vision impairment and depressive symptoms in older adults. Cambridge University Press. https://www.cambridge.org/core/journals/ageing-and-society/article/mediating-roles-of-functional-limitations-and-social-support-on-the-relationship-between-vision-impairment-and-depressive-symptoms-in-older-adults/1864BD6E8564777DDEC1EBD3D36C7A79

Koma, W, True, S, Fuglesten Biniek, J, Cubanski, J, Orgera, K, Garfield, R. One in Four Older Adults Report Anxiety or Depression Amid the COVID-19 Pandemic. Kaiser Family Foundation https://www.kff.org/medicare/issue-brief/one-in-four-older-adults-report-anxiety-or-depression-amid-the-covid-19-pandemic/

Loades, M, Chatburn, E, Higson-Sweeney, N, Reynolds, S, Shafran, R, Brigden, A, Linney, C, McManus, M, Borwick, C, Crawley, E. J Am Acad Child Adolesc Psychiatry. 2020 Nov; 59(11): 1218–1239.e3. Published online 2020 Jun 3. https://doi.org/10.1016/j.jaac.2020.05.009

National Academies of Sciences, Engineering, and Medicine 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663

Sepulveda-Loyola, W. J Nutr Health Aging. 2020 Sep 25 : 1–10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7514226/

Troutman-Jordan M, Kazemi DM. Public Health Nurs. 2020; ePub(ePub): ePub. https://www.safetylit.org/citations/index.php?fuseaction=citations.viewdetails&citationIds%5b%5d=citjournalarticle_654151_18

Wagner, K. New Findings About Children’s Mental Health During COVID-19. Psychiatric Times. https://www.psychiatrictimes.com/view/new-findings-children-mental-health-covid-19

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