People In Isolation May Have Trouble Coping, Doctor Says

By DAN HOROWITZ

People who are isolating themselves due to the COVID-19 pandemic risk turning to unhealthy coping strategies such as alcohol and online gambling, says the chief of psychiatry at North York General Hospital.

“When people are forced to spend too much time in a closed setting with family members, it can result in anger and various types of abuse,” Dr. David Koczerginski, the medical director of the mental health program at the hospital says. “I think we need to be careful to avoid those unhealthy coping strategies and becoming too isolative and inward, and blaming others – or ourselves.”

Dr. David Koczerginski

Koczerginski says that many people are also struggling with the way the rules of grieving have changed.

“A lot of people know individuals who are in hospitals who are ill, and many of these people are going through grief because they’ve lost friends or loved ones through the pandemic or for other reasons. Of course, the rules of grieving are now complicated as we can’t visit people in hospitals, we can’t have large gatherings or even normal funerals or a shiva. The whole world is upside down. That’s created a lot of stress, anxiety, worry, fear and just normal sadness,” Koczerginski says. “It needs to be supported and dealt with.

“Then there are those who have a vulnerability towards mental illness, be it depression or anxiety, which may be a tipping point where they may relapse into a state of diminished functioning and personal risk.”

Of all the challenges faced by mental health professionals today, giving patients advice that may be counterintuitive is perhaps most difficult.

“When we see patients in non-pandemic times, we may tell them that they should go outside more; be socially connected and reach out to their communities and social networks,” says Koczerginski. “That is what we tell patients who are feeling anxious, withdrawn and isolated. Today, we have society – for understandable reasons – telling us not to go outside, to stay home and stay isolated.  That is what we are seeing a lot of: people who are struggling with this isolation, spending too much time at home separated from their networks, their activities – things that give them a sense of value and enjoyment.”

This has been especially hard for the pandemic’s most vulnerable demographic – seniors.

“They are now cut off from their regular visits from their children and grandchildren, so the isolation is even more profound,” says Koczerginski. “Their comfort level with technology and video makes it more challenging for them to connect to their friends and loved ones virtually.”

Fortunately, there are other ways that we can connect with our elderly loved ones without them mastering Zoom.

“There’s always the good old telephone,’ says Koczerginski. “Letting them know that we are there for them and that we care about them can work wonders and make an enormous difference.”

Koczerginski says it’s important that we implement lessons today that we learned through other difficult times, most notably during the AIDS epidemic and SARS.

“Hopefully those of us who were around during those times have learned that we are all together in this as a community and that what we are experiencing today is a shared experience that will help us cope without placing blame, or stigmatizing anyone, regardless of what cultural group they may be from,” says Koczerginski.

He thinks that something good can come out of the pandemic if we just recalibrate our priorities.

“I believe that during this unusual time in our history, there’s an opportunity to reflect on what is truly important, and that maybe the things we thought really mattered the most, don’t,” he says. “What matters is the connection we have with the people who are important in our lives. This is an opportunity for a lot of personal reflection and growth no matter our age. We all have that capacity for personal growth during this unusual time.”

This link to the mental health/COVID web site developed by a psychiatrist at North York General Hospital contains many useful resources and links. https://mentalhealthcovid19.ca