Are we coping with social distancing? Psychologists are watching warily

The sudden confinement of millions to their homes could have serious mental health effects, and scientists are already studying this unprecedented experiment.

Photographer Camilla Ferrari takes a self-portrait while under quarantine in Milan. Psychologists are just beginning to study the impact this unintended experiment isolation could have on people's mental health.
Photograph by Camilla Ferrari

With much of the world facing stay-at-home orders in response to the global pandemic, hundreds of millions of people are suddenly involuntarily engaged in a previously unimaginable experiment. Virtually overnight, we’re trying to figure out how to stay in touch while alone.

Social scientists are watching with alarm, worried about the harm this will inflict on some of us: depression, substance abuse, domestic violence. Forty-five percent of Americans say the coronavirus outbreak has taken a toll on their mental health, according to a Kaiser Family Foundation poll. Cigarette and alcohol purchases are up. So, too, are gun sales.

But research underway in Seattle, Washington, where I live and where COVID-19 first surfaced in America, suggests many of us are finding our way—at least so far. Washington State’s King County, the region around my home, was one of the first places in the United States to practice social distancing, and scientists are already tracking 500 people. Residents log into their phones and laptops nightly to answer survey questions online: How much did they interact with others today? Do they feel cared for and connected? How outgoing have they been? How hard has it been to rid their thoughts of COVID-19?

Nearly a month into one of the earliest social research projects in the wake of the U.S. coronavirus outbreak, “it’s telling a story of resilience and adaptation,” says Adam Kuczynski, a University of Washington graduate student who’s leading the study. “People earlier were seeing a lot of intrusive thoughts—not being able to get it out of their head. . .That’s going down.”

'I don't recognize myself.'

We can’t yet say how this period of confinement will change us. Humans need each other to survive. Excessive isolation can weaken the immune system, increase blood pressure, and may even help cancer cells spread. Over time, lack of human contact can be as risky as smoking.

Social ties, of course, don’t just protect us. Agustín Fuentes, a University of Notre Dame anthropologist, says we evolved to solve problems together. Our ancestors created stone tools using teamwork and developed glues and dyes to share insights through art. Connecting is central to what makes us human. “It helps keep us alive,” Fuentes says.

Now those bonds are being strained, but in a way the world has never seen. As harrowing and heartbreaking as this outbreak is, it’s not close to the most devastating diseases that have ravaged the world. It’s not the 1918 Spanish flu pandemic, which killed 20 million to 50 million people, many of them children, just as the world was ending a horrific war. It’s not London in the 1600s, when bubonic plague cycled through every few decades and constables padlocked the houses of victims, leaving healthy inhabitants trapped inside. (Here's how some cities "flattened the curve" in 1918.)

We are isolated, and we are quarantined, but today we have Zoom and Xbox and iPhones. We see the world on bike rides or on TikTok. Cat videos are as popular as ever, as are lip-synched Broadway show tunes, the lyrics rewritten for coronavirus. If friends can’t share dinner, they’re sharing lists. Books to read. Bucket lists. To-do lists. Once-mundane treks to the supermarket are major social outings, albeit behind face masks while steering wide of everyone.

Across the street from my house a tubby, blond, eight-foot stuffed bear rests on a porch. It’s part of a social media-inspired movement to help cooped-up kids find joy. Children meander sidewalks, giggling with their parents, tallying the number of toy animals we’ve hidden on stoops and in windows—a bear hunt, if you will.

Yet much of the larger world is eerily quiet. Trafalgar Square, St. Peter’s Square, Times Square—they’re all empty, or nearly so. Seattle’s Space Needle shuttered weeks ago.

I feel that stillness in my own home and it fills me with unease. For half her life, my soccer-obsessed 11-year-old—co-captain of her citywide team, with a poster of U.S. star Megan Rapinoe above her bed—has played or practiced four days a week. Now the only goals she scores are in the yard against dad. The field where she was to try out for next season has become a 200-bed hospital. It has taken until just days ago for her, through tears, to finally ask, “How much longer?” I didn’t know how to answer.

The magnitude of all the change can strike at any moment. My neighbor Shannon Campe, usually hard to rattle, has been surprised by her own sudden fragility. A close friend lost her restaurant job, as has that friend’s husband. Two families on our street are in self-quarantine after exposure to sick friends or relatives. Campe’s seventh-grade daughter is pleading to see other kids, but Campe knows her trial has just begun. Overwhelmed, Campe found herself, on April Fool’s Day, sobbing on the sidewalk. “I don’t recognize myself,” she says.

Some, of course, have maintained their equanimity. “We’re not too distressed at all,” says James Smith, a 74-year-old retiree, who lives 30 miles south of me in a ranch house in Tacoma. His 93-year-old mother is alone in Los Angeles. His son works as a paramedic. But Smith and his wife aren’t worriers. They watch the news, wipe the mailbox with alcohol, putter in the garden. He says he’s used to life being challenging. “This is just something else we need to get through,” he says. But, he adds, “we’re happy people.”

So is my friend Mike Lewis, an AM news radio host who co-owns a Seattle tavern he was forced to close three weeks ago. He’s temperamentally upbeat but conscious enough of his own stress now to know his listeners are grasping too. So he relieves some of his own anxieties by trying to help lighten theirs. He relishes the chance to share silly things, such as the day last month when Chicago’s Shedd Aquarium let the rockhopper penguins—Edward, Annie, and Wellington—loose to waddle through empty halls to spy on marine life from the other side of the glass.

“It’s like there’s no handholds anymore,” Lewis says.

Distress over social distancing is, of course, normal. “This is our body signaling a need to reconnect,” says Julianna Holt-Lunstad, an expert on the psychology of human connection at Brigham Young University. “Just like hunger signals us to eat, and thirst signals us to drink water, loneliness is thought to be a biological drive that motivates us to reconnect.” (At times, the six-foot barrier between us can feel like a million miles.)

But what happens when we can’t? Hospital workers who were isolated after exposure to SARS in 2003 experienced more insomnia, irritability, exhaustion, and detachment than those who were not isolated. Most were quarantined for just a few weeks. Their symptoms, though, sometimes lingered for years.

Monitoring stress, day by day

Kuczynski, the University of Washington grad student, began his survey on March 14—the day after Washington Gov. Jay Inslee shut down all schools and the day before he announced he was closing all bars and restaurants. Working with Jonathan Kanter, a psychologist at the University of Washington’s Center for the Science of Social Connection, Kuczynski set out to capture people’s day-to-day experiences when the details were still fresh, before they fell asleep. So every day at 7:30 p.m., their subjects begin answering at least 27 questions, sometimes more. The survey takes about three minutes. They plan to continue it at least 75 days.

An expert on socialization and well-being, Kanter was concerned. For people who live alone or with mental illness, such as obsessive-compulsive disorders, social distancing may well bring out the worst. He’s already hearing as much from colleagues. “Most of us will land on our feet,” he says. “But there are groups of people who are more vulnerable and don’t have safety nets.”

The early results have surprised them both. People, generally, seem to be coping. They expressed solidarity and a sense that they felt cared for even as they obsessed about the virus. Kanter suspects the nearly universal nature of their plight helps. “Even though almost all of the news is bad, there’s something about all of us being in this at the same moment in time which I think is keeping people from falling apart,” he says.

Over time, anxiety began leveling off, as did interpersonal conflict. People thought about the virus less each day. People exercised more. “It could be that we’re getting used to this,” Kuczynski says. But then stress ticked back up—on the day that Washington’s governor extended the state’s stay-at-home order to early May.

But through it all, despite the generally positive trend, a significant minority have been suffering debilitating anxiety and spikes of sadness. “We ask ‘How lonely do you feel on a scale of 0 to 10?’” Kanter said. By early April the average was still only about 3. But every day there are people answering 0—and people answering 10.

Kanter was distressed by that. His initial interest in this research was humble. He hoped to identify who did well, who struggled, and learn why.

His outlook now has changed. Last week he started a new project designed, in part, to learn whether there’s a way to alleviate such suffering. He plans to conduct a similar survey nationally for four weeks, but this time during weeks two and three, half of participants will get a daily text message offering evidence-based tips for well-being. (This astronaut has some advice for surviving cramped spaces.)

Some will be simple—such as breathing exercises, suggestions for expressing gratitude or reaching out to friends. Other responses will be more involved, offering links to a web page including more detailed information. In some cases, he’ll even urge people to engage a partner in answering a standard set of 36 questions designed to draw people closer, starting with “Given the choice of anyone on earth, who would you want as a dinner companion?”

“For many people, their normal social interactions and connections have been disrupted, and loneliness and social disconnection are worries, if not realities,” Kanter says. “We are hoping to reconnect people with the basic dance steps of relationships and connection right now.”

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