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COVID-19 Factsheet: Social Isolation and SCI

Author: SCIRE Professional Team | Reviewer: Rachael Neal | Published: 23 July 2020 | Updated: ~

In the time of COVID-19, physically distancing is necessary to limit virus transmission and to keep everyone as safe as we possibly can. However, social isolation can have serious effects on mental health for everyone, including those with spinal cord injury (SCI).

Key Points

  • Social isolation is the absence of relationships and interactions with one another and is linked to mental health issues like depression and anxiety.
  • People with SCI may be at increased risk for the negative effects of social isolation.
  • Consider seeking help if you experience symptoms such as marked changes in personality, difficulty coping with daily activities, prolonged sadness, or excessive worry.
  • Strategies to maintain good health while physically distancing include daily structure, reaching out to others, good diet/hydration, and regular exercise.

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What is social isolation?

Social isolation is described as the absence of relationships, often due to physical separation from others. This differs from loneliness, which is a state of distress caused by feeling alone or separated.

Social isolation has been linked to various mental health issues, such as higher fatigue and depression rates. People who are socially isolated often report more difficulties with access and fewer close relationships.

Am I at increased risk for these potential effects if I have an SCI?

People with SCI are not necessarily more vulnerable to the effects of social isolation. However, research shows a higher proportion of depression and anxiety in people with SCI compared to the general population. The COVID-19 pandemic may limit access to caregivers or peer support networks that people with SCI depend on which can worsen symptoms of depression and anxiety.

You may want to reach out to a professional if you experience any of the following symptoms to the extent that it is concerning to you or close others:

  • Marked changes in mood, eating or sleeping patterns
  • Excessive anxiety
  • Prolonged sadness, depression, or apathy (disinterest)
  • Thoughts or statements about hurting yourself, harming others, or suicide
  • Increased substance use or using substances in ways that could be harmful
  • Excessive anger, irritability, hostility, or violent behavior

Look after your general health

There are direct links between mental health and physiological health. So, it is especially important at a time like this to take care of your general health. Stay mentally and physically active, have proper nutrition, hydrate well, and get enough sleep. Maintaining physical health can help serve as a buffer for emotional stress as we are more likely to feel that we have the resources to cope with stress when we are rested and eating well versus when we are tired and hungry.

Manage your worry

Some degree of worrying at a time like this is normal, but it is important to note if your worry is excessive, or if worry thoughts are interfering with your ability to do other things.
Strategies you can employ if you are feeling worried include:
• Noticing and limiting your exposure to things that trigger your worry,
• Practice postponing your worry to a later time, and
• Relying on reputable news sources to ensure your information regarding the pandemic is up-to-date and accurate.

Set a routine

Setting a routine can help you maintain a sense of normalcy during the pandemic. Stick to the usual structure of your day as best as you can by eating, exercising, and sleeping at the same times that you normally would. By setting a routine, many people find that they feel have a sense of purpose and predictability that is comforting. Using structure can also encourage us to work on tasks, which can bring feelings of accomplishment, and that feeling of accomplishment is naturally rewarding.

Stay connected

In the digital age, there are many ways to stay connected virtually to your loved ones. Videochatting, calling, and messaging is possible through many different platforms. ForaHealthyMe SCIO: Home is an example of a virtual platform established for connecting people with SCI.
As restrictions to physical distancing are slowly relaxing, it is possible to physically meet some of your loved ones in small numbers and at a safe distance from each other (it is still important be cautious and maintain physical distancing).

Be knowledgeable and take appropriate precautionary measures

A study has shown that being up-to-date with accurate health information (e.g., treatment, local outbreak situation) and taking particular precautionary measures (e.g., hand hygiene, wearing a mask) was associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression. Taking recommended steps to protect your health (e.g., washing your hands, mask use) can also remind you of the strategies that are currently within your control, which can also increase your self-confidence in coping with uncertainty over time.

Reach out for help if needed

Most of us are currently facing challenges that we have never faced before. It is natural and encouraged that you seek help if you require assistance in any aspect of your life. Seeking help when you need it is a sign of strength and good judgment!
There are many resources you can currently access that provide information, emotional support, and advice to people with SCI. Below are a few examples of such resources.

Resources to access

BC Government COVID-19 mental health support: Virtual Mental Health Supports During COVID-19 – Province of British Columbia

BC Mental Health Hotline: dial 310-6789, and do not add 604, 778 or 250 before the number. It’s free and available 24 hours a day.

We also recommend: keltyskey.com/, BounceBack bouncebackbc.ca/ and a “FACE COVID” e-book that can be found at actmindfully.com.au.

For good plain language information on COVID in multiple languages, visit flattenthecurve.com and for reliable data on COVID cases worldwide, visit coronavirus.jhu.edu/map.html.

You can also check out the other resources listed on our site: scireproject.com

Physical distancing is a necessary precaution that needs to be taken during the COVID-19 pandemic, but it can have adverse mental health effects if you do not take steps to stay socially connected. To maintain good mental health when isolation is inevitable, we recommend maintaining good physical health, managing your worry, setting a routine, staying connected with family and friends, and staying knowledgeable about the current situation.

Frank, M., Heinemann, A. and Wong, A., 2016. An Empirical Investigation of a Biopsychosocial Model of Social Isolation in Persons with Neurological Disorders. Archives of Physical Medicine and Rehabilitation, 97(10), p.e20.

Brooks, S., Webster, R., Smith, L., Woodland, L., Wessely, S., Greenberg, N. and Rubin, G., 2020. The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence. SSRN Electronic Journal, 395(10227).

Migliorini C, Tonge B, Taleporos G. Spinal cord injury and mental health. Aust N Z J Psychiatry. 2008;42(4):309‐314. doi:10.1080/00048670801886080

Mayoclinic.org. 2020. Mental Health: What’s Normal, What’s Not – Mayo Clinic. [online] Available at: <https://mayoclinic.org/healthy-lifestyle/adult-health/in-depth/mental-health/art-20044098?p=1> [Accessed 10 June 2020].

Ohrnberger J, Fichera E, Sutton M. The relationship between physical and mental health: A mediation analysis. Soc Sci Med. 2017;195:42-49. doi:10.1016/j.socscimed.2017.11.008

Wang C, Pan R, Wan X, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17(5):1729. Published 2020 Mar 6. doi:10.3390/ijerph17051729

Image credits

  1. Woman in House © Mohamed Hassan, CC0 1.0
  2. Image by SCIRE Team
  3. Doctor © CO. Department of Health Care Policy and Financing, CC0 1.0
  4. Image by SCIRE Team
  5. Notebook © Gentaur CC0 1.0
  6. Image by SCIRE Team
  7. Man on computer © user:cth103_t CC0 1.0
Disclaimer: This document does not provide medical advice. This information is provided for educational purposes only. Consult a qualified health professional for further information or specific medical advice. The SCIRE Project, its partners and collaborators disclaim any liability to any party for any loss or damage by errors or omissions in this publication. SCIRE receives no compensation and there are no conflicts declared with sources of information on this factsheet.