COVID-19 Factsheet: Social Isolation and SCI

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.

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

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1. Woman in House © Mohamed Hassan, CC0 1.0
2. Image by SCIRE Team
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4. Image by SCIRE Team
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