The mental and physical costs of lockdown

The mental-health consequences of the virus are particularly troubling, as rates of depression and anxiety have risen during the crisis.

Teen depression (photo credit: INGIMAGE)
Teen depression
(photo credit: INGIMAGE)
As Israelis prepare to enter a second lockdown on Friday to stop the spread of the coronavirus, researchers caution that the effects of lockdown on people’s physical and mental health can be as devastating as the virus itself.
The mental health consequences of the virus are particularly troubling, as rates of depression and anxiety have risen during the crisis.
“There is no health without mental health,” said Dr. Ido Lurie, the chairman of the Israeli Society for Community Mental Health, which is part of the Israeli Medical Association. From a mental health professional’s point of view, he said, “It would be better if it were possible to use methods that are less draconian” than another lockdown.
Lurie said that he is part of a WhatsApp group with more than 100 mental health clinicians, including directors of mental health clinics from health funds, Health Ministry clinic directors and private providers.
“In the last few weeks, we’ve seen a 20%-30% increase in referrals,” Lurie said. These include patients who are children, adolescents, adults and elderly, he said. The mental health system was “already stretched to the limit before this crisis, and it can’t keep up with the pressure of this increase.”
Starting in the first lockdown and going up till the present, “People talk about their loneliness.... The elderly say there’s no joy in life when they can’t see their families and take part in the activities that they love.... Unlike in a war or an economic crisis, people can’t turn to their families for comfort, because they’re afraid of infecting them or being infected.”
On the other hand, in situations where families are forced to spend time together without the opportunity to go out and see other people, like quarantine or lockdown, “it can cause a great deal of stress.”
The ministry just released numbers at the Knesset that showed an increase in the number of people who committed suicide between January and September 2020 in comparison to the two years prior. This year, some 207 – though this is not an exact figure – were brought to the Institute of Forensic Medicine on suspicion of suicide, versus 191 in 2019 and 196 in 2018.
The problem of a rising suicide rate during lockdown is not unique to Israel. In May, ABC News reported that doctors at John Muir Medical Center in Walnut Creek, California, said they had seen more deaths by suicide during this quarantine period than deaths from the COVID-19 virus.
“We’ve never seen numbers like this, in such a short period of time,” a physician from the report said. “I mean we’ve seen a year’s worth of suicide attempts in the last four weeks.”
Jonathan D. Huppert, PhD, professor, Sam and Helen Beber chair of clinical psychology at the Hebrew University of Jerusalem, said, “Isolation and quarantine are not positive for people’s mental health. There have been increasing levels of depression and anxiety in people who were not experiencing depression and anxiety before.... There are contradictory data on whether people who were anxious and depressed prior to the first closure are feeling worse now.”
The stress of being stuck at home during the first lockdown, coupled with financial uncertainty from COVID-19-related layoffs, has resulted in a spike in domestic violence incidents. In June, the Knesset’s Labor, Welfare and Health Committee met to discuss a 40% rise in the number of reports of domestic violence since the start of the pandemic.
In terms of physical health, many Israelis have reported gaining weight and exercising less during the last lockdown According to a study conducted by the Hebrew U., 55% of Israelis gained weight during the first coronavirus lockdown as their training regiments were severely affected by the shelter-in-place orders.
Out of the 1,200 people surveyed, 70% of Israelis indicated that they have been training less intensively than they did before the lockdown began, adding that the average weight gain for Israelis was 1.2 kg. Fifty percent of those who put on weight gained more than 2 kg., according to a report published in Israel Hayom.
All medical procedures and tests deemed nonessential were canceled or postponed during the previous lockdown, and these included screenings for serious illnesses, such as cancer. While cancer patients were allowed to continue to receive chemotherapy, thousands had preventative screenings, such as mammograms, postponed for months.
An article in the British journal The Lancet, published in June, concluded, “Substantial increases in the number of avoidable cancer deaths in England are to be expected as a result of diagnostic delays due to the COVID-19 pandemic in the UK.”
ALL THE experts agree that a lockdown is a tough situation that can affect many negatively, and that everyone has to find ways of coping with it.
“When the government chooses to increase the speed limit, there’s an increase in fatalities,” Huppert said. “What I see a lot in the media is a bias toward the mental health implications of the crisis outweighing the physical implications of COVID-19. If the hospital system collapses, that will also have an impact on mental health.”
He emphasized that it is important for everyone to take care of themselves as best as they can, and said, “How the government messages is important. If people feel they are staying inside not just to protect themselves but to help protect other people, if they feel there is a societal impact to their actions, it will help them stay positive.... The goal is not to rid ourselves of all stress but to manage it and regulate it to manageable levels and not to let it consume us.”

Celia Jean, Tzvi Joffre and Maayan Hoffman contributed to this report.