For half a year now, governments around the world have been telling citizens to distance themselves from others. Experts say the mental health impact of life under the pandemic is hitting home, especially for older people and those who live alone.
Advised to avoid human contact to prevent the spread of the coronavirus, alongside other worries, people around the world are coming to terms with one major side-effect of social distancing: loneliness.
Scientists fear that forced isolation may be creating a new kind of epidemic as those forced into solitude face growing mental health problems.
At the outset of the pandemic, psychiatrists polled 5,070 Australian adults and found that more than three quarters reported their mental health was worse since the start of the outbreak.
Almost 80% of those polled reported moderate to extreme levels of uncertainty about the future while half said they felt moderately to extremely lonely and half also reported moderate to extreme financial fears.
"It is understandable that during times like this, people may be feeling afraid, worried, anxious, and overwhelmed by the constantly changing alerts and media coverage regarding the spread of the virus," Lifeline, an Australian crisis support charity, notes on its website.
It provides mental health and wellbeing tips, suggesting people should actively manage their wellbeing and be mindful of how much media exposure they can handle.
Beyond Blue, an Australian mental health charity, has set up a coronavirus mental wellbeing support service, with a hotline and website.
Loneliness was an invisible problem even before the pandemic, say doctors in Germany.
"There are more people than you would think who live in a major city and have almost no social contacts," says Stefan Deutschmann, who heads the advice and counselling section at the Diakonischen Werk in Hamburg, a charity.
That problem is now growing worse amid the pandemic. In the first phase of the outbreak, between mid-March and mid-May, his helpline in Hamburg saw 25 to 30% more calls.
"Many people expressed a deep sense of loneliness," he said.
Across Germany, the 100 helplines run by the Catholic and Protestant churches saw similar levels of need. Some 40 per cent of people called wanting to talk about the restrictions, uncertainty and changes brought about by the pandemic, says Ulrike Mai, a spokeswoman for the helplines.
The pandemic may be creating an "epidemic of loneliness," in Germany, says Horst Opaschowski, a futurologist based in Hamburg.
Some 80% of people said the lack of contact with family and friends was a heavy burden, according to a survey by the Forsa Institute commissioned by a German health insurer, Techniker Krankenkasse.
The boundaries between loneliness, depression and mental illness are fluid, Germany's chamber of psychotherapists noted in August.
"Alongside depression and anxiety disorders, acute and post-traumatic stress disorders, alcohol and drug addiction, obsessive-compulsive disorders and psychoses may also rise," says Dietrich Munz, the chamber's president.
Elderly people are among the groups most affected, he says.
Scientists worldwide are now weighing the dangers of loneliness and its effects, and calling on those staying at home to be open about their worries and maintain their relationships online.
Mental health experts at Britain's National Health Service it's also important to "not stay glued to the news" and take some offline time to do things you really enjoy and look after your physical health, which is connected to your mental health.
Loneliness has a serious impact on people's health, according to Carla Perissinotto, associate professor of medicine at the University of California, San Francisco.
Loneliness and social isolation are associated with increased risk of chronic conditions, including dementia and cardiovascular disease, as well as a higher risk of premature death, she told Dr Audiey Kao, editor of the American Medical Association's Journal of Ethics.
The coronavirus began sweeping the globe at a time when more people than ever in the United States live alone, according to Kao. Now, amid the pandemic, many people have even fewer social contacts.
"We are protecting people in the short term by isolating, but we have no idea how long it takes in terms of poor health effects." - dpa
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