Isolation, quarantine, tele-working. Our freedom of movement has been restricted. Yet, it is still up to us to manage this situation. We choose which memories to make at this time. Dr Anthony Zahra shares his insight on how to better deal with isolation.
We can remain free to choose to react to a situation, and that is a freedom that no virus can take away.
Unprecedented, unpredictable, catastrophic. The rapid and profound changes happening everyday are being described in superlatives, with such intensity and impact that leaves us disoriented. We are reacting to this threat with the expected fight or flight response. We are physiologically attuned to rush away from this imminent danger, our bodies preparing to sprint away. Our thinking process, the data processing mechanism is pushed in overdrive, worrying about all the scenarios which could go wrong. It starts to devalue the possible positive outcomes, focussing only on what may go even impossibly wrong. Thinking incessantly, even if I’m exhausted, and needing to sleep. Resting is not restful anymore, and you may find yourself pacing, scrolling incessantly through your feeds, on the lookout for the next developments.
The brain can’t rest when faced with such peril. The body is constantly prepared, with surges of stress hormones and neural systems pushing up the heart rate, pumping blood with determined efficiency to all your muscles, providing them with the much-needed oxygen to dash away at a moment’s notice. Your lungs feel like you can never breathe deeply enough, physiologically ensuring that all possible oxygen is driven into our bloodstream. We start getting all sorts of odd sensations, noticing every distant ache, every muscle twitch, even the normal movement of our heart in our chest. The blood supply to our organs is shunted to the muscle systems. All profound physical changes, preparing us for this real and sudden danger.
This response has served its purpose in our evolutionary history. The necessary response was to run away, to dash, to physically fight the predator. In this pandemic, we still do need the anxiety response. We need to be aware of the sense of danger, the assessment of the situation. The action that we need to take, however is against our natural instinct. It is not to run. It is not to engage the predator. We are being asked to stay put. We are being asked to stay physically away from each other. This is a conflict between what our natural innate automatic response and the solutions being proposed from our higher order cognitive functioning.
The response as a collective group, such as social distancing, comes from a mechanism that has developed later in our evolutionary development. The higher order cognitive functions are made possible by the development of more complex neuronal networks, organised in such a way to facilitate assessment and learning of a specific situation, together with the increased ability to work in teams towards a common goal. This response is in direct conflict with our more primal flight or fight response. This can lead to a form of affective dissonance, where our automatic responses and emotional states will not match with the behaviours needed to take us into a safe situation, creating a further sense of apprehension and confusion.
Speaking mechanistically and probably simplistically, it is more than ever the time to engage our full cognitive resources to address this pandemic. Whilst our instinct will unthinkingly and automatically rush us to do more, we need to be aware of these mechanisms that will push us on and on to exhaustion and fatigue. Take active control of your news consumption, setting out hours where you can focus on slowing down activities, such as reading from a book without interruptions being allowed.
Exercise is great, ensuring that you avoid groups and perhaps sticking to less busy hours. Do get a few minutes in the sun every day, get creative with cooking, keep to schedule, whether tele-working or not.
This pandemic, like many before, will pass. What will remain is also how we choose to manage this situation, the memories that we will form during this time of paradoxical closeness and isolation. We can remain free to choose to react to a situation, and that is a freedom that no virus can take away.
Dr. Anthony Zahra is a Consultant Psychiatrist working in General Adult Psychiatry with special interest in anxiety disorders and old age mental health
