As I drove back home from the hospital yesterday, I noticed that traffic was lighter. Then tonight as I walked my dog in the early evening I cannot help but notice the lack of foot traffic, the relative emptiness of the street. There are others like me walking their dogs, but as I pass the popular coffee shop I notice the quiet. It is not a calm quiet, but an eerie quiet. Last night, Mayor Garcetti enacted a mayoral executive order to place necessary restrictions on restaurants, bars, gyms, and entertainment venues. An action that was necessary for these circumstances. 

In the coming months as we band together to slow the progress of COVID-19 we are faced with a true dilemma. To protect our physical health and safety, we are likely to pay the cost of social isolation and there will be those who fall into depression. In the clinic that I work in, we as psychiatrists ask that our patients listen to the advice of the CDC, the Governor, and even the President — limit your exposure to others outside of your household and practice social distancing. Those very same patients were told by us a few weeks ago to make lifestyle changes — to stop snacking on junk food, to exercise daily, and to reach out to support groups to motivate themselves to reach their mental health goals. 

Our goal as a community of healthcare professionals, physicians, psychologists, social workers, nurses, respiratory therapists and every staff member that walks through the door of a hospital to do our jobs is to minimize the impact this virus will have on human life. This remains the utmost importance of course. But after the air clears and people emerge from lock-down or quarantine — what type of world will they return to? People in service industries may not have jobs to return to. People may have lost love ones. A certain level of fear will penetrate every public gathering for months.

Right now our first responders, as well as our primary care physicians and nurses, are fighting the first battle. They fight a battle while potentially exposing themselves to this virus, their safety not guaranteed. But those of us who are further from the front line should be ready soon. Our battle will begin months from now as the world begins to turn once again. Right now many clinics are pushing out their appointments or switching to telehealth. In the mental health field, we understand the abandonment that we are imposing on our patients. It makes us anxious. The anxiety we feel is merely a fraction of what our patients are experiencing, but we do feel it too.

For now, we will make adjustments and become flexible in our treatment. Not all of the states have full parity for telemedicine, but now is the time for that to change. As physicians, we need to be vocal with our representatives in government. We need each other’s help. I am proud to see my colleagues from all fields of health care raising their voices and stopping the spread of misinformation in a time of panic. I think that people are starting to trust us again, and for us to get through this together we have to trust each other.  

For the general public reading this, here are some tips for avoiding and coping with depression during our time of social distancing:

1. Do your best to stay in communication with friends, family and loved ones. Make it a habit to contact at least two people a day. You will feel better and they will feel better. Isolation will likely accelerate you towards depression.
2. As most gyms and fitness facilities are closed during this time, it is important to get into a habit of exercising at home. Just because you are stuck at home doesn’t mean that you can’t continue working towards your fitness goals. This will help your mental health. 
3. Avoid eating lots of junk food. As I explored the grocery store in my neighborhood I noticed that a majority of empty shelves were the home of high carbohydrate, sweet, or salty foods.
4. Continue your previous sleep pattern. Do not start sleeping in and binge-watching shows to stay up late into the night.
5. Stay motivated towards something. If you can work remotely that is great. If you are currently displaced from a job, think about what you would like to improve upon, create, or learn about. Some boredom is inevitable but you don’t have to just accept it.

You are not alone, we are all in this together. We can beat COVID-19.