Impact of COVID-19 Confinement on the Brain
Thanks to extensive research, we know that cognitive decline is directly related to the length of confinement. More importantly, the cognitive decline then further exacerbates the perceived isolation.
Photo courtesy of pixabay.com
There is an increasing amount of research appearing on the psychological and social impact of COVID-19 confinement. One recent report by the National Institutes of Health (NIH), Psychosocial impact of COVID-19 delves into some detail of these issues. There are many others like it. What may be of interest is how all this new research on confinement may suggest similarities with the experiences that new home-based businesses owners have been experiencing when they left an out-of-home job to work entirely in their own homes.
This is a very broad topic and there is a considerable amount of research available already, so it may be of some interest to consider one specific aspect of this: how COVID-19 confinement impacts not just a person’s psychology, but how it may actually be impacting the physiology of the brain.
The psychosomatic relationship
Last month’s article that I wrote, Posture & Pain looked at the physical impact on the body of sitting in front of a screen for prolonged periods of time, especially for children being made to home-school. The conclusion was that small business owners working from home on a computer can experience many of the same physical ailments.
The reason that physical ailments are of interest is that they require different treatments than psychological ones and that they could become physically debilitating. The question we are asking this month is whether there are physically apparent ailments resulting from the psychological impact of confinement.
As it turns out, there are.
Research on Solitary Confinement
Considerable research has been done on inmates, particularly those who have been placed in solitary confinement, sometimes for years. In the very moving article, Understanding the Effects of Solitary Confinement on the Brain Robert King, one of the well-known cases of the “Angola 3” describes how this confinement impacted him:
“My conversation skills are very limited,” he said. “I have some problems with my memory. And my navigational skills have suffered. Places that I know, even where I grew up, I have trouble getting around in, especially at night.”
It is really a heart-wrenching story, but the reality is that over 80,000 people are placed in solitary confinement at any given time. Depending on how long the confinement lasts, their mental capacity is similarly impacted. As such, there is ample evidence that their brains are physically impacted by this experience.
Further down in the article, they describe the effect on laboratory mice who are placed in solitary confinement. In looking at the brains of these mice, they discovered that after just one month of confinement, the neurons in their brains shrunk in size by 20%. After three months, they observed “shrinkage of the cell’s dendrites and axons,” which impacts how brain cells communicate.
There is also a psychosomatic link to stresses of the conditions of the confinement. In one study with rats, they discovered that when they are “under chronic stress as a result of social isolation, [they] possess a smaller hippocampus. This part of the brain is important for memory formation, spatial orientation, and mood regulation.”
There is also evidence that it adversely impacts their circadian rhythms, the body’s internal clock. This in turn “dramatically alters the activity of many genes in the brain… it thinks it’s night when it’s daytime — and those genes are out of sync with one another, affecting the function of eating, feeling, thinking, and interacting.”
The conclusion is quite clear: “the physical and molecular findings in animals are backed up in human behavioral studies,” according to Stephanie Cacioppo, behavioral neuroscientist at the University of Chicago. “In human beings, as social creatures, the stress of seclusion can lead to mood swings and depression, then to cognitive decline in spatial orientation, memory, and attention abilities, and finally, in some cases, to psychosis.”
What is also troubling about the research is that scientists do not know if the effects are reversible. According to the scientists in this article, there is yet not enough data to show that returning a former inmate to a non-confined environment will reverse the cognitive decline. This would prove to be especially disturbing if this is also the case with less severe forms of confinement, such as with COVID-19.
What the neural networks in the brain look like.
Photo courtesy of pixabay.com
What about milder forms of confinement?
The study of solitary confinement (as well as the impact on the brains of laboratory animals) present extreme cases of confinement. What is the current research about COVID-19 confinement? Will this confinement present milder changes, but equally identifiable ones? Perhaps more pertinently, what is the collective impact of confinement on a very large portion of the entire world’s population?
In the May 2020 NIH study cited above, they determined that “lockdowns can produce acute panic, anxiety, obsessive behaviors, hoarding, paranoia, and depression, and post-traumatic stress disorder (PTSD) in the long run.” Those can be broadly described as socio-psychological effects.
PTSD, in particular, is a recognized long-term effect of one or more traumatic events. It is also recognized as a condition that can physically alter the brain. The Psychology Today article, How PTSD and Trauma Affect Your Brain Functioning, describes that PTSD creates changes in the amygdala and the prefrontal cortex so that they remain in a higher state of tension. This causes lower control over anger and impulsive behaviors. It then also interferes “with the ability to regulate negative emotions and assign more positive meaning to events.” The article concludes that PTSD does alter the brain.
Returning to the NIH article, the authors point out that PTSD is of particular interest and that its symptoms “have been positively associated with the duration of quarantine.” While not everyone will have PTSD, it is definitely a risk.
The mental-physical link
There are also several studies that point out the relationship to illnesses from a sedentary lifestyle. As millions of people are confined to their homes these illnesses are growing exponentially as well. In the article How Social Isolation Affects the Brain, in the journal, The Scientist, epidemiologist Daisy Fancourt points out that: “We are seeing a really growing body of evidence… that is showing how isolation and loneliness are linked in with incidence of different types of disease [and] with premature mortality.” She goes on to say that in addition to obesity and cardiovascular problems, social isolation is linked to cognitive decline and dementia.
While the article also discusses the effects of severe isolation such as with prisoners, it also points out that there are less severe forms of isolation that are less well understood but that have a cumulative effect over time that may be severe.
For example, the elderly and the disabled are subjected to sometimes partial social isolation, but it is the fact that the isolation is long term, sometimes even decades long that leads to cognitive decline, measured by reduced verbal fluency and memory recall.
They also point out from a study of 11,000 subjects that there may be a reciprocal effect as well. The deteriorating brain function also leads to less desire to socialize. This in effect exacerbates the cognitive decline.
Photo courtesy of pixabay.com
Other environmental factors
It is also true that the external environment is likely to play a role. One study focused on an arctic exploration team that was also subjected to temperatures below -50 degrees Celsius as well as drastic changes in light exposure. This also affected their circadian rhythms, which can also influence outcomes as we saw above.
The subjects “showed anatomical changes to the dentate gyrus, a region of the brain that feeds information into the hippocampus and is associated with learning and memory; the crew members’ dentate gyruses had shrunk by an average of around 7 percent.
The crew members also had reduced blood levels of brain-derived neurotrophic factor (BDNF), a protein involved in stress regulation and memory, and they performed worse on tests of spatial awareness and attention than they had before they left.”
While this is another extreme case, there are some similarities with work-at-home environments that should be pointed out. For example, working in an office outside the home ensures regulated temperatures and schedules, but working from home those environmental factors could be quite different. Likewise, lighting is also less uniformly regulated in a home.
Obviously, those are much less severe environmental factors, but as has been pointed out, it is not just the severity of the factors that impacts the brain, it is also how long those factors were in effect. For business owners making a permanent change in the middle of life to a work-at-home career, there could be many years maybe even decades of impact.
Photo courtesy of Ana Shvets - pexels.com
In a separate study of MRI scans done at UCLA, it was also found that these subjects tended to have smaller gray matter volumes in the hippocampus and amygdala sections of the brain. While the scientists point out that this is not conclusive evidence that isolation causes shrinkage of these portions of the brain, it does suggest some correlation that should be studied further.
The article also mentioned several mice and rat studies not unlike the ones mentioned above. Those experiments corelate the effects with naturally occurring signaling proteins in the brain such as Rac1 and Tac2, which are also linked to memory problems such as Alzheimer’s and other degenerative cognitive conditions. They do point out, however that more research will be needed to arrive at more concrete conclusions.
Also interesting is that there does appear to be a concrete relationship between isolation and inflammation signaling molecules known as interleukin-6. They concluded that “Both isolation and loneliness were linked to inflammation” which can have negative effects on cognitive function as well as other processes throughout the body.
The research is also looking for remedies to these instances for cognitive decline. While the article mentions several pharmacological treatments, there is also an effort to physically boost engagement with inflicted individuals from frequent visits to social outings and online interaction.
It is important to point out however, that those are remedies against further decline. There is yet not enough conclusive evidence that cognitive decline from isolation or confinement is reversible. This is a critical point that the researchers in these articles are quite clear about.
Conclusion
The bottom line is that there is still considerably more research needed to discover the long-term effects of COVID-19 confinement and work-from-home isolation. That said, there is value in looking at extreme confinement such as seen in prisons, research done on lab animals, and the more comprehensive and longitudinal studies of selected groups. The current research in those cases shows that there is measurable cognitive decline that results from confinement, especially when combined with additional external environmental factors such as temperature and light.
The bigger question we cannot yet answer is whether the observed cognitive decline from those studies will also be measurable when confinement it is imposed on a large percentage of the population because of a world-wide pandemic. Yet even in that case, we do know from the research that cognitive decline is directly related to the length of the confinement. More importantly, the cognitive decline then further exacerbates the isolation.
To put it simply, the longer we are confined, the more dramatic the cognitive decline may be. What impact this will have when we also consider the large number of people impacted today, that is still a mystery.
Of course, this pandemic cannot last indefinitely – it will eventually subside. For those who are confined to work from home, there is ample research being done as well as treatments being developed to address those issues. This article is not meant as a source of actionable medical information, but I do hope it is a starting point for a broader discussion about the impact of prolonged isolation on the brain.
Posture and Pain
The issue of posture and prolonged screen time for our children as a result of the pandemic will continue to be an important one, that adults, especially gig workers, can learn from as well.
Bad posture, especially in front of a laptop, impacts children as well as adults. Photo courtesy of pixabay.com
Today I walked in to check on my son’s schoolwork and found him horribly hunched over working at the computer in his room. Before school started just a couple of weeks ago, this was primarily a gaming computer and we limit his gaming time, so I did not really notice it. Our son is also very athletic, so when he wasn’t playing a game, he was outside working out, biking, or running.
Now that school has started, he hardly has time to go outside as much. In addition to spending over six hours a day in school , he also has homework that plants him in front of a screen another 2-3 hours a day. The same is true for our daughter. This can’t be good.
The Science Behind the Concern
In an article titled School at home: How to keep attending virtual classes from being a real pain in the neck, Jennifer Jolly of USA Today explains that this is becoming a very common problem. Her own daughter suffered a herniated disk as a result of bad posture and using less than adequate furniture. Ouch! According to some research she found online, “the American Chiropractic Association, [found that] 92% of chiropractors said patients are reporting more neck, back, or other musculoskeletal issues since the pandemic began. Kids are no exception.”
She inquired more information from Dr. Jared Vagy, physical therapist, author, and USC Clinical Assistant Professor, who said that: “low back pain and neck pain are two of the most common sustained posture injuries from non-ergonomic sitting… Spine hunched and shoulders rounded, that’s the classic middle-school and teenager posture while sitting.”
That is very likely where my own children are headed. I also do not believe that teachers are aware of this. For them, it is one or two lectures back to back at most, and then they can take a break. Many teachers also pre-record their lectures, so the teachers are not even there when the students watch the videos.
For the students, however, they are forced into that sitting position for hours on end. Sure, they are allowed a few short breaks, but these do not address the cumulative effect of hours of computer-time a day. There is P.E., which consists of a few stretches and strength exercises in front of the computer, but again, this is not sufficient to cope with the remaining hours of sitting in that chair.
Another concern I have is for their eyesight. My son just happens to have a larger gaming monitor, so I’m guessing he’s better off than all those kids huddled over a 15” laptop or Chromebook. While our daughter also had a desktop computer with a larger screen (fortunately), it is not as detailed as the one my son uses. I am quite certain that everyone will be needing new glasses by the end of the year
Remote work did not free us from the physical problems of working at a computer all day. Photo courtesy of pixabay.com
Computing for the rest of the family
In our family, we have 1.5 high quality computer chairs. I say that because the second chair is a generic one that we purchased on sale at Office Depot. It is OK, but not ideal. We purchased these chairs when our work started to require longer hours in front of a screen. The chairs are a couple of years old.
That said, these chairs are far from adequate as well. Prior to the pandemic, we frequently attended meetings, workshops, and events so we were out and about quite a bit. I also took time to exercise several times a day before the pandemic – now not so much. We have been cooped up inside much more than what is healthy.
Unlike our children who were still able to spend much of their time outside and on the go, we typically stayed inside and worked. We have adapted our work to comply with the lockdowns and the restrictions, but what will be the long-term ramifications for us? Will we suffer the same problems as our children?
Actually, because we are a bit less active than our children, and because we are older, our problems are likely to be much more severe. My work usually becomes busy towards the end of the month when I need to meet deadlines, and truth-be-told, I have noticed far more muscle and nerve issues lately.
Chairs matter
Our previous chairs, which were very much inadequate are the ones that our children are now using – this is what happens in most households, I am told. The problem is that those older chairs are sagging, springs are worn, and the cushioning is flat. This causes pain in the lower legs after a few hours of use and does not support the back adequately.
When the kids were just sitting in short stints for a quick game of Fortnite, between longer times playing outside, then this wasn’t an issue. This fall, however, schools seem to be trying to make up for whatever academic setbacks were not met last Spring. It seems that students are required to spend far more time in their chairs now.
I think this is a perfect time to invest in quality chairs for our kids, but also to replace that .5 chair that we should also replace. Our old chairs should not be handed down either. That is just kicking the bucket down the street, and this bucket equals pain.
If you do have decent chairs that you use for work (we only have the one), then you could hand those to the kids and then make the new chairs a business expense (possible tax write-off) for yourself. Most small businesses tend to spend more liberally on technology while furniture is often forgotten. This pandemic year, the priority needs to also include chairs.
Other steps to take to improve posture
As it turns out there are many things, we can do to improve our posture when working at the computer. First and foremost: take regular breaks to stretch and do some light exercises. I have a system for doing this myself by frequently changing the music I listen to while I work (I listen to records). This is not something everyone has access to, but maybe you can find your own distraction that forces you to walk away from the screen on a regular basis.
The USA Today article mentioned above, also has a good diagram describing how children and adults should sit in front of a computer:
Proper posture is more important that we think. Click on image above for a more complete description of proper posture.
This does not necessarily require new and expensive equipment, either. Many of the suggestions can be implemented with things we have laying around the house, like using a thick book or two to raise the monitor to the correct height.
In the article, Jennifer Jolly also provides specific recommendations for improving posture. These include purchasing a laptop stand, replacing the chair, the desk, and considering a new keyboard and mouse as well. Obviously, these have a cost, but as mentioned above, you can substitute with items you have paying around.
Conclusion
I will not say that this issue is anywhere near the seriousness of the pandemic, but the pandemic is making this issue more serious for our children and us gig workers. Correct ergonomic equipment is an expense that large businesses and corporations can cover – for them it is less expensive than a lawsuit. For those running small businesses, this becomes a question of balancing this against other financial expenses the business needs to incur.
That said, I do think that this is the year to make an investment in better furniture. You can always tell your tax accountant that you have higher expenses this year because of the pandemic (which is not untrue). So do your research and invest in better chairs for yourself and your children. Just as it is cheaper than a lawsuit for a large corporation, it is also cheaper than long-term medical care for you.
The issue of posture and prolonged screen time for our children as a result of the pandemic will continue to be an important one. I expect that it will reappear in the media throughout the year. No, it is not as serious as the pandemic itself, but it will still be a serious health issue for millions that will have long-term ramifications as well.