The Covid-19 pandemic is as big a threat to mental health as it is to physical health, and some in Bermuda are already suffering the effects, specialists said.Kelly Madeiros, Adriene Berkeley and Grant Farquhar of Solstice Bermuda, an holistic wellness centre in Hamilton, said uncertainty about the future had increased stress and anxiety.Dr Farquhar, a consultant psychiatrist, said: “This is putting another layer of stress on top of the stress people already have.“It means more people will de-compensate and start showing symptoms of depression or symptoms of anxiety because the stress is beyond the level they can handle.“All of the publicity has also meant that those with underlying health anxieties have had a fire lit under those anxieties.”He added that quarantines — particularly longer quarantines — could also damage mental health.Dr Farquhar said: “It does seem to be quite a detrimental thing; forced quarantine was more harmful than voluntary quarantine, and the longer durations were more harmful.”Dr Berkeley, a chartered psychologist and a neuroscientist, said that people stressed about the pandemic should avoid “overindulging” in health news and social media.She said: “It’s understandable, but the first thing to do if you are getting stressed would be to scale it back.“It’s difficult to do when there’s this mass hysteria about staying away from others, but you really have to stay connected because we are social beings.“Right now there are people who are completely isolating, and that is making things worse in terms of adding to their emotional stress.”The specialists said some of the symptoms of increased stress and anxiety included irritability, changes in eating or sleep patterns, sadness, worry and anger.Dr Berkeley warned that quarantine can put additional strain on families. She said: “It can be tough, especially when you are in quarantine. It is about creating ways that you can manage your stresses.“It’s going to reach the point where your partner is breathing too heavy or they blink at you and you want to strangle them.”Dr Farquhar added: “Everybody needs to relive that stress from time to time. “Establish a quiet area in the house where people can go and listen to music on their headphones and not be disturbed when they need to get away or need their own space. People are going to get stir crazy.”Kelly Madeiros, a social worker and owner and director of Solstice, added that extra stress could also lead to increased drug and alcohol use, particularly when people are at home for long periods.She said that people should continue to communicate with friends and loved ones electronically and go outside, but maintain social distancing.Ms Madeiros said: “There are a great number of parks where you can go for a walk. You can work in a garden, if it’s not around people.“If you have a porch or a patio where you can sit in the sun, that would be helpful.”“We also suggest, if people are stuck inside, that they structure their day around a calendar.” Ms Madeiros added that there were options for people who needed to speak to mental health professionals even if they were under quarantine.She said: “If you start to see people getting withdrawn or showing signs of stress, people can reach out to mental health service providers, like Solstice at 292-3456. “We have an intake person that will speak to people as soon as possible and we have a number of great clinicians ready to be there for the community if people start to de-compensate or excessively worry.”Ms Madeiros added that healthcare providers had lobbied insurance companies to extend patient coverage to online and Skype sessions.She said: “Not only are we being told to practise social distance, but companies are telling their staff to stay home. Children are being told to stay home.“If people can’t use their policies to receive mental healthcare online, we can’t get the service to our clients.”