Q. I'm a freelance journalist working for a reputable news organization. I often write about changes in society and their effects on us. As someone who works from home I'm often aware that this solitary activity sometimes has a strange effect on me. I feel a distinct need to get outside and socialize, even if this only means walking to the nearest shopping mall.

I feel that as more and more people work from home the traditional symptoms of cabin fever will become more prominent again. Clearly there is a big difference between being cooped up with other people and spending huge periods of time alone. I am really interested in finding out more about each set of circumstances. I would be extremely grateful if you could suggest where would you recommend that I start looking. Do you believe that working from home, alone for huge stretches of time has an effect upon our mental health and behavior?

A. Well, as a freelance writer myself, I can attest to the need to get out of the house after many hours of clicking away at the old keyboard! I guess this qualifies as a sort of cabin fever--not exactly a medical diagnosis, but something almost all of us can understand. There seems to be very little on the question you raise in the professional psychiatric literature--which suggests that this has not (yet?) become a significant clinical problem.

Personally, I'm inclined to believe that "working from home, alone for huge stretches of time" is not sufficient, in and of itself, to cause any major negative effects on our mental health and behavior. I think the critical issue is (a) how this work pattern fits in with the individual's underlying personality traits; (b) how much sense of control and autonomy the person feels while working at home alone; and (c) how maladaptive working alone becomes in his or her emotional, personal, and family life.

For example, a person who really must work home alone because he can't get along with anybody in the work place is one case--someone who chooses to work as a freelance; has very good social and family relationships; and could just as easily function in the usual office setting, is quite another case. (I suspect that your urge to get outside and socialize is precisely the sort of healthy personality trait that will prevent you from developing any serious emotional problems!)

Of course, if the freelance begins to feel extremely lonely or isolated, that's a different matter. Clearly, that might lead to frustration, unhappiness, and even to clinical depression (though I confess I've never seen a case like that). There are a few professional articles you might chase down that bear on some of these issues; e.g., Williams et al, "Psychosocial correlates of job strain in a sample of working women", in the Archives of General Psychiatry June 1997.

This study points out that high job demands and feeling little sense of control over them are associated with feelings of anger, depression, and hostility. Similarly, Yang et al (Public Health 2001; 115:265-71) discuss how job-related feelings of alienation and powerlessness figure in to emotional problems, such as problem drinking. Both studies suggest to me that these factors (lack of control, feeling isolated and overwhelmed, etc.) may be more important than whether one is working alone at home, or with others. Now--ready for that trip to the mall?

June 2003

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