Last week the World Health Organization officially declared Covid-19 a pandemic. The virus has infected approximately 210,000 people globally, rattling financial markets, upending local economies and resulting in over 8,700 deaths worldwide, with numbers expected to climb. According to the Centers for Disease Control and Prevention, there are more than 5,300 cases in the United States and, as of publication, close to 100 people have died.
We are being told to hunker down, limit trips outside and practice social distancing – a deeply unnatural practice for humans, but an essential one in stopping the spread of the disease.
Aside from the general worry people have about their physical health here at home, there’s a larger toll this is taking on our collective mental health.
- The coronavirus can significantly affect mental health for everyone, but especially for those with mental illness.
- The anxiety of contracting the disease as well as the increase in loneliness and isolation can worsen and trigger symptoms in those struggling with mental illness as well as those without.
- Acknowledging, recognizing and acting on mental distress in these uncertain times is key to lessening the impact.
What we are seeing is…
Anxiety: 42.6% of Chinese citizens of reported anxiety related to the coronavirus outbreak. Primary concerns related to the coronavirus pandemic are:
- You or someone in your family will get sick
- Your investments, retirement or college savings, will be negatively impacted
- Loss of income due to a workplace closure or reduced hours
- Inability to afford testing or treatment
- You will put yourself at risk of exposure to the virus because you can’t afford to stay home and miss work
Obsessions: People become obsessive about disease prevention, especially for those with OCD who already experience contamination obsessions— “unwanted, intrusive worry that one is dirty and in need of washing, cleaning or sterilizing.”
Loneliness: Social distancing is considered critical to slowing the spread of the coronavirus. However, it can understandably lead to loneliness. Numerous studies have shown the adverse mental health and physical impacts of loneliness, including the potential to trigger a depressive episode, hopelessness and suicidal ideation.
Traumatic Stress: A survey of people subject to quarantine during the SARS outbreak in 2003 found that nearly 29% experienced traumatic stress.
Here is a list of coping strategies to help get through these uncertain times:
1.Be Mindful of Your “News” Consumption
The news can be helpful by encouraging precautions and prevention, but compulsively and obsessively reading and watching about the outbreak can be detrimental to mental health. Here are a few suggestions that may help you follow the news while protecting your mental health:
- Limit your sources: Rely on only one or two reliable sources of news as misinformation and bad reporting are rampant. The CDC is a great resource for updates and precautions.
- Practice acceptance: Accept that the news coverage will not answer all your questions or address all your worries. Accept uncertainty. Trust that officials around the globe and the medical community are trying their best to address the situation.
- Limit consumption: Perhaps checking for updates one or two times a day. Consume only what you need to know, what’s most relevant to you and particularly what is happening or anticipated in your own community.
- Distinguish between global and local news: The virus will not necessarily take the same course in the U.S. as it has in other countries. It’s important to think critically about the information provided and not jump to conclusions.
- Ask someone for help: If you feel you need separation from the news, have a friend or loved one filter the news for you, and give you updates based on a reasonable assessment of what’s relevant to you. This will allow you to reduce direct news consumption.
There is time to change the course of Covid-19, but it is hard to remember this when we’re hand washing, stockpiling and practicing social distancing.
Here are several ways we can stay centered, refrain from succumbing to our worst fears and be better prepared for whatever our collective future holds:
2. Put the Pandemic in Perspective.
The current crisis is not the only stressor most of us are dealing with. If your dog just died, you lack economic resources and necessary social services or your partner is leaving you — Then, the current world crisis will obviously hit you harder than if everything in your life was otherwise fine. Everyone is confronting challenges we may not fully recognize or understand.
Another important component of putting the pandemic in perspective is balancing what we should and should not do. As a rule, be vigilant rather than underreacting. Erring on the side of being overly cautious is challenging because it goes against our deep human need for physical connection. It’s tempting to rationalize our wish to have that one friend over or to see that one client in our office, especially when our economic interests are at stake.
Uncertainty and second-guessing are part of the human condition. While the anxiety they create feels dreadful, unlike denial and underreacting, you will not die from it. Identify the source(s) of your anxiety. We are hard-wired for a fight-or-flight response. The greater the simmering anxiety, the more you will see individuals stuck in fighting and blaming on one hand, or distancing and cutting off on the other. Identify anxiety-driven reactivity, we can get some distance from it, rather than being propelled into action before we have calmed down enough to do our best thinking.
Also note that while “flight or fight” is the most common response to a threat, what we are seeing a lot of is “freeze”, where people are feeling immobilized by their fear.
3. Refrain from Shaming and Blaming
When survival anxiety is high and goods feel scarce, it’s easy to blame or scapegoat others, forgetting that we are all in this together. Our target may be a particular group or an individual, like the woman who sneezes in line in front of us. While we can’t fully eradicate our fears, we can work to understand how anxiety operates and how it affects us — for better and for worse. Anxiety can be useful when it signals a problem and motivates us to unite to solve it. If we make a deliberate effort to hold on to our humanity, it can bring us together.
4. Have a Routine (as much as you can)
We know how important routine is, especially for kids, under normal conditions. And when schools are closed and many people are working from home or told to stay at home, it might feel like all bets are off. But it’s much better for everyone’s mental health to try to keep a routine going, as much as possible.
“Studies in resiliency during traumatic events encourage keeping a routine to your day,” says Deborah Serani, PsyD, professor of psychology at Adelphi University and author of “Sometimes When I’m Sad.” “This means eating meals at regular times, sleeping, waking and exercising at set times, and maintaining social (socially distant) contact. Unstructured time can create boredom, spikes in anxiety or depression, which can lead to unhealthy patterns of coping.”
So in the morning, rather than wondering whether to start work or help the kids with their online learning, it’s better to know what you’re going to do—make a schedule that everyone can get on board with, and try to stick with it (as much as is possible—don’t beat yourself up if it doesn’t always work, and it’s sure not to work some days). This will free up some mental bandwidth during this time of uncertainty, which is already straining everyone’s cognitive capacities.
5. Start An At-Home Exercise Routine
Working out at home in these times is obviously a good way to stay healthy and kill indoor time. There are lots of options, from the 21st-century ones (Peloton and MIRROR) to the old-fashioned ones (workout videos and the dusty hand weights in your closet). Many online workout sources are offering free access or longer free trial periods during this time, which might be worth looking into. But again, anything that gets your heart pumping or builds muscle is excellent for both physical and mental health.
6. Get Outside—In Nature—If You Can
This is much easier in the country or suburbs, but if you’re in the city and it’s feasible, shimmy past your building neighbors and go for a walk in the park. Remember to stay six feet away from other people—as city dwellers know, this can take some maneuvering, but it’s possible.
Lots of recent research finds that spending time in nature is a boon to both mental and physical health. For instance, multiple studies have found that time in green and blue space is associated with reduced anxiety and depression, and the connection may well be a causal one.
7. Declutter Your Home
Working on your home if you have time can be a good way to feel productive and in control. “Take the opportunity of the extra time by decluttering, cleaning or organizing your home,” says Serani, referencing the book Trauma-Informed Care. “Studies say the predictability of cleaning not only offers a sense of control in the face of uncertainty but also offers your mind body and soul a respite from traumatic stress.”
The caveat is that you don’t want to become obsessive about cleaning since there’s only so much you can do. But using the extra time, if you have it, to reorganize and toss or donate items you no longer use is a very good idea.
8. Find Things To Do/Distractions
Activities that distract you from current events can be helpful. Here are a few ideas:
- Household chores, such as spring cleaning, will give you a sense of purpose and accomplishment when completed.
- Free online university courses and courses through cousera, such as Yale University’s most popular class ever: The Science of Well-Being. They offer a great learning opportunity.
- Movies are moving from theaters to online. Netflix is also a good option.
- TV programming has expanded during the crisis, particularly through streaming services like Netflix. You can also currently stream the Met Opera for free. The NFL and NBA are also offering complimentary access to online streaming platforms.
- Virtual parishes, which faith leaders are offering, can help maintain religious connections.
9. Just Breathe
Controlled breathing has been used for millennia to calm the mind. Researchers also point out that slow breathing is used “clinically to suppress excessive arousal and stress such as certain types of panic attacks,” which is nothing to sneeze at. So, trying some controlled breath work (there are good resources for this online) may be an especially healthy idea these days.
10. Maintain Community and Social Connection
As mentioned, we’re fundamentally social creatures, and during crises, it’s natural to want to gather. Social connectivity is perhaps the greatest determinant of wellbeing there is, as this landmark 80-year-long study from Harvard reported, and one of our most basic psychological needs. Unfortunately, it’s the opposite of what we can do right now, so we must be creative, to maintain both psychological closeness and a sense of community. Texting and social media are ok, but picking up the phone and talking or videoconferencing, or having a safe-distance conversation on the street, is probably much better. Be ready to listen to other’s concerns and share yours. Learn effective listening skills to help your friends and loved ones.
Reflective listening is an excellent communication technique, where you listen to what a person is saying and repeat it back to them. You may help validate their concerns and show them you understand their concerns, which can help put them at ease. Talking to another person about worries and fears can help, and just knowing that others share them can validate your own fears and worries.
Social connectedness is critically important to ward off loneliness and resulting depression. There are many online peer support communities to turn to, including those for mental illness caregivers such as ForLikeMinds, and for people living with mental illness such as 7 Cups, Emotions Anonymous, Support Groups Central, Therapy Tribe, Support Groups, 18percent and PsychCentral.
11. Be Of Service, From A Distance
Being of service is one of the best things we can do for society—and on a more selfish note, for ourselves. Studies have repeatedly found that serving others, even via small acts of kindness, has strong and immediate mental health benefits. And feeling a sense of purpose has also been shown to help people recover from negative events and build resilience. For people who are lucky enough to be healthy right now and not caring for a loved one who’s sick, finding ways to help others in this kind of crisis is probably very good for your own well-being.
Here’s a breakdown from the Times on organizations that are helping those affected by coronavirus on a larger scale. And on a more local note, organizing efforts to help neighbors in need of food or supplies, buying gift certificates to local business, ordering takeout from neighborhood restaurants, and helping fundraise locally can help the financial fallout that’s happening all over the country.
In these uncertain and unprecedented times, it is natural to experience stress and anxiety. However, an awareness of these stressors better positions us to address them. And there are many tools and coping strategies available to combat the strains on our mental health.
12. Practice Gratitude
This is not the easiest thing to do in these times, particularly if you’ve felt the more brutal effects of the pandemic, like job or business loss, or illness. But practicing gratitude for the things we do have has been shown again and again to be hugely beneficial to mental health. For instance, in one of the first key studies on the subject, the researchers found that writing down five things one was grateful just once a week was significantly linked to increased well-being. Other studies since have borne this out; and of course, gratitude is a central tenet of most religions and philosophies around the world.
So even though it might be a challenge right now, write down some of the things you’re grateful for; or if you have little kids and it’s easier, try talking about and listing aloud things that make you happy and that you’re thankful for.
13. Let Yourself Off The Hook
This might be the most important thing to keep in mind—don’t beat yourself up when things are not going perfectly in your household. On top of everything else, being upset with yourself is totally counterproductive. If the kids watch too much Netflix or play too many hours of video games, it’s not the end of the world. Things are going to be hairy for a while, and if you can’t stick to your schedule or can’t fit in your at-home workout every day, it’s not such a big deal in the long run. It’s much more valuable to everyone to cut yourself some slack, use the time to reflect on the important things, and try to keep a sense of “we’re all in this together” at the forefront
14. Don’t Be Afraid To Ask For Help
Now is the time to turn toward each other. “We are here to help each other out,” “so avoid being a do-it-yourselfer when you’re not qualified. Grab some other clear-thinking person to ask what she thinks or what he would do about stockpiling food, or taking that plane trip, or talking to little Billy about what’s going on with grandma in the hospital and his school being closed. You may choose not to follow the advice you seek, but it’s essential to have other perspectives.”
15. Practice Self-Compassion
This moment calls on us to not only care for others but to also be gentle with ourselves. “Anxiety and fear,” “are physiological processes that cavort and careen through our bodies and make us miserable. They will subside, only to return; they will arrive uninvited for as long as we live. So, don’t be hard on yourself when you can’t shut yourself off from fear and pain — your own and the world’s. Fear isn’t fun, but it signals that we are fully human.”
16. Take Care Of Yourself
It’s essential to make your health a priority during this time. The critical self-care activities are sleep, physical exercise, and a healthy diet. Find ways to address forms of stress, such as journaling, going for walks or calling a loved one. Maintaining a sense of normality and routine can also reduce stress. Slow down, engage in healthy practices and try to sustain regular routines that bring comfort and stability. Therapy, conversation, exercise, and religious and spiritual practices are good starting points, but she suggests also considering the healing impacts of making art, singing, journaling and being useful to others. It can be especially helpful to practice mindfulness and try not think of the future or worst-case scenarios. While we can’t drive fear off with a big stick, we can learn ways to calm ourselves down and find a little peace of mind. Action is powerful, even if we start with just one thing.
Don’t Let Fear And Anxiety Become Pandemics, Too
In these stressful times, it’s important to try to manage our own anxiety and do our best not to pass it on to others. But most importantly, we should not let fear lead us into isolation or stop us from acting with clarity, compassion, and courage. Terrible things happen, but it is still possible to move forward with love and hope.
For God has not given us a spirit of fear, but of power and of love and of a sound mind. (2 Tim. 1:7)
1. Coronavirus: Mental Health Coping Strategies by Katherine Ponte BA, JD, MBA March 20 written for NAMI
2. 10 Ways to Ease Your Coronavirus Anxiety by Simran Sethi, March 2020
3. 9 practices To Help Maintain Mental Health During The Coronavirus Lockdown by Alice G. Walton.