As the reality of a world pandemic sets in, people naturally feel increasingly anxious. It is normal to feel this way. Being in denial is not helpful. If people go about their day the way they did before COVID-19, they may become infected or infect others. So we want to work on acceptance of this strange reality, without a sense of panic—and without denial of facts.
Life feels uncertain and our world as we know it has changed, replaced by a confusing and surreal situation. We want to be compassionate toward ourselves, validate our own emotions, as well as be compassionate with others who may be struggling emotionally. It is a stressful time for our world, and we need to be patient with ourselves, as well as others.
Experiencing stress may result in a wide variety of symptoms of anxiety and depression:
- Sadness, feeling tearful
- irritability, anger
- feeling agitated, feeling slowed down
- decreased concentration, confusion
- Increased heart rate
- difficulty controlling worry
- Feeling lonely due to social isolation
- Body aches and pains (e.g., headaches, jaw pain, stomach aches, muscle tension)
- Appetite loss or overeating
- Panic, sense of impending doom
- Insomnia, nightmares, restless sleep
- loss of interest in pleasurable or fun activities
- Suicidal thoughts--always take these thoughts very seriously. Please call the National Suicide Prevention Lifeline 1-800-273-8255 if you are having these thoughts. If you feel like you are a danger to yourself or anyone else, please go to the nearest emergency room or hospital or call 911.
For people who have a history of trauma, current events may feel retraumatizing. They may be experiencing an increase in symptoms of post-traumatic stress disorder (PTSD). For nurses, doctors, or other health providers fighting to save people’s lives, symptoms of acute stress disorder (ASD) may emerge. These symptoms of PTSD/ASD include:
- Experiencing intrusive thoughts or memories of trauma; distressing dreams; or flashbacks of trauma event.
- Avoiding reminders of the traumatic event; this may include avoidance may include people, places, activities, objects and situations that trigger distressing memories.
- Engaging in persistent negative evaluations about oneself, others, or the world (for example, "I am unsafe," or "The world is a scary place”; experiencing feelings of fear, horror, anger, guilt or shame; decreased interest in pleasurable activities; or feeling detached or estranged from others.
- Experiencing irritability, angry outbursts; increased impulsive or self-destructive behavior; being easily startled; poor concentration or sleep problems.
If you are feeling depressed, anxious or traumatized, talk with someone, seek psychological help, but don’t suppress how you feel. It is tempting to tune out and avoid emotions which feel scary and threatening. Nobody likes to feel distressing emotions. However, ignoring or dismissing our emotions can cause us more psychological harm. The numbness that may set in will eventually feel even more distressing. The more we push our emotions down, the more they tend to bubble up to the surface in other unhealthy ways (e.g. feel irritable, engage in unhealthy habits, abuse substances, etc.).
Understanding and listening to emotions can be effective in decreasing distress. Many people have the impression that listening to distressing emotions is the same as being ruled by these emotions. This is not accurate. Having an awareness of the emotional pain we are experiencing, is not the same as being helpless in the face of this suffering. It means that we can allow important information to come to the surface, which can then be processed. This can help us understand the way we are perceiving ourselves, our world, and others, and can help guide us in making wise decisions. We want to allow our emotions to tell us a story--to inform us about what our needs are right now. This narrative can suggest a healthy action tendency.
What are my emotions telling me I need in order to feel less distressed? Here are some examples of emotions and action tendencies:
I feel lonely. This tells me that I would like to be around others. I can’t do it in person due to current restrictions, but I can call or facetime a friend.
I feel unsafe. This tells me that I understand there are some health risks. What are reasonable things I can do to help myself be safe? I can wash my hands, socially distance, and keep myself safe.
I am overwhelmed. I feel paralyzed. This tells me that I am exhausted, that I am carrying a huge emotional load. How can I set some of this burden down? Is it necessary to carry it with me all the time? I can turn off the news. I can remind myself that I am doing my best. I can try to do something small that feels productive (e.g. put dishes away) or do something that is self-caring (e.g. listen to my favorite music) and see if this helps.
There are various mental health strategies that may help decrease symptoms of depression and anxiety. Here are some ideas for coping with distressing emotions:
- First, don’t panic (yes, that’s a Hitchhiker’s Guide reference): Protect yourself from emotional contagion (a phenomenon involving adopting the emotional state of another person, sort of like empathy). Yes, people are buying all the toilet paper. Just because some people are panicking, it doesn't mean we all should. And perhaps see the humor in this situation. Who needs so much toilet paper?
- Be proactive: If you think you have COVID-19, talk to your doctor or advice nurse at a hospital, rather than ruminating, worrying, googling symptoms or asking a friend. Go to the experts!
- Don't obsess: Take a break from constantly watching the news, reading articles or researching every detail about COVID-19. This behavior won’t be productive, and it will lead to increased feeling of anxiety.
- Don't jump to conclusions: If you are sneezing, and certain this means you have COVID-19, could you be jumping to conclusions based on little evidence? What else could be going on? Do you normally sneeze this time of the year? Could it be allergies?
- Decrease unnecessary worry thoughts: Many of us engage in anticipatory anxiety, or predicting that something bad will happen in the future, which makes us feel unnecessary suffering. By holding on to our thoughts lightly, we can learn to tolerate uncertainty, and go with the flow a little more. We can let go of rigid beliefs about what might happen. As our mind runs away creating a scary future scenario, we can bring ourselves back to the present moment, and allow ourselves to experience our emotions from a place of curiosity.
- Decatastrophize: Imagine the worst-case scenario, and how you might cope with it if it were to occur. Bringing worries that you may be suppressing to the surface, and make them overt, can help us feel increased sense of calm and agency. This will help us come up with solutions that feel proactive.
- Be solution focused: Forgive yourself for perceived mistakes (e.g. You are the only person in the world who forgot to stock up on toilet paper, and now it’s sold out everywhere). Try to find a solution instead of beating yourself up (e.g. Do you have tissues in the house?)
- Stay emotionally connected: Call or email a friend, co-worker or family member. Social isolation does not have to mean emotional isolation.
- Give yourself a sense of structure: None of us do well without a sense of structure, which our work or school previously provided. Come up with a routine/schedule for yourself or your child and follow it.
- Decrease arousal: Engage in diaphragmatic breathing, or deep abdominal breathing. Breathe out more slowly than you breathe in.
- Do something soothing: take a shower/bath, smell something nice, have a cup of tea, pet your dog/cat, play with your kids, or talk with a friend or partner
- Stay busy: Take up an old hobby or activity or try a new activity: bake cookies, try a new recipe, learn a language, paint a picture
- Increase endorphins:
- Do something that is physically active: go for a walk, yoga, stretch, run on a treadmill, dance.
- Or do something that makes you feel good: watch a TV show, Tic Toc or YouTube video to make you laugh out loud.
- Be present-focused and mindful: Anxiety can result in disconnecting from thoughts, feelings, and the present moment. To disrupt this process, use a mindfulness technique, such as paying attention to your five senses. This can help to ground you in the here and now, rather than ruminate about current events or what the future might bring. Keep gently bringing yourself back to the present moment.
- Practice good sleep hygiene. Make sure you go to bed at the same time, wake up at the same time, and turn off electronic devices one hour before bed. Dim the lights an hour before bed, don’t work out two hours before bed, and don’t have your biggest meal before bed.
- Be gentle with your self and others. If you are working from home, perhaps you don't have as much time as you would like to help kids with their online learning. Perhaps you can't produce the same quality work at your job due to distractions, and are not as productive as you would like. Understand that the stress you feel may affect your mood. For instance, it is normal for people to experience increased irritability. Forgive yourself for losing your temper, and forgive others as well. Apologize and make amends, as needed. We are all doing the best we can during this scary and difficult time.
I hope some of these suggestions help. Please take care of yourselves during this uncertain and difficult time. And remember that we are all in this together, and that we will get through this together. Our humanity binds us. Throughout this storm that has taken over our world, it is inspiring to see acts of courage, altruism and compassion. It is amazing to see people jump into action to help others, or jump into song in Italy as an act of solidarity. It is encouraging to know that there are research scientists working around the clock to come up with a solution. So when life feels at its scariest, remember Fred Roger’s words, and “look for the helpers.” Look for the good. Because it’s all around us—and because that’s how we bring back hope.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.