10 Ways to Stay Sane through COVID-19

Whether you’re quarantined in New York City or socially distancing in a Midwest suburb, coronavirus is affecting all of us. Feeling afraid or worried is a completely natural, instinctive response to this global pandemic, and it seems the majority of us are experiencing anxiety.

In a survey study of more than 1200 people in China from January 31st – February 2nd 2020, researchers found that more than 50% of respondents considered the psychological impact of the coronavirus outbreak to be moderate to severe (Wang, 2020).

Uncertainty, particularly the uncertainty around a threat like coronavirus, heightens anxiety. Many factors play into the fear behind coronavirus—it’s spreading fast, we have limited (though growing) knowledge regarding its infectious properties and ultimate physical effects, and as of yet we haven’t developed an effective treatment. The numbers of people sick, the mortality rates, and the locations of new hotspots are changing daily, and the media is overpowering us with sometimes conflicting headlines. With so much uncertainty, it’s understandable that we, as a worldwide community and as individuals, are frightened.

Psychological Impacts of the COVID-19
Humans are hardwired to respond to threats as a function of survival. Our brains developed the mechanisms of anxiety and fear as a way to heighten our senses and prepare us for response to an attack. If we were unconcerned in the face of a threat, we might not respond fast enough, run far enough, or fight hard enough. Fear and anxiety are normal and necessary evolutionary responses to dangerous situations, and it seems that people around the world are experiencing these instinctive responses in similar ways.

Psychological Impact of COVID-19 in China
An article published March 6, 2020 in the International Journal of Environmental Research and Public Health reported the following data from survey of 1210 respondents from 194 cities in China during the COVID-19 outbreak:
• 53.8% of respondents reported moderate to severe psychological impact of the outbreak
• 16.5% reported moderate to severe depressive symptoms
• 28.8% reported moderate to severe anxiety symptoms
• 8.1% reported moderate to severe stress levels
• Young women reported higher levels of stress, anxiety and depression (Wang, 2020)

Psychological Impact of COVID-19 in the United States
The Pew Research Center conducted a similar survey in the United States from March 19-24, 2020. Their findings showed:
• 73% of respondents reported feeling nervous, anxious, or on edge at least some of the time
• 60% had trouble sleeping at least some of the time
• 48% reported feeling depressed at least some of the time
• 57% of people who perceived the outbreak as a major financial threat experienced moderate to severe distress
• Young people and people who are financially affected report higher levels of stress, anxiety, and depression. (Keeter, 2020)

Vulnerable Groups
Given such widespread psychological impacts, it is also important to keep in mind those groups that may be particularly vulnerable. Those include:
• People currently diagnosed with anxiety or OCD
• People with a history of trauma and PTSD
• Patients undergoing infertility treatment
Pregnant women

Impact on Pregnant Women
During the SARS outbreak in 2003, one study revealed that pregnant women had worries of contracting the virus and transmitting infection to the fetus, acquiring infection during delivery, or risking teratogenicity if drug treatment was required. These women made behavioral changes, (e.g., isolation), and nearly a third of the women were homebound.

According to the study, pregnant women tended to overestimate the risk of contracting SARS, but their anxiety levels were only slightly elevated. The improved social support experienced by pregnant women during SARS might have buffered the stress associated with an outbreak (Lee, 2006).

What Can You Do About Your Anxiety?
To recap, anxiety and fear are a natural, instinctive response to threats. People around the world are experiencing heightened levels of anxiety in response to the coronavirus outbreak and all the uncertainties that come with it.

Moderate anxiety is adaptive and beneficial to us as individuals and as a community. During the 2003 SARS-CoV epidemic, researchers found that moderate levels of anxiety were associated with higher uptake of preventive measures (Lee, 2006). Preventive measures mean greater personal and collective safety and a mitigated spread of the virus.

When fear or anxiety become paralyzing, that’s when it’s a problem. But it doesn’t have to get to that point! Here are ten strategies for managing your anxiety during these trying times.

1.Be Intentional About Media Consumption
We are bombarded by media, taking in news headlines and memes and anecdotes on social media throughout the day. It is nearly impossible to avoid the constant stream of information (and sometimes misinformation) about the progress of the coronavirus pandemic, which can ramp up the perception of danger and keep us in a state of hyper-vigilance.

Being intentional about your media consumption can reduce feelings of anxiety. During the COVID-19 outbreak in China, “specific up-to-date and accurate health information” resulted in lower levels of stress and anxiety (Wang, 2020).

For the media and information you do consume, use reputable sources of only! Information can be reassuring if it is rooted in facts. A good resource for reliable, trustworthy information is the CDC website.

Stay informed without overdoing it and consider taking a day periodically to detox from health news.

2.Have a Routine
Routines calm anxiety. The predictability of routine gives us some control in a world that feels uncertain.

Try to maintain some semblance of your normal schedule; wake up and go to bed around the same time, eat regular meals, shower, and continue an exercise regimen. Some things may need to be adjusted, like working out to an online class instead of going to the gym, but modifying routine is different than scrapping it altogether—and more beneficial to your mental health.

If you work from home, it is tempting to fall into a lethargic lifestyle and stay in your PJ’s the whole day. Resist that temptation and get dressed every morning. The simple act of showering and putting on your work clothes helps put you in the headspace for work and helps divide your day into its familiar schedule.

Also, remember to take breaks. When you’re working just feet from where you sleep, days and routines can meld into one long stretch. Get up and move around, change your perspective and set some time limits.

3.Connect, Connect, Connect!
Research shows that emotional isolation is more dangerous for our health than smoking or high blood pressure (Xia, 2018). On the other end of the spectrum, social engagement can boost your mood and increase your resilience to stress.

Having close connections is crucial for our mental, emotional and physical well-being. Even fifteen minutes of talking with someone you really love and enjoy can do wonders for your anxiety. Thankfully, though we may need to physically isolate ourselves, there’s no reason we need to socially isolate ourselves. Keep connecting via video chats like FaceTime, Skype, and Zoom. These video calls and daily connection are like medicine for anxiety.

4.Practice Self Compassion
It is easy to be critical of yourself when you feel anxious. Simply take a moment to acknowledge you feel anxious and remind yourself that it’s okay and understandable that you feel afraid. People around the world are experiencing similar anxiety, and it’s completely normal.

5.Name Your Feelings
You can’t try to suppress, or think yourself out of, anxiety. But studies show that the simple act of naming feelings calms the brain and regulates painful and difficult emotions (Lieberman, 2007). Identifying your feelings puts you in a better position to change them and control them.

Talk about your feelings with someone you feel close to or with someone who may have similar experiences. By sharing our stories, we can bring meaning and create order out of chaos, and ultimately recover a sense of control.

6.Your Perception Matters
When you are in it, anxiety always feels as though it will never end. But it will.

Emotions and reasoning are entangled: negative thoughts evoke anxiety and anxiety evokes negative thoughts. You can cope by reducing global negative thinking like “this will never end” and reframing the situation to view it as temporary. Think to yourself, “this will pass,” or “the outbreak is time-limited.”

Try to keep your self-talk specific and look for the manageable aspects: “I am anxious about not seeing my friends, but I can do a video chat with them.” “I may lose my job. If I do, I can look for help from these people and organizations.”

7.Remember to Breathe
People under stress or experiencing panic unconsciously change their breathing. They hold in their breath or breathe with their chest.

When you feel stressed or panicked, take 4-5 slow, deep breaths. Make sure that your exhale is longer than your inhale. The longer exhale naturally deepens and slows your breath and reminds your body to be calm.

8.Relaxation Techniques
These relaxation techniques are easy to employ at home, even at a moment’s notice. Online videos and tutorials are available for each of the following techniques if you need an intro or refresher:
• Meditation
• Mindfulness
• Yoga
• Deep belly breathing
• Progressive muscle relaxation
• Journaling
You may also find that regularly practicing these responses throughout the day, even when (or especially when) you’re not anxious, reduces overall levels of anxiety – and makes the response easier to access during times you do feel anxious.

9.Practice Self Care
• Exercise: Physical movement and exercise is one of the most powerful anti-anxiety techniques we have. Any kind of moderate level of exercise for 10 or 20 minutes reduces anxiety. Try an at-home workout routine, YouTube yoga, or get out for a walk around your neighborhood.
• Eat Healthy: Make it a priority to eat fresh fruits, vegetables, whole grains, and proteins. Filling, healthy meals give your body and brain the fuel they need to maintain optimal functioning. Try to avoid sugar, alcohol, and processed foods.
• Get Enough Sleep: Everything is harder when we’re not sleeping well, from physical energy to regulation of our emotions and our ability to focus. To help make sure you get enough sleep, tighten up your sleep habits:

1.Have a consistent bedtime and wake up time

2.Set an alarm clock

10.Love on Your Pets
Pets provide tremendous comfort when we feel the most vulnerable. Pets fulfill the basic human need for touch, which has therapeutic effects (Pendry, 2019). They can reduce stress, anxiety, and depression, ease loneliness, and encourage exercise and playfulness—so snuggle up with your furry friends!

If anxiety is overwhelming you or impacting your ability to function, it may be time to seek outside help. Fortunately, thanks to modern communication technology, you can get help even while #StayingHome. Many psychologists are offering tele-sessions and video sessions during this difficult time.

During this crisis, Dr. Irena is available every day for telehealth sessions. If you need support staying calm during this season of uncertainty with Coronavirus, call Dr. Irena for a free 10-minute phone consultation: (281)-267-1742 or e-mail her at irena@permalink.com

Sources Cited:

Keeter, S. (2020). People financially affected by COVID-19 outbreak are experiencing more psychological distress than others. Pewresearch.org. Retrieved from 2. https://www.pewresearch.org/fact-tank/2020/03/30/people-financially-affected-by-covid-19-outbreak-are-experiencing-more-psychological-distress-than-others/

Lee, D. T. S., Sahota, D., Leung, T. N., Yip, A. S. K., Lee, F. F. Y., & Chung, T. K. H. (2006). Psychological responses of pregnant women to an infectious outbreak: A case-control study of the 2003 SARS outbreak in Hong Kong. Journal of Psychosomatic Research, 61(5), 707–713. doi: 10.1016/j.jpsychores.2006.08.005

Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M. (2007). Putting Feelings Into Words. Psychological Science, 18(5), 421–428. doi: 10.1111/j.1467-9280.2007.01916.x

Pendry, P, Jaymie L. Vandagriff. Animal Visitation Program (AVP) Reduces Cortisol Levels of University Students: A Randomized Controlled Trial. AERA Open, 2019; 5 (2

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. International Journal of Environmental Research and Public Health, 17(5), 1729. doi: 10.3390/ijerph17051729

Xia, N., & Li, H. (2018). Loneliness, Social Isolation, and Cardiovascular Health. Antioxidants & Redox Signaling, 28(9), 837–851. doi: 10.1089/ars.2017.7312

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