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Coronavirus Disease 2019

Coping With Anxiety During the COVID-19 Crisis

A psychiatrist shares 18 tips on managing anxiety during the COVID-19 pandemic.

The novel coronavirus has created unprecedented levels of stress for most of us. Some are actually battling the virus now, but the vast majority of the harmful effects are coming from the fear of the unknown, disruption to our routine, loss of productivity, and financial concerns.

As most of us are in uncharted territory, I hope the following tips will provide a bit of comfort.

Be Calm and Smart

Try to optimize your mental health by activating the calming part of your nervous system. This is called the parasympathetic nervous system nicknamed “Tend and Befriend” and “Rest and Digest." It is the opposite side of our nervous system that is in overdrive now; our sympathetic nervous system nicknamed “Fight or Flight."

We need the arousal side when we face emergencies. It kicks in to prepare us for battle and to stay focused. The situation now is highly unusual in that to fight effectively, we must stay home. Our best defense paradoxically is to relax yet it can be very hard to do. But if we stay in an aroused state for prolonged periods, we can actually damage our health. To beat this pandemic, we must try to be calm and smart. We have to use our most advanced weapon, our frontal lobe, to get out of this situation.

Each of us must do our part by taking care of ourselves, then our family and closest friends. After that, we must see if there is a way to contribute to the public health of all. For most of us, our biggest contribution is to stay home and activate our parasympathetic nervous systems.

1. “Tend” to Yourself First!

Make sure you are getting enough rest. If you are not sleeping through the night, try to address this issue as sleep is the base of the wellness pyramid. Many people are feeling very tired from spending so much of the day in a state of high anxiety. Let yourself sleep if your body needs it.

2. Eat Well

One defense against the coronavirus and most diseases is proper nutrition. Eat fruits and vegetables in a balanced fashion. Avoid empty calories, as eating should be a way of nourishing ourselves. Of course, being home all day makes it easier to eat out of boredom or anxiety, but do your best to avoid these potholes. Talk to your doctor about vitamins or other supplements. Stay properly hydrated.

3. Eliminate/Reduce Alcohol and Other Intoxicants

Even though alcohol and marijuana might make you feel calmer for a short period, it is better to use and develop other tools to relax during this crisis and moving forward.

4. Go on a News Diet

Limit the amount of upsetting information to what you need to know. Make sure you are getting enough information to stay safe and follow the advice of experts. Then turn off the news. Same advice for financial worries. Watching the stock market all day can negatively impact how you feel. Make sure you don’t combine negative news and eating. Remember that food allows us an opportunity to “rest and digest” so use meal and snack time wisely. Choose the right food and the right mood.

5. Exercise

Although most of us can’t work out the way we used to, we must find safe alternatives. Use YouTube and Instagram to help you find ways of staying fit in your own home. Ask friends for tips and consider sharing work out time with friends via Zoom or FaceTime.

6. Have Some Fun

Give your brain an outlet to have fun. Puzzles, magazines, humor provide much-needed respite from the stress. Many families are enjoying the extra time together and are playing board games, cards and cooking.

7. “Befriend”

Reach out to those important to you. Make sure they are staying safe. Everyone reacts differently to stress and it is important to assure that those you value are making good choices. Use this time to tell people how important they are to you and reach out to those you care about. Many are finding comfort in FaceTime. Companies are setting up Zoom meetings and people are connecting. Take advantage of the myriad resources online to get support.

8. Emote

It’s beneficial to let your feelings out with a friend, family member or professional. A wide variety of feelings are coming up for people now and they should be acknowledged to ourselves or with others. Many therapists are available for online consultation.

9. Be Kind

Most everyone is upset and could use a kind word right now. When we help others, we also help ourselves. Since it is difficult to donate time right now, consider donating money to relief efforts. Use Charity Navigator to guide you, or the New York Times has recommended Global Giving and Relief International.

10. Limit Interactions With Negative People

Limit the number of people you interact with that will distress you. If you find conversations with friends and family are very upsetting, limit them to daytime hours and make them brief. Remember most everyone is upset and it does feel good to lend a helping ear but it shouldn’t be at the expense of your mental health. Emotions are contagious and right now fear is rampant.

11. Meditate

If you haven’t found the time to start, find it now. You can begin very simply with an app called HeadSpace or Calm. You can google “five-minute meditation” or any length you desire. You can simply sit in a quiet spot and focus on your breathing and let thoughts pass through your mind and drift away. Make sure your exhale is longer than your inhale as this triggers your parasympathetic nervous system and helps you relax.

12. Secrete Oxytocin

Humans are designed to connect via touch, so being apart is unnatural. If you are home alone or social distancing in your own home, you can simulate touch by wrapping yourself in a warm blanket or taking a hot bath or shower. Hugging a pet has the same effect.

13. Clean and Organize Your Home

We can counteract our distress over our loss of control by straightening up what we can. Catch up on your mail, work, taxes, or other chores that might have fallen behind. Completing tasks gives your brain a boost of dopamine, so even simple tasks like emptying a dishwasher or folding laundry can give us a quick boost in times of distress.

14. Create New Routines

Many find comfort in the predictable. With your routine gone, it can help to try to create a new one. For example, stick to the same bedtime and wake-up time. Work out at the same time each day. Try to be productive during certain hours and relax at other times.

15. Engage in Positive Activities

Read a book. Listen to soft music. Dim the lights. Watch the sunset or be in nature if you can do so safely. Watch a TedTalk. Brush up on a foreign language. Take a deep breath. Journal. Think about and express gratitude.

17. Avoid Big Decisions

Right now, your thinking might not be the clearest due to the excess cortisol. Try to stay away from conflict with others. We need one another now more than ever. Postpone any decision that can wait.

18. Reflect

Even in the darkest times, there is always light. In the words of author James Carroll, “There are times when we stop, we sit still. We listen and breezes from a whole other world begin to whisper.”

We are collectively experiencing a very unusual time as our daily lives have come to a sudden halt. Try to think about how you want to go forward when the pause button is removed. What activities are most important to resume? Which ones were you doing on autopilot and perhaps you are better off not resuming? Are we treating ourselves, one another, and our planet with enough kindness and compassion? What can we learn from the challenges of the novel coronavirus? How can we come together to face this and future challenges more effectively?

I hope I have been able to provide you with some comfort and my greatest wish is that you and your loved ones stay safe in the upcoming days and beyond.

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