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Dealing With Stress During a Pandemic

How to cope with anxiety and panic during public health crises like the COVID-19 pandemic. 


Public health crises can take a huge mental toll on people as these create fear, worry and uncertainty. For many,  these crises can take away the very things that give life joy, meaning and purpose. And, these situations are especially tough for those struggling with anxiety, depression and other mental health conditions.

SPAN spoke to Nivida Chandra on how people can ease some of that anxiety and gain a better sense of being in control during a public health crisis. Chandra is a Fulbright-Nehru doctoral scholar (2017-18) and has a master’s degree in psychology from Delhi University. She is currently a research scholar at Indian Institute of Technology Delhi and is the founder-editor of TheShrinkingCouch.com, which hosts informational and experiential articles for those affected by mental health concerns. 

Excerpts from the interview.

In what ways do public health crises take a mental toll on people?

Public health crises can ​create mass panic and fear, which have a tendency to gain a momentum of their own. People fear for the health and lives of loved ones and their own, they ​grapple with the uncertainty of what’s next and the sudden disruption of life ​as they knew it. External pressures like threatened job security add to this syndrome. ​Suddenly, ​nothing seems to be in our control​.

In situations like the COVID-19 pandemic, where we are required to stay home for extended periods of time, there are additional feelings of dismay. ​Even if we expect ourselves to feel relaxed at home, have a lot of time on our hands, and achieve our bucket-list items, there is an inexplicable lack of motivation to actually execute these tasks​. Somehow, we feel exhausted instead of feeling energized. ​People who are used to having full schedules with predictable and organized tasks may suddenly find themselves with “nothing to do.”

As a result, some people feel lonely, anxious, panicked, hopeless and isolated. Others may feel a sense of illness in their mind and body. We may experience an increase or decrease in appetite and sleep, making us feel physically weak and disoriented. 

Issues that one might have been avoiding have a tendency to emerge. For instance, we may be f​orced to face personal issues​ such as our purpose in life, ​or relationship issues​ like re-evaluating marriages. There is also an increase in incidences of domestic violence and other forms of abusive relationships. ​Those already coping with depression or anxiety may be more susceptible to feeling hopeless or listless in the face of a public health crisis.

How can people control their sense of panic and anxiety at such times? 

Some of the popular and effective ways being widely shared are eating healthy; exercising daily, even if indoors; meditating or doing yoga; and keeping in touch with friends and family. ​​Creating a daily routine​ that incorporates these is a good practice.

I would like everyone to remember that ​feelings of fear, panic, listlessness or any of the related psychological states is absolutely normal. ​In fact, it is detrimental to your health to rationalize it as weak or unnecessary. When feeling any form of distress, take a moment to accept it. Try simple exercises like taking a few deep and calming breaths. If this feels inadequate, consider asking yourself what’s bothering you. If you can verbalize the fear, you can talk to yourself about it. If these don’t work, ​call a friend or loved one ​and ask them to help you talk it through. If nothing seems to work, ​you could engage yourself in any task that can help you disengage from that emotion for that moment​, though I would encourage you to return to it later and understand it, so that it does not keep coming back a​nd overwhelming you.

Days may seem to blur together, so maintaining a routine helps retain a semblance of normalcy. There can be tremendous pressure to “make the most of this time” at home. Avoid falling for this! ​Examine what you can reasonably do in a day​. Tasks involving work from home, cleaning, cooking, other odd chores take both time and mindspace, and can even be frustrating to adjust to. Do not discount their effect on your day.

While you may be at home, these are not times of rejuvenation any more than they were before these circumstances set in. This, of course, should not stop you from taking time for self-care. But, just be careful to not hold soaring expectations of yourself to come out a brand new person on the other side of this pandemic. ​Not accomplishing these unrealistic goals will then become another source of disappointment and frustration. 

​It is also important to take a moment to examine what is meaningful for you right now. It must include setting a routine and ​continuing to pay attention to projects and tasks that you were in the middle of before we had to stay at home.​ ​Pick activities or tasks that make you feel fulfilled with your day. 

Steps to Control Anxiety

Establishing a routine to create a sense of normalcy and predictability during a public health crisis can help people feel calmer and more in control. Here are some suggestions from Dr. Kathy HoganBruen, on things to include in a routine. Dr. HoganBruen is a clinical professor of psychology at The George Washington University and adjunct psychology professor at The Chicago School of Professional Psychology (D.C. campus).

• Exercise. It can reduce anxiety; improve mood; improve sleep, which can reduce anxiety and improve problem-solving abilities during crises; and improve health.

• Prioritize setting the same bedtime and wake-up time, along with a dark room, no screens 30 to 60 minutes before bed, no caffeine after 2 p.m. and limited alcohol.

• Eat healthy.

• Spend time in sunlight, which has positive effects on mental health.

• Connect with others through social hours for texting or video calling.

• Take up meaningful and/or challenging work, if possible.

• Do something to help others. For example, make masks to donate, call to check on elderly relatives.

• Start a new hobby or pick back up an old one.

• Take in a moderate amount of news from trusted and reliable sources. Get enough information to know what to do, but not too much to be emotionally overwhelmed, or to take you away from healthier activities.

• Get grounded, meditate, practice thinking and being in the “here and now” rather than excessively worrying about the future.

--D.K.

For those who have to self-isolate or go into quarantine, what can they do to deal with feelings of loneliness and being disconnected?

Self-isolating is a physical activity and should not be equated to emotionally distancing oneself. ​Reach out to old acquaintances, join online communities, play online games. Most importantly, talk to people both about the difficulties of self-isolating as well as the ways in which you are coping.

All the tips mentioned in the previous question also apply. When feeling lonely or disconnected, remind yourself of the ways in which you cope​--whether it is through breathing exercises, calling a friend or loved one, taking one’s prescription medication, writing about it, or engaging in some activity. If the feelings persist and feel out of control, please reach out to a mental health professional.

Working from home during a public health crisis sometimes creates stressful situations due to the blurring of boundaries between work and home. What steps can people take to deal with these stressful situations?

The first and most important step is to temper one’s expectations about having clear boundaries at home. They will be blurred. If with family, ​talk to them about your need for a separate work time, and what might help you be efficient in that time. Try and ​set some rules like no distractions during work hours, and ​break your day up into chunks of hours ​and allot work, family, self , home, etc. labels to it. ​Expect a restlessness​ in implementing this, but allow yourself to ​adapt as you learn.

You might also have to adjust to working alone. Many of us are used to going to work and seeing it as a place of meeting friends or working hands-on with a team. It may also feel like you have a lot more time to accomplish tasks in the work-from-home option, but this is not the case. There are a lot of commitments that may arise, including cooking and cleaning, which take substantial amounts of physical and mental energy. Remember to account for these when you plan your work day.

What can parents do to create a safe environment for children, where they can convey the urgency of the situation without scaring them?

First, there are many children of all ages who are not panicked or fearful, even when they have been asked to stay home. They may just be wondering about what’s happening and why their routines have changed, where their friends are and when they’ll get to go back to school. In such cases, ​parents should be careful not to introduce panic or transfer their own to their children.

With children who need interventions, ask them what they understand about the circumstances and tailor your response to them. I would recommend ​using terms like “shelter-at-home” as opposed to lockdown.

If they are afraid, ask them to trust you, remind them of their safety in the world, and ask them to talk openly about this fear. Most importantly, do not minimize or banish your child’s fears, or believe that they are not capable of dealing with it. Trust in them as they trust in you, and invite them to engage with their fears in the safety of your presence.

For those struggling with anxiety, depression and other conditions, these situations are especially challenging. In what ways can families and caregivers help ease the impact? 

Times such as these have the unique effect of exaggerating pre-existing conditions. Caregivers and loved ones are experts at knowing these signs and symptoms. They should be prepared for, though not assume, heightened symptoms; be in ​constant touch with the psychiatrist or clinical psychologist​; and definitely find resources of support for themselves too. They must carve out some time for themselves when they do not have to engage with their loved one’s mental illness.

If possible, ​talk to the ​person with mental illness​ and help them to take additional precautions​ to keep symptoms at bay. These times may be frustrating and angering for those involved. ​The role of compassion cannot be emphasized enough, both toward others and oneself.