From the Experts: How to Cope with Anxiety and Loneliness in the Age of Coronavirus
These are unprecedented times. The threat posed by the coronavirus continues to force schools to close, businesses to shutter, and people to quarantine. Fear and anxiety are natural responses to such upheaval, and the social isolation that’s required to keep people physically safe poses a threat to our mental health.
If you’ve been feeling fearful, panicked, anxious, or lonely the past week — we see you. TIME’S UP spoke to two founding members of TIME’S UP Healthcare and clinical psychiatrists, Jessi Gold and Kali Cyrus, for their perspective and advice for managing anxiety, battling loneliness, and creating a sense of normalcy in the midst of this crisis.
Additional mental health resources and support can be found at the bottom of this page.
TIME’S UP: What are you hearing from your patients right now and what are you most worried about in terms of the biggest mental health risks facing people going through this crisis?
Kali: The thing that’s most distressing as a psychiatrist is the uncertainty of the information.
|To protect yourself and others from COVID-19, you should follow the most up-to-date guidelines issued by your city or state. You can also find the CDC’s latest guidelines here.|
People in general are uncomfortable with uncertainty and the fact that any symptom that comes up might be a positive, you don’t know who’s infected, some people don’t know anything about it so they’re just proceeding.
Jessi: Anxiety in general is triggered by uncertainty and not knowing what’s going on in the future. So the fact that there’s mass confusion about what is going on in the future and pretty much no one has answers, it’s not surprising that anxiety is increasing. I saw a lot of racism around Asian students and them feeling isolated and concerned about their place in the community.
Anxiety in general is triggered by uncertainty and not knowing what’s going on in the future.
Jessi: Down the line with social isolation, the concern would be depression worsening because of lack of social support, coping skills being negative ones, like turning to alcohol, drugs, self-harm, and eating disorders because it’s a way to control something that’s not controllable. People with OCD, it’s really hard to balance what the normal societal response to this and what is my disease getting in the way.
TU: Do you have any advice for someone managing anxiety right now, particularly if they’re stuck in their homes? What techniques would you recommend that you’ve seen help your patients?
Kali: One thing I would do is limit news consumption. Too much news will drive you more insane. For folks who are getting triggered by the news, set boundaries, for example by listening to the morning news or before you go to bed, but allowing yourself not to listen to it or watch it on the television all day long.
Another strategy is taking steps if you’re working from home. Try to pretend like it’s a work day: Wake up at your normal time, take a shower, get ready, put on clothes, and do work. If you exercise — if you don’t exercise — this is a good time to start exercising at home. Maintain some kind of daily schedule that has structure and variety in it.
Set boundaries.... Maintain some kind of daily schedule that has structure and variety in it.
Jessi: If you look at what minimal data we actually have on isolation and quarantine studies, a lot of the mental health risks come from complete disruption to your schedule. We take for granted how much socializing we do in a day, so even if you consider yourself to be somewhat introverted, a lot of people still talk to the barista at the coffee place or pick up their mail and talk to the mailman. There are a lot of ways we socialize and when that completely goes away, there will be a big aftermath without realizing it.
It’s important that people think about coping strategies and things they like to do when they are at home. What things are relaxing or bring you joy at home? Is that taking a bath? Watching some silly show on TV? Whatever that is, actually putting the investment into thinking about what you can do to cope and what brings you joy at home and with limited social interaction is good preparation for people.
When things get more stressful, we tend to forget our coping skills. If we think about it ahead of time and write it down and come up with things we can do, we can turn to that list when things get more stressful.
Kali: You have to take care of yourself first. If you’re a parent, if you’re a health care provider, protect yourself first. At the end of the day, that’s the thing that matters most.
TU: Are there any self-soothing techniques you would recommend? Some anxiety coping skills people can learn to deal with this?
Kali: Apps like Headspace or any kind of meditation apps.
My go-to meditation is progressive muscle relaxation. Start from your toes all the way up through the rest of your body and take a second and imagine the position of where your feet are, how the pressure of your body is hitting on the floor, on the bed, really focusing on each aspect of your body going all the way up, even if it’s just five or 10 minutes.
Jessi: I love progressive muscle relaxation and other forms of grounding. When you start to feel overwhelmed mentally or physically, try to notice what you’re feeling. It’s okay to lean into that a little bit. Some people like to look around the room and notice what they see, what they smell, what they feel — something as simple as “I feel my legs on the chair.”
Journaling is going to be important for people. Take time in the morning or evening, or if you’re feeling particularly stressed out, it’s okay to write it down.
Be gracious and generous to yourself. If you’re feeling anxious and not showering or eating, say: You know what, I’m human.
Kali: Music. Play a song that you know and try to focus on the music for the entire duration of that song. Some of it is just recognizing the anxiety — not just shoving it away somewhere — and then the meditative aspect, which is giving your brain some concrete time to focus on something else and calm it. Pick a song that’s four or five minutes, put on your headphones, and close your eyes.
It’s taking some of these behavior skills and packaging them for you in the moment. You can also look at the DBT 100 list of things to do.
Jessi: Yes, pleasant events!
Kali: There are over 100 positive activities you can do. Some people don’t know what they like, and so that’s a good way of helping people find distractions and activities.
Jessi: Just because you’re at home, keep doing the things that make us feel activated because depression comes from lack of any behavior. If you’re sitting at home in pajamas for two months, you’re going to get depressed. Keeping your routine is a key coping strategy that we often take for granted.
Kali: Moderation. You’re going to binge all that Netflix and then feel some kind of way about yourself — so pace it out.
Be kind to people as much as you can and just listen. People’s emotions are always valid.
TU: Is there anything else you would tell people?
Kali: Be gracious and generous to yourself. If you’re feeling anxious and not showering or eating, say: You know what, I’m human. Acknowledge it. If you’re feeling crappy, then it’s okay. This is a new situation that you have to just learn to get through so take some time to offer that grace if you end up going down that hole. Just as long as you check it, try to do one different thing a day that’s positive.
Jessi: Be kind to yourself. This is definitely a time of uncertainty for everyone and a time of stress for everyone. A lot of those feelings are completely valid and normal. Don’t beat yourself up if you’re feeling more anxious, especially if you have anxiety. To be completely honest, you should! It’s okay. Don’t drop all your support systems. If you have a therapist and they’re doing telepsych, keep going.
Check on your friends, check on your colleagues. Be as supportive as possible.
- Protecting Your Mental Health During the Coronavirus Outbreak
- What to Do If Your Anxiety about Coronavirus Feels Overwhelming
- Survive a Crisis Situation with DBT Distress Tolerance Skills
- How Mindfulness Can Help Navigate the Coronavirus Panic
- The CDC’s Guide for Managing COVID-19 Anxiety and Stress
- A Loving-Kindness Meditation to Cultivate Resilience
- Coping with Addiction in Isolation
- Resources for the OCD and Related Disorders Community During the COVID-19 Outbreak
If you are feeling suicidal, know that you are not alone and there is help available 24/7 by calling 1-800-273-8255.
If you are dealing with a substance abuse problem, you can contact 1-800-622-HELP 24/7.
Kali Cyrus MD, MPH works as a community psychiatrist in the District of Columbia and an Assistant Professor at Johns Medicine. She is a founding member of TIME’S UP Healthcare.
Jessi Gold MD, MS is an Assistant Professor in the Department of Psychiatry at Washington University in St. Louis who works primarily in college mental health. She is a founding member of TIME’S UP Healthcare.