When life came to a halt because of the pandemic, stress set in. At least that is what happened to my family. My children had to switch to remote learning and I was working from my basement. There were a lot of sleepless nights just worrying about the unknown. When will we be back to normal? Will my kids be able to return to school in the fall and will it be safe when they do?
Dealing with anxiety was not a fun thing for myself or my family, and I know we were not alone. I talked to Monica Sullivan, MD, from The Christ Hospital Physicians - Primary Care about the impact a pandemic can have on mental health, and the best ways to handle it. Here's what I learned.
What are some general ideas for staying mentally healthy during stressful times, and managing stress, anxiety, or depression?
Dr. Sullivan: During a pandemic or time of stress, self-care becomes a critical element to keeping your mental health optimal. We tend to stop taking care of ourselves. We forget that a healthy diet, exercise, and sleep are extremely important and we allow ourselves to get out of schedule.
Take a moment and think about your typical daily routine - when you wake up, what and when you eat, when you work, when you exercise, when you play or relax, and when you start to slow down to get ready for bed. We can learn a lot from examining our own behavior. When our mental health is starting to suffer we are more tired and lack energy. We lose interest in our hobbies and we start to avoid social outings or conversations with family and friends. We may experience trouble sleeping and our appetite either increases or decreases. We may avoid exercise, and our work performance starts to decrease.
When you wake up, or prior to sleep, “check in” with yourself. Ask “What am I feeling? What can I improve tomorrow, did I take care of myself today?” Make a small note of those things and develop a short plan for yourself.
Anxiety, stress, depression can manifest in a variety of ways. Taking just a minute or two of self-reflection each day is important to recognize signs of these feelings in yourself. When you learn to recognize those feelings it is much easier to develop a plan of action to start training your brain to cope. Someone very wise once told me to, “Plan your plan, don’t plan your outcome.”
Staying focused on a daily plan makes such overwhelming and stressful situations more manageable. Make a daily schedule, sometimes even hour-by-hour plans. Make the schedule and STICK to it. Finishing a plan provides a sense of accomplishment and positive reward for the brain and thus a general feeling of well-being. Challenge yourself - try something new - even if it is just reading a quick article that you wouldn’t have read before. Get outside of yourself. Do something kind for another person (write a letter, send a quick text, or call a neighbor or someone who could use a kind word, pick up some garbage in your neighborhood).
Create a list of short things you enjoy and pick one from the list every couple of days. Take some time to develop new eating/sleep/exercise that works for you. Learn how to PLAY and to be STILL. The brain can learn, and if you stick with it, these responses will become automatic.
What can we do to help our children feel better about the disappointments they have faced during the pandemic with school and summer activity cancellations?
Dr. Sullivan: Children have an incredible ability to adapt. Their brains are wired for challenge and change. Keeping a positive attitude will help immensely. Role model for them and provide stability. Keeping a schedule is important. Involve them in decisions and planning - if you involve children they feel included and responsible.
Take the time to play with them. Even if it is for just 5-10 minutes at a time. Get down to their level, literally. Sit on the floor and face them, color with them, have them help make their snacks. Be open to conversations and encourage them to talk about how they are feeling in a basic sense - sad, lonely, angry, happy, excited, or even sleepy.
Give them more responsibility around the house. Allow them to experiment and figure out how best to be more independent - they will make messes, or might get frustrated, but allow them to work through things. They are missing their buddies and their grandparents just like you. Set up virtual dates for them each day so that they feel connected with the outside world.
What are some tips for keeping children busy without increasing screen time?Dr. Sullivan: Have them help make their schedule and plan for the screen times throughout the day. Setting limits and reinforcing those limits is important. If they would like extra screen time, develop a chore list for them so that if they complete tasks the reward, if they want it, is extra minutes (5 minutes for small task, 15 for medium, and 30 for harder tasks).
Develop a packet of games they can play independently so that instead of reaching for the tablet, they play a short game of cards, hide and seek, scavenger hunts, etc. Have some art or crafting supplies available lot them. Make sure outside time is scheduled into their day as well. Have them do something kind for another person (pick up trash, weed, or write a letter). Encourage independence. It may be hard at first but they will quickly get the hang of it.
As recent graduates prepare for college or the next phase of their life, is there a way to ease anxiety about uncertainty or restrictions that may be in place?Dr. Sullivan: This is such an exciting time for recent graduates. Starting a new chapter in life can be stressful and adding the pandemic and subsequent restrictions can definitely make things more anxiety-provoking. Staying in close contact with the college/university or planned employer to keep communication open is a great idea. It provides an arena for questions, concerns, and updates. Getting into a good daily routine to prepare for future class schedule or work hours is very helpful. Information is changing constantly and college officials and employers are adapting as best they can, but changes are constant.
What suggestions do you have for adults working from home who might be experiencing anxiety wondering how long it will last and how to ease the transition when they do return?
Dr. Sullivan: Keeping in close communication with bosses/coworkers regarding updates and expectations is important. Keeping your expectations and their expectations in line with each other will help ease any tension. If possible, schedule your transition on a day that works well for you, perhaps when there are no other plans or activities that would cause a time crunch. A week or two prior to returning, make sure to be on a good sleep/wake schedule. Plan ahead for unforeseen circumstances and make sure to pack food and drinks so you stay fed and hydrated in case the day becomes chaotic and you don’t have a distinct time to eat lunch. Familiarize yourself with any new computer/meeting formats so that you are not having any technical problems prior to returning to work.
Set yourself up for success by planning carefully ahead of time!
Another topic that has been discussed recently is increased alcohol use during the pandemic. Why is this and what is the impact?
Dr. Sullivan: Times of increased stress, such as the pandemic, will challenge a person’s coping tools. Change of any sort is a stressor, but such drastic change that has resulted from the pandemic has quickly exhausted most people of their traditional coping tools.
Adapting to these changes is a stress to the emotional center of the brain, and overall health. When a person’s coping tools have been challenged, the next common reaction is to reach to an outside substance to supplement such as alcohol.
Using substances such as alcohol provides people with an escape - a way to “relax” and to discharge fear and anxiety. Unfortunately it provides only temporary relief and disrupts sleep, appetite, and work/family performance when used to excess or daily. An easy way to find out if you need to work on other coping tools would be to keep track of your drinking or other substance use for a few days. If you are using a substance daily or multiple times a day to relax or calm down, it may be time to reassess.
The daily use of a substance can sometimes sneak up on you in times of extreme stress. You may be very surprised when you review your substance use over a week or two. If you are concerned or are looking for a way to develop other coping tools please reach out to your healthcare provider. Available resources to help develop healthy ways to relieve stress have increased dramatically as a result of the pandemic.
Overall, how can we continue to stay in a routine and take care of ourselves during these times? Dr. Sullivan: Staying healthy or developing a new healthy routine can be done easily with just a few adjustments. Remember, plan your plan - not your outcome. Set an intention every day. Take a minute and write down your plan and your schedule. Stick to that plan/schedule. Once the day has ended and your action plan was accomplished, your brain will feel that sense of relief and positive feedback.
Once you experience that sense of accomplishment you can make adjustments if needed and you will feel motivated to continue the momentum in a positive direction. Talk about your feelings; ask for feedback. Once you are able to get those dysfunctional and chaotic thoughts out of your brain, they lose their power over you and your well-being.
Find a way to stay connected - whether it is a socially distant in-person conversation or a phone call/text - reach out and form that connection. Make it a habit each day. If you are struggling, please reach out to your healthcare provider for help. Sometimes all it takes is a bit of time to organize thoughts and feelings and come up with a plan that will help you thrive.
Humans require personal connection and contact. Times of change threaten that basic connection, but we can proactively combat that threat. You have everything you need inside of you to get through this stressful time - we just have to find a way to channel it in a positive way.
Thank you, Dr. Sullivan! These ideas are things that I know I will be using and teaching to my children. Hopefully we can instill certain routines in our everyday life, regardless of the status of the current pandemic. With thoughtful planning and deliberate goals, maintaining a positive, healthy lifestyle is still possible!
If you need help managing stress for yourself or your family, a primary care provider can help! Schedule an appointment online at a location near you, or set up a video visit.