Feeling Anxious or Depressed Amidst COVID-19?
Feeling Stressed? W.A.I.T and B.R.E.A.T.H.E
Between the headlines that we can’t help but click on and the people we can’t help but see every day, including the direct reflection of ourselves in the mirror, it’s apparent that by and large, we– as a world– are not okay. According to recent publications in the New England Journal of Medicine, it’s clear that the psychological ramifications of the COVID-19 pandemic are not only noticeable but constitute a public mental health epidemic of its own. It makes sense, doesn’t it, that a pandemic would lead us to feel anxious and worried, sad and disappointed, lonely and afraid, unsure and confused? Sure, genes, neurochemistry, acute stressors, daylight, and our social environment are some of the greatest contributors, but when it comes to predicting mental health challenges, difficult life events certainly take the cake.
If you’ve got a pre-existing psychological condition (i.e., you were not a stranger to feelings of depression and anxiety even pre-pandemic), fall into one of the high-risk groups (i.e., you are elderly or have an underlying health condition or weakened immune system), have experienced a coronavirus-related job loss, or are a health care provider, then it’s likely that you’re especially vulnerable to feeling distress during these times. Whether that distress comes in the form of stress, anxiety, depressive symptoms, or a combination of all three, fear of being exposed to the virus, fear of getting sick and dying, fear of losing friends or relatives, and the general fear of the unknown (will there be a vaccine?, how long will this go on? etc.) are all underlying contributors to the currently rampant feelings of unease and anxiety around the world.
How has our stress, anxiety, and depression shown up? Well, if you think back to when news of the pandemic first broke, we were panic buying (a clear indicator of how anxious we were!) and supermarket shelves were empty of water and toilet paper; many of us were over-consuming stress-inducing news headlines while others of us were avoiding it by sticking our head in the sand; and many of us continue to ruminate and feel irritable, impatient, tense, or simply “not like ourselves”.
WE ARE NOT OKAY. BUT WE WILL BE…
All of this is horrible but also hopeful news. Let’s not forget the one quality we all share as human beings– we are all resilient to some degree (want a refresher on what it means to be resilient? click here to read about the true definition of resilience); some of us even resilient as f*@k. And resilience is a quality that we can, and often do, continue to build throughout the course of our lives. Even after facing unexpected, horrible life events, most people don’t develop a mental illness, and most who do bounce back. Consider this: 65% of the people directly exposed to the 9/11 attacks did not develop PTSD 1. Also, there is early evidence from a longitudinal study conducted at Vanderbilt University 2 that suggests that as the world recovers from COVID-19, many people’s mental health will too! Between just May and June of this year, rates of depression and anxiety, which started out quite high among the nearly 300 participants in the study, decreased. Now these are the kinds of numbers we like to share… the kinds that point to our individual and collective resiliency and recovery, rather than the kinds that increase our stress, depression, and anxiety.
HOW DO WE GO FROM BAD TO BETTER?
In life, problems don’t come without solutions. We may not see them right away, or we may not have sufficient resources to implement them in a day’s time, but if we are willing to keep our eyes and heart open, and if we are able to exercise just a little bit of patience, we will notice that the solutions to our challenges aren’t far. And in the case of our current collective crisis and related life circumstances that are asking us to live with a new reality that includes fear, illness, uncertainty, and social isolation, the solution to feeling better too isn’t far.
Brilliantly developed and shared with me by my dear friend Kristen Chazaud, this life hack comes in the form of two acronyms: W.A.I.T and B.R.E.A.T.H.E.
W.A.I.T is all about taking a moment to remember that We’re All In This.
Stop. Pause. Take a moment to recognize or remember that we are all collectively in this. If you’re worried about your safety, if you’re unsure about when the next check is coming, if you’re concerned that you won’t be able to juggle both work and children simultaneously needing your attention at home– you are not alone. We are all in this. Everyone is being impacted by this pandemic. EVERYONE.
When stressed, anxious, or depressed, we tend to feel and focus on our own experience extravagantly, but it’s important to also pause and recognize that every single person is being impacted by these same events. And sometimes, like in our current reality of civil unrest and divisiveness of our fears, prejudices, and political leanings, the connection and bond we share as a function of our common humanity may not be apparent. Nevertheless, even though we may not all be in this together in every moment, we are still all in this. Regardless of the specific cause and levels of your stress, you can know that you are not alone. Plain and simple.
Once you’ve taken a moment to let the fact that we’re all in this sink in, I invite you to engage in a stress hack that’s got elements that begin working in just a matter of moments, and others that take a little longer and last a little longer too: B.R.E.A.T.H.E.
B Breathe regularly.
Take deep breaths. Breathe in through your nose and out through your mouth. Take a big, slow inhale for 2-3 seconds, then exhale for 2-3 seconds. Inhale and fill up your belly and lungs, and exhale as you expel the air from your belly and lungs. Then try deepening your breath by taking a conscious inhale for 4-5 seconds, and then releasing an exhale for 4-5 seconds. Continue breathing gently and regularly, without holding your breath and also without trying to force it out. Do this for a few minutes and steadily increase to 5 minutes over the course of a few weeks.
Breathing consciously and paying attention to our breathing patterns in this way helps to circumvent the irregular and shallow breathing that we often experience when we are anxious or stressed. By intentionally inviting more air flow into our body, our nervous system begins to relax, and as more carbon dioxide flows into our bloodstream, our mind follows suit. Any time you feel stress creeping in, taking just a few deep, conscious breaths can help kick in your body’s rest and relaxation response in just a matter of moments.
R Recognize what you need.
One of the most productive things we can learn to do in life when it comes to our stress levels, friendships, relationships, and well-being is to bring awareness and pay attention to what we need. Right at this very moment, I invite you to stop and pay attention to how you are feeling. Are you sad? Anxious? Frustrated? Tired? Down? Disappointed? Uneasy? Uncomfortable? Unmotivated? Are you feeling “Blah”? “Meh”? “In a funk”?
Feelings of depression, frustration, anxiety, or any related emotion are not a sign of weakness. Nor are they unusual during times of extreme hardship. It is an unfortunate stigma that we often see in our world to label these emotional experiences as indicative of a person being weak, broken, or flawed in some fundamental way. What happens when we believe this about ourselves is that we become weighed down by feelings of self-doubt and shame. But these emotions happen to everyone. And when they happen to us, we’ve got to be able to recognize that something isn’t quite right so that we can take initiative and ask for support (rather than judge and reprimand ourselves). In contrast to being a sign of weakness, asking for support is too a sign of courage, undeniable strength, and if I may say so, badassery! Notice what’s going on with you, and know that it isn’t wrong or weak to feel that way, no matter what it is. It’s not just okay that you have emotions and needs; it’s imperative.
E Express what you need.
Once you know what your needs are, the next vital step is to express what your needs are. While a bit of sadness, anger, and grief in relation to the impacts of the pandemic on your everyday life are normal and expected, if you are having trouble completing your normal tasks, if you’re feeling down most days, or if you find that you’re just not enjoying much anymore, it’s time to ask for support, whether from a family member, friend, mental health professional, or any combination of the three. To recognize what you may be lacking or needing more of, and to share those personal needs with the people in your life is a gift to you, and it is also a gift to them. Reaching out for help makes you stronger. It makes the people who are able to support you stronger. It makes your community stronger. And it makes our world stronger. When needs are expressed rather than withheld, forward movement and comfort (the antitheses of stress, anxiety, and depression) are what typically result.
Expression isn’t limited to just your needs. Expression also relates to your creative self. How can you express yourself creatively? How can you turn the ability to create that we’ve all been given into something tangible and meaningful during this time? Whether making or playing music, making art, playing with your children, playing with your animals, or spending time in nature, getting inspired to do anything at all creative is a beautiful form of personal care that can begin to dissolve fear, stagnation, and frustration, regardless of where they came from.
A Accept what is.
See if you can accept the current circumstances of your life without resisting them. Why? Well, as has been the topic of discussion for us lately, arguing with reality– as tempting as it may be at times– typically ends up in a somewhat anticlimactic series of events. Upon pushing away things and experiences we don’t want, we expect our circumstances to change and for us to feel better. Yet what you fight, you strengthen, and what you resist, persists.
There’s a third part to the ‘what you fight, you strengthen, and what you resist, persists’ mantra. In its entirety, it goes like this: ‘what you fight, you strengthen, what you resist, persists; and what you accept, transforms you’. Alas, it turns out that being okay with life as it is is the holy grail of happiness (more on that here). What might that look and feel like for you right now?
“There’s so much I planned to do but can’t do…” “Well, there’s no use banging my fists against the wall, screaming about how I can’t believe that this pandemic isn’t over yet… I’ve tried that. Instead, what if I do what I can do, and make the best of right now?”
“My small business has been struggling, and I’m having trouble getting clients through the door. I’ve been focusing on how unfair this situation is and honestly, it’s been draining every drop of joy I have left. Hmm.. how can I try and meet people where they’re at? how can I meet myself where I’m at? how can I use my gifts to live and prosper in the world as it currently is, rather than spending all my time hoping, praying, and fighting for a world that no longer exists?”
T Talk and take.
No matter how you slice and dice it, connection is a basic human need that when curtailed, easily leads to psychological distress 3. Yet the risk of loneliness, especially in North America, has only gotten worse as a function of COVID-19. Reaching out and talking to one another is a must right now. Some of us are talking about and admitting to not having enough social connection, yet many of us are needing more of it.
If you’re quarantined at home for days or weeks on end, reach out. If you’re working from home and starting to feel lonely or isolated, reach out. If you thrive when living alone (like the 35.7 million other Americans who choose to do so), but the pandemic has meant that you haven’t had any interaction at all for several weeks or months, reach out for a phone or video call. Especially if you don’t feel like reaching out but you know that one of your main coping mechanisms tends to be social interaction, reach out.
And don’t forget to take. Take some down time, take a nap, take a walk, take a moment to reflect, take a timeout in nature, take a break from listening to or watching the news, take a few minutes to appreciate yourself, take a breather, take a daytrip, take a chance. Whatever you choose to do, just make sure you are tuning in to what you need and then doing it.
H Help someone else.
Feeling like the world is coming down on you is the clearest sign that it’s time to stop focusing solely on you. “Contribute positively to someone else’s life when my own is so hard and $h!tty? Isn’t that counterintuitive?” you might say. The answer is a big, resounding “yes”! According to research, doing something for someone else can help you get out of your own funk. For one, helping someone else triggers the release of the love and connection hormone oxytocin, perpetuates the neurotransmitter serotonin which helps to regulate mood, and boosts activity of the neurotransmitter dopamine which comes with its own boost in neurochemical activity called the “helper’s high”. Helping others is also regularly associated with increases in substance P, an endorphin-like chemical in the body which helps to relieve pain.
As I mentioned earlier, everyone is being impacted by this pandemic. Just as it’s important for you to connect, spend time with, and talk to people you trust and find contentment by being around, it is important for everyone in your family, social circle, and neighbourhood to do the same. So if you’re feeling down or find yourself in psychological or physical pain, be kind. Help someone by calling and lending a listening ear. Write a thank you card to a healthcare worker. Deliver groceries to an elderly neighbour or friend. Write an email to an acquaintance who you know is socially isolated. Do whatever feels good to you. And do it not just once, but many times. Really consider making kindness a way of being. A single act of kindness will give you a 3 to 4 minute boost of oxytocin and other positive biochemical responses that come with helping. Kindness as a staple in your daily routine will give you much much more!
E Eat, exercise, stretch, and stick to a daily routine.
When we can’t control much of what’s going on around us, focusing on what we can control can offer relief. Taking comfort in the things that are a part of our daily routine like what and when we eat, how and when we move, how much sleep we get, and whether we stretch our body with yoga or stretch our mind with meditation can help us recover from emotional dips and turns.
One piece of immediate advice? If you want to be in a better position to cope with life’s uncertainties, go for a walk, a jog, or a bike ride. Whatever your favourite activity, aerobic exercise– thanks to increased blood circulation to the brain– can transform your physiological reactivity to stress, increase your feelings of self-efficacy, and help to reduce negative thoughts and symptoms of anxiety and depression.
Whatever the ways you choose to W.A.I.T and B.R.E.A.T.H.E today, tomorrow, and this week, be sure you are taking care of you. In those moments that things feel especially stressful, I hope you’ll remember that we’re all in this.
Please reach out to us via email or in the comments below! #WeAreAllinThis
1 North CS, Pollio DE, Smith RP, et al. Trauma exposure and posttraumatic stress disorder among employees of New York City companies affected by the September 11, 2001 attacks on the World Trade Center. Disaster Med Public Health Prep. 2011;5 Suppl 2(0 2):S205-S213. doi:10.1001/dmp.2011.50
2 Kujawa, A., Green, H., Compas, B., Dickey, L., & Pegg, S. (2020, June 29). Exposure to COVID-19 Pandemic Stress: Associations with Depression and Anxiety in Emerging Adults in the U.S. https://doi.org/10.31234/osf.io/aq6u5
3 Usher, K., Durkin, J. and Bhullar, N. (2020), The COVID‐19 pandemic and mental health impacts. Int J Mental Health Nurs, 29: 315-318. doi:10.1111/inm.12726