Coping with COVID-19: Strategies for Anxiety

Feeling anxious? Does this whole COVID-19 thing have you feeling stressed-out?

Perhaps not, maybe you’ve adjusted to the new reality and are doing just fine, or, perhaps you are feeling even worse lately as this surreal, movie-like story grinds on, and on, and on.

Whether you are struggling or not depends largely on your own unique circumstances, and also on your personality – your natural way of thinking and behaving, but both responses are valid.

The other day someone told me she feels bad because she isn’t anxious or upset about COVID-19, interestingly, her lack of anxiety seems to have caused her a bit of anxiety.

Of course, there is no rule that says you should feel dread or worry due to our current predicament; as long as safety rules are being followed in a responsible manner, it’s a good thing you are cool as a cucumber.

Similarly, there’s no rule that says you should feel calm, cool and collected either! If you are struggling, know that you are perfectly normal for feeling this way and remind yourself that there are things you can do that will help.

Allow the Anxiety

This may sound counter-intuitive at first, but if you are feeling quite anxious, I suggest the first strategy is to allow it – truly allow it.

Don’t deny it, don’t ignore it, and don’t feel ashamed. Just notice the anxious feelings, and don’t judge yourself.

Anxiety is a natural mechanism that has evolved to help keep us safe, so it’s perfectly normal to feel anxious during a pandemic.

Allowing yourself to feel anxious by intentionally getting in touch with your uneasy feelings, and then accepting these feelings, can paradoxically increase your sense of control. Allowing the anxiety helps reduce the anxiety.

Connecting to the anxiety mindfully (emotionally, intellectually, and even physically) provides an opportunity to shift to a less anxious state, rather than being stuck in a spinning cycle of numbing worry, irritability and mindless repression of the uncomfortable feelings.

When you let yourself “feel the feels”, it is easier to move beyond them. Greater awareness and acceptance actually increases your chances of letting go of the gripping unease, and of making thoughtful choices that will help you.

While allowing anxiety is critical, remember that there are many other things you can do so that anxiety doesn’t control you or push your worry to unhealthy levels.

Thought Audits

As noted above, it is important to not judge yourself; however, it can help to analyze your thoughts in a mindful way. Thoughts lead to feelings (and vice versa), so greater awareness of your thinking (i.e. your internal dialogue), can help diffuse the anxious feelings.

Making a list of frequent troubling thoughts can help you become more aware of them. You can then replace these anxiety-inducing thoughts with ones from a list of more helpful thoughts. This mindful re-structuring of your thinking can reduce your overall anxiety and train you to be more aware of your helpful vs unhelpful thoughts.

“Keeping it Real”

Anxiety can be useful when it is appropriate, both in terms of what you are anxious about, and how anxious you get. For example, if your level of anxiety is proportionate to your actual circumstances, it can motivate you to take appropriate action, but if your level of unease is grossly out of step with what is necessary to keep you safe, for example, then it becomes problematic and can needlessly lead to feelings of panic and eventual exhaustion or depression.

It is useful then to think about the difference between “actual circumstances” and “perceived circumstances”, because we often perceive threats when they don’t really exist, at least in proportion to our feelings.

During times of stress we are prone to dramatic “catastrophizing” and “negative forecasting”, so greater awareness of these counter-productive thought-patterns can lead to better coping.

This thoughtful self-analysis doesn’t come easily, especially when we are already in a state of elevated stress; our active minds lead us astray, and there are complex reasons for this, but thankfully there are ways to work through this. Taking pen to paper or talking things through with a trusted friend or a therapist can help gain perspective and sort through our thoughts.

Exercise, Exercise, Exercise!

The more I work with clients dealing with anxiety the more I appreciate the consistency with which exercise aids in reducing it.

There isn’t anything more reliably restorative as a workout when stressed, and it need not be at a gym. You know this.

Remember that what is good for your body is good for your mind!

If you are able to go outside, go for it!  A walk or run in the fresh air and sunlight is remarkably good for your nervous system, and the regular rhythmic patterns of your steps help regulate your breathing and it literally calms your mind.

Yes, exercise can be harder to do while quarantined (like I was last week), but really, there are no legitimate excuses thanks to the internet! YouTube alone has a veritable treasure trove of routines you can follow from your living room, such as yoga, Qi-Gong, tai-chi, and Zumba.

As the Nike Corporation famously stated many years ago, do yourself a favour and “just do it!”

Of course, there is such a thing as over exercising, so be mindful of that too, and if you do start an exercise routine, go easy at first, if necessary consult your doctor for medical advice in advance.

Exercise Video Resources:

Yoga for Beginners:
https://youtu.be/pWobp3phsEU

Qigong for Beginners:
https://www.youtube.com/watch?v=IyINAjEoTIs

Tai Chi for Beginners:
https://www.youtube.com/watch?v=hIOHGrYCEJ4

Zumba:
https://www.youtube.com/watch?v=-VXhoeaxxi0

Zumba for Beginners or Seniors:
https://www.youtube.com/watch?v=7aHK2sgjBCM

Relationships – Do Your Best

Being stuck in the house with your partner 24-7 got you down? Feeling sad because you can’t see your “gf” or “bf” in the next province? Or maybe you are not in a relationship but would like to be, but can’t because of COVID-19? Either way, your pain is real.

Close personal relationships have a large effect on wellness. In fact, those with good healthy relationships are measurably happier and healthier on average. Whether these relationships are with spouses, friends or other family members, it is worthwhile investing time and effort to keep things healthy, especially as worries are mounting.

The focus should be on taking personal responsibility, not on expecting change from others.

During times of elevated stress, self-care is vital, as this will lead to less tension within the relationship and will make you more emotionally available towards others.

As celebrated relationship researcher John Gottman illustrates, it is helpful to strive for a 5:1 positive-to-negative interaction ratio, where most of your encounters are of the uplifting nature.  Couples that maintain a similar ratio are likely to have a healthy, lasting relationship. Don’t worry, it’s normal to have a lower ratio at times, but is a good target to keep in mind!

Spending 24/7 together has its benefits but it’s likely that some “alone time” should be maintained if possible. Too much contact can be smothering for certain personalities.

And if your relationship has become unhealthy, and if it remains unhealthy with little hope for change after considerable effort, it should be re-evaluated.  Reaching out to trusted others or professional counsellors is always an option and there is no shame in doing either.

Resource:

Article – Surviving a Lockdown:
https://www.nytimes.com/2020/04/03/smarter-living/coronavirus-relationship-advice.html

Finances

Sadly, the surprise Coronavirus has left millions of people with elevated anxiety about their finances. Most readers facing this issue have likely taken steps to address this concern, but if not, now is the time.

When faced with a stressful issue it’s a common temptation to turn away and avoid facing it directly, unfortunately this tends to exacerbate the problem and can create other problems.

Whenever appropriate, I encourage my clients to “go towards the source of their anxiety”, as this typically helps diffuse the anxiety which is only made worse with avoidance.

Thankfully there are several options for financial support through government programs and most banks are making sincere efforts to ease your financial strain.

Resources:

Financial Help for Canadians:
https://newsinteractives.cbc.ca/coronavirusbenefits/

Canada’s COVID-19 Economic Response Plan:
https://www.canada.ca/en/department-finance/economic-response-plan.html

Government of Alberta:
https://www.alberta.ca/covid-19-supports-for-albertans.aspx

Substance Use

Earlier today I was speaking with a waste management worker as I brought my garbage to the alley, (just in the nick of time, as usual).  I asked him if things have been normal with the whole COVID-19 situation, and he replied, “Yah, pretty much, except we pick up a lot more bottles!”

We both had a bit of a chuckle, but then it occurred to me that this sounds like the ol’ canary in the coal-mine warning system, and seemed to confirm reports that drinking and drug use is on the rise.

In the past I’ve worked for five years at Canada’s largest jail and I’ve seen, hundreds of times, how substance use can lead to miserable consequences for normal, decent people. I’ve learned that huge respect must be given to all substances. Nobody intends to have great difficulties in their lives, but failing to anticipate what follows from ever-increasing substance use can lead to misery.

Of course, moderate use of substances are normally not cause for concern, but, these are not normal times. While it may be tempting for some to rationalize day-drinking, or frequent “rips on the bong” during long hours of house-bound boredom, (or maybe between yet another Zoom meeting – hope not!), clearly this is counter-productive behaviour in the long-run.

Although it may seem to help at first, coping through substance use is a mirage – escalating and prolonged use of drugs and alcohol only leads to worse anxiety, often much worse.

Preventing the problem from developing in the first place is obviously better than trying to deal with things after they’ve become a bigger concern, but if problems do arise, it’s important not to despair – believe that you can return to sobriety, many do, and so can you!

The psychological stress that goes with financial strain and/or unemployment is very significant, so working to manage that stress in a proactive way will help in relation to substance use as well.  If substance use is a concern, work to develop healthy coping strategies and reach out for help. There is absolutely no shame in admitting you have a substance-use problem, and it’s a sign of character to get help.

Resources:

Low-risk Drinking Guidelines According to the Canadian Mental Health Association:
https://www.camh.ca/-/media/files/canadas-low-risk-guidelines-pdf.pdf

Alcoholics Anonymous:
https://edmontonaa.org/

Narcotics Anonymous:
https://www.eana.ca/

Breathing

Mindful breathing is seemingly simplistic, but is profoundly useful for anxiety. The breath is a tool you always have with you. Deep slow breathing leads to literal changes in the way your brain functions, and consequently the way you feel.

Simply noticing your breath and then breathing in slowly and deeply and then relaxing your body as you exhale is a good technique.

Diaphragmatic breathing, box breathing and progressive muscle relaxation exercises are all useful.

Resource:

Breathing Techniques Step-by-Step:
https://www.healthline.com/health/breathing-exercise#pursed-lip-breathing

Food and Anxiety

Has constant close-proximity to your fridge become a thing? How about your snack cupboard(s)?  It has for me and my incredible-shrinking-pants! Wait, if my pants aren’t actually shrinking, then that means…

Staying home is a mixed-bag for our diets.  We likely eat better in some ways, especially if we skip the “skipping”, if you know what I mean. But suddenly being around food the whole day can be a tricky thing for our waistlines.

As I write this I’m literally in the middle of a surprisingly tasty, steamy plate of meat-loaf and mashed potatoes (and, of course, Frank’s hot-sauce), it’s the second helping today, so I need to catch myself from sounding like a holier-than-thou therapist admonishing you with more “do-as-I-say-not-as-I-do-isms”. I feel your pain.

We should all be comfortable with our bodies no matter what size, as long as we are happy and healthy, but if you do want to eat a bit less, one classic idea from behavioural psychology is to try and “control the environment”.

This idea is mostly just common sense, but it helps to create distance between you and the things you are trying to avoid. If someone has a gambling addiction, for example, it’s obviously best that they avoid going for lunch in a casino every day, there are simply too many temptations in that environment (not that they can now anyway, but you get the point).

Controlling the environment helps limit certain behaviours. In keeping with this idea, I should likely get my son to remove the remaining meat-loaf off my desk, and, while he’s at it, hide the giant bag of Sweet Chili Heat Doritos that’s been calling my name all day. Proximity matters – having healthier food choices readily available, and having the less healthy ones out of reach is wise.

So stash those all-dressed chips well behind the apples and the Melba toasts, or better yet, (much better), don’t buy the chips to begin with! And of course, planning meals (and snacks) ahead of time, instead of reflexively reaching for the naughty stuff when hungry, is very important.

That said, be realistic about your eating, and don’t expect perfection! Enjoy your food and indulge once in a while.

Remember however, that eating is directly related to your wellness, which includes your mental health, so it’s important to eat mindfully for these reasons more so than any arbitrary, superficial, “beauty” considerations.

Cooking a nice healthy meal can be a creative exercise and is therapeutic on its own!

Even though you may not have as many ingredients as you’d like – making healthy but yummy pantry meals may still be possible. (See video below).

Resource:

Video – Cooking Quarantine Meals:
https://www.youtube.com/watch?v=8h_4HgnGB8c

Gratitude

Well established now in mental health literature, practicing gratitude is good for your mood and overall mental health. Intentional effort to contemplate the good things in your life leads to greater peace of mind and contentment.

Resource:

Article – Tips for Keeping a Gratitude Journal:
https://ggia.berkeley.edu/practice/gratitude_journal

Kids at Home?

Warring siblings not your jam? Are they turning your hair grey, or quickening the pace of your receding hair-line? Or, like me, both of these?

If greater proximity to the Doritos is challenging, the same can be said for our kiddos!

Earlier today, when my son and I had a slightly snarky exchange about video gaming vs school work, I was thinking of my brother-in-law Sean who normally works in a government office in Ottawa and is now working from home. Tricky thing is, Sean and my saintly sister Gillian have nine children, and seven of them still live at home. As awesome as that is in many ways, it’s also a tall order, reeeaaally tall when suddenly trying to work from home, especially when everyone is house-bound for weeks on end.

Thankfully for them (and my nieces and nephews), Sean and Gillian are the calm, cool and collected type who manage remarkably well. Clearly this scenario however would cause some of us mere mortals to nearly self-combust, and my left eye gets a bit twitchy just thinking about it.

In truth, I find working from home doing video counselling sessions is going surprisingly well, despite the occasional noise from a distant teenager (or dog bark); however the virtual schooling thing has been a challenge, the tensions have been real some days, and this adds to overall anxiety for many a family.

Unfortunately the Coronavirus seems to have an amplifying effect, and where there is preexisting stresses, things can become worse. Both parents and kids are more vulnerable to unhealthy levels of stress and doing what we can to support each other is crucial.

The more positive energy we can bring to the interactions with our kids the better. Clearly this is easier said than done when your sixteen year old is giving you some major ‘tude, but do your best!

The days with our kids at home pass fast, and at some point we may wish for a chance to spend so much time together again, well, maybe!

So, whenever possible, lead with love, not with criticism or hostility – things are more likely to stay on track when you keep your cool as a parent. I have a wise colleague who grits her teeth when frustrated by her children as she tells herself: “This relationship is more important than this specific issue at this time”.

Classic parenting advice includes trying to engage your children in decision making rather than being authoritarian. It also includes looking for and reinforcing their good behaviour, and being consistent yet still flexible as a parent. And of course compassion and a kind heart is always important, especially at a time like this.

Resources:

Supportive Information – Caring for Kids During Covid-19:
https://www.caringforkids.cps.ca/handouts/the-2019-novel-coronavirus-covid-19

Creative Ways to Stay Sane with Kids During the Coronavirus:
https://rochester.kidsoutandabout.com/content/250-creative-ways-keep-your-family-sane-during-covid-19-crisis

Get Creative!

If there is a silver lining to this COVID crisis it might be in the new routines we establish. Having time to be more creative is a potential game changer in terms of lowering our anxiety and hopefully these habits continue when this crisis passes in the coming months.

Things like music, dance, painting, singing, poetry, photography, knitting, drawing, writing, gardening and cooking are all wonderful ways to not only pass the time but to learn and grow. All of these are creative endeavours and are good for our brains and your well-being.

Resources:

Article – Creativity in a Corona Virus World:
https://www.psychologytoday.com/ca/blog/and-all-jazz/202004/creativity-in-coronavirus-world

Online Guitar Lessons:
https://youtu.be/HNSaXAe8tyg

Getting Stuff Done!

It’s ok to lounge and rest, in fact it’s important for your well-being, but so too is a certain level of activity/productivity. Having a plan for your day and getting up and getting at it helps, especially if you can accomplish things that are important to you.

So align your behaviour with your intentions. Going after your goals with passion gives purpose to your day and this behaviour is incompatible with feeling depressed and anxious.

Spirituality

Although less people practice spirituality now than decades ago, it is hard to doubt the benefits from a mental health perspective.

Most religions and spiritual practices stress the value of supporting others during times of need and in being of service to others. Connecting to a higher power and finding purpose and community in your faith builds resilience and fosters well-being for all.

While in-person gatherings are clearly off-limits for the time being, many communities continue to provide services online.

Resource:

Article – The Need for Spirituality in the Time of the Coronavirus:
https://www.cnbc.com/2020/04/03/deepak-chopra-the-coronavirus-and-need-for-spiritual-wellness.html

Additional Ideas

Here is a quick list of more common and uncommon ways to help you cope with COVID-19, thanks to those who’ve offered suggestions:

• Keep a semblance of routine and get up and shower and get on with the day
• Set goals for your day before you get out of bed
• Make your bed
• Capitalize on the rare opportunity to do projects you’ve meant to get to for years
• Build a backyard greenhouse
• Enjoy things that make you laugh, like funny bloopers videos, or comedian acts
• Take an online training course
• Watch documentaries of your favourite artists
• Try adult colouring books for relaxation
• Meditate (The “Headspace” App may be useful)
• Bake bread
• Learn dancing online, like belly-dancing or African dancing
• Take music lessons or practice that instrument!
• Try watercolour painting
• Plant a garden
• Write letters or postcards
• Take singing lessons
• Do puzzles
• Reach out and help others daily
• Practice random acts of kindness
• Make a home movie
• Watch enriching programs on Netflix
• Strategize with your partner and develop a schedule to share parenting duties so as to allow “time off” for personal needs and interests
• Download the “Fabulous” App
• Catch up with old friends
• Take advantage of online tech programs and apps to visit with family and friends
• ****Remind yourself that this will end before too long, and that in some ways you will be better off for the experience – look for and find meaning in this challenging time!

NOTE: If you or your loved one continues to struggle with anxiety and/or depression, take advantage of resources such as those found on AnxietyCanada.com (https://www.anxietycanada.com/).

For further information and for specific consultations and ongoing counselling, consider reaching out to a mental health specialist such as a Registered Psychologist.

Thanks for reading!

– Gerard