Managing the stress associated with coronavirus

Raymond Shelton Ph.D., F.A.A.E.T.S.

Director, Professional Development

American Academy of Experts in Traumatic Stress

We find ourselves in a time of unprecedented stress, anxiety, and uncertainty in the presence of the coronavirus crisis. The wellbeing of society; families, communities, businesses, organizations as well as our nation are all impacted. How do we survive and recover from such a massive assault on our population? As this crisis unfolds, media reports consume the airwaves with reports of travel restrictions, self-quarantine, event activity shut down, work place restrictions, schools closed, and concerns for your own and your loved ones’ health – people can experience a wide range of thoughts, feelings and reactions. All of which are normal in the presence of a crisis / traumatic incident.

These reactions include the following:

•Feeling stressed or overwhelmed
•Anxiety, worry, or fear
•Sadness, tearfulness, and/or loss of interest in usual enjoyable activities
•Physical symptoms, such as increased heart rate, stomach upset, low energy, or other uncomfortable sensations
•Frustration, irritability, or anger
•Feeling helpless
•Difficulty sleeping
•Loss of appetite
•Loss of focus and concentration
•Isolating or withdrawing from others, and/or fear of going to public spaces

Managing stress in times of prolonged crisis

The Coronavirus outbreak has the potential to increase stress and anxiety, both because of the fear of catching the virus and also because of uncertainty about how the outbreak will affect us socially and economically. During this time of uncertainty there is a feeling of loss of control. While we cannot take control of the situation, information gives you a sense of power by eliminating the fear of the unknown.

Managing stress during a crisis:

• Keep in mind that alcohol is a depressant and as such will intensify the negative reactions experienced following the crisis. Caffeine will increase anxiety and negatively impact the ability to sleep. Use cautiously and be aware of the effects.

• Drink plenty of fluids such as water or juice. Avoid consuming large quantities of soda that contains caffeine.

• Use quick relaxation techniques to regain control of emotions. Take a slow deep breath by inhaling through the nose, holding the breath for 3 seconds and exhaling through the mouth. Upon exhalation the words “relax,” “let go,” “I can handle this” may be spoken. Repeat the process a second time. Utilize this technique when you become aware of negative reactions or thoughts beginning to occur.

• Resist the desire to withdraw. Maintaining a connection with the people in your life is of the utmost importance. Maintain your support systems of family and friends. If you feel the need for some quiet time, tell those around you of this need. Ask them to give you some “space.” Do not just shut down.

• Engage in simple exercise. The stress reactions produced by the crisis, coupled by the wide range of thoughts, will produce a sense of unrest. Engaging in simple exercise such as walking, biking, and swimming will assist in dissipating these reactions.

• Limit exposure to the news. We live in a media powerful world that allows us to experience events in real time. The constant exposure to the crisis through media will continue to trigger negative reactions as the crisis unfolds over and over. Choose a news program to stay informed. Watch the program in the early evening and allow yourself time to process the information and take appropriate action steps to alleviate the stress reaction that may be created. Do not watch the news immediately prior to going to bed.

• Try to develop a new schedule as close to your normal schedule as possible. By maintaining as normal a schedule as possible you protect some degree of a normal existence while in the midst of the crisis. During this time of stress, it is important to continue to do things you enjoy. Schedule time for recreational activity. Go ahead and continue your recreational interest and just have fun. Make daily decisions and follow through.

• Set short range goals. Goals provide a sense of direction during a time when confusion and fear of the unknown are present. Attempt to set goals for 1 week, 2 weeks, etc. Be certain that the goal you set is realistic and manageable. By setting realistic goals you will avoid the frustration that always accompanies failed goals.

• Set limits for yourself. Avoid the urge to push on without allowing sufficient time to relax and unwind. Give yourself permission to take the “intermission.” Listen to the “wisdom” of your body. When you are tired… rest

• Be aware of your feelings and talk about them. Keep a journal and write your thoughts. If you have difficulty sleeping, do not fight the sleeplessness. Find a quiet place and write your way through the sleepless nights. The process of talking or writing will assist you in quieting your mind thus enabling you to relax and sleep.

• During the crisis realize that those around you are also in varying levels of distress. Be tolerant; seek first to understand others’ reactions and allow them space.

• Resist the desire to make major life changes. Allow time for the crisis to pass and recovery to occur before making major decisions.

• Eat well balanced meals.

• Remember your symptoms are normal having experienced a powerful negative event. Understand that during times of great distress “it is OK not to be OK.”

Guidelines for assisting children:

• Help yourself first. Be certain you are in a good frame of mind when discussing the crisis.
• Be honest and open discussing the crisis in age appropriate terms.
• Encourage talk about the event.
• Children may not communicate their feelings with words. Encourage them to draw a picture.
• Acknowledge that being frightened is OK.
• Monitor and limit media exposure. Allow time for discussion following exposure to powerful media stimuli.
• Spend extra time at bedtime.
• Remain connected, tune in to their needs.
• Be tolerant of behavior issues during times of distress.
• Hug and cuddle with young children.

Follow safety guidelines:

• Wash hands frequently with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer.
• Cover your mouth and nose with a tissue when you cough or sneeze.
• Properly dispose of used tissues.
• Cough or sneeze into your upper sleeve, arm, or elbow if you don’t have a tissue.
• Clean your hands after coughing or sneezing.
• Stay at home if you are sick.
• Avoid contact with those who are sick.
• Clean and disinfect objects or surfaces that may have come into contact with germs.

Workplace crisis stress management:

Leadership teams: Keep your staff informed of all work-related updates, discussions and plans. Stay connected be aware of and STOP all rumors! Be aware of increasing fatigue, focus and concentration issues. Allow for more frequent breaks. Allow staff to maintain connection with family to lessen their fears of home-based safety. Remind staff that if feeling ill – STAY HOME.

If staff is working from home – stay connected, demonstrate your concern for their well-being.

Final thoughts:

• Look to the future and what you have learned about yourself during this difficult experience.
• Choose to relax and allow some time to simply flow as the day unfolds.
• Set attainable goals and see your success.
• Continue to practice and attend to your spiritual needs.
• Spend time with your loved ones. Be tolerant to their needs and distress.

Do something that helps you keep a sense of normalcy:

When you’re in the middle of a crisis you might feel like the entire world is upside down.

Doing one thing that helps you feel “normal” will help you stay mentally stronger. Watch your favorite show before you fall asleep. Go for a walk in the morning like you always did before the crisis. Engage in your hobby. Whatever it is, look for one shred of normalcy that you can continue even when life feels anything but normal. Stay informed but lessen your time watching news programs.

Be safe, be well, and be careful.
Dr Ray

Reference:
American Academy of Experts in Traumatic Stress, www.AAETS.org
National Center for Crisis Management, www.NC-CM.org
Center for Disease Control, www.cdc.gov