The “new normal” during the coronavirus pandemic is a very different place. The home may no longer feel like a castle of refuge, but a prison of isolation. Trips to the store for groceries are different: Keep a social distance; staff swirls around, wiping down each refrigerated section handle; and if you do recognize a friend behind their mask, they cannot see your smile, hugs cannot be shared.
It’s a different place that gives everyone different, sometimes fearful feelings. The good news is that there are things that can be done about it.
“Home can feel like a prison when our rhythms are disrupted, but it’s not,” said Dr. Itai Danovitch, chair of the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai. “Social distancing does not mean emotional distancing.”
In addition to reaching out to others via phone, letter or internet, Danovitch says it’s important to acknowledge your own personal feelings.
“The foundation of health — both physical and mental health — is safety,” Danovitch said. “In a crisis, we perceive external threats to that sense of safety.”
Experts say that during times such as these it is important to determine exactly how one feels. Is that feeling fear, stress, helplessness, worry, sadness or anger? These feelings are real and are the body’s natural, biological reaction to any threat.
“It helps to ensure that the day doesn’t get consumed by worrying, because our fear and our worries, when we don’t have control over them, can sometimes have the effect of overtaking other activities,” he said. “We want to acknowledge our emotions. It’s OK to worry, and it’s OK to have fear. On the other hand, we want to try to put a container around them so that they don’t consume all the other components of the day.”
Danovitch stressed that it is important to distinguish feelings.
“An emotional response to a real threat is a fear,” he said, giving an example of a biting dog. “A worry creates anxiety, a fear response to an imagined threat, a threat that you perceive can happen in the future, but it’s not there in front of you. A ‘what if?’ It’s important to separate them.”
Next, Danovitch said, one needs to make a plan and respond to what your brain is telling you.
“Write down what you’re worried about,” he said. “Sometimes when you put things down in writing, sometimes your own inner wisdom gives guidance on how to respond. Show yourself that you’ve taken reasonable precautions. You may be having an emotional reaction even though you’ve done everything you need to do.”
Although it’s impossible to escape the news stories about COVID-19 in the various media—this threatening disease is making its mark worldwide—it’s important to limit the amount of news you take in.
Danovitch stresses the importance of making sure that the limited amount of news you do take in is from trustworthy sources, such as the Centers for Disease Control and Prevention (CDC), doctors, scientists and local public health authorities.
“Getting accurate information includes accepting areas where there is uncertainty,” Danovitch said. “It also includes responding to areas where there’s very clear direction from trusted authorities and experts.”
Words are powerful and affect the psyche, agrees Dr. Kimberly Newsom, the director of psychology training at the Veterans Administration (VA) Los Angeles Ambulatory Care Center. And, she explained that those words don’t always have to come from others.
“We need to talk to ourselves,” Newsom said. “The language we use is powerful. We can psych ourselves up or we can psych ourselves down. We have to be very careful how we talk to ourselves. Use positive self-talk.”
Newsom recommends everyone check their thinking for accuracy, rather than just assuming that negative voice in your head is speaking the truth.
“‘Oh, this quarantine is never going to end,’ might be some automatic thought, but let’s check that for accuracy,” Newsom said. “What’s your evidence for that? That evidence would have to hold up in a court of law. Feeling angry is no evidence. Feeling frustrated is not evidence.”
In addition to instructing interns and post-doctorate residents in the VA training program, Newsom works with veterans who are struggling with anxiety and other mental health conditions.
“We counsel them to get out and enjoy pleasurable activities, which they first feel is in direct opposition to being quarantined,” Newsom said. “You can go outside and take a walk, just maintain appropriate distance between yourself and others and wear a face covering. The problem is that people are under the mistaken impression that staying at home and sheltering in place means that you’re in prison and cannot leave the house, which isn’t the case.”
Just like the airline flight procedure which instructs passengers to put on their oxygen masks before assisting their children or other loved ones, both doctors insist that individuals work on self-care, then they will be in a better position to help others.
“I think one of the basic tenets of how to manage your mental health in a crisis like this is to ensure that you’re taking care of your own basic needs—taking breaks, having rest and sleep, getting adequate nutrition, exercising and having compassion for yourself and others,” Danovitch said, explaining that while our usual daily routines have been disrupted, new ones need to be established.
“We’re social people and live in rhythms, biological, physical and social,” Danovitch said. “We sleep, breakfast, go to work, take rest breaks, get back to work… We get accustomed to those rhythms. One of the major things that happened is the complete disruption of those rhythms. We’re not sleeping well, not eating regularly. We rely on this rhythm to keep us healthy both physically and mentallly.”
Danovitch suggests creating a daily schedule. Carve out separate blocks of time to eat, work, relax and play. Even schedule a time to ingest some information about the crisis. Consume the news for a short while, then “tune that stuff off,” he said. “That stuff has a way of fueling our worries.”
“We have to look for opportunities to create structure in our lives,” Danvitch said. “We have to create a new rhythm to give us a sense of control.”
Dr. Lenore Tate, a licensed psychologist in private practice in Sacramento, agrees and recommends that households maintain a flexible schedule and reach out to other households for help and/or comfort.
“For the most part, we are social animals and connecting with others helps us thrive,” Tate said in her recent article. “Seek social support from family members and/or friends and maintain social connections.”
“Just take good care of yourself and reach out to people and use your support system. That’s what is going to get people through—using that system.”
Danovitch concurred, and noted that in addition to practicing relaxation exercises, eating well and doing physical workouts, reaching out to others is therapeutic in many ways.
“It’s useful to talk to people, to vent and express emotional feelings,” he said, adding that it’s also important to be a listening ear for others.
Danovitch suggests calling or video-chatting with those who are isolated or otherwise at risk for mental health struggles.
“Optimism and compassion can go a long way during these uncertain times,” Danovitch said. “I think that listening—listening with empathy, listening with compassion—is very powerful.”
“We can’t change every difficult circumstance, but by being with people, by bearing witness to what they’re going through, by connecting with them and letting them know that we are there for them, even if we’re not there physically, I think we help each other out.”
For those feeling overwhelmed with mental health struggles, a referral for mental healthcare may be available without having to physically visit a doctor’s office.
“People can reach out to their primary care doctors remotely to let them know if they have new concerns or anxiety or changes in mood, and to get guidance and referrals to appropriate treatment providers,” Danovitch said.
“In today’s world, you don’t even have to leave your home, Tele Psych is available,” Tate said. Telepsychology will allow you to access a licensed provider in the comfort of your home or other personal space. It is convenient, prevents missed appointments and may encourage those in our community concerned about the stigma of mental health to seek the help they need to ‘rise up’ to life’s challenges facing us today.”
Insurance providers, along with state and local departments of health, can also help identify an appropriate and accessible care provider.
Additionally, those who aren’t mental health professionals, but who have certain talents or skills, may be uniquely qualified to lend a hand to others, Danovitch said.
“This is a time to reach deep down into our values and think about how we can take the talents and the skills and the training and the energy, and apply it to try to help our community,” he said. “Focusing on others can help us get out of our own heads sometimes.”
“There are lots of ways people can be of service,” Danovitch said. “And there is a reward that is associated with serving.”