Thoughts on overcoming the stresses of COVID-19

We certainly live in a difficult time don’t we? The headlines tell us about the catastrophic number of deaths worldwide from the virus, which is now over 144,000 just in the USA. We are bombarded by discouraging news of an unseen danger that is unprecedented in its scope and unknown to science in the nature of its symptoms as well as treatment. The result is that for the first time in anyone’s memory we are all huddled in our homes while consciously avoiding social contact that was normal and comfortable for all of us. The question for me as a psychologist is “What is the best practice to cope with such widespread stress that effects all of our population?”

The first thing that we DON’T want to do is panic! There are very few situations that are best addressed by panicking. Although not everyone in America is panicking there are a large number of citizens who are suffering from COVID-19 related mental health issues. According to a May 26, 2020 article in the Washington Post written by Alyssa Flowers and William Wan approximately one third of all Americans are currently struggling with anxiety and/or depression that is related to the pandemic. They break the numbers down specifically to 10% struggling with anxiety, 9% with depression and the rest a combination of both anxiety and depression. A similar survey conducted by the American Psychological Association put the number for anxiety and depression totals at 11%.

Whether you believe either study, it is a huge problem in our society that is effecting upwards of 30 million Americans and worthy of being addressed. Two researchers writing for the Journal of Trauma Psychology: Shuquan Chen and George Bonanno of Columbia University (https://dx.doi.org/10.1037/tra0000685) studied psychological adjustment and resiliency during the pandemic. They noted that the stress came not just from the numerous unknowns about COVID-19 but the secondary stress of not working or working from home, homeschooling children or helping care for the aged, adapting to financial stress of dramatically reduced income, as well as fear of infection and possibly a painful agonizing death struggling and failing to breathe. Much of their work was based on previous studies of the SARS virus (Boanno, 2008) which was actually more lethal than CoVID-19 and what coping skills worked during that epidemic. Given what is known thus far in their studies the authors believe that approximately two-thirds of all Americans will remain resilient in the face of the pandemic and not just survive but may actually thrive in the fact of this danger.

Several findings from their studies are worth noting:

1. Those individuals who are able to remain optimistic despite the overwhelming negative news were much less stressed than pessimists.

2. Having strong social support and bonding with loved ones as well as friends was also a significant stress inoculative factor against stress. Drawing strength from other’s presence had a significant calming effect on individuals.

3. Staying informed about the details of COVID-19 was important in maintaining resiliency. This meant being current on what was being discovered about self-protection and yet not allowing themselves to be overwhelmed by too much information which would result in an uptick in anxiety and depression.

4. It was also discovered that having a playful attitude of “making the best of a bad situation” was very helpful. Individuals who could employ hobbies and games with their families seemed to fair much better as a result of “play” and distraction.

5. In addition to bonding it was found that building an online social media support group was helpful in building resiliency to stress. The study also found that among those individuals who actually contracted COVID-19 that it was essential that they mobilize social support, increase help-seeking behaviors, and maintain ongoing physical care in order to maintain resiliency. The study also found that maintaining a “flexible attitude” was very significant in maintaining health and resiliency. In other words deciding on an initial strategy (i.e. work from home) but being willing to periodically re-assess the situation and change when it seems to have become ineffective (i.e. mask up and go to the office two days a week).

In a study by American Psychological Association (APA) from the APA Monitor November 2016 issue, Lorna Collier wrote about a case study in which her client, who was brutally stabbed and left for dead, made a long recovery in therapy only to find that she was much improved. She not only recovered from PTSD, but more importantly, her quality of life was much improved in the areas of having a new found personal strength (she was much more resilient than she had previously thought), a deeper appreciation for her gift of life, and a new focus on wanting to give back to and help other people. Researchers Dr. Richard Tedeschi, and Dr. Lawrence Calhoun working with this phenomenon in the work published in 1996 in the Journal of Traumatic Stress have dubbed this result of working through trauma “Post-Traumatic Growth” or PTG. They described positive changes in five areas: Spiritual change, personal strength, a deeper appreciation of life, improved relationships with others and an openness to new possibilities in their lives.

What are some very practical coping skills that we can use to cope with the day to day reality of COVID-19 in our lives?

First of all, we all need to realize that as a nation we have survived national crises that were potentially lethal to every American and yet the United States is still the envy of the world. As proof simply consider how many others wish to immigrate here every year (8 million visa granted in 2019). As a nation, we fought off Nazi Germany, Imperial Japan and Fascist Italy in World War II in battles that claimed more than 60 million lives worldwide. We were totally unprepared for that war, but when Japan attacked Pearl Harbor we attacked back. The U.S. military was able to carry on an all-out war in both the Pacific and Atlantic Ocean as well as in Africa and later the European continent. Less than five years later we had beaten Japan, Germany and Italy to the point that they all surrendered unconditionally to the U.S. A and our allies. How did we do that amazing feat? We pulled together and realized that though we had our differences we’re still all Americans and have a stake in preserving our nation and all that it stands for.

Secondly, we need to take one day at a time and perhaps even one minute at a time. This is often referred to as “Mindfulness” training. It simply means quit worrying about things over which we have very little control and focus where you do have control…meaning what can we do right now? Fundamental to being able to limit our scope of awareness is the ability to self soothe. This means taking the time out periodically in our day to take a few minutes to breathe deeply and remind ourselves that we are doing fine at the moment. Sounds silly that we should want to reassure ourselves of our worth and well-being but it works well and is the foundation of prayer and meditative practices.

Thirdly, it is important to get some sort of physical release from tension. The book entitled “Younger Next Year” by Crowley and Lodge suggest that we can enhance and lengthen our lives by exercising an hour a day has good research support. However, if we don’t have that much time or energy we can all at least take a walk outside (or on a treadmill) in addition to taking up yoga, Pilates, or simple calisthenics. Whenever we physically exert ourselves we literally drain off the tension in our bodies that accumulates during the day.

Fourth, stay focused on achieving short term goals and reward yourself with at least acknowledging that we have accomplished something worthwhile. When I have managed to work on my website (a never ending chore) I acknowledge that I spent an hour on it whether I accomplished all I wanted to or not. There is some important satisfaction on achieving something by spending time on the project even if it isn’t perfect. Having a Fitbit on my wrist has given me some built in goals each day that has allowed me to lose 20 pounds over the past two years by having simple goals and getting feedback each day on my efforts to meet those goals. Over time nothing is more encouraging than meeting a goal and then the excitement of setting up a new goal.

Note: always a good idea to make goals small and achievable so that we aren’t discouraged and give up. Part of setting goals is daring to dream for the future and be specific about what you want to have happen. This is an essential skill that it taught in therapy.

Most clients come to therapy because they have focused almost exclusively on what they did not want to have happen and then spent most of their energy worrying about when this awful future will arrive.

It is much more healthy, and courageous, to dare to dream about a specific set of circumstances that we want for ourselves in the future and then break down the individual steps to make it happen and bring that future into existence. It is especially helpful if we have a faith and relationship with God and that we feel we deserve to be happy, healthy and capable of the pursuit of happiness.

Finally, there is always the option to obtain professional help. At this time in our history that professional help can be easily obtained over the internet via our computer using a variety of platforms (i.e. ZOOM, Doxy.me, Vsee, and Spruce to name a few) and with a variety of health professionals (i.e. psychologists, psychiatrists, social workers, counselors, Nurse Practitioners, physicians, and P.A.s). Telehealth provides the comfort of getting professional help and we never have to leave our homes or our loved ones. It has been proven to be as helpful as face to face contact and infinitely safer in terms of COVID-19. Hopefully this short review will be of help to all of us and we strive to not just survive but also thrive in this challenging time.

Michael Murrell Psy. D.

www.murrellpsychologicalservice.com

July 22, 2020