Fear, loss, economic stress, the angst of a seemingly endless crisis — coronavirus is taking a toll, not just physically but on our mental health. Here are some tips and tweaks from California mental health professionals.
The world as we knew it a few weeks ago — remember handshakes? — is now upside down. The coronavirus has sickened untold numbers of us, claimed thousands of lives, and shaken almost every corner of society.
Fear of the virus leaves us hyper-aware of every sniffle and cough, of the unanticipated limits of our health care system, of preexisting conditions, high-risk age brackets, precarious or crowded living situations. We fear the vulnerability of our own bodies, the invisible risk to those we love. Locked inside our houses, even the mail seems a threat.
We face sudden economic stress — vanished jobs, cut hours, the prospect of small businesses closing. We are bracing for weeks or months of missing contact with friends and relatives or — on the flip side — of having too much contact with them. Some fear racist attacks; others increased domestic abuse.
Layered on top of all of this is a patina of angst: How long will this go on? What will our world look like when it’s over? How will our lives have changed?
Of course, things feel overwhelming.
But there are ways to care for your mental health, outside resources and small tweaks that can help. We asked experts for guidance to get through this challenging time.
Honor your feelings but don’t let them control you
Let’s accept it — this moment is very, very hard. Feeling sadness, fear, anxiety, anger, trauma, grief, loss or some evolving combination of these emotions, makes total sense.
“We’re all feeling anxious, it’s an appropriate reaction,” said Dr. Mark Levine, a psychiatrist who founded Community Psychiatry, which has 50 offices throughout California.
But while fearing a virus can help us protect ourselves, by prioritizing washing our hands and social distancing, for example, allowing that fear to foment negative, catastrophic thoughts can hurt us, and impact the way we view everything else.
These “negative thought loops” often are just versions of negative thoughts we’ve dealt with for our whole lives, but they can get magnified in moments of crisis or stress, Levine said.
Breathe, meditate and be mindful
One way to train your brain to manage these negative emotions, Dr. Levine said, is by practicing mindfulness, taking calming breaths and meditating. Mindfulness nurtures a gentle curious attitude toward the world around and within, including stressful thoughts and emotions.
Plenty of apps and podcasts provide opportunities for guided meditation, yoga, or even just a minute of calming breaths. Levine recommends an app called Unwinding Anxiety, and another called Headspace. Sacramento clinical psychologist Amy Ahlfeld also recommends a podcast by Dr. Rick Hanson called “Being Well.”
Ahlfeld says taking breaks to listen to ocean sounds, practice yoga or take a mindful walk using your sense to ground you (without your phone) can also be helpful. A few years ago, Dr. Levine started offering a live 4-week group therapy session to teach his patients about mindfulness. His practice is now offering a free version of the program.
Know the facts but limit news intake
The onslaught of disturbing news is hard to ignore. But that makes it all the more important to limit your intake. Focus on getting the right information — in intentional doses.
Go with trusted sources and basic news updates and avoid overdosing on pundits. No one needs to watch CNN or Fox News 24 hours a day, said Paul Marcille, a psychologist in Saratoga: “That would make anybody sick.”
“Maybe listen to things once a day,” he said. “Things aren’t going to change that much.”
Remember the big picture
Ahlfeld recommends trying to keep things in perspective. Go out in the wilderness and contemplate how small this moment is in the broad span of time and space. Or think about all of the terrible moments in history that humanity has come through intact. Or try thinking about the hard moments in your own life, and your own strength and resilience.
Also try to avoid focusing on personal catastrophe.
“Normally our minds go to the worst case scenario,” Ahlfeld said. “That is, most times, probably not going to happen.” The best case scenario probably also won’t happen, she said. Odds are, things will likely be somewhere in between.
She also recommends thinking about all the capable people
Keep a schedule but mix it up
Marcille tells the people in his practice to keep a regular schedule, rather than treat the shut down as some sort of prolonged vacation. He worries about teenagers staying up until 3 a.m. playing video games and watching movies, then sleeping until noon.
Adults should also aim to wake up at a regular time, shower and get dressed. “Sitting around all day in sweatpants and pajamas doesn’t make you feel like you’re up and active,” he said.
Marcille says it’s also important to mix things up — kids should aim for an hour or two of schoolwork in the morning, some exercise and entertainment, lunch, and then the same again in the afternoon. Adults who are working from home should also attempt to mix up their schedules during the day. Those who are retired or currently unemployed should consider developing hobbies or doing chores.
“Keeping busy is absolutely essential,” he said. “If you don’t have projects, look for them.”
Loneliness is a real concern right now. That makes it all the more important to connect with friends and loved ones — and those who might be especially isolated right now. Don’t cancel your book club. Do it over Zoom.
Patrick Arbore founded the Friendship Line in San Francisco back in 1973. At the time, he was concerned about the loneliness and social isolation experienced by elderly people and those with disabilities. He wanted to offer them a way to connect.
“With this shelter-in-place request, I just see the urgency of it,” said Arbore, who says staff and volunteers fielded 18,000 calls last month from all over the country. Calls have definitely increased in recent weeks, he said, though his organization has been too busy to run the numbers.
“People are scared,” he said. He always starts his calls by validating callers’ feelings.
“I don’t present a rosy picture,” he said. “They would know instantly that I was being false and fake.”
He lets callers know that he’s happy to listen. Some people call several times a week, just for the company. He’s also been working to recruit and train volunteers who can field calls from their homes, and encourages others to reach out to people who might be isolated, even if it’s just slipping a note under the door of an elderly neighbor with a list of resources including the friendship line and Meals on Wheels.
Finding ways to help other people can make a huge difference in your outlook. Maybe it’s having your kids write thank you notes to healthcare workers, or paying household employees who can’t come to work, or checking in (safely) on an isolated neighbor. Not only are these good things to do — they also get you out of your own head.
“In whatever way you’re contributing to other people, whatever that is, that’s going to dramatically influence the quality of this experience,” said Levine. “It all has to do with how kind you want to be, who can you take care of and how do you want to help.”
Use the time to pick up a new skill
Just because our normal avenues for exercise, relaxation and socializing are temporarily out of service, doesn’t mean we should stop taking care of ourselves. On the contrary, with all the stress we’re experiencing, self-care is especially important. You just have to get creative.
Tonya Wood, a Los Angeles-based psychologist and current president of the California Psychological Association, recommends virtual happy hours with friends, online yoga or art classes, anything to help you stay active and connected. “Maybe this is the time to take up that hobby that you never thought you could do,” she said.
Ahlfeld agrees that now is the right time to try to pick something you have always wanted to learn — a musical instrument, a foreign language, a baking or cooking skill — and working on mastering it. When life feels out of control, it is especially helpful to find something you can control, she said. Another benefit: it gives you something to think about besides Covid-19.
Ask for help
Sometimes it’s just not feasible to navigate the tricky anxiety, depression, isolation and trauma by yourself. For those who have underlying mental health conditions, for those who have experienced past traumas, for people on the frontlines in medicine, and for people who are lonely, this moment can be especially tough. But there are a number of free, confidential resources to turn to for help. Here are a few:
—Steinberg Institute website, links to mental health resources and care throughout California, https://steinberginstitute.org/links-research-care/
—Institute on Aging’s 24/7 Friendship Line (especially for people who have disabilities or are over 60), 1-800-971-0016 or call 415-750-4138 to volunteer. https://www.ioaging.org/services/all-inclusive-health-care/friendship-line
—Los Angeles County Department of Mental Health, 24/7 Access Line 1-800-854-7771, links to COVID-19 information. https://dmh.lacounty.gov/covid-19-information/
—Mental Health Association of San Francisco 24/7 Peer-Run Warm Line, 855-845-7415. https://www.mentalhealthsf.org/covid-19/
—Fresno County Behavioral Health Warm Line, Monday-Friday, 8 a.m. to 5 p.m., 559-600-WARM (9276). https://www.co.fresno.ca.us/departments/behavioral-health
—National Suicide Prevention Lifeline, 1-800-273-8255 (TALK)
—The Crisis Text Line, Text “HOME” (741-741) to reach a trained crisis counselor.
—California Psychological Association Find a Psychologist Locator, https://www.cpapsych.org/page/find
—Psychology Today guide to therapists, https://www.psychologytoday.com/us/therapists
Some psychologists will work with people for free or reduced rates, if needed, given the challenging times.