In early April, Physicians for Human Rights hosted a webinar featuring psychiatrists and PHR Board Members Gail Saltz, MD and Kerry J. Sulkowicz, MD on the mental health impacts of the coronavirus pandemic, as part of our ongoing series “Science-driven Solutions for Combating COVID-19.” Here is an extract of their discussion.
As COVID-19 continues its relentless spread across the globe, the mental health impacts of the novel coronavirus are becoming clear. In many places, we are facing not one but two pandemics: the pandemic of COVID-19 and the pandemic of anxiety.
There are a lot of things to be anxious about: contracting the virus, an uncertain economic future, and even uncertainty itself. Anxiety compromises our ability to plan, make decisions, exercise empathy, and envision future recovery. But while it’s difficult to predict whether we will become sickened with COVID-19, coping strategies can allow us to adjust to our present situation, make good choices, and have hope for the future.
Anxiety compromises our ability to plan, make decisions, exercise empathy, and envision future recovery.
One of the best ways of coping with anxiety around life changes like this pandemic – talking to each other – is impeded by the requirements of social distancing. Yet we are still able to talk by phone and, through technology, face-to-face. We should check in on each other, on our families and colleagues. We know that human touch is hard to replace and being deprived of it has consequences. But a hug is an expression of feeling, and verbalizing these feelings – “I care about you,” “I want to comfort you,” even “I wish I could hold you” – is a profound way of injecting meaningfulness into a conversation. If people come out of this more willing to express love and vulnerability, that would be a tremendous thing.
Setting a routine and taking care of yourself at home is incredibly important. Work-from-home is grueling. You need to take breaks, walk around, put the screen away. Now is also a time to be flexible: your colleagues might be dealing with the stress of living alone, having children home from school, or living in over-crowded homes. It is essential to make room for calming techniques throughout your day to stop the accumulation of anxiety. Take some time for deep breathing, muscle relaxation techniques, or a warm bath. Thirty minutes of aerobic exercise will make a huge difference in your day.
You should also limit your intake of news. Check just one or twice a day, turn off your push notifications, and avoid social media – it fuels anxiety, and, frankly, there is a lot of misinformation going around.
Something else to keep in mind is that there has been a huge uptick in the availability of telemedicine and phone therapy services; if you feel you need professional help, you should seek it out. One question that doctors hear a lot is: am I anxious, or do I have the virus? That’s very understandable; anxiety is a physiological experience and a lot of the symptoms of coronavirus and anxiety are the same. Yet there are significant differences: one does not have a fever with anxiety, and one does not typically have a cough. If you are feeling particularly anxious and short of breath, you can use the app Pulse Oximeter to check your blood oxygen level. If you are oxygenating above 95% you don’t need to go to a hospital. Some people who feel short of breath due to anxiety, whether or not they are ill, feel reassured by being able to see that they are oxygenating well.
If you are a health care worker, it is important to recognize that this is an acutely difficult time for you in particular. We are used to being the helpers, so needing to ask for help is hard; yet it is essential that we reach out as well.
Children, too, can become very anxious, as they have experienced the same life changes in the past month that adults have. Undeniably, when your children become overwrought it makes it much more difficult for you to contain your anxiety. Helping your child starts with your own self-care, because if you are worried, your child will see your anxiety and mirror it. You can let children know what is happening in broad terms, but generally, kids want to know that the people they love will be OK. They want to feel that they are safe and that your family has a plan to ride this out together. Your child should be engaged in the work of setting up structure in your home. They should be engaging in educational activity, having structured play time, and socializing with friends – try a Zoom playdate! Get creative together.
Finally, if you are a health care worker, it is important to recognize that this is an acutely difficult time for you in particular. We are used to being the helpers, so needing to ask for help is hard; yet it is essential that we reach out as well. The heath care workers on the front lines of this pandemic need to eat healthily, get exercise, and be on a regular schedule just like the rest of the population. Social connection is vital, whether through connections at the workplace, virtual lunches, or other means. It is crucial that health care workers open up about the burdens we are carrying. Likewise, recognizing trauma in the medical staff under your supervision is critical. It is hard to see someone struggling without availing themselves of available resources. Ask your coworkers how they are doing, and if someone lets on that they are struggling, follow up. Don’t be shy about suggesting that somebody seek more treatment. Medical workers and people who have been sick in the hospital are going through extraordinary circumstances and are likely to experience acute stress reactions afterwards; the more social connection and support they can get, the less likely it is that this stress reaction will become post-traumatic stress disorder.
While the ultimate personal and societal impact of the COVID-19 pandemic is hard to predict, these are some steps we can take to mitigate the anxiety caused by the strange new reality coronavirus has brought on.