Dr Anjana Kannankara
As the new coronavirus continues to spread, so have the anxieties about COVID-19 and the illness it causes. The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for many people. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. Effective coping with stress will make you, the people you care about and your community stronger.
Everyone reacts differently to stress. How you respond to the outbreak can depend on your background, the aspects which make you different from other people and the community you live in. Understanding your issues properly and taking adequate steps to tackle the same can be very crucial in this time of crisis to maintain good mental as well as overall health.
The US Centers for Disease Control and Prevention (CDC) and the World Health Organisation (WHO) have released guidelines and recommendations for managing anxiety and stress during the novel coronavirus (COVID-19) outbreak.
Who can be affected
People who may respond more strongly to the stress of a crisis include older people and people with chronic diseases who are at higher risk for COVID-19, children and teens, people who are helping with the response to COVID-19, like doctors and other health care providers, or first responders and those who have mental health conditions, including problems with substance use
Signs of stress
Stress during an infectious disease outbreak can include:
■ Fear and worry about your own health and the health of your loved ones
■ Changes in sleep or eating patterns
■ Difficulty sleeping or concentrating
■ Worsening of chronic health problems
■ Increased use of alcohol, tobacco, or other drugs
Coping mechanism
People with pre-existing mental health conditions should continue with their treatment and be aware of new or worsening symptoms.
Taking care of yourself, your friends, and your family can play an important role to help you cope with stress. Helping others cope with their stress can be beneficial for the society as a whole. Getting professional help when you feel you can’t handle your stress is also very important.
For adults
In order to support yourself:
■ Take breaks from watching, reading or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
■ Take care of your body. Take deep breaths, stretch or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
■ Make time to unwind. Try to do some other activities you enjoy.
■ Connect with others. Talk with people you trust about your concerns and how you are feeling.
Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.
Sharing the facts about COVID-19 and understanding the actual risk to yourself and the people you care about can make an outbreak less stressful. When you share accurate information about COVID-19 you can help make people feel less stressed and allow you to connect with them.
Children and teens react, in part, on what they see from the adults around them. When parents and caregivers deal with the COVID-19 calmly and confidently, they can provide the best support for their children. Parents can be more reassuring to others around them, especially children, if they are better prepared.
What to look for
Not all children and teens respond to stress in the same way. Some common changes to watch for include:
■ Excessive crying or irritation in younger children
■ Returning to behaviours they have outgrown for example, toileting accidents or bedwetting
■ Excessive worry or sadness
■ Unhealthy eating or sleeping habits
■ Irritability and troubling behaviours in teens
■ Poor performance in studies or avoiding school
■ Difficulty with attention and concentration
■ Avoidance of activities enjoyed in the past
■ Unexplained headaches or body pain
■ Use of alcohol, tobacco, or other drugs
There are useful methods that can be followed to support your child.Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions and share facts about COVID-19 in a way that your child or teen can understand. Reassure your child or teen that they are safe. Let them know it is alright if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.
For responders
Responding to COVID-19 can take an emotional toll on you. There are measures you can take to reduce secondary traumatic stress (STS) reactions:
■ Acknowledge that STS can impact anyone helping families after a traumatic event.
■ Learn the symptoms including physical (fatigue, illness) and mental (fear, withdrawal, guilt).
■ Allow time for you and your family to recover from responding to the pandemic.
■ Create a menu of personal self-care activities that you enjoy, such as spending time with friends and family, exercising, or reading a book.
■ Take a break from media coverage of COVID-19.
■ Ask for help if you feel
overwhelmed or concerned that COVID-19 is affecting your
ability to care for your family and patients as you did before the outbreak.
Quarantined life
Being separated from others when a situation arises where you may have been exposed to COVID-19 can be stressful, even if you do not become sick. Everyone feels differently after coming out of quarantine. Some feelings include:
■ Mixed emotions, including relief after quarantine
■ Fear and worry about your own health and the health of your loved ones
■ Stress from the experience of monitoring yourself or being monitored by others for signs and symptoms of COVID-19
■ Sadness, anger, or frustration because friends or loved ones have unfounded fears of contracting the disease from contact with you
■ Guilt about not being able to perform normal work or parenting duties during quarantine
■ Other emotional or mental health changes
■ Children may also feel upset if they or their acquaintances, have been quarantined.
Steps to cope
■ Remember the cause for which you went through this and how you became a part of controlling the disease
■ Try to be active as much as possible because staying occupied can take away some amount of stress and instill happiness
■ Communication is key and reach out to your family members
■ Combat frustration and boredom by executing ideas that you had always wanted to accomplish
■ Stay well informed
■ Establish routines that are not boring to you
■ Get professional help if required
Older adults (65 years and above) are at higher risk for severe illness. COVID-19 is a new disease and we are learning more about it every day. It’s natural that older people may feel tense in the given circumstances. Some ways to cope are:
■ Try to not rely on false news circulated but get actual Information from reliable sources
■ Be in touch with family members. Their support and love is a great way to relax.
■ Understand that panic is not required
■ Maintain proper health and diet, give proper exercise to the body depending on the physical condition.
■ Engage in activities that keep your mind calm and happy
■ Maintain good communication with near and dear
■ Write down your concerns and try to address what is in your control
■ Contact a mental health professional if you feel too stressed
Be mindful
It is important to not let fear control your life. Stress can affect the immune system. Taking steps to reduce your stress in a healthy way and maintaining your mental health intact is essential.
One way to lessen worry is to ground yourself in the present moment through mindfulness. “Mindfulness is a great technique that can help reduce stress during challenging times,” says McGuire, reputed Child Psychologist with Hopkins Medicine. One can practice mindfulness even by sitting quietly and focusing on his breathing and senses.
Another way to manage stress is by limiting computer screen time and media exposure. While keeping informed about current events is important, too much attention can cause problems. Setting boundaries can prevent feeling overwhelmed by the situation. What we must remember is that panic is not the need of the hour. Careful planning, preparedness and caution to prevent as well as control the spread of virus is most needed in this situation. Let us come together to step up the efforts to contain and fight against one of the most contagious diseases if not the deadliest that has hit our green planet. Let’s follow the safety measures, care for each other, stay focused on the safety of those most vulnerable and witness humanity triumphing over the pandemic. Let’s not panic but be best prepared by all means to conquer the devastating crisis and survive successfully!
(The author is chairperson of CSA and senior director at FWO)