Manisha Adhikari
Pandemics can be stressful the coronavirus disease 2019 (COVID-19) pandemic may be stressful for people. Fear and anxiety about a new disease and what could happen can be overwhelming and cause strong emotions in adults and children. Public health actions, such as social distancing, can make people feel isolated and lonely and can increase stress and anxiety. However, these actions are necessary to reduce the spread of COVID-19.
Taking care of your friends and your family can be a stress reliever, but it should be balanced with care for yourself. Helping others cope with their stress, such as by providing social support, can also make your community stronger. During times of increased social distancing, people can still maintain social connections and care for their mental health. Phone calls or video chats can help you and your loved ones feel socially connected, less lonely, or isolated.
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Stress during COVID-19 outbreak can sometimes cause the following:
• Fear and worry about your own health and the health of your loved ones, your financial situation or job, or loss of support services you rely on.
• Changes in sleep or eating patterns.
• Difficulty sleeping or concentrating.
• Chronic health problems.
• Worsening of mental health conditions. Increased use of tobacco, and alcohol
Signs of Stress
Everyone reacts to stress differently. However, some common signs and symptoms of the fight or flight response includes:
• Frequent headaches.
• Cold or sweaty hands and feet.
• Frequent heartburn, stomach pain, or nausea.
• Panic attacks.
• Excessive sleeping or insomnia.
• Persistent difficulty concentrating.
• Obsessive or compulsive behaviors.
• Social withdrawal or isolation.
• Constant fatigue.
• Irritability and angry episodes.
• Significant weight gain or loss.
• Consistent feelings of being overwhelmed or overloaded.
Suicide
• Different life experiences affect a person’s risk for suicide. For example, suicide risk is higher among people who have experienced violence, including child abuse, bullying, or sexual violence. Feelings of isolation, depression, anxiety, and other emotional or financial stresses are known to raise the risk for suicide. People may be more likely to experience these feelings during a crisis like a pandemic.
• However, there are ways to protect against suicidal thoughts and behaviors. For example, support from family and community, or feeling connected, and having access to in-person or virtual counseling or therapy can help with suicidal thoughts and behavior, particularly during a crisis like the COVID-19 pandemic.
Effects of stress on depression
While stress can generally have negative effects on your physical and mental health, it can be especially harmful if you have depression.
Stress can make you feel less able to maintain positive habits or coping strategies, which are important to managing depression. This can make symptoms of depression feel more intense. Interrupting a healthy routine can result in negative coping strategies, such as drinking or withdrawing from social relationships. These actions can result in further stress, which can then make depression symptoms worse.
Stress can also affect your mood, as anxiety and irritability are both common responses to stress. When a stressor causes you to feel anxious, the anxiety may result in more negative feelings or frustration, even if the stressor is only temporary.
Tips on managing stress
Stress management techniques are useful in coping with depression. Stress relief can also help prevent depressive symptoms from developing. Some helpful stress management techniques include:
• getting enough sleep
• eating a healthy diet
• getting regular exercise
• taking occasional vacations or regular breaks from work
• finding a relaxing hobby, such as gardening or woodworking
• consuming less caffeine or alcohol
• doing breathing exercises to lower your heart rate
If lifestyle choices are causing you stress, you may consider changing the way you approach your personal or professional life. Some ways you can help decrease this kind of stress include:
• putting yourself under less pressure to perform at work or school, such as by lowering your standards to a level you still find acceptable
• not taking on as many responsibilities at work or activities at home
• sharing responsibilities or delegating tasks to others around you
• surrounding yourself with supportive and positive friends and family members
• removing yourself from stressful environments or situations
Activities such as yoga, meditation, or attending religious services can also help you deal with stress. A combination of these techniques may prove even more effective. It’s important to find what works for you. And no matter what you choose, it’s vital to have close friends and family members who are willing to support you.
Talking to a counselor, therapist, or other mental health professional can also be a useful way to deal with stress and depression. Talk therapy alone or combined with cognitive behavioral therapy (CBT) or medication is a proven solution for both depression and chronic stress. Medications for depression include:
• selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa)
• monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan)
10 Simple Ways to De-stress during Covid
1. Keep your routine as much as possible
Maintain some routine structure during these days. Try to keep your morning, mealtime and bedtime routine consistent. Take care of yourself making your physical and mental health a priority during this time.
2. Breathing exercise
Breathing exercises are helpful in relieving stress and anxiety. Inhale slowly and deeply through your nose and hold it for four seconds. Then, exhale slowly through your mouth with slightly pursed lips as if you are blowing out a candle. Repeat this exercise for several minutes.
3. Eat healthy snacks
Try to indulge yourself into eating healthy snacks and balanced diet as possible that comprises largely of fresh produce and whole grains, vegetables, fruits etc. which improves physical and mental well-being. It is recommended to have at least 5 servings of fruits and vegetables in a day, as per World Health Organization. Though it may not be fully approachable, do as you can.
4. Get plenty of sleep
Do not deprive yourself of sleep. Sleep in, go to bed early, and take naps as needed. Get into a healthy sleep routine so you can allow your body and mind to restore.
5. Exercise regularly even if it’s a bit
While many of us cannot go outside for a walk or gym, try working out at home. Perform some form of exercise to help your body feel energized, even if it is household chores. Even a simple workout will do magic. Make it habitual. Doing a couple of simple stretches can get the blood pumping and offer immediate relief in stressful situation. When you move around, your body releases endorphins which can improve mood almost instantaneously.
You can also perform yoga and meditation to incorporate mindfulness and relax your mind. Meditation at sunrise and sunset can help you with energy and sleep. Overall, exercise helps to keep our body and mind healthy.
6. Take a bath or shower
It is also known as hydro or water therapy. It is said that within five minutes of therapy, your blood pressure will drop and you will feel calmer. Further exposure will increase circulation and make your muscle feel less tense.
7. Get into a hobby
You can use this period of time developing your skills. Set yourself small goals for the day. On the process of fulfilling those goals, you get into productivity and creativity and eventually become happy on accomplishment of those goals.
Plan activities which pleasure your mind and help relax to pass the time. Be it painting, dancing, singing, gardening, listening to your favorite music, reading, cooking, playing indoor games with family, watching movies etc. Fostering a pet can also give you a sense of comfort and companionship.
8. Get some sunlight and fresh air
Sunlight and darkness trigger the release of hormones in your brain. Exposure to sunlight releases serotonin which is associated with boosting mood and helping a person feel calm and relaxed.
9. Be careful what you feed yourself on social media
Social media these days are overloaded with various information, rumor, gossips where most are directed towards this deadly pandemic which can be overwhelming and intimidating. Be selective what you feed to your mind because news which you consume will have effect on you.
Find a credible source, you can trust. Stay informed that will help you accurately determine your risk so that you can take reasonable precautions.
10. Spend time with your loved ones
Have each other and vent out your feelings and concerns in these times. Getting together through this situation will be lot easier. Though it may not be possible to catch-up in person these days, you can use modern technology and maintain social connections through texts, phone calls, video calls, emails etc.
Don’t hesitate from seeking help if you need to. Have a plan, where to go and how to seek help (in person or through telepathy services) for physical and mental health needs if required.
Healthy ways to cope with stress
• Know what to do if you are sick and are concerned about COVID-19. Contact a health professional before you start any self-treatment for COVID-19.
• Know where and how to get treatment and other support services and resources, including counseling or therapy (in person or through telehealth services).
• Take care of your emotional health. Taking care of your emotional health will help you think clearly and react to the urgent needs to protect yourself and your family.
• Take breaks from watching, reading, or listening to news stories, including those on social media. Hearing about the pandemic repeatedly can be upsetting.
• Take care of your body.
o Take deep breaths, stretch, or meditateexternal icon.
o Try to eat healthy, well-balanced meals.
o Exercise regularly.
o Get plenty of sleep
o Avoid excessive alcohol and drug use.
• 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.
• Connect with your community- or faith-based organizations. While social distancing measures are in place, consider connecting online, through social media, or by phone or mail.
Prevention from COVID 19
Encourage social distancing during your visit
• Visit with your friends and family outdoors, when possible. If this is not feasible, make sure the room or space is well-ventilated (for example, open windows or doors) and large enough to accommodate social distancing.
• Arrange tables and chairs to allow for social distancing. People from the same household can be in groups together and don’t need to be 6 feet apart from each other.
• Consider activities where social distancing can be maintained, like sidewalk chalk art or yard games.
• Try to avoid close contact with your visitors. For example, don’t shake hands, elbow bump, or hug. Instead wave and verbally greet them.
• If possible, avoid others who are not wearing masks or ask others around you to wear masks.
• Consider keeping a list of people you visited or who visited you and when the visit occurred. This will help with contract tracing if someone becomes sick.
Wear masks
• Masks should be worn over the nose and mouth. Masks are especially important when it is difficult to stay at least 6 feet apart from others or when people are indoors to help protect each other.
• Masks may slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others
• Wearing a mask helps protects others in case you’re infected, while others wear one to protect you should they be infected.
• Who should NOT use masks: Children under age 2 or anyone who has trouble breathing, is unconscious, or is incapacitated or otherwise unable to remove the mask without assistance.
Wash hands often
• Everyone should wash their hands for at least 20 seconds at the beginning and end of the visit and whenever you think your hands may have become contaminated.
• If soap and water are not readily available, such as with outdoor visits or activities, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
• Remind guests to wash or sanitize their hands before serving or eating food.
• Use single-use hand towels or paper towels for drying hands so visitors do not share towels. Have a no-touch trash can available for guests to use.
Limit contact with commonly touched surfaces or shared items
• Encourage your visitors to bring their own food and drinks.
• Clean and disinfect commonly touched surfaces and any shared items between use.
• If you choose to use any shared items that are reusable (e.g., seating covers, tablecloths, linen napkins), wash, clean, and sanitize them after the event.
Stay healthy during the COVID-19 pandemic.
Staying healthy during the pandemic is important. Talk to your healthcare provider about whether your vaccinations and other preventive services are up to date to help prevent you from becoming ill with other diseases.
• It is particularly important for those at increased risk of severe illness, including older adults, to receive recommended vaccinations against influenza and pneumococcal disease.
• Remember the importance of staying physically active and practicing healthy habits to cope with stress.
If you have an underlying medical condition, you should continue to follow your treatment plan:
• Continue your medicines and do not change your treatment plan without talking to your healthcare provider.
• Have at least a 30-day supply of prescription and non-prescription medicines. Talk to a healthcare provider, insurer, and pharmacist about getting an extra supply (i.e., more than 30 days) of prescription medicines, if possible, to reduce your trips to the pharmacy.
• Do not delay getting emergency care for your underlying medical condition because of COVID-19. Emergency departments have contingency infection prevention plans to protect you from getting COVID-19 if you need care.
• Call your healthcare provider if you have any concerns about your underlying medical conditions or if you get sick and think that you may have COVID-19. If you need emergency help, call 911 right away.
• If you don’t have a healthcare provider, contact your nearest community health centerexternal icon or health department.
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Stress & coping
You may feel increased stress during this pandemic. Fear and anxiety can be overwhelming and cause strong emotions. Learn about stress and coping.
If you think you may have COVID-19 or were exposed to COVID-19:
• If you have symptoms of COVID-19, get in touch with your healthcare provider within 24 hours, and follow steps for when you feel sick. You can use CDC’s self-checker to help you make decisions.
• If you or someone you know has COVID-19 emergency warning signs (trouble breathing, persistent chest pain, new confusion, inability to wake or stay awake, or bluish lips or face), seek emergency care immediately. Call 911.
• If you think you might have been exposed to someone with COVID-19, contact your healthcare provider. If you don’t have a healthcare provider, contact your nearest community health centerexternal icon or health department.
(Adhikari is Staff Nurse at Manmohan Memorial teaching Hospital)
