a montage of all the stressors and things to remember as people attempt to cope with covid-19
Graphic by Taylor Knopf

By Taylor Knopf

North Carolinians will be living in a state of uncertainty a little longer. This week, Gov. Roy Cooper announced a modified “stay home” order that extends to May 22 which looks very similar to the original order with a few exceptions. It’s clear that our lives will not return to normal anytime soon as our state leaders take a slow, phased approach to reopening businesses, schools, and places of play and worship. 

All of these life disruptions are enough to cause stress and anxiety. But additionally, there’s been great loss during the COVID-19 pandemic. Millions across the world have been sickened or have died from diseases caused by this contagious virus. 

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People have lost work and jobs. Kids are home from school and missing their friends, teachers and learning structure. Some families are without an adequate food supply. Some parents are working from home while also trying to homeschool. Weddings, funerals and special events have been canceled or postponed. Every aspect of life has been touched by this pandemic. 

The good news is most of us will get through this. “Humans are quite resilient,” said Roxane Cohen Silver, a professor of psychological science, medicine and public health at the University of California, Irvine. 

She and her colleagues studied the aftermath of tragic events, such as the September 11 terrorist attacks, the Boston Marathon bombings, and Hurricanes Irma and Harvey. And the research shows that people pull through, she said.

“But somehow this event feels different, and it is,” Silver said.  

She said the COVID-19 virus is unique in that it is an invisible, ambiguous and global threat.

“And our need to social distance conflicts with our natural desire to connect with our friends and family during stressful times.”

The mechanisms and distractions we use to cope during disasters, such as social gatherings, personal or professional sports, and going to restaurants and movies are all prohibited as we physically distance ourselves to prevent the spread of the virus. 

Silver and other mental health experts say it’s OK to feel anxious or distressed by these events. That is a normal response to this pandemic, and it’s important to acknowledge that. There are healthy and unhealthy ways to talk about and cope with these feelings. And there are resources available to help.

Socializing is healthy

Dr. Julianne Holt-Lunstad, professor of psychology and neuroscience at Brigham Young University, has focused her research on the intersection of social relationships and long-term health outcomes. 

“When it comes to the long-term health effects, we now have robust evidence that social isolation and loneliness are independent risk factors for premature mortality and social connection is a significant protective factor,” she said. 

However, the analyses Holt-Lunstad and her colleagues conducted were from long-term studies of several years. This should not encourage anyone to defy the current social distancing orders which protect against the virus, she warned.

Feelings of distress are a normal response to social isolation, she said.

“This is our body signaling a need to reconnect” Holt-Lunstad explained. “Just like hunger signals us to eat and thirst signals us to drink water, loneliness is thought to be a biological drive that motivates us to reconnect.”

If social isolation persists on a chronic basis, this biological drive can lead to increased blood pressure, stress hormones and inflammatory responses, which puts people at an increased risk for a variety of chronic illnesses, she said.

Healthy and unhealthy coping mechanisms

Experts agree that there are good and bad ways to cope with stress. 

Healthy habits include maintaining daily structure, exercise and eating a balanced diet, even during stressful times. Mindful meditation and creative expression can help with feelings of loneliness. 

Unhealthy behaviors to be aware of are overeating, excessive sleeping, withdrawing or substance abuse. It can also be harmful to fixate too much on news coverage of the pandemic. Take time to unplug from social media and turn off the TV.

Though we cannot connect with family and friends in person, mental health professionals recommend reaching out to others by phone and spend meaningful time with those under the same roof. Regardless of living situation, you can still reach out and support others, which is beneficial to both parties, Holt-Lunstad said.

It can be helpful to change the way you process the events around you.

“Instead of interpreting the situation as being cut off from others, we can focus on doing this to protect those that we love,” Holt-Lunstad said.

Tammy Cook and Christine Dicks have a counseling practice in Raleigh, where they now see clients via telehealth. Though they miss seeing clients in person, they report that it’s going well. 

They have been reminding clients to focus on the positives throughout this pandemic. 

“We have a negativity bias in our brains. It’s hard for us to focus on what’s going well. That takes practice,” Cook said. “That’s the lens in which we treat people.”

She encourages clients to keep a gratitude journal and look for the ways in which communities are pulling together to support and help each other through this. 

For those experiencing anxiousness, Dicks said something as simple as basic mindfulness, such as five deep breaths into the belly can help to calm and reset the nervous system. 

More telehealth options

Since the COVID-19 pandemic began, there’s been a significant rise in calls and texts to mental health and crisis support lines across the U.S. 

The American Psychological Association (APA) shares tips to reduce anxiety and stress, including keeping things in perspective, getting the facts from reliable sources, communicating with children, family and loved ones, and keeping connected to your support system.

Additionally, there are countless online support groups, classes and resources for people in mental health and substance use recovery right now. The National Alliance on Mental Illness NC has a page of COVID-19 resources for people across the state to connect to peer-led online groups to support their mental health recovery. 

Mental health resources

If you need support, the following resources are available:

– Source: NC DHHS

Many providers are seeing patients through digital platforms, and insurance companies are reimbursing for telehealth visits.

The N.C. Department of Health and Human Services has extended the types of providers who can see patients and clients through telehealth during the pandemic to include providers such as mental health counselors and addiction specialists. There are also practices taking new patients through telehealth as well.

People with a history of mental health issues are more likely to struggle in the wake of a community-wide disaster, said Holt-Lunstad. So it’s important for those folks to connect with their previous supports.

Helping children cope

It’s important to remember that children and teens are also feeling the effects of this pandemic. Parents should talk to their kids of all ages about it, said Robin Gurwitch, a clinical psychologist and professor of psychiatry and behavioral science at Duke University. 

You may worry that talking about the virus may make things worse, Gurwitch said. But research says the opposite is true. 

After you have that initial conversation, be sure to check in with your children and validate their feelings, she advised. It’s normal for them to feel sad, angry or worried. Some young children may even be happy because their parents are home all day, she said.

“When we validate, we show that we understand and hear them,” Gurwitch said.

It isn’t fun to be home from school, sports and afterschool activities and not to see their friends. And it’s OK to talk about that. As adults, if we are told not to feel a certain way, it doesn’t make the situation better. That doesn’t work on children either, she said. 

Help your children find ways to connect with those who they miss, Gurwitch suggested. And ask them how they would like to do that. 

Structure and routine will help children cope with the days at home. Remember to include family time, calm time, quiet time and alone time, Gurwtich said. Children need the same healthy habits as adults: rest, exercise and a healthy diet. 

Stress in children often presents itself in behaviors, such as irritability and increased defiant behavior. Sleeping issues, head and stomach aches can also be signs of stress in children.

“Which is challenging as adults right now because we are a little bit more short tempered and less patient,” Gurwitch said. “So we have to make sure we take a breath and realize their irritability or defiance may be related to distress.”

Their ability to concentrate on schoolwork may be reduced as well which could be made worse by figuring out a new learning platform as they do school work from home, she said. 

It’s important to encourage and praise them when they do well, Gurwitch said. 

“If they are remembering to wash hands frequently, tell them they are doing a good job keeping the family healthy,” she said.

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Taylor Knopf writes about mental health, including addiction and harm reduction. She lives in Raleigh and previously wrote for The News & Observer. Knopf has a bachelor's degree in sociology with a...