Looking after yourself during COVID-19

Written by: Dr Catherine Pitfield @ Roots Psychology. Brighton & Hove

The Coronavirus situation can affect us in many different ways: physically, emotionally, economically, socially and psychologically. We are in an abnormal situation, which means there is no “normal” response and however you are feeling at the moment is valid. Because we haven’t faced something like this before we don’t have a blueprint to tell us how we will get through it or what to do. This situation will mean different things to different people. Each person and family will have their own stressors; stressors that have happened as a result of COVID-19 and stressors that were already present that may now feel exacerbated. It is a time of fear for many people, fear for keeping yourself and loved ones safe and well, of loneliness, and of financial concerns.

Understanding anxiety is key for managing it:

Anxiety is a really healthy normal response, which helps to protect us. By learning more about anxiety and why we experience it, we can see that it is not harmful and finds way to acknowledge and manage the difficult feelings it brings up.

To simplify the brain, we could say it is divided into three sections. The ‘primal brain’, the ‘mammalian brain’ and the ‘human brain:

1.       The primal brain: Houses the “fight or flight” path. It is key for survival and detecting danger.

2.       The mammalian brain: Involved in the development of emotion and stores memories.

3.   The human brain: Responsible for planning, organising, thinking about consequences, higher level thinking and language.

Our brain will essentially always try and keep us safe and alive, but it can over-respond to perceived threats and danger. The primal brain acts as an “alarm system” in the brain. It scans for danger signals and is capable of turning on the “fight / flight” response. When we are anxious the human brain essentially shuts down, and we can become stuck in the primitive part of our brain.

The “fight / flight” response:

Imagine if you are walking across a road and a car is coming at you quickly, if you use your human brain to think about what colour the car is, who is driving, what make the car is, different routes you could take to get out the road, etc.; you risk being hit by the car. So you don’t want to use your thinking system, you need to use your “emergency” system.

The primal brain doesn’t think, it does. The primal brain will send a “threat” signal to your body and your body will take over, you will get a rush of adrenaline to prepare you to either fight or flight; “fighting” the car is not useful, so instead you will “flight”, you will run out of the road. Here the brain has done its job, it’s kept you safe.

The “fight, flight” response is a really clever automatic physiological response to danger. Your brain releases adrenaline into your body, this makes our heart beat faster to help pump blood quickly round our body, this is because if we are to run or fight, we need our legs and arms to have blood available for our muscles. Our lungs need to breathe faster so as we get more oxygen going in to the body. We take blood away from non-essential organs at that time, so if we are in immediate danger we divert blood away from our gut and digestive system. This is a really effective system if we are about to burn this adrenaline off (by running / fighting) but if we are just sitting then this leaves us feeling really uncomfortable.

Once the danger is over (the car has gone past) and you are safe your brain will start to reset. Imagine, you have just managed to avoid being hit by a car. You will feel a sense of relief and the adrenaline you felt in your body will start to leave. However, as you walk home you may be more hypervigiliant; paying attention a bit closer to other cars and speed. It’s a way of our brains focusing more on potential threats to keep us alive. Over time this hypervigilance leaves us and our brains have reset to a normal level.

It is an evolutionary adaption to focus on risk. We are designed to remember negative memories more than we are positive events. It is survival – we are more likely to survive if we see things as more negative or risky. However, it feels incredibly uncomfortable to live with so much anxiety, so we need our thinking brain to rationalise and think about whether we need to be so worried or afraid.

Anxiety and Coronavirus:

Recently, you may have found it harder to think, to concentrate, to finish jobs you have started. Your human brain is likely not working as well as it usually does, because you may feel an underlying sense of anxiety.

With Coronavirus our brains our likely operating on high alert. We are constantly told of the danger and threat to human life, and yet we can’t see it. We don’t know if we might be carrying it, who is carrying it, or how it might affect us if we get it. You may have noticed that you are hypervigiliant to any mention of it, you might be seeking out news of the spread and looking for information to try and understand it. Our brains are unable to “reset” because we can’t fully comprehend when we are safe and when we are in danger.

You may have experienced some physical symptoms of anxiety; heart beating fasting, breathing changes, feeling sick or nauseous, tingly, flushed, or a bit “on edge”. These are all normal in response to the current situation. However, these physical symptoms can also mean that we start to think there is a problem as we can interpret them as though we are in danger. We can end up in a “double threat” situation; we perceived an initial threat (i.e worries about a virus) that caused physical symptoms, these responses then feel very frightening and we can worry that something is wrong; we end up in a situation whereby worry causes worry.  

What can we do to manage anxiety?

• Don’t forget the basics: Maintaining a regular sleep / wake routine, and meal times is important for your body’s circadian rhythm. When it is disrupted we feel out of sorts and find it hard to focus.

• Exercise: it helps disperse adrenaline in our body, this means we can burn off some of those physically difficult feelings.

• Open up to the difficult feelings and accept they are there: You may need to make room for the difficult feelings, these may change as the Coronavirus situation unfolds; fear, anxiety, overwhelm, anger, sadness, loneliness, frustration, confusion, and many more. We can’t stop the feelings, they are normal responses. One useful image might be to think of feelings like beach balls in the sea, trying to stop, suppress or avoid our emotions is a bit like trying to push a beach ball under water and keep it down. It will keep trying to pop to the surface and take you a lot of time and energy to keep it under water. It might be more useful to learn to swim with it floating around next to you.

• Acknowledge and name the anxiety and difficult feelings:  Research shows if we name the feelings we are having it has a big impact on our brain. If we label an emotion we move from the primitive part of our brain and increase activity in the pre-frontal cortex (the “human” thinking brain). This means we can think more about the problem.

• Process what is happening: Write a journal or diary of what is happening for you. This does not need to be huge, you may just log what happened that day; think of this as a brain dump. It helps us process the difficult feelings, but also with time we can start to see our growth in this.

• Keep connected to others: We are social beings, we rely on others to survive. Our connections to others will look very different for a while. You may need to acknowledge and process the grief and sadness involved in this change. Think about how you will foster connections in these uncertain times and connect with others.

• Reflect and review: We haven’t done anything like this before, we will try new things to help us and some will work and some won’t. That’s ok, be kind to yourself. Perhaps schedule in a reflection time each week, think about what was useful last week, what was difficult for you, what ideas or strategies would you like to take forward with you into the next week.

• Keep perspective: This is a really scary and hard time. But it will not last forever. For most of us, we will return to normal life.

• Reframe language: Language is powerful and can affect how we view situations. Moving from being “stuck at home” to “we are staying at home to keep ourselves safe”, moves from a decision that feels imposed on us, to one that you are actively taking yourself, and offers an image of protection and reassurance rather than of force.

• Communicate: If you live at home with another adult think and talk about what you will both need. Think about times of stress before, what helped you then? What might you both find difficult? What can you do for yourselves and each other that will help you both live together.

• Pay attention to your thoughts:  Are they helpful, rationale and realistic? We can’t predict the future, yet when we feel anxious it is common for us to spend a lot of time predicting what could go wrong. Many of our predictions don’t happen and we have wasted time and energy being worried and upset about them.  For example:  I will lose my job. I won’t be able to survive financially. My child will return to school and will be behind everyone else in their class. Notice and acknowledge the worry, and then think about whether this is something that you can control or not. If you can’t control it, then allow yourself to feel the emotion and think about a way to live with that worry – can you limit how long you allow yourself to think about it? What can you tell yourself when those thoughts come up? i.e. “I’m noticing I’m worried about my job, I can’t predict what will happen at the moment and that’s really hard. But I can control what I do and how I will spend my time”. A useful “worry tree” can be found at: https://www.getselfhelp.co.uk/docs/worrytree.pdf This looks at your options when you can or cannot control worries.

• And finally, BREATHE. Breathing helps you to overcome the physical feelings of panic, and return to a state of calm. A useful check can be to put one hand on your stomach and one on the top of your lungs/chest. Ensure that your breath goes right down into your belly and doesn’t stay in a shallow breath at the top of your lungs. Useful breathing exercises and techniques can be found at: https://www.getselfhelp.co.uk/relax.htm