San Francisco Chronicle - (Sunday)
How to calm anxiety during the shutdown
The shelter-in-place orders in effect across California are an effort to slow the spread of the coronavirus in the region. But while the virus itself is a source of anxiety and stress, the precautions taken to protect residents’ physical safety are also having a detrimental impact on people’s mental health.
“We’re having mental health crises, as you might expect,” said Dr. Elissa Epel, professor of psychiatry at UCSF Weill Institute for Neurosciences. “Dealing with a global pandemic is new to most of us alive today. This is a very novel situation steeped in uncertainty and full of threat. It’s the ideal mixture of circumstances that will make anyone feel anxiety.”
Feeling worried right now is totally normal. But living in uncertain times shouldn’t mean letting stress spiral out of control, said Dr. Don Mordecai, Kaiser Permanente’s national leader for mental health and wellness.
We asked Mordecai and Epel how the coronavirus is affecting Bay Area residents’ mental well-being and what strategies can help people stay connected during the global pandemic.
If you’re feeling in crisis due to the coronavirus, find mental health resources at the end of this story.
Q: How is the coronavirus impacting people’s mental health?
A: Many people are feeling anxious, stressed and concerned about the coronavirus. Experiencing some anxiety, Epel said, is normal and good. It drives us to take the necessary measures to stay safe. “But the human mind is also well equipped to overpredict danger, and that turns into panic,” she said. “The problem with panic is that it’s highly socially contagious.”
Hoarding groceries doesn’t just strip shelves and leave people without cans of black beans, it also creates a ripple of panic that spreads to others.
Q: How are the precautions we’re taking — sheltering in place and social distancing — affecting mental well-being?
A: The measures we’re taking to prevent the spread of the disease have their own potential cost in creating loneliness and isolation. Mordecai worries that people following the shelter-in-place order could feel extremely socially isolated.
“Social distancing and social isolation can be different,” he said. “Make it your mission to strengthen social bonds even as we maintain our distance from one another.”
Q: Who is most at risk?
A: People who already suffer from mental health problems like depression and anxiety are the most vulnerable to the additional stress. “This can feel like an unbearable load,” Epel said.
With the statewide shelter-in-place order in effect indefinitely, senior citizens who may be more isolated and people who live alone are also especially at risk.
“If you are somebody who’s struggling, reach out and use your support system,” Mordecai said. “One of the cruelest things about depression is that it pulls people inward. It’s OK to share that burden.”
A: Send a message, get on the phone or use video chat to stay in touch. “Video is better than audio,” Epel said, suggesting video chat apps such as FaceTime and Zoom. “Seeing human faces is reassuring. It provides so much more information about how someone’s doing.”
Q: What strategies can help people cope with the shelter-in-place order?
A: Self-care during self-quarantine means eating well, getting enough sleep and spending time outside to the extent that it’s safe and possible.
Mordecai suggested trying a gratitude practice — writing down or sharing something you’re grateful for every day.
Epel recommended establishing a new schedule or daily structure to replace patterns thrown out of whack by school closures and working from home.
“My family sat down with a piece of paper and wrote down a schedule,” Epel said. It includes mealtimes, work blocks, social hours and movie nights. She also advised making a concerted effort to step away from screens and coronavirus news during the day. Maybe that means turning off your phone and going for a walk. Maybe it’s designating mealtime conversation as coronavirus free. “I really think breaks are critical,” Epel said.
Q: What should you do if you start to feel really anxious or stressed?
A: First, recognize what you’re feeling. Then think about the tools you use to manage stress — exercise, cooking or art — and tap into them. And don’t forget the power of deep breathing. “It can be a very powerful way to settle yourself, just by taking slow, deep breaths,” Mordecai said. Breathe in to the count of five. Exhale slowly. Repeat.
Q: What are the warning signs we should watch for in ourselves or others?
A: Anxiety is normal right now, but when it starts interrupting your ability to manage daily life or sleep, that’s a cause for concern.
“We want to prevent people from feeling hopeless, because we will be going through a hard” period, Epel said. “We have to remember we can survive this, this is short term, and (to) approach it day to day with new, fresh energy to make the best of it.”
Sarah Feldberg is The San Francisco Chronicle’s Culture Desk editor. Email: sarah.feldberg@sfchronicle.com Twitter: @sarahfeldberg