Coping with Stress - Advice from the CDC
Updated Dec. 11, 2020
PLEASE CLICK HERE FOR A LINK TO THE ORIGINAL ARTICLE ON THE CDC WEBSITE

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. Coping with stress in a healthy way will make you, the people you care about, and your community stronger.

Stress during an infectious disease 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.
• Worsening of chronic health problems.
• Worsening of mental health conditions.
• Increased use of tobacco, and/or alcohol and other substances.

Everyone reacts differently to stressful situationsHow you respond to stress during the COVID-19 pandemic can depend on your background, your social support from family or friends, your financial situation, your health and emotional background, the community you live in, and many other factors. The changes that can happen because of the COVID-19 pandemic and the ways we try to contain the spread of the virus can affect anyone.
People who may respond more strongly to the stress of a crisis include:

• People who are at higher risk for severe illness from COVID-19 (for example, older people, and people of any age with certain underlying medical conditions).
• Children and teens.
• People caring for family members or loved ones.
• Frontline workers such as health care providers and first responders,
• Essential workers who work in the food industry.
• People who have existing mental health conditions.
• People who use substances or have a substance use disorder.
• People who have lost their jobs, had their work hours reduced, or had other major changes to their employment.
• People who have disabilities or developmental delay.
• People who are socially isolated from others, including people who live alone, and people in rural or frontier areas.
• People in some racial and ethnic minority groups.
• People who do not have access to information in their primary language.
• People experiencing homelessness.
• People who live in congregate (group) settings.

Take care of yourself and your community
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.

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.
  • Take deep breaths, stretch, or  meditate 
  • Try to eat healthy, well-balanced meals.
  • Exercise regularly.
  • Get plenty of sleep.
  • 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.

Know the facts to help reduce stress
Knowing the facts about COVID-19 and stopping the spread of rumors can help reduce stress and stigma. Understanding the risk to yourself and people you care about can help you connect with others and make an outbreak less stressful.

Take care of your mental health

Mental health is an important part of overall health and wellbeing. It affects how we think, feel, and act. It may also affect how we handle stress, relate to others, and make choices during an emergency.
People with pre-existing mental health conditions or substance use disorders may be particularly vulnerable in an emergency. Mental health conditions (such as depression, anxiety, bipolar disorder, or schizophrenia) affect a person’s thinking, feeling, mood or behavior in a way that influences their ability to relate to others and function each day. These conditions may be situational (short-term) or long-lasting (chronic). People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms. If you think you have new or worse symptoms, call your healthcare provider.

​Whether through a comprehensive mental health program or through activities that boost employee morale, tactics that focus on employees’ mental health can reduce burnout.The COVID-19 pandemic is at the top of everyone’s minds. Working a full-time job during a pandemic, while sometimes playing teacher to young children, is undoubtedly exhausting. Employers are turning to wellness tactics to ensure employees maintain their overall health. A crucial component to wellness for leaders to focus on is employee burnout.

What is Burnout?
Consulting firm Eagle Hill defines burnout as “the result of stress that is more prolonged and intense in nature.” Just last year, the World Health Organization updated its definition of burnout in its handbook of diseases, International Classification of Diseases — ICD-11 effective January 2022. The new definition describes burnout as a “syndrome,” and specifically ties it to chronic workplace stress. It’s characterized by energy depletion, increased mental distance from one’s job, and reduced professional efficacy. Prolonged stress and exhaustion associated with burnout were even found to increase the potential for serious and life-threatening heart conditions.

COVID-19 is Exacerbating Employee Burnout
A recent online survey of a random sample of employees around the U.S. with 1,001 respondents found that nearly half (45%) are feeling burnt out, with one in four attributing the burnout to COVID-19. Respondents to a survey of more than 6,000 working professionals from anonymous networking site Blind revealed that 73% are feeling burnt out, compared to 61% in mid-February. The top reasons for burnout included the lack of work-life separation, unmanageable workloads, and job security concerns, all tied to the COVID-19 pandemic. At 74.8%, marketing and communications respondents were feeling the most burnt out.

Tactics for Improving Employee Mental Health
Thirty-six percent of the Eagle Hill survey respondents also reported that their organization isn’t doing anything to help with employee burnout. Developing an employee health and wellness program can go a long way in enabling employees to tap into wellness resources but is only just the beginning. Workplace Strategies for Mental Health recommends the implementation of a psychological health and safety management system. Such a system doesn’t diagnose the mental health of employees, but rather helps assess policies, processes and interactions in the workplace that might impact psychological safety.

When planning the system, company leaders can start by forming a health and safety committee that can establish a process for employees to bring forward mental health concerns and issues safely and confidentially. Additionally, this system should include training and education on workplace psychological health. Implementation can involve workplace dialogues, with senior leadership leading by example to create a workplace environment conducive to mental health. Senior leaders can also take a self-assessment to ensure they’re well-versed in leadership strategies known to create a psychologically sound workplace.
​
In addition to these procedures, planned activities can improve the overall mental health of employees that reduce feelings of burnout. Whether hosting a virtual mindfulness workshop, team fitness challenges, or setting aside 20 minutes to laugh at a funny video, team leaders can use this time to think of creative, mind-healthy activities that reduce stress and increase team connection.
Helping employees feel connected, appreciated, and able to openly share their mental health concerns, reduces burnout. As the world continues to deal with the COVID-19 pandemic, incorporating mental health into overall wellness programs is more important than ever.

​CLICK HERE FOR ORIGINAL ARTICLE ON WORLDWIDE ERC® - May 29th 2020

Forever is composed of nows. - Emily Dickinson. 

​Summary: Mouse models of corticospinal injuries reveal adult neurons begin a natural regeneration process by reverting back to an embryonic state. The regeneration is sustained with the help of a gene more commonly associated with Huntington’s disease.  - Source: UCSD

​When adult brain cells are injured, they revert to an embryonic state, according to new findings published in the April 15, 2020 issue of Nature by researchers at University of California San Diego School of Medicine, with colleagues elsewhere. The scientists report that in their newly adopted immature state, the cells become capable of re-growing new connections that, under the right conditions, can help to restore lost function.
Repairing damage to the brain and spinal cord may be medical science’s most daunting challenge. Until relatively recently, it seemed an impossible task. The new study lays out a “transcriptional roadmap of regeneration in the adult brain.”
“Using the incredible tools of modern neuroscience, molecular genetics, virology and computational power, we were able for the first time to identify how the entire set of genes in an adult brain cell resets itself in order to regenerate. This gives us fundamental insight into how, at a transcriptional level, regeneration happens,” said senior author Mark Tuszynski, MD, PhD, professor of neuroscience and director of the Translational Neuroscience Institute at UC San Diego School of Medicine.
Using a mouse model, Tuszynski and colleagues discovered that after injury, mature neurons in adult brains revert back to an embryonic state. “Who would have thought,” said Tuszynski. “Only 20 years ago, we were thinking of the adult brain as static, terminally differentiated, fully established and immutable.”
But work by Fred “Rusty” Gage, PhD, president and a professor at the Salk Institute for Biological Studies and an adjunct professor at UC San Diego, and others found that new brain cells are continually produced in the hippocampus and subventricular zone, replenishing these brain regions throughout life.
“Our work further radicalizes this concept,” Tuszynski said. “The brain’s ability to repair or replace itself is not limited to just two areas. Instead, when an adult brain cell of the cortex is injured, it reverts (at a transcriptional level) to an embryonic cortical neuron. And in this reverted, far less mature state, it can now regrow axons if it is provided an environment to grow into. In my view, this is the most notable feature of the study and is downright shocking.”
To provide an “encouraging environment for regrowth,” Tuszynski and colleagues investigated how damaged neurons respond after a spinal cord injury. In recent years, researchers have significantly advanced the possibility of using grafted neural stem cells to spur spinal cord injury repairs and restore lost function, essentially by inducing neurons to extend axons through and across an injury site, reconnecting severed nerves.

Last year, for example, a multi-disciplinary team led by Kobi Koffler, PhD, assistant professor of neuroscience, Tuszynski, and Shaochen Chen, PhD, professor of nanoengineering and a faculty member in the Institute of Engineering in Medicine at UC San Diego, described using 3D printed implants to promote nerve cell growth in spinal cord injuries in rats, restoring connections and lost functions.
The latest study produced a second surprise: In promoting neuronal growth and repair, one of the essential genetic pathways involves the gene Huntingtin (HTT), which, when mutated, causes Huntington’s disease, a devastating disorder characterized by the progressive breakdown of nerve cells in the brain.
Tuszynski’s team found that the “regenerative transcriptome” — the collection of messenger RNA molecules used by corticospinal neurons — is sustained by the HTT gene. In mice genetically engineered to lack the HTT gene, spinal cord injuries showed significantly less neuronal sprouting and regeneration.
“While a lot of work has been done on trying to understand why Huntingtin mutations cause disease, far less is understood about the normal role of Huntingtin,” Tuszynski said. “Our work shows that Huntingtin is essential for promoting repair of brain neurons. Thus, mutations in this gene would be predicted to result in a loss of the adult neuron to repair itself. This, in turn, might result in the slow neuronal degeneration that results in Huntington’s disease.”
Co-authors include: Gunnar Poplawski, Erna Van Nierkerk, Neil Mehta, Philip Canete, Richard Lie, Jessica Meves and Binhai Zheng, all at UC San Diego; Riki Kawaguchi and Giovanni Coppola, UCLA; Paul Lu, UC San Diego and Veterans Administration Medical Center, San Diego; and Ioannis Dragatsis, University of Tennesee.

​ABOUT THIS ARTICLE​
Source:
UCSD
Media Contacts:
Scott LaFee – UCSD
Image Source:
The image is credited to UC San Diego Health Sciences.
Original Research: Closed access
“Injured adult neurons regress to an embryonic transcriptional growth state”. by Gunnar H. D. Poplawski, Riki Kawaguchi, Erna Van Niekerk, Paul Lu, Neil Mehta, Philip Canete, Richard Lie, Ioannis Dragatsis, Jessica M. Meves, Binhai Zheng, Giovanni Coppola & Mark H. Tuszynski.
Nature doi:10.1038/s41586-020-2200-5.
Abstract
Injured adult neurons regress to an embryonic transcriptional growth state
Grafts of spinal-cord-derived neural progenitor cells (NPCs) enable the robust regeneration of corticospinal axons and restore forelimb function after spinal cord injury1; however, the molecular mechanisms that underlie this regeneration are unknown. Here we perform translational profiling specifically of corticospinal tract (CST) motor neurons in mice, to identify their ‘regenerative transcriptome’ after spinal cord injury and NPC grafting. Notably, both injury alone and injury combined with NPC grafts elicit virtually identical early transcriptomic responses in host CST neurons. However, in mice with injury alone this regenerative transcriptome is downregulated after two weeks, whereas in NPC-grafted mice this transcriptome is sustained. The regenerative transcriptome represents a reversion to an embryonic transcriptional state of the CST neuron. The huntingtin gene (Htt) is a central hub in the regeneration transcriptome; deletion of Htt significantly attenuates regeneration, which shows that Htt has a key role in neural plasticity after injury.

​Nearly one in 25 American adults has serious mental illness, which means odds are someone in your life is coping with anxiety, depression, OCD, bipolar disorder or another debilitating condition. Still, shame about mental illness — likely a holdover from when people wrongly believed such conditions were character flaws or a mother’s fault — can make it hard to seek help or even know what to say to those who struggle. To shine a light on the daily realities of mental illness, Good Housekeeping and the National Alliance on Mental Illness (NAMI) surveyed more than 4,000 people, and found that over a third had a close friend or relative with mental illness. In our special package on how to support loved ones with mental illness, women who live with these widely misunderstood psychological issues share what it feels like, and how you can make a difference.

Going through a frightening or heart-wrenching experience — losing a loved one, being injured or assaulted, witnessing an act of violence, even living through a pandemic — triggers a range of emotions, from sadness to anger to fear. For most people, the intensity of those feelings fades over time. But for the 6 to 7% of Americans who will suffer from post-traumatic stress disorder at some point in their life, the feelings can linger for months or years, and can even get worse over time.
“I would have reenactments of the sexual abuse I experienced,” says Rachel, 34, from Danville, PA. “I would have the same physical feelings and shortness of breath that I had when it was happening, and at times I would even disassociate. It was almost as if my vision was coming from above me and I was watching myself go through it. There was this intense feeling that I was living in one reality that was physical and another reality that was emotional, but no one could see the second reality except me.”

​For some people, no matter how much they may want to leave the past in the past and move on with their lives, the flashbacks don't stop. “It plays in a constant loop in my head, like a movie. Even though I wish I wasn’t watching it, it pops on whenever it feels like it,” explains Melony, 38, from Baltimore. Simple, everyday interactions can trigger her PTSD, which stems from domestic abuse and assault. “Even a stranger getting too close to me makes me feel like I have to back away or run because they’re going to hurt me. It could be someone just looking at me — I get paranoid and feel like they’re trying to grab me.”
In addition to avoiding certain people and places, people with PTSD may feel like they’re constantly unsafe and on edge, which can affect their relationships. They may become detached emotionally as a protective mechanism, Dr. Weinstein says, adding that one of the most common symptoms is recurring nightmares and difficulty sleeping. It can sometimes be difficult for friends and family to understand why the person with PTSD continues to have trauma, even years after the event, which leads to further feelings of isolation. “Two people can experience the same events very differently, Dr. Weinstein says. “They can have a different interpretation and what happened may have a different impact on them.”

​When dealing with PTSD, support from loved ones is crucial. Here are ways you can be an ally to someone struggling:

• Don’t imply that there's a deadline for "getting over" it: Never say to a person with PTSD, But that happened so long ago, can’t you just move on? “This is not like breaking a bone, where it heals and you’re over it. The timeline is very variable,” says Dr. Weinstein. “For some people, it will naturally fade over time, but for other people it can continue to be very real and present in their daily life.”
• Listen without judgment: Instead of trying to explain away your friend’s fears or challenge their memory of the trauma, give them the freedom to be in charge their own narrative. “When you’re talking to someone who’s experienced emotional abuse, letting them be an expert on their life is so vital,” says Rachel, who explains that an abuser often convinces his victim that her feelings have no value and her words are unbelievable. Simply listening and asking "Can you tell me more about that?" is a powerful gift, she says.
• Ask about triggers and help make a plan: If your friend or family member knows that certain things can set off flashbacks or panic attacks (loud noises, news footage of war zones, or family gatherings, for example), ask in advance how you can help if they need it, and follow their lead.
• Don’t try to put a positive spin on the past: It can be really hard to hear about someone else’s trauma, so you may be tempted to say something like, “Well at least you weren’t permanently injured,” or “At least they finally arrested the guy.” Rachel says this happens quite often. “It makes me feel like I’m supposed to have thankfulness for what happened to me." Sitting with your friend while they talk about the most difficult parts of their story can help provide the sense of safety and trust they are trying to rebuild.

​The COVID-19 crisis has made life more challenging for everyone — especially those who are struggling with a mental illness. Visit NAMI’s COVID-19 Resource and Information Guide for additional advice. For more info on PTSD, visit the PTSD Alliance.

​by Scott Berinato  March 23, 2020 at Harvard Business Review - Click HERE for original link to article

​HBR Staff/d3sign/Getty Images

Some of the HBR edit staff met virtually the other day — a screen full of faces in a scene becoming more common everywhere. We talked about the content we’re commissioning in this harrowing time of a pandemic and how we can help people. But we also talked about how we were feeling. One colleague mentioned that what she felt was grief. Heads nodded in all the panes.
If we can name it, perhaps we can manage it. We turned to David Kessler for ideas on how to do that. Kessler is the world’s foremost expert on grief. He co-wrote with Elisabeth Kübler-Ross On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss. His new book adds another stage to the process, Finding Meaning: The Sixth Stage of Grief. Kessler also has worked for a decade in a three-hospital system in Los Angeles. He served on their biohazards team. His volunteer work includes being an LAPD Specialist Reserve for traumatic events as well as having served on the Red Cross’s disaster services team. He is the founder of www.grief.com, which has over 5 million visits yearly from 167 countries.  Kessler shared his thoughts on why it’s important to acknowledge the grief you may be feeling, how to manage it, and how he believes we will find meaning in it. The conversation is lightly edited for clarity.

HBR: People are feeling any number of things right now. Is it right to call some of what they’re feeling grief?
Kessler: Yes, and we’re feeling a number of different griefs. We feel the world has changed, and it has. We know this is temporary, but it doesn’t feel that way, and we realize things will be different. Just as going to the airport is forever different from how it was before 9/11, things will change and this is the point at which they changed. The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.

You said we’re feeling more than one kind of grief?
Yes, we’re also feeling anticipatory grief. Anticipatory grief is that feeling we get about what the future holds when we’re uncertain. Usually it centers on death. We feel it when someone gets a dire diagnosis or when we have the normal thought that we’ll lose a parent someday. Anticipatory grief is also more broadly imagined futures. There is a storm coming. There’s something bad out there. With a virus, this kind of grief is so confusing for people. Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety. We’re feeling that loss of safety. I don’t think we’ve collectively lost our sense of general safety like this. Individually or as smaller groups, people have felt this. But all together, this is new. We are grieving on a micro and a macro level.

What can individuals do to manage all this grief?
Understanding the stages of grief is a start. But whenever I talk about the stages of grief, I have to remind people that the stages aren’t linear and may not happen in this order. It’s not a map but it provides some scaffolding for this unknown world. There’s denial, which we say a lot of early on: This virus won’t affect us. There’s anger: You’re making me stay home and taking away my activities. There’s bargaining: Okay, if I social distance for two weeks everything will be better, right? There’s sadness: I don’t know when this will end. And finally there’s acceptance. This is happening; I have to figure out how to proceed.
Acceptance, as you might imagine, is where the power lies. We find control in acceptance. I can wash my hands. I can keep a safe distance. I can learn how to work virtually.

When we’re feeling grief there’s that physical pain. And the racing mind. Are there techniques to deal with that to make it less intense?
Let’s go back to anticipatory grief. Unhealthy anticipatory grief is really anxiety, and that’s the feeling you’re talking about. Our mind begins to show us images. My parents getting sick. We see the worst scenarios. That’s our minds being protective. Our goal is not to ignore those images or to try to make them go away — your mind won’t let you do that and it can be painful to try and force it. The goal is to find balance in the things you’re thinking. If you feel the worst image taking shape, make yourself think of the best image. We all get a little sick and the world continues. Not everyone I love dies. Maybe no one does because we’re all taking the right steps. Neither scenario should be ignored but neither should dominate either.

Anticipatory grief is the mind going to the future and imagining the worst. To calm yourself, you want to come into the present. This will be familiar advice to anyone who has meditated or practiced mindfulness but people are always surprised at how prosaic this can be. You can name five things in the room. There’s a computer, a chair, a picture of the dog, an old rug, and a coffee mug. It’s that simple. Breathe. Realize that in the present moment, nothing you’ve anticipated has happened. In this moment, you’re okay. You have food. You are not sick. Use your senses and think about what they feel. The desk is hard. The blanket is soft. I can feel the breath coming into my nose. This really will work to dampen some of that pain.

You can also think about how to let go of what you can’t control. What your neighbor is doing is out of your control. What is in your control is staying six feet away from them and washing your hands. Focus on that.
Finally, it’s a good time to stock up on compassion. Everyone will have different levels of fear and grief and it manifests in different ways. A coworker got very snippy with me the other day and I thought, That’s not like this person; that’s how they’re dealing with this. I’m seeing their fear and anxiety. So be patient. Think about who someone usually is and not who they seem to be in this moment.

One particularly troubling aspect of this pandemic is the open-endedness of it.
This is a temporary state. It helps to say it. I worked for 10 years in the hospital system. I’ve been trained for situations like this. I’ve also studied the 1918 flu pandemic. The precautions we’re taking are the right ones. History tells us that. This is survivable. We will survive. This is a time to overprotect but not overreact.
And, I believe we will find meaning in it. I’ve been honored that Elisabeth Kübler-Ross’s family has given me permission to add a sixth stage to grief: Meaning. I had talked to Elisabeth quite a bit about what came after acceptance. I did not want to stop at acceptance when I experienced some personal grief. I wanted meaning in those darkest hours. And I do believe we find light in those times. Even now people are realizing they can connect through technology. They are not as remote as they thought. They are realizing they can use their phones for long conversations. They’re appreciating walks. I believe we will continue to find meaning now and when this is over.

What do you say to someone who’s read all this and is still feeling overwhelmed with grief?
Keep trying. There is something powerful about naming this as grief. It helps us feel what’s inside of us. So many have told me in the past week, “I’m telling my coworkers I’m having a hard time,” or “I cried last night.” When you name it, you feel it and it moves through you. Emotions need motion. It’s important we acknowledge what we go through. One unfortunate byproduct of the self-help movement is we’re the first generation to have feelings about our feelings. We tell ourselves things like, I feel sad, but I shouldn’t feel that; other people have it worse. We can — we should — stop at the first feeling. I feel sad. Let me go for five minutes to feel sad. Your work is to feel your sadness and fear and anger whether or not someone else is feeling something. Fighting it doesn’t help because your body is producing the feeling. If we allow the feelings to happen, they’ll happen in an orderly way, and it empowers us. Then we’re not victims.

In an orderly way?
Yes. Sometimes we try not to feel what we’re feeling because we have this image of a “gang of feelings.” If I feel sad and let that in, it’ll never go away. The gang of bad feelings will overrun me. The truth is a feeling that moves through us. We feel it and it goes and then we go to the next feeling. There’s no gang out to get us. It’s absurd to think we shouldn’t feel grief right now. Let yourself feel the grief and keep going.

Scott Berinato is a senior editor at Harvard Business Review and the author of Good Charts Workbook: Tips Tools, and Exercises for Making Better Data Visualizations and Good Charts: The HBR Guide to Making Smarter, More Persuasive Data Visualizations.

​by Aarti Gupta, PsyD - Originally Published in  ANXIETY AND DEPRESSION ASSOCIATION OF AMERICA

Since the World Health Organization declared the COVID-19 outbreak a global pandemic, many of us, even those who have not been infected by the virus, will choose to quarantine in our homes for the upcoming weeks. Capsized travel plans, indefinite isolation, panic over scarce re-sources and information overload could be a recipe for unchecked anxiety and feelings of isolation. Here are a few pointers that could help you survive spiraling negative thoughts about this uncertain time.

1.) Reframe “I am stuck inside” to “I can finally focus on my home and myself”
As dismal as the world may feel right now, think of the mandated work-from-home policy as an opportunity to refocus your attention from the external to the internal. Doing one productive thing per day can lead to a more positive attitude. Set your sights on long-avoided tasks, reorganize, or create something you’ve always wanted to. Approaching this time with a mindset of feeling trapped or stuck will only stress you out more. This is your chance to slow down and focus on yourself.

2.) Stay close to your normal routine
Try and maintain some semblance of structure from the pre-quarantine days. For those individuals with children, sticking to a routine might be easier; however as you work from home, it could be tempting to fall into a more lethargic lifestyle, which could lead to negative thinking. Wake up and go to bed around the same time, eat meals, shower, adapt your exercise regimen, and get out of your PJ’s. Do laundry on Sundays as usual. Not only will sticking to your normal routine keep you active and less likely to spiral, it will be easier to readjust to the outside world when it’s time to get back to work.

3.) Avoid obsessing over endless Coronavirus coverage
Freeing up your day from work or social obligations gives you plenty of time to obsess, and if you have a tendency to consult Google for every itch and sneeze, you may be over-researching the pandemic as well. Choosing only certain credible websites (who.int or cdc.gov is a good start) for a limited amount of time each day (perhaps two chunks of 30 minutes each) will be in your best interest during this time.

4.) A chaotic home can lead to a chaotic mind
With all the uncertainly happening outside your home, keep the inside organized, predictable and clean. Setting up mental zones for daily activities can be helpful to organize your day. For example, try not to eat in bed or work on the sofa- just as before, eat at the kitchen table and work at your desk. Loosening these boundaries just muddles your routine and can make the day feel very long. Additionally, a cluttered home can cause you to become uneasy and claustrophobic of your environment- so keep it tidy.

5.) Start a new quarantine ritual
With this newfound time, why not do something special during these quarantined days? For ex-ample, perhaps you can start a daily journal to jot down thoughts and feelings to reflect on later. Or take a walk every day at 4pm, connect with your sister over FaceTime every morning, or start a watercolor painting which you can add to everyday. Having something special during this time will help you look forward to each new day.
​
6.) Use telehealth as an option to talk to a professional if your anxiety becomes unmanageable
Many licensed psychologists are offering telehealth options over HIPAA-compliant video chat platforms. Remember to reach out for help if your anxiety is reaching proportions that is unmanageable without professional help.
Letting go of illusions of control and finding peace in the fact that you are doing your part to “flatten the curve” will certainly build mental strength to combat the stressful situation the whole globe is experiencing

​About the Author
Dr. Aarti Gupta, PsyD is Founder and Clinical Director at TherapyNest, A Center for Anxiety and Family Therapy in Palo Alto, California. She specializes in evidence-based treatment for a wide spectrum of anxiety disorders, including OCD, panic disorder, social anxiety, trichotillomania, and generalized anxiety disorder. Dr. Gupta serves on ADAA's public education committee.

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On This Page

• Reducing stress in yourself and others
• Information for parents
• Information for responders
• Information for people released from quarantine

Stress and Coping
The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. Coping with stress will make you, the people you care about, and your community stronger.

Everyone reacts differently to stressful situations.  How you respond to the outbreak can depend on your background, the things that make you different from other people, and  the community you live in.
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
• People who have mental health conditions including problems with substance use

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others call

• 911
• Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)


• 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

People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Additional information can be found at the Substance Abuse and Mental Health Services Administration (SAMHSAexternal icon) website.

Taking care of yourself, your friends, and your family can help you cope with stress. Helping others cope with their stress can also make your community stronger.

Things you can do 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.

Reduce stress in yourself and othersSharing the facts about COVID-19 and understanding the actual risk to yourself and 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.
Learn more about taking care of your emotional health.
For parentsChildren 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.

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 behaviors they have outgrown (for example, toileting accidents or bedwetting)
• Excessive worry or sadness
• Unhealthy eating or sleeping habits
• Irritability and “acting out” behaviors in teens
• Poor school performance 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 many things you can do 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 ok 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.

Learn more about helping children cope.

For responders
Responding to COVID-19 can take an emotional toll on you. There are things you can do 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.


• Learn more tips for taking care of yourself during emergency response.

For people who have been released from quarantine
Being separated from others if a healthcare provider thinks you may have been exposed to COVID-19 can be stressful, even if you do not get 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, even though you have been determined not to be contagious
• 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 or have other strong emotions if they, or someone they know, has been released from quarantine. You can help your child cope.

Resources
For Everyone

• Coping with a Disaster or Traumatic Event

For Communities

• Coping with stress during an infectious disease outbreakpdf iconexternal icon
• Taking Care of Your Behavioral Health during an Infectious Disease Outbreakexternal icon

For Families and Children

• Helping Children Cope with Emergencies
• Coping After a Disasterpdf icon – A Ready Wrigley activity book for children age 3-10

For First Responders

• Emergency Responders: Tips for taking care of yourself
• Disaster Technical Assistance Centerexternal icon  (SAMHSA)