The COVID-19 pandemic has been a novel and challenging experience, likely leading to increased levels of stress and the use of additional self-care and coping strategies to stay healthy and well.
Everyone handles these tough situations differently based on their current level of stress, current or past experience with mental health concerns or symptoms, and their capacity to cope and stay resilient. Challenges to mental health are experienced by everyone in unique ways, so it is important to be mindful of and monitor for changes that are new for you and your experience.
For individuals facing pre-existing mental health symptoms or diagnoses, the pandemic and its associated stress can exacerbate mental health concerns, particularly for individuals that are unaware of their positive coping skills. It is normal to feel overwhelmed, unwell and challenged to maintain functioning and rational thinking during such a novel and difficult situation.
Impact of COVID-19 on mental health
The impact and uncertainty of COVID-19 will be felt differently by everyone. Diseases, like other stressful life situations, challenge our resilience and our coping skills. Worry or anxiety about our own personal safety and the safety of others is common and completely normal as we learn about the virus and its consequences. These reactions can be worsened by other distressing events or worries, particularly those that are unexpected, traumatic, health or infectious disease-related, or ones which have previously compromised our personal safety or the safety of others.
The pandemic can also increase mental health concerns as a result of increased stress and reduced coping strategies. The loss of employment or economic instability can lead to financial strain, and housing and food insecurity. These catastrophic outcomes or worries can significantly impact mental health and worsen our feeling of being unsafe. A disruption in routine and social distancing restrictions can mean imbalances in work and home life and roles, it could present challenges to maintain proper self-care and quality sleep, or even impact your ability to access necessary medical or psychiatric care. Social distancing restrictions also challenge our ability to access professional and social systems of support which can make it more challenging to reduce stress.
Increased stress can influence our thinking and understanding
When faced with new or increased stress or fear, such as the COVID-19 virus, we experience a physiological response known as the fight, flight, or freeze response. This response floods our body with stress hormones which can impact cognition, your sensing, thinking, processing, and understanding, in many ways. It becomes more difficult to think clearly, to recognize or challenge automatic thoughts and beliefs, and to respond rationally. The stress hormones make it difficult to access the part of our brain responsible for reasoning and advanced thinking. You may experience intrusive or unwanted negative thoughts or images, or rumination, which can be distressing and anxiety-provoking. Individuals with previous trauma experiences may be triggered by the pandemic and have flashbacks or nightmares as well. You may become hypervigilant or unusually sensitive to sensations or symptoms you experience, or even anxious or paranoid about your own, or others, risk of infection. These negative beliefs and thinking patterns may elicit a shift in your view of yourself, your trust or belief in others, and your perspective of the world as you hear about the impacts of the virus and try to navigate the worry of what the future has in store.
Uncertainty and negative thinking can impact mood and emotions
A wide range of emotions are common or normal during this challenging time, from feelings of sadness and loss of pleasure, grief, confusion, or even frustration as we struggle to understand and process this new normal. As the uncertainty about the future impacts your thinking and perspective of yourself, others, and the world, you may become exceedingly anxious, depressed, or angry about the impact of the pandemic on your life and your mental health. Shifts in understanding and perspective, and challenges to manage negative or worry thinking as a result of COVID-19, can also lead to an increase in anxiety and depression symptoms, including fear, pessimism, or even feelings of hopelessness and suicidality.
Difficult emotions can impact your behaviours and routines
As a result of difficult emotions, shifts in mood, and challenges to ordinary thinking, it is common to experience a variety of behavioural reactions as well. The stress or overwhelm of the pandemic can lead to withdrawal from social connection and activities that you once enjoyed. A disruption in routine and challenges with coping can lead to unusual outbursts of emotion and mood swings. Decreased concentration and motivation can make it difficult to complete daily chores, participate in exercise or self-care, and achieve goals, which can exacerbate feelings of anxiety and depression. Without positive coping skills and social supports, you may find yourself coping using food, alcohol, drugs, or increased medication use, and suicidal ideation may increase as well.
Stress hormones can activate physical sensations and symptoms
An increase in stress, fear, and emotion can lead to new or increased physical sensations or bodily experiences through the release of the stress hormones from the fight, flight, freeze response. Persistently high levels of these hormones can result in muscle tension, headaches or migraines, frequent nausea, and even increased heart rate and shortness of breath. They can also make it difficult to engage in moderate exercise, to achieve quality sleep, and lead to weight gain and a general feeling of being unwell. This decrease in physical fitness, nutrition, and sleep, can lead to feelings of fatigue and exhaustion, as well as a reduction in our immune system and our body’s ability to fight back against mental and physical illness.
Monitoring your mental health
The pandemic will influence each individual’s unique capacity for mental wellness and resilience in a different way. This means that you will need to monitor for changes to behaviour that are new or unusual for you and your experience. Self-awareness is critical as experiences or symptoms that are reflective of an increase in stress or a decline in mental health and coping may not be experienced or interpreted the same way by others.
Some important signs to be mindful of include:
Changes in sleep, eating, and exercise patterns
Withdrawal from social connection, hobbies, and other pleasurable activities that are not directly impacted by the pandemic and social distancing restrictions
Decrease in self-care, hygiene, and inability to complete chores or everyday tasks
Increase in mood swings, irritability, and outbursts, especially if recognized by others
Increase in suicidal or homicidal ideation or intention to harm one’s self or others
Increase in muscle tension, headaches, nausea, and fatigue
Irregular use or termination of psychiatric medications
Increase in substance use or other addiction and risky behaviours
Strategies for Staying Mentally and Physically Well
Maintaining routines that are healthy for your body is a critical foundation for preserving mental health and wellbeing. Some body-based strategies include:
Maintaining proper sleep hygiene and routines to ensure you are getting quality sleep
Engaging in regular moderate exercise which could be at home or going for walks outside
Eating nutritious well-balanced meals throughout the day to ensure you are providing your body with the energy it needs
Taking your medication and supplements as prescribed by your health practitioner or psychiatrist, keeping them informed of changes to your mental health which may require adjustments in your medication.
Negative or inaccurate thinking patterns can lead to increased worry and a decline in mental health. Cognitive strategies for staying mentally well focus on being mindful of one’s thoughts, assessing if they are facts based in evidence, and understanding the impact they have on mood and behaviour. Some thought-based strategies include:
Staying mindful and being in the present moment, the here and now, while trying not to predict the future or fixate on the past.
Challenging negative or damaging thinking and perspectives. Are these thoughts based in fact and evidence or are they beliefs about yourself and others which may be skewed?
Assessing if a thought is a worry or “what-if” situation, or if the problem is real and needs attention or a solution. Focus on solving problems you can control and let go of things beyond your control.
Scheduling or delaying worry time for when it is more convenient if you are finding it difficult to move past it and focus or accomplish other tasks. Don’t let worry consume your every day and every thought.
Seeking optimism and positive thoughts or perspectives. View challenges as an opportunity to learn and grow and believe in your ability to cope and succeed.
Practicing gratitude, even in challenging times. Thinking of 3 good things each day can have huge benefits, even if they are small wins.
Seeking or using humour to reduce stress and break negative or ruminating thinking patterns.
Emotional expression is essential to processing difficult emotions which can have damaging impacts if they are suppressed or ignored. Emotional strategies for coping focus on processing difficult emotions by being mindful of them, understanding where they come from, and recognizing their impact. These include:
Believing that all emotions are normal under periods of added stress and overwhelm. Embrace these emotions without judgment and name them for what there are.
Assessing where specific emotions are coming from. Anger is a secondary emotion often masking sadness, fear, or hurt. Take some time to think about your feelings and understand what has triggered them.
Writing down the feelings you are experiencing as this can help to name them, understand where they are coming from, and process them, allowing you to heal and let them go. This could mean journaling or even writing stories that represent your experience.
Talking about the feelings and thoughts with positive social supports can be even more beneficial to healing and processing.
Building helpful routines and structure are essential to happiness, achievement, and overall wellbeing. Behavioural strategies for coping with mental health challenges involve positive activity scheduling, monitoring self-care, and sticking to a schedule even if it is different than your usual routine. These include:
Taking some time for self-care to reduce stress, including meditation, prayer, music, dancing, reading, yoga, or even sitting with nature. Think about what has helped in the past, and schedule these into your routine on a weekly basis to ensure you are doing things for yourself and continuing to experience pleasure in everyday life.
Setting small, achievable, goals each week to increase focus and productivity which will positively impact mood and motivation.
Scheduling time to be social and reach out to others to offer social support or help them in practical ways. The act of helping others can increase a sense of optimism and gratitude.
Taking breaks and setting boundaries when you need them. Use this time for relaxation, deep breathing, or grounding exercises to keep you in the present moment and reduce stress and overwhelm.
Educating yourself using credible sources and limiting your attention to negative or emotionally charged media. Try to stick to news that is factual and not publicity or conspiracy based.
Talking about suicidality. Adjust your suicide safety plan, as needed, if symptoms of suicidality increase, or reach out for professional support to create a safety plan if suicidal ideation is new for you.
Supporting Others Experiencing Changes in their Mental Health
If you have a colleague, friend, or family member that is experiencing changes to their mental health and overall functioning, they may come to you for support and guidance. Your response to their request for support can have a dramatic impact on their ability to stay resilient and move forward.
Here are some tips you can try to support others during difficult times:
Give them the opportunity to share their concerns and experiences without passing judgment.
Provide them with the support they need by asking what they are looking for help with, whether hands-on support, a listening ear, or someone to bounce ideas off.
Avoid providing unsolicited advice, especially to someone who you don’t have a close relationship and understanding with.
Reassure them that their emotions and experiences are normal so they feel validated and supported, even if they seem unusual or different.
Listen fully and paraphrase or reflect back their experiences and emotions so they feel appreciated, cared for, and understood.
Use empathy to understand the other person’s perspective or story. Don’t sympathize or assume they experience the situation the same way you do.
Help them to brainstorm some positive coping strategies that they can use, talking to them about what has helped them to cope in the past.
Encourage talking to a professional, a crisis service, or contact emergency services if you are concerned about someone’s suicidal ideation.
Contact your Employee and Family Assistance Program for Support
If you are experiencing persistent or worsening mental health or emotional struggles as a result of COVID-19, or for any other reason, reach out to your EFAP program for support. A professional can help you to process emotions, recognize unhelpful thinking or behaviours, and begin the journey toward healing. We are here to help.