Coronavirus: How to Protect Your Mental Health During The Covid-19 Outbreak

Medical experts and scientists are focusing mainly on the physical aspects of the disease caused by the novel coronavirus (2019-nCoV pneumonia), treating the critically ill and trying to develop a vaccine or a cure.

Meanwhile, less attention is being given to our mental health. For example, how is the emergency affecting us? What can be the consequences of social isolation? Are some people getting overly anxious? What can we do to mitigate the psychological stress and existential worries that are naturally arising for most of us?

Uncertainty Causes Stress

The coronavirus pandemic is an example of a situation that our brain perceives as very uncertain. We do not know what is going to happen; we fear that the outcomes might turn out to be something other than expected. We don’t know how to safeguard our physical, mental and social well-being. This is a very stressful scenario for the human brain. In fact, according to neurobiologists, stress originates from uncertainty.

Researchers from the University of Luebeck in Germany, The Rockefeller University in New York, and the University College London explain that when we can’t avoid surprise, our cognitive systems try to reduce the uncertainty. In order to do that, a lot of cerebral energy is required. The extra energy is taken from other parts of the body, leading to a potential shortage, especially if the situation persists [1].

When a long-term energy crisis develops in the body, this can lead to a break down. For example, we know that persistent stress can damage our vascular system (leading to atherosclerosis, heart attack and stroke) [2] and the cell’s mitochondria (leading to systemic inflammation and cell ageing) [3]. Simply put, the emotional stress caused by uncertainty and ambiguity starts in the brain and ends in the body.

Psychological Contagion

Stress is not bad just for the body, however. The stressful situation connected with COVID-19 outbreak can be particularly taxing for our mental health, triggering mood swings, depression, anxieties and even symptoms of post-traumatic stress disorder - PTSD [4].

Studies on the psychological consequences of coronavirus are already underway. For instance, a group of Chinese scientists from the Naval Medical University in Shanghai found that 7% of the population in China’s hardest-hit areas experienced post-traumatic stress symptoms a month after the start of the COVID-19 epidemic [5]. Women and people with poor sleep quality were affected more severely. In the article, published in the Psychiatry Research, Dr Nianqui Liu and colleagues warn that such outbreaks of infectious disease have “significant potential for psychological contagion, and typically result in widespread fear, anxiety and a variety of psychological problems.”

Post-traumatic stress symptoms (PTSS) have also been reported in the previous SARS and H1N1 (swine flu) epidemics. Dr Maria Deja of the Department of Anesthesiology and Intensive Care Medicine at the Universitätsmedizin Berlin explains that PTSS follows traumatic occurrences outside the range of common human experience. It is usually associated with violent physical assaults, torture, accidents, rape, but also with natural disasters. PTSS is characterized by a typical symptom pattern of intrusions, persistence of trauma, stimuli avoidance, emotional numbing and physiological hyperarousal [4]. The most affected people are often those in the “impacted group” (they or their friends and family had been quarantined, or suspected of being infected), as well as health care workers [6].

The possible scenario sounds rather bleak. So, what can we do to reduce the feelings of uncertainty, fear and panic and stay as healthy and sound as possible in the time of coronavirus?

1. Distinguish facts from rumours

The media outlets are full of information on coronavirus. The language of the reports often involves a sense of urgency and crisis; such as “the virus is rapidly spreading”, “a global disaster”, “no one is allowed to go out”.  There is a near-constant stream of the latest updates on the virus, which can cause anyone to feel worried and anxious. People who are already prone to anxiety and obsessive-compulsive disorder (OCD) can be particularly vulnerable to the “onslaught” of news and recommendations.  

While it’s important to stay informed, we shouldn’t overdo it either, especially if we notice it makes us feel very stressed.  

Also, we need to make sure we get the facts, from reputable sources. To help maintain psychological and mental well-being, the WHO released some advice for the general population [7]:

• Avoid watching, reading or listening to news that cause you to feel anxious or distressed.
• Seek information mainly to take practical steps to prepare your plans and protect yourself and loved ones.
• Seek information updates at specific times during the day once or twice.
• Gather information at regular intervals, from the WHO website and local health authorities’ platforms.

In other words, don’t flood yourself with repetitive information that can be perceived as scary and anxiety-provoking.  Instead, be selective about where you get your news from and when you want to receive them.

2. Employ healthy coping strategies (think of those that have helped you in the past)

You must take good care of your basic needs during the COVID-19 outbreak, such as:

• ensure you get enough sleep and rest,
• eat healthy food,
• engage in outdoor physical activity (activities that don’t involve close contact).

While it might be tempting to resort to habits such as tobacco, alcohol or other drugs, you should try to avoid such unhelpful coping strategies. Keep in mind that in the long-run, they will worsen your mental and physical health.

Instead, think of the strategies that you have used in the past to manage stress. You probably already have a portfolio of good coping techniques you can employ in the current scenario, such as going for a run, doing pleasurable activities, writing a journal or watching your favorite sitcom on Netflix. Such activities can help you distance yourself from the stressors [8].

3. Keep a daily routine

Although the notion of a routine might seem dull, it can be very beneficial to our mental health to follow a predictable route. Experts agree that when you stick to a specific routine, you can ease the anxiety about the new [9]. Daily routines require less mental energy, bring fewer (unpleasant) surprises and, therefore, less unexpected stress. They somehow keep us grounded.

So, even if coronavirus made it necessary for you to change your habits and work patterns, try to establish new ones. For instance:

• have regular waking and bedtimes,
• develop a morning ritual, e.g. do some exercise and have breakfast,
• have set mealtimes,
• divide your day into a “working” part and a “fun” part,
• plan things that you need to do at certain days of the week,
• enjoy some revitalizing routines, such as having a cup of coffee between chores.  

Routines can be particularly useful to those whose work rhythm got disrupted by the coronavirus. While you have little influence over the effect the current situation will have on the economy, you can stay calm and productive in ways that matter at the moment.

4. Follow hygiene recommendations – but don’t get excessive

Prevention measures, such as washing and sanitizing hands, are at the top of the list of how to stop the pandemic. You should, of course, do what you can to follow the recommendations. However, it can be easy to take it a step too far and become overwhelmed with the constant worry. OCD Action, UK’s largest OCD charity, suggests that you should look out for the function of the task. For instance, is the washing being done to prevent the risk of spreading of the virus? Or, is it being done ritualistically, in a specific order because you need to feel “just right”?

5. Stay connected (with others and yourself)

To slow down the spread of the virus, we have been advised to cease all non-essential activities and tasks, stop socializing and limit our contacts. Those showing symptoms should self-isolate, which really means “go nowhere, see no one”. In reality, however, this can be hard to implement. Also, the stress of trying to keep physical distance can have consequences that can sometimes outweigh the benefits.

Digital technology makes it possible to remain in contact and foster connections, including establishing new ones. Make sure you stay connected with family and friends (via phone, email, social media).

Furthermore, in crisis situations, it is particularly beneficial to practise mindfulness, compassion and gratefulness – these are the positive psychology interventions that are the most established and evidence- backed [10]. Online resources can be extremely helpful, too, such as relaxation soundtracks, meditation recordings and hypnotherapy apps like Mindset.

Can You Put a Positive Spin on It?

The new coronavirus shouldn’t be taken lightly; however, we can transform the experience into something less hostile. For instance, this can be an opportunity to stop – at least for a short while – and press the reset button in our lives.

By spending more time at home, away from all the distractions, we can use the time to reflect on our lives, re-connect and prioritize. Perhaps, this can be an excellent time to develop new, healthier habits, such as spending more time in nature and having quality time with loved ones. You might even decide you want to take a new direction in life, for the better.

A Word from Mindset Health

It’s essential to take appropriate actions to contain the COVID-19 outbreak. To do that, you might need to adopt a different rhythm of life and adjust your habits and relationships. Think of this as just another period in your life, one that could also have some positive aspects to it. Make sure you take care of yourself and your needs. Digital health technology can be extremely useful during this time as it enables you to receive the support that you might need without any delays and from the comfort of your home (where you now need to spend more time than usual).