Covid-19 – Psychological Survival

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I started off blogging about how to talk to kids about covid-19. Things have significantly escalated since then and we are in the midst of a worldwide pandemic that this generation and generations before of us have never had to endure. It is important to consider our own self-care, now, if we need to self-isolate and what happens afterwards.

The first thing we should do and continue to do is to follow the advice of the Public Health doctors in the HSE. Before we can be psychologically safe we need to be as physically safe as we can be so we need to not only heed the medical advice but embed it in our new routines, it needs to become our mantra.

FOLLOW THE ADVICE

WASH YOUR HANDS

Unless you’ve been living under a rock for the last few weeks you’ll have seen signs, ads, posters, radio, tv, social media ads reminding you of the importance of hand washing to reduce the risk of contamination from covid-19. We do it every day (or we should have been). Now we need to do it more and make sure that our kids / friends / families also adhere to it. It’s a small but important essential part of our new routine. Like any habit we need to keep doing it until it becomes second nature, when we do it without thinking because we instinctively and automatically know it’s the right thing to do. Washing your hands is also important psychologically because it gives you a sense of control, a way of keeping yourself and other safe when there is so much danger going on in the world around you. It may only take the edge of your anxiety but every little thing counts.

PHYSICAL DISTANCING

The majority of the advice on this has been advocating social distancing. I went along with this in the beginning but a number of learned commentators have changed my mind on the relevance of the wording of this advice. Either way the most important message is keep you distance from others and reduce the risk of infection and contamination, from others or from you contaminating others. You may be asymptomatic and not know you are infecting others. Some of the best advice I’ve read has been view yourself as symptomatic and contagious even if you’re not and keep your distance from others. For me physical distancing vs social distancing is an important differentiation, more on this later.

STAY AT HOME

There are nurses, doctors, porters, health care assistants, health & social care professionals all around the world who get up every day and spend 12+ hour shifts, leaving their loved ones at home, risking infection and tragically for some, death, to keep us safe. You’re being asked to stay at home, not congregate, maintain physical distance from others, it’s the least we can do for our health care professionals and for our loved ones. Ask yourself the question before you leave the house, do I really need to go? Yes it is painful to have to be cooped up at home for period of time, it could even lead to some of suffering isolation, loneliness, anxiety, boredom, irritation, anger, all unpleasant, but generally short term & not nearly as unpleasant as death, there’s no coming back from that.

To Psychologically survive Covid-19 we must physically stay alive, make that your first priority for yourself and others.

FAKE NEWS

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This is an important starting point in our psychological survival guide. Fake News is a challenge at the best of times, seeing dramatic and catastrophic click-bait headlines on social media or whatsapp messages sent to us multiple times. We need to do a couple of things to combat this:

Maintain a healthy degree of skepticism about what we read / see on social media and actively wonder about whether some of the content could be click-bait

The WHO have partnered with Whatsapp to provide up to date and accurate information on covid-19 (vs the usual nonsense we’ve all been receiving forwarded on whatsapp)

Stick to reliable / reputable / trustworthy sources of information such as the HSE

WHO have an excellent Myth Busters section on their website that can counter fake news and panics

Take a break from social media, we’re at less risk of being vulnerable to fake news about corona-19 if we’re not constantly on it

ROUTINE

When something as big and dramatic as a worldwide pandemic occurs it interferes with our daily routine. Limits have been imposed i on where people can go / travel / school / work / sporting occasions etc. Routine’s reassure us, they make the world feel predictable, we don’t need to think as much or worry because things follow a pattern, they’re predictable.

That’s where Covid-19 has been having such a negative psychological impact, it’s knocked out routines, we can’t predict with any degree of certainty how long this will last or whether we will contract the virus or not.

Unpredictability and uncertainty feeds and fuels anxiety and panic. Routine while not a complete antidote to it will take the edge off it and sometimes that’s realistically as much as we can hope for.

What we need to remember about routines is that they take time to build and develop, they don’t happen magically or overnight, we need to put time, planning and effort into them in advance, they rarely if ever sprout up spontaneously. Now that much of the world is on essentially lock down the routines we are used to have been pretty much thrown out the window and many people are struggling with this.

What we need to do is at a minimum the night before plan what are we going to do the next day, or preferably plan a few days in advance. This is where technology can be our friend. My go to for routine and planning is my google calendar. I can see at a glance when I look at a day / week what’s coming up, what I need to do, where I need to be, and what fun / enjoyable things I have coming up. The key to this is to use different coloured calendars so we can see at a glance what things are, especially the fun / enjoyable things:

We don’t want to lose our spontaneity but we do need to find some degree of certainty in our lives when we are currently trying to cope with so much uncertainty. Scheduling in lunch, dinner, chat’s, book reading makes sure that we are less likely to forget the important things.

FOUR KEY ROUTINES FOR PSYCHOLOGICAL SURVIVAL

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In general there are four key foundations that give us the potential for not only psychological survival but give us the possibility of enhanced psychological well-being. The analogy I use the most is a table. It has four key legs to keep it stable and strong. All four are equally important and need to be equal in length for the foundation to be balanced and strong. If any of the four are neglected or if we do too much of any one of them then it will knock us off balance and it will be harder for us to cope with the challenges of every day life, never mind the enormity of covid-19. Lets look at each of them in turn:

SLEEP

When we’re out of routine we often neglect one of the most important aspects of our self-care, sleep. We might stay up too late watching a box set knowing we don’t have to be up in the morning or stay in bed way beyond what we usually would. For a prolonged period of isolation it is inevitable that there will be some times where we will go to sleep later / get up later. What we need to try and do is make sure that it doesn’t become a pattern, for ourselves or our kids. When covid-19 comes under control, we will need to adapt back to our pre covid-19 lives again, this will be easier when our imposed isolation routines are not too out of sync with our previous routines.

The other aspect of covid-19 that will impact on our sleep routines is worry / anxiety. It is understandable that we are at risk of lying in bed thinking about lots of “what if”, what if I get it / a family member gets it / if someone I loves gets so sick they die. No matter how long / how many angles you think about it from while lying in your bed trying to sleep, it won’t change the risks or the reality of covid-19. The only thing it will change is your tiredness levels and ability to think straight and emotionally cope the next day. Prioritise a good sleep routine.

SOCIAL

It is crucially important for our psychological well-being to be socially connected to others. With covid-19 resulting in self or imposed isolation we could go through period (maybe even an extended one) where it is difficult or not possible to be as socially connected as we are used to. So what do we do to maintain our sense of connectedness? As bad as a rap as it gets sometime this is were technology and social media can play an important interim role:

Whether it’s whatsapp video chat, Facetime, Skype or any other video communication tool, at this time it can be an important facility to maintain safe social contact with others irrespective of where we are or what our medical status is. It will never replace face to face person to person contact, but as a temporary measure it can meet our needs for social connectedness and reduce risks of isolation and loneliness. Given that some people are not as technically minded as others, here’s a link to setting up a whatsapp video chat (up to 4 people at the same time)

People are adapting to this (not that new but now less maligned) way of communicating and are organising virtual playdates, coffee (or wine) chats via video chats.

We know that loneliness and isolation is particularly hard for those in our communities that are elderly. It is something they struggle with at the best of times but even more so now when they have to be distant from family & friends because of their increased vulnerabilities to covid-19. Some grandparents have adapted wonderfully to modern technology and are as digitally native as your average teenager. Others find it more difficult. We should not let this impede us finding whatever ways we can to support and connect with them. If they can’t follow a youtube instruction on setting up a whatsapp video call, print it off, hand write it, call them on the phone and talk them through it.

Irrespective of the manner of communication, standard phone or video call, try to set a day / time that you will call at. For an elderly person living at home alone, through enforced isolation the loneliness can be excruciating, spending hours looking at the phone wishing it would ring, knowing the door bell is unlikely to ring. Make a new routine, every 2nd or 3rd day you ring at for example 6pm for a chat. Knowing that call is coming, having something to look forward to can give an elderly person something to get through the day. They will have supported us most of our lives, it’s the least we can do for them.

We’ve witnessed already the incredible support and altruism that people are capable of with social media being the means of facilitating this through #Selfisolationhelp #selfisolation

This will be particularly important for teenagers. During periods of isolation and shut-down out teens will rely on social media and their phones much more than they would usually do. We will need to be more flexible and understanding of their need to feel and stay connected to their peers but we will also need to keep some minimum boundaries on it’s use too.

EXERCISE

Exercise is a well known mood enhancer. With isolation we might be at risk of telling ourselves well I shouldn’t go the gym / football training so I can’t exercise. A quick google search or any free exercise app on our phones will give us a myriad of exercises that we can complete at home or weather permitting in our gardens. Regular exercise will protect both our physical and mental health

FOOD

When we’re out of routine our healthy food habits and routines can slip also. We need to try and maintain our routines around eating and also resist the temptation to over indulge in alcohol or caffeine (both will negatively impact on our mood and anxiety levels).

MANAGING OUR EMOTIONS

The very existence of Covid-19 and how much it is now a constant on our news, social media and conversations means that there is a strong likelihood that we will be experiencing a wide range of challenging feelings with the following being the most likely:

Anxiety

Frustration

Anger

Irritation

Boredom

Most of the above will be normal reactions to trying to manage the realities of the stress of covid-19. What makes it extra difficult is that the degree of uncertainty that exists about how long this will go on for or how serious it could get for each or us and our loved ones.

In this situation, Anxiety is likely to be one of our biggest challenges. We will be bombarded by news cycles of infection rates, news of people who have died, enforced closures of places and events which will only fuel our anxiety. Worrying about the worst is an understandable reaction, especially in light of the WHO designating Covid-19 as a worldwide pandemic, it would be more unusual if you weren’t worried about the implications of Covid-19.

The challenge for all of us is differentiating between symptoms of anxiety (upset tummy, tension, aches, pains, increased heart beat, shortness of breath) and then mis-interpreting those as being signs of covid-19. It’s not unexpected for us to catastrophise and think of the worst outcome when we feel any physical symptoms in our body. As I mentioned earlier in the blog, stick to reputable sources of information from the HSE or WHO and please recognise that “Dr Google” will only increase not decrease our anxiety. It’s also important when we’re feeling anxious to check in with friends and loved ones. There’s a high likelihood that they will have been feeling anxious too. It helps to know we’re not the only ones that feel a particular way. Anxiety is our bodies response to threat, perceived or real. What is draining for us is being in a constant state of alertness for threat and danger.

Self-care and self-compassion is never more important than now.

One way of doing this is not to wake up each day wondering “What will I / we do today”. Make a schedule, preferably written, of plans for the day ahead. Use the time to re-discover things that might have gotten previously lost in the hectic busyness of life, books we meant to read, albums we want to re-listen to, board games we can play as a family, movies we could watch together. Don’t leave it to chance, schedule them.

Boredom is a sure fire recipe for anxiety to take a hold in our minds and increase our stress levels. The busier we can be the less time we have to think / overthink. It’s crucial to focus on what we can and can’t control. Focusing on what is out of our control will only make us feel more anxious.

No one of the above will exclusively protect us psychologically, at different times different combinations will be more effective. The one constant that will protect us more than anything? Hope. Hope is crucial, it gives us energy to keep going, for ourselves and others. When we feel despair at the latest catastrophic headline, we need to try to keep hope, hope is our psychological antidote to anxiety, sadness and despair, When we can’t find it in ourselves reach out to others, we don’t need to be alone, we shouldn’t be, together we will find a way to get through this, our strength is in our collective unity and out willingness to be there for each other.

HOPE

It is probably, borrowing an old Dublin phrase “stating the bleedin obvious” to recognise that we are going through (literally) a world of pain right now and pain and death are inevitable parts of the human experience. In saying that the level of pain and death currently occurring is on a scale not witnessed in many generations. As tragic as this is it doesn’t mean that we have to suffer. The antidote to suffering? Hope.

When we keep hope that we will get through this it will give us the energy to get up in the morning, to volunteer, to support our friends and families, to keep trying, to survive the grief and losses that could accumulate and risk overwhelming us. Hope is the indomitable spirit that endures, hope is what will ultimately be the bedrock upon which we will rebuild our lives and our world post covid-19.