The Pandemic’s Mental Health Toll

From layoffs, to less in-person social interaction, to increased risk of illness, to childcare woes, the COVID-19 pandemic has come with no shortage of stress.

“Many people are facing a challenging combination of high workload, family obligations and limited time for themselves,” says Northwestern Medicine Psychologist Jacqueline K. Gollan, PhD.

Below, Dr. Gollan offers advice for people coping with additional stress during the COVID-19 pandemic.

Assess Your Stress

There are three main types of stress. Each comes with its own warning signs. If stress starts to interfere with your daily tasks, that’s a good indication it’s time to talk to your primary care physician about interventions, especially if you feel that making changes in your life will be difficult. Start with your primary care physician because:

• They have the full picture of your overall health.
• They can refer you to a specialist if needed.
• They can provide you with resources to help you cope.

Please note: Stress from work and caregiving are not the same when someone is exposed to such trauma as domestic abuse and emotional manipulation. If you are experiencing abuse, seek immediate help from your primary care provider or from the National Domestic Hotline (1.800.799.7233).

In addition to taking inventory of your physical, mental and emotional stress levels, Dr. Gollan suggests looking at the following areas of your life to identify stressors:

• Your physical environment. What can you change in your home to help you feel better? Decluttering your space can help eliminate what Dr. Gollan calls “chronic hassles,” which can irritate and create recurrent tension. Examples include:
• Folding laundry
• Dealing with clutter
• Emptying the dishwasher
• Cleaning the kitchen
• Checking your email
• Doing tasks at work that you tend to put off and let accumulate

Getting rid of chronic hassles on a regular basis can help reduce your cumulative stress. Dr. Gollan suggests that you track when you get irritated and take five minutes daily (per task) to directly eliminate each hassle. If you feel like you’re overwhelmed with chronic hassles, prioritize them and schedule daily and weekly goals about when and who in your household can tackle them.

• Your routine. How can you shift your routine to reduce your exposure to the things that stress you? One example: Avoid reading the news on your phone when you wake up.

Are you covering your basic needs? Start small by addressing these areas:

• Sleep: Aim for seven to nine hours per night.
• Diet: Eat a healthy diet that includes a variety of nutrient-rich foods.
• Exercise: Shoot for at least 150 minutes of moderate-intensity exercise per week. Seek regular daily walks and mobility stretches.
• Social support: Carve out time to connect virtually with friends and family.
• Your relationships. What will help reduce stress in your relationships? Are you stuck in any negative communication patterns?
• The cause of stress in many relationships is often repetitive conversations that accumulate just like the chronic hassles in your life.
• “Declutter” your relationships by tackling these little problems through an open dialogue on an ongoing basis. If you cannot have this type of conversation, read about ways to improve relationship communication, listen to podcasts, or talk with a trusted friend or family member about ways to navigate the situation.
• If you need to, seek out couple’s counseling to provide support around these conversations.

Avoid the sentiment that for you to feel better, the other person in the relationship must change. This means your mood is dependent on change in another person. Find what you can do to help modify your mood and stress independent of the other person. Cognitive behavioral therapy is useful in changing mood states.

• Yourself. You can only control your own mood and decisions. What can you change about yourself that might make you feel better? How can you build more resilience to everyday stressors?

“When we feel stressed, we may feel depleted and view small inconveniences as large problems. This means that our thinking is biased toward negative predictions and catastrophizing,” says Dr. Gollan. “It’s important to test your thinking to make sure you have data to support your thoughts. Test the accuracy and usefulness of your thoughts.”

Once you’ve determined the sources of your stress, you have two options:

• Directly address them to reduce their recurrence.
• View the hassles differently. Ask yourself, “What is this teaching me?”

Address Your Stressors

Look at the triggers of your stress through an objective lens. Is what’s stressing you unique to only you (internal), or is the source of your stress external? For example, if you are missing deadlines because you’re not motivated to do your work, see if you can use stress-reduction strategies to shift your motivation. Work on yourself to either fix the issues that are bringing you stress or just let them go.

Or, are you feeling stress because of external factors, like helping your children with online school? If the issues are external, reach out to your partner or employer to discuss how their behavior can help you manage the stress.

• Before your conversation, gather evidence to back up your feelings and demonstrate how changes can help you. If you don’t have the evidence, then consider trying to let go of these feelings, or talk to your primary care physician for guidance.
• Use the DEAR method to start the conversation:

D – Describe the facts. What events have led up to this point?
E – Express how you feel in one sentence (“I feel …”).
A – Ask for what you want in specific terms (“I would like …”).
R – provide Rationale. Give two to three reasons to explain why it’s in your partner’s or employer’s best interest to give you what you are asking for (“This could work for you because …”).

Stress and Self-Care

“Strong feelings, such as sadness or anxiety, make it hard to stay focused on small daily and weekly goals,” says Dr. Gollan. “Overriding stress reactions is possible. Start with a small easy task, move your body, promote positive emotion through an outlet like listening to music, rest your brain with nature walks, and use the Only Handle It Once (OHIO) approach.”

If you’re struggling to fit self-care into your routine:

• Make a list of the pros and cons of placing a higher priority on self-care.
• Make a list of the pros and cons of not putting a priority on self-management.
• From these lists, write down a plan of action for self-care, which may include blocking off your calendar to focus on doing activities that are fun or easy or make you feel competent.

“Caregivers who also work full time face the tension of managing multiple roles and responsibilities, and they are at risk for physical and mental exhaustion. If this is you, ask yourself what can you do to reduce your burden,” says Dr. Gollan. “There isn’t an answer for every problem. Remain optimistic, talk to someone about what you need, and give yourself a little bit of grace.”