Coping with stress and anxiety

COVID-19 is a new virus and we are still learning about it. The uncertainty about the virus and the changes that are unfolding can make most people feel a bit anxious. This is normal, and it actually can help motivate us to take action to protect ourselves and others, and to learn more about the pandemic.

Stay informed by checking information provided by experts and credible sources. A lot of information is disseminated about COVID-19 every day, but not all of it is accurate. Some reliable sources include: 

• The World Health Organization
• Health Canada
• Ontario Ministry of Health
• Your local public health unit

Avoid unfamiliar websites, or online discussion groups where people post information from non-credible sources or share stories which may or may not be true. Be wary of what is posted on social media, and always consider the reliability of information you see on Facebook, Instagram and Twitter.

While staying informed is helpful, too much information may not provide extra benefit. Limit checking sources to once per day or less if you can. This includes reading or listening to news stories about COVID-19. Even though things are shifting rapidly, daily changes are not likely to affect how you should manage your risk.

• Set aside some time to unplug from all electronics, including phone, tablets and computers. Disconnect for a while from social media outlets. You may need to schedule this to make sure it happens.
• Do something fun and healthy for yourself instead (e.g., read, work, exercise).

All the issues you might need to address during this pandemic situation may feel overwhelming. It can be useful to identify which things are actually problems that need to be solved or addressed, and which are just worries that are not necessarily grounded in reality. Click here for some steps you can take to resolve issues that come up for you.

Our stress and anxiety generally cause us to focus on negatives and trigger “What if” questions, such as “How will I cope if I get sick?” They can also drive us to think about worst case scenarios.

In stressful situations, people often overestimate how bad the situation can get, but underestimate how well they will be able to cope. People are resilient and have coping skills they use every day.  

• Think of difficult or challenging situations you have an encountered that you were able to manage. Even if things weren’t perfect, what did you do to cope with the situation?
• Remind yourself that you can handle stress and that if you feel you need support, you can reach out to family, friends, colleagues or professionals.
• Remember our collective resources – from excellent health care and public health response systems to strong and resilient communities. Try to replace catastrophic thoughts with something like, "This is definitely a difficult time, but we will get through it together."
• Don’t underestimate what you are able to do when faced with challenges. 

High levels of anxiety and stress are usually fuelled by the way we think. For example, you might be having thoughts such as “I am going to die” or “There is nothing I can do” or “I won’t be able to cope.” These thoughts can be so strong that you believe them to be true. 

However, not all our thoughts are facts; many are simply beliefs that we hold. Sometimes we have held these beliefs for so long that they feel like facts. How do we know if our thoughts are true or are just beliefs we’ve grown used to? Click here to work through an exercise to challenge your worries and anxious thoughts.

COVID-19 is probably not the only source of stress in your life right now. Consider addressing other sources of stress to reduce your overall level of anxiety. You can use problem solving steps outlined above, challenge your thinking, practicing relaxation and meditation or other strategies you may have used in the past that have helped.

Relaxation strategies and meditation can help reduce or manage your levels of stress and anxiety. There are many options to consider:

• formal meditation practice such as yoga or mindfulness meditation
• informal or self-help approaches such as books and online videos
• relaxation through any activity that you find enjoyable and relaxing.

Choose an activity that works for you and that you are likely to continue doing. Start slowly and gradually work toward a regular practice. 

Social distancing does not mean you should break off all contact from loved ones. Being alone can lead to spending too much time thinking about the current situation, resulting in increased stress and anxiety. It can be helpful to connect with people who are a positive influence when you are feeling stressed.

• Reach out and get support from these people – through phone or video calls or text messaging. 
• Look for formal support, either online or by phone, that can help you during high-stress times. For example, you may turn to distress lines, online support groups, or resources in your community such as religious institutions. 

Try to avoid people who are negative when talking about current affairs or events, or who generally increase your stress and anxiety. 

The strategies mentioned here can take some time to work. We need to practise them regularly and in different situations. Don’t be hard on yourself if you forget to do something or if you are not feeling better right away. 

Eating healthily can help us feel better. When we are stressed, many people might choose comfort foods that are not actually good for stress and overall health. As much as is possible, choose more fruits and vegetables, and drink lots of water.

Some people use substances, including smoking or vaping, to cope with stress, anxiety and depression. This may appear to help reduce stress initially, but in the long run can make things worse. The brain and body develop a tolerance to the numbing effects of these substances, and people have to compensate by using more and more. That leads to additional harms and often delays the recovery from the stress. Moreover, in those at risk, substance use can lead to an addiction or a relapse in those who are in recovery. If you are in recovery and experiencing stress, it is important to reach out for help before a relapse occurs.  In general: 

• Reduce or stop using any non-prescribed substance if you can do so safely. 
• Take prescription medications as prescribed. 
• Try to reduce or avoid alcohol.
• Seek out professional help if you cannot do it alone. 

Caffeine may be an important part of our daily routine, but too much can make your heart race and interfere with sleep. This can make anxiety worse. Try to stop intake before the evening so you get proper sleep.

Getting enough sleep can both help reduce the amount of stress we experience and prepare us to better manage stress. Here are some quick strategies to help you get a good night’s sleep.

• Keep a consistent sleep schedule. This going to bed and getting up at the same time each day (including weekends). 
• Practise relaxation or meditation before bedtime. 
• Schedule physical activity for earlier in the day.
• Practice sleep hygiene: keep your bedroom cool, avoid any light in your room, use your bed for sleep (not reading, watching TV, using your phone, etc.), and get out of bed if you don’t fall asleep after half an hour). 
• Talk to your doctor if these strategies don’t work — there may be other issues affecting your sleep.
• If you drink  caffeine or alcohol, avoid them late in the day.
• Avoid naps during the day if these interrupt your sleep at night.

Physical activity is a great way to reduce stress and anxiety, and improve our mood and overall health. If you are self-isolated, find ways to exercise in your home. For example, use your stairs or follow an exercise video on YouTube.