En español | As it upends normal life, COVID-19 is causing people to feel anxious, angry, frightened, frustrated and sad. All these feelings are normal during this pandemic, mental health experts say.
But as the crisis stretches on, the prolonged isolation, financial uncertainty and fears about the coronavirus will almost inevitably trigger a spike in mental health issues such as depression, anxiety, insomnia and substance abuse.
Notably, nearly half of Americans said the COVID-19 pandemic is already harming their mental health, in a recent poll by the Kaiser Family Foundation. And almost 1 in 5 said it has had a “major impact” on their mental health.
To boost your overall outlook, psychologists recommend getting plenty of sleep, eating balanced meals, going outside if you can and staying physically active. Self-compassion is also important; acknowledging your feelings can help you cope in a healthy way.
AARP asked psychologists for tips on how to handle specific mental health challenges during this stressful time.
"I can't stop worrying about COVID-19.”
If anxiety about the virus is dominating your thoughts, your first step is to reduce your exposure to news and social media. Psychologists agree that a constant cycle of negative headlines is linked to anxiety and stress.
"News puts your brain on alert, even if you don't realize it,” says Jameca Woody Falconer, a licensed psychologist and faculty member atWebster University in St. Louis, Missouri. “I have patients who watch the news around the clock, flipping from channel to channel, and it just amps up their cortisol levels.”
Consider limiting yourself to 30 minutes a day or just checking the news once in the morning and once in the evening.
Falconer also recommends connecting regularly with friends and family members by video chat or phone. “When you're alone with your thoughts, your anxiety can spiral,” she says.
If your anxiety is interrupting your ability to function or to perform ordinary activities like paying bills or showering, that's a sign it's time to consider professional help.
Most therapists across the country are offering virtual sessions, and Medicare and many private insurers have expanded their coverage to include teletherapy. Ask your primary care provider for a referral, or use the national Crisis Text Line. Texting HOME to 741741 connects you to trained volunteer crisis counselors who reply quickly and are available 24/7.
"I'm so anxious I can't sleep.”
Psychologists say fears about the virus are keeping many of their patients up at night. “It's a big deal,” says Kristin Daley, a clinical psychologist and sleep expert at BASE Cognitive Behavioral Therapy in Charlotte, North Carolina.
Worry and fear release fight-or-flight hormones in your brain that make you feel agitated and hyper-vigilant, she explains, making it harder for you to enter the restful state needed for sleep.
If you can't get your brain to turn off at night, Daley suggests setting aside some “worry time” each day, when you write down your concerns. “After dinner take 10 minutes where you just bullet-point everything your head is talking to you about. Say, ‘OK, brain, what have you got for me?’ “
Then write down the steps you're taking to protect yourself, such as handwashing and wearing a mask. Also, try to acknowledge that you've controlled everything you can. “When your brain starts to chatter at you at night, remind it that you have already listened and will listen again the next night,” she says.
At bedtime have an idea of a restful place where you can go mentally, Daley advises. “I tell my clients to think about your favorite vacation or your happy place. Then gently unhook yourself from that worry and get yourself to that good place.”
Further, don't forget basic sleep hygiene: Avoid long naps, put away screens for the hour before you turn in, try to go to bed and wake up at the same time each day, and keep your bedroom cool and dark.
"I'm angry at my parents (or someone else) for not taking social distancing seriously."
It can be maddening to see others ignoring health guidelines when you're doing everything you can to stay safe. It's especially upsetting if your older parents are the ones taking unnecessary risks, since their generation is the most vulnerable to COVID-19.
Still, when you talk with your parents, try not to sound bossy, demanding or judgmental, says psychologist Lynn Bufka, senior director of practice at the American Psychological Association. Instead, start from a place of love by saying something like, “I'm concerned about your health and well-being.” Then see if you can find out what's behind their reluctance. “Maybe they're afraid of being lonely or disconnected or don't want to burden you with running errands for them,” she says. Or, perhaps, they don't know how to do online ordering, and you can help with that.
If they're still not receptive, it's important to try to let go of some of your anger, Bufka emphasizes. “Being angry is just going to deplete your own emotional resources, and it's not going to change their behavior. Acknowledge that the only thing you can control is yourself.”
If you feel your frustration building, try taking slow, deep breaths — in for a count of 4, out for a count of 6 — picturing yourself “blowing away” your exasperation. Or write down what you'd like to say to your parents — every angry, biting word — then wad up the piece of paper and throw it into the bin.
"I'm drinking more than usual.”
Sales of alcoholic beverages skyrocketed in March as Americans turned to drinking (or prepared to do so) to cope with coronavirus-related worries and fears. While there's nothing wrong with enjoying a glass of wine after dinner, it's important to have other ways to manage stress during this time, Bufka says.
Drinking too much can exacerbate health conditions like high blood pressure and heart disease and can deepen feelings of depression, anger and anxiety. Heavy alcohol use can also weaken your immune response — exactly the opposite of what you want to do during a pandemic. The Centers for Disease Control and Prevention defines “heavy drinking” as eight or more drinks per week for women and 15 or more per week for men.
If you're concerned that you may be drinking too much, Bufka recommends setting limits (maybe you imbibe only on certain days or wait until dinner to have your first glass) and seeing if you can follow them. “If you find yourself coming up with reasons why it's OK to have a drink anyway, or you wonder the next day why you had three glasses of wine, then it's time to reach out and get some support,” she says. Call a substance abuse hotline, or ask a friend to be your accountability partner.
"I feel sad, unmotivated and alone. Am I clinically depressed?"
A lot of people these days feel sad, for good reason, and that doesn't mean you have depression, Daley says. Give yourself permission to mourn the things you're missing — eating out at restaurants, travel, spending time with friends, and so much more — and even to cry a little.
Signs of clinical depression include trouble sleeping, feelings of helplessness or hopelessness, bouts of crying, social withdrawal and decreased activity. Also, many people who are depressed find that they no longer enjoy the things they once found pleasurable.
"The challenge is that most of those are also the characteristics of quarantine,” Daley says.
To lift your mood, try to get outside each day. Sit on your porch, or take a stroll, remembering to keep the proper distance from others. Research shows that spending time outdoors and getting sun on your face are closely linked with happiness, says David Cates, director of behavioral health at Nebraska Medicine in Omaha.
"If you can't actually go outdoors, the literature says that even looking through a window at nature or looking at virtual photos of nature can be helpful,” Cates notes.
Try to schedule a variety of activities each day so you have things to look forward to, and find ways to connect with friends and family members. Mindfulness, meditation, yoga and other forms of self-care can also boost your mood.
If you're still feeling down, and especially if you're having suicidal thoughts, seek professional help. The federal government's National Suicide Prevention Lifeline can be reached at 800-273-TALK (8255).
"My spouse is driving me crazy.”
Living with someone else always requires some give-and-take, but that's particularly true if you're stuck in the house all day while social distancing and your spouse is the only person you see.
Cates recommends sitting down with your partner to establish boundaries and a basic daily schedule. “Make sure you include uninterrupted alone time for both of you.”
You can create space for yourself, too, by going outside or into another room and putting on headphones.
Exercise is critical to reduce stress and irritation during a quarantine, he says. While you may not be able to play tennis or basketball, there are plenty of free online fitness videos available, from cardio routines to yoga classes.
Meanwhile, make sure you set aside time to have fun with the people who share your space. Work on a puzzle together, head out for a walk, or see if you can still win at Scrabble. Even better, try a new activity, like an online class.
"I'm going stir-crazy trapped at home.”
Instead of thinking of yourself as trapped, change your mindset and consider this a time to focus on yourself and your goals, Cates suggests. Can you learn a magic trick to show the grandkids? Is there an easy home improvement project you can tackle? Have you always wanted to learn a language?
If that's overwhelming, start with small, achievable daily goals, like listening to an audiobook for 30 minutes, exercising for just 10 minutes every day or reorganizing one drawer at a time.
"It's important for us to feel like we're doing something meaningful, and there's something magical about achieving something and saying, ‘OK, I did that,’ “ Cates says. “Then you can slowly build on it. It's like priming the pump."
Connecting with friends and family regularly can also help ease cabin fever, he says. Schedule a happy hour with buddies over Zoom, check in with an old college pal, or call your aunt who's in a nursing home.
"There are probably people in your orbit who are lonely,” Cates says. “Reach out and give them a call. There is nothing more important for their mental health — and yours — than social support."