Stop the COVID Stress Spiral

By Sondra Forsyth

Now that the pandemic has raged on for nearly a year, people’s stress levels are through the roof. Teachers, healthcare employees, and other frontline workers, along with parents, kids, and all other citizens, are feeling the impact. It’s gotten so bad that even veteran media professionals are struggling to keep a stiff upper lip (take, for example, the live emotional breakdown of CNN journalist Sara Sidner as she reported outside of a hospital in South Los Angeles where COVID is surging).

While many people realize they are facing unparalleled levels of stress and anxiety, others may be so busy trying to keep their lives together that they’re not even aware of how frazzled they are. But no one thrives when they constantly feel afraid, exhausted, and overwhelmed, say Diana Hendel, PharmD, and Mark Goulston, MD.

“COVID-19 has pushed many of us into survival mode,” says Dr. Hendel, coauthor along with Dr. Goulston of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99). “We are doing what’s necessary to survive, but the stress of continuing to function while under such extreme pressure to carry on eventually takes a toll.”

“It is important to learn to recognize when your stress is rising and take steps to mitigate it,” adds Dr. Goulston. “Acknowledging what’s going on with your mental health empowers you to do something about it.” The good news is it doesn’t take much time or effort to reduce stress—even the severe stress so many are facing right now. Read on for this tool kit of simple “stress stoppers” you can use any time you feel stress or anxiety taking hold.

Do frequent self “check-ins” to recognize when your stress levels are rising.

When you’re busy and under pressure to perform, it’s easy to go on “autopilot.” Therefore, periodically pause and do a quick self-assessment throughout the day. Consider your emotional state (Do I feel friendly and engaged, or edgy and aggressive?) as well as your physical state (Is my body calm and at ease, or is it holding onto tension?).

“Take 20 or 30 seconds to scan your body and identify areas that may be holding onto tension or stress,” says Dr. Hendel. “For example, you might be carrying tension in your jaw or shoulders. When you notice an area that is tense, gently release the tension. Over time it should become easier to recognize when stress begins to take hold—and to do something about it.”

Ground yourself when you start feeling overwhelmed.

Grounding is a great way to reduce anxiety and arrive in the here and now. Use it any time you feel carried away by anxious thoughts or feelings, or triggered by upsetting memories and flashbacks.

• Find a comfortable place to sit (or stand). If sitting, rest your hands on your legs. Feel the fabric of your clothing. Notice its color and texture.
• Next, bring your awareness to your body. Stretch your neck from side to side. Relax your shoulders. Tense and relax your calves. Stomp your feet.
• Look around and notice the sights, sounds, and scents around you for a few moments.
• Name 15-20 things you can see. For example, the floor, a light, a desk, a sink.
• As you keep looking around, remind yourself that The flashback or emotion I felt is in the past. Right now, in this moment, I’m safe.

Pause and take a few deep breaths.

We tend to hold our breath whenever we are stressed, but this only exacerbates feelings of anxiety and panic. Instead, use “box breathing” to calm yourself and heighten your concentration. Box breathing is the technique of taking slow, deep, full breaths. Here’s a tutorial for when you’re feeling triggered.
Slowly exhale your breath through your mouth. Consciously focus on clearing all the oxygen from your lungs. Inhale slowly and deeply through your nose for four slow counts. Hold your breath for four more slow counts. On the next four counts, exhale again through your mouth until your lungs are empty. Hold your breath again for a final slow count of four beats.

Reach for something that anchors you in the present moment.

Carry a small reminder of what you love about your life and focus on it if you feel triggered and need to center yourself. It might be a photo of your kids or pet, a small rock you picked up on a scenic nature hike, or a special necklace. Think of the gratitude you feel for your life whenever you look at this token.

Keep something that makes you laugh nearby.

Humor is a great way to alleviate stress. Tape a clip of a funny cartoon to your work area or carry a small notebook with jokes that make you laugh every time you read them.

Use calming affirmations to give you strength and peace.

Written positive statements can give you a lift when you feel yourself sinking. If self-talk is not for you, imagine a supportive other saying these to you in your mind’s eye. A few examples:

• I feel energized and ready for anything the day has in store for me.
• I accept myself as I am. I am enough.
• I am safe in this moment.

Let your feelings out (when possible) at work.

At times you may find you need to step away from your work duties for a few minutes and give any intense emotions you might be experiencing some “breathing room.” Try to move to a private area so you can cry or discreetly express your feelings. Sometimes you need to release the stress that’s built up in your body, and finding a private place to let the tears fall or vent for a few minutes can lighten your stress and enable you to get back to work.

Play a mind game.

“If there is no way to speak to someone else and you need comfort in the moment, imagine talking to someone who loves you,” says Dr. Goulston. “Imagine that they are listening and lovingly holding and encouraging you. As you hear them talking and walking you through it, you will feel their love and belief in you. This kind of mental pep talk can be a bridge until you are able to speak your feelings to somebody in person.”

Head outdoors for a few minutes.

If at all possible, try to get outside for a few minutes of fresh air when you are feeling stressed. Take deep breaths, stretch your arms and legs, and take in the gifts of nature around you. And if possible, invite another person (either someone in your household or a coworker if you are at work) to join you for a 10-minute walk so the two of you can blow off steam.

“When you do nothing about ongoing stress, it can increase until it dominates your life,” concludes Dr. Hendel. “None of us can afford to be sidelined when we need all of our energy to face these current challenges. But it is never too late to take charge of your mental health and build up the resilience that will sustain you through the pandemic and beyond.”

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About the Authors:
Mark Goulston, MD, FAPA
Dr. Mark Goulston is the coauthor of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020) and Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side (HarperCollins Leadership, Spring 2021). He is a board-certified psychiatrist, fellow of the American Psychiatric Association, former assistant clinical professor of psychiatry at UCLA NPI, and a former FBI and police hostage negotiation trainer. He is the creator of Theory Y Executive Coaching—which he provides to CEOs, presidents, founders, and entrepreneurs—and is a TEDx and international keynote speaker.

He is the creator and developer of Surgical Empathy, a process to help people recover and heal from PTSD, prevent suicide in teenagers and young adults, and help organizations overcome implicit bias.

Dr. Goulston is the author or principal author of seven prior books, including PTSD for Dummies, Get Out of Your Own Way: Overcoming Self-Defeating Behavior, Just Listen: Discover the Secret to Getting Through to Absolutely Anyone, Real Influence: Persuade Without Pushing and Gain Without Giving In, and Talking to Crazy: How to Deal with the Irrational and Impossible People in Your Life. He hosts the My Wakeup Call podcast, where he speaks with influencers about their purpose in life and the wakeup calls that led them there. He also is the co-creator and moderator of the multi-honored documentary Stay Alive: An Intimate Conversation About Suicide Prevention.

He appears frequently as a human psychology and behavior subject-area expert across all media, including news outlets ABC, NBC, CBS, and BBC News, as well as CNN, Today, Oprah, the New York Times, the Wall Street Journal, Forbes, Fortune, Harvard Business Review, Business Insider, Fast Company, Huffington Post, and Westwood One. He was also featured in the PBS special “Just Listen.”

Diana Hendel, PharmD
Dr. Diana Hendel is the coauthor of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020) and Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side (HarperCollins Leadership, Spring 2021). She is an executive coach and leadership consultant, former hospital CEO, and author of Responsible: A Memoir, a riveting and deeply personal account of leading during and through the aftermath of a deadly workplace trauma.

As the CEO of Long Beach Memorial Medical Center and Miller Children’s and Women’s Hospital, Hendel led one of the largest acute care, trauma, and teaching hospital complexes on the West Coast. She has served in leadership roles in numerous community organizations and professional associations, including chair of the California Children’s Hospital Association, executive committee member of the Hospital Association of Southern California, vice chair of the Southern California Leadership Council, chair of the Greater Long Beach Chamber of Commerce, board member of the California Society of Health-System Pharmacists, and leader-in-residence of the Ukleja Center for Ethical Leadership at California State University Long Beach.

She earned a BS in biological sciences from UC Irvine and a Doctor of Pharmacy degree from UC San Francisco. She has spoken about healthcare and leadership at regional and national conferences and at TEDx SoCal on the topic of “Childhood Obesity: Small Steps, Big Change.”

About the Book: 
Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99) is available in bookstores nationwide and from major online booksellers.

To learn more, please visit https://whycopewhenyoucanheal.com/.