Let’s talk about stress during COVID-19

The biggest thing in the news for the past several months has been COVID-19, a novel coronavirus that has been spreading around the world and killing hundreds of thousands of people.

In some ways, I’m very tired of covering it – in others, because it is constantly on my mind, I’m feeling like I need to write about it. I dithered a lot about this post, and have had a hard time staying focused – initially this was intended as an article about stress-responsive health issues, but I kept falling back into talking about COVID. So, today’s post is on stress and COVID-19, and hopefully later, when I’m feeling a bit more focused, I’ll do the original post I meant to – on stress-responsive illnesses. *Edit: yep, I did it, just follow the link!*

What is stress?

According to the Cleveland Clinic: Stress is the body’s reaction to any change that requires an adjustment or response.

It doesn’t matter what the change is, or whether that change is positive or negative. It’s the fact of a change or difference that makes it ‘stress’ not the type or extremity of said change.

Stress comes in many forms, and while we’re used to thinking about it in terms of events(that fight made the day stressful) or actions(my stress level increased dramatically when you did that) the fact of the matter is that stress is a lot more than that.

Stress on your knee when sitting is what causes you to shift your position.

If you have an allergy, being exposed to the allergen triggers an immune response. This is a stress on your body, as an immune response often takes a lot of energy.

Inflammation is a form of stress – whether it be deep inside your body, or visible from the outside.

Low levels of stress usually don’t matter much, that’s part of life, but higher levels of stress or feeling stress for a prolonged period of time, can cause a lot of damage to our bodies.

The current situation: COVID-19 and living in isolation

Right now, there’s more than enough environmental stresses to go around.

The COVID-19 pandemic in and of itself is of uncertain duration, with the condition itself being new to the medical and scientific community, leaving them unable to provide the types of answers we’d all prefer. Most information needs to be laced with uncertainty ‘it appears’ ‘it’s been reported’ ‘so far, we have seen’, and that’s because it is so new.

This condition recently jumped species, so our immune systems are much less prepared for it than they are for most of the other illnesses we worry about. There is more mystery and less certainty involved, and medical professionals are doing their best to manage basic research while our hospitals are being flooded with new patients.

For those of us with chronic conditions, there’s an extra layer of fear. This condition can be deadly for the healthy population, so what’s it going to do to us?

Also, for many of us, our normal treatments are either unavailable or more dangerous to get than they typically were.

I’ve been able to continue to see my therapist online, but as the date for my botox injection(to manage my migraine) approaches, it’s becoming more and more obvious that I can’t safely go in and get that treatment.

Because it is a series of injections, it’s considered an invasive procedure and so is postponed due to the outbreak.

I’ll survive not getting that shot, even if I’m in more pain, but people who need dialysis or other survival-supporting treatments can’t afford to wait it out, and so are getting the treatments they need which is, unfortunately, increasing their risk of being exposed to COVID19.

Others who are scheduled for life-saving surgeries or operations to remove life-threatening tumors also are being put on hold. One of the few things more frightening than a risky surgery, I’d imagine, is having that surgery delayed with no knowledge of when it will be rescheduled to.

Even if, like me, your life isn’t being threatened by not being able to go to the hospital, there’s then the struggle of being alone or with a very limited range of social opportunities while knowing that you need to maintain that for an unknown amount of time with no clue when you can once more physically interact with ohter people.

Humans are social creatures, we depend on social interactions to help with our own identities and often define ourselves partially in relation to others.

Losing the ability to physically be with others, to touch and be touched, and to share space with others is painful. Not knowing how long that will be the case makes it harder.

This is another new consistent emotional stress that many of us are managing.

Leaving our homes is now dangerous. Staying at home starves us of stimulation. Most interactions with others endanger ourselves and our families.

There is little that is reliable and safe, and so many unknowns surrounding us. We need to find ways to channel these stresses and fears into things we can understand, manage, and make sense of.

Additional stresses from COVID19

On top of all of that, the COVID19 pandemic has triggered a massive closure of businesses, loss of employment, and closure of schools. For people with school-age children, their children are suffering the loss of time with classmates, a complete disruption of their schedule, and this sudden shift to distance learning models with minimal warning. For teachers, they have suddenly had to shift to distance teaching instead of in person, usually with less than a week’s notice.

For the people lucky enough to still have a job, many are working from home if possible, or are in a completely altered working environment where every interaction with other humans is another possible exposure to the COVID-19 virus.

Any one of these pieces would be stressful, but altogether it’s terrifying. People like routines and schedules, and this virus and the response to it have damaged or destroyed most of the habits and routines of pretty much everybody’s lives out there. As mentioned above, dealing with the unknown is stressful, but the even more disturbing part of this is that there is no time frame. We can tolerate most changes if we know that there’s an end in sight – a deadline at which point things will return to normal.

One of the ways in which the healthy person’s interactions with the COVID pandemic is like our individual struggles with chronic health conditions is that so much is in the ‘unknown’ category. Also, I suspect that there is not going to be a ‘return to normal’ so much as a creation of a ‘new normal’ in both cases.

Many people don’t know how they will be able to continue supporting their families, aren’t sure when, if, or how they will return to work. In the US, health insurance is usually entangled in employment, and so losing work also translates into changes in(more often the loss of) health insurance. And that during a pandemic has got to be terrifying.

I think that’s one of the positives I have in this case: I’m on SSDI, and so my income and insurance have neither changed nor are threatened. However, I know that I’m very much in the minority on that front and really feel for the people who are currently struggling to survive or make plans for an unknowable future.

How do we reduce our stress during this?

One of the most important things right now is to acknowledge what we can and can’t control, and think through what we can do as individuals to reduce that sense of pressure on ourselves.

For example, with COVID-19, we are staying home for good reason. By limiting our contact with others, we are lowering the number of potentially infected people, reducing strain on our hospitals and critical resources, and reducing our risk of catching or spreading COVID-19. It’s the right thing to do and the best thing we can do.

However, it’s likely safe to go for a walk in your neighborhood. Getting some fresh air in your lungs, feeling a breeze, or other interactions with nature have been proven to reduce stress. If you are living in a densely populated area, you may want to wear a mask, but you still can and should get some fresh air.

If you really can’t go outside for whatever reason, maybe it’s time to watch a nature show or view some lovely natural scenes(or listen to nature sounds, etc). Give yourself a bit of the natural world.

You also still can(and should) exercise. If you can’t go for a walk, run, or bicycle ride, find a workout video or tai’chi exercise or another way for you to build up a sweat and get in some cardio.

Remember giving yourself a bit of that pressure on a regular basis is very healthy stress and one that improves your overall health.

Also, it’s often possible to be social without having the physical interaction. Think about family or friends that you may want to communicate with and give them a call, send an email, chat with them, or set up some form of video conference.

Even if all your senses can’t be filled with them, some interaction is much much healthier for you than none. We are social beings and while we don’t have our usual outlets, we definitely still can create some new ones.

One of the most important things through all of this is attitude. Often for people with disabilities, the condition itself is definitely not the biggest problem(though it can seem that way). Instead, it’s the challenges go with the problem.

For example, if you are in constant pain, the pain itself is bad, but the worrying about what else may happen, or the fears of not being able to do things because of the pain, or the loneliness that comes from having limited energy are additional stresses that tend to magnify the pain itself and the sense of loss and fear that may accompany it. If you can separate the pain from the fears that surround the pain, the pain itself is often the smaller stress(though of course the rest primarily exists due to the pain).

Mindfulness and meditation techniques can really help tease apart these pieces and help you live better with the parts of your life that you can’t change.

I found, for example, that when I stopped worrying about how other people would react to my movement symptoms, my life became much easier and less stressful. If I shook or my leg collapsed or whatever other symptom occurred, my only concern became how that symptom affected me in that moment, with no other worries popping in.

Instead of a process like ‘ouch I just slammed my head into the seat in front of me, what are the people around me thinking? Should I get off the train? Is somebody going to call for an ambulance or the police? Should I really have tried to go to the city? What am I going to do?’, instead it becomes

‘Oh, I hit my head on the back of the seat. I guess I’m more symptomatic than I expected. Let me take a breath and calm down. There’s a set of facing seats over there, I’ll just move there and then I’ll be ok’.

With everything that’s been going on lately, I’ve focused on taking a walk regularly and meditating close to daily, to try to help myself stay calm, healthy, and as minimally stressed as possible.

Another thing is to create rituals and habits to help you manage during this time. Even with the external structure we’re used to, you still can set time aside for breakfast, exercise, school work, and other responsibilities – and by setting up a habit and structure, you’re helping rebuild some of that sense of structure that is usually provided by society.

Along those lines, I think it’s really important to celebrate what we do have and what is going right. For example, if currently your household is struggling with routines but is healthy, it’s well worth it to take some time to be grateful that your family hasn’t caught COVID-19.

If you are able to work from home, it’s worth taking some time to be grateful to still have your position when so many people are losing their jobs.

If you had COVID19, you can be grateful to have survived(or recieved appropriate medical supports, etc), and so on. My point is that being grateful is in itself a powerful coping tool, and it’s one that you could make a habit of, especially during this crisis when so many people are struggling.

With all of this, please make sure you take time to focus on what you need and how you can get yourself through all of this. There’s a lot going on and a lot to consider – so taking time for you is an essential tool to keep yourself mentally and physically healthy.

Conclusion: Stress is everywhere, but it is something we can manage

Stress always has and always will be a part of our environment. While we intellectually compartmentalize stress(emotional, physical, psychological, environmental, etc), the fact of the matter is that our bodies respond to all forms of stress in basically the same fashion: by preparing our bodies to fight, freeze, or flee. While that was a necessary part of our species’ survival, we currently have many forms of stress that simply don’t require that type of response. Because we do have this instinctual response to stress, it’s essential that we find ways to manage these stresses so our bodies are not constantly feeling and responding to life stresses in this way.

During COVID-19, there are a lot of extra environmental stresses, a lot of schedules and lives thrown into upheaval, and a deadly disease that is easily transmitted spreading around the world.

That’s a lot of stress.

But we can identify and manage it, by looking at directly how it impacts our state of mind and our reality. ONce we know what is affected, we then can take steps to manage each piece the best we can.

With our routines broken, we can create new ones. Getting exercise and rest are still important. Preventing the spread of COVID is essential, but once we have done what we can on that front, we need to let go of that fear and do our best to relax so that we’re not constantly feeling that environmental stress.

Focusing on self-care, gratitude, nature, and healthy mental and emotional patterns can help us protect ourselves and give us the best chance of getting through this crisis in the best possible shape.

Hang in there and keep taking care of yourself – I know you’ve got this.