Prolonged uncertainty and cumulative trauma are leaving many fatigued and stressed. Here are some tips from mental health experts for accepting change, managing anxiety and mental fog.
Are you feeling tired all the time, and that third cup of coffee is basically useless? Do you walk into the kitchen only to find yourself racking your brain for why you went in there? Are you struggling to focus, perhaps because you’re overwhelmed by anxiety?
You’re not alone. Twenty months of a drawn-out pandemic is taking its toll, to varying degrees, on all of us. The unpredictability as new variants of the coronavirus emerge and wane; the collective grief of unprecedented human loss; the continued, albeit lessened, social isolation. Many of us have not dealt with this scale of uncertainty or stress in our lifetimes. In a recent survey, 32% of adults reported being so stressed by the pandemic, that they sometimes struggle with daily tasks like choosing what to wear or eat.
“The COVID-19 experience has qualities of a mass trauma and a natural disaster,” says Dr. Deanna Nobleza, director of the Student Counseling Center and Emotional Health & Wellness Program for House Staff at Jefferson. “And it has happened on the backdrop of political unrest, racial injustice, and those on the front lines, like health care and essential workers, putting their lives at risk every day. There is a layering of trauma.”
There is no denying that people’s mental health has suffered; the incidence of mental health conditions has indeed increased over the last year. At the same time, in a sign of things improving, some aspects of life have resumed – people are returning to restaurants, movie theaters, shopping malls, travel, schools and colleges. But this transition phase brings its own challenges.
“Life has changed indelibly, for some more than others,” says Meghan O’Meara, LPC, director of Jefferson’s East Falls Student Counseling Center. “So we’re all emerging to a completely different normal, but at different paces and to different degrees. It’s a lot to navigate.”
This enormous and chronic load of stress and trauma has physiological effects on our brains and bodies. It’s not surprising that many are feeling burnt out – Dr. Nobleza and O’Meara provide some tips for how to cope and build resilience in a changed world.
Focus on Small Tasks
“One of the biggest complaints I’ve been hearing from patients and my own social circles at this stage of the pandemic is the impact on cognition,” says Dr. Nobleza. Having a hard time concentrating, but also mental fog and forgetfulness – some are calling it ‘pandemic brain.’ It can be frustrating, and worrying, to experience.
The COVID-19 experience has qualities of a mass trauma and a natural disaster. – Dr. Nobleza
Dr. Nobleza suggests thinking about your brain as a sponge – some days, it’s going to feel saturated and has to be “wrung out” and on other days, it can expand and take on more and new things. This will change day to day, maybe even hour to hour. At times when you feel saturated, Dr. Nobleza recommends setting an intention to complete 1-2 small tasks, nothing more. This can be related to work or school, but depending on your stress level and mental state, the task might be as simple as grocery shopping, or something you’ve been putting off, like laundry.
“By making your to-do list more manageable, it can help your brain cultivate focus and concentration,” she says. “And that sense of accomplishment you feel after completing a task is positive reinforcement, and you’ll naturally want to check something else off.” Positive reinforcement has to do with “feel-good” neurochemicals like dopamine being released in your brain. The more we experience it, the more dopamine is released – that biofeedback can help with developing resilience.
Boost Concentration with Physical and Mental Exercise
Physical exercise is another way to naturally release similarly “happy” chemicals called endorphins, whether it’s a brisk walk around the neighborhood or a more intense workout. It can help clear some of that fog and boost memory. Mental exercises are just as important, says O’Meara. “Sudoku, puzzles, board games or even card games are all ways to tap into cognitive functions that we may not use as much in our daily work tasks,” she says. “It’s a way to keep the brain nimble.”
Studies have also shown that mindfulness meditation can help with focus and concentration, even just 5-10 minutes a day. “People sometimes say ‘Oh I can’t do meditation, I get too distracted,’” says Dr. Nobleza. “But that’s the whole point of mindfulness meditation, is to notice when that distraction happens and gently bring your focus back to something tangible, like your breath.” The practice is another way of exercising the brain in a way that is different from our work. Dr. Nobleza strongly suggests this for healthcare workers and essential workers, who may not have the luxury of paring down their to-do list or have time for regular physical exercise.
Connect Outside of Technology
In the early month of the pandemic, lockdowns and quarantines forced many of us to rely on technology to stay connected with the world, from online learning and doctor’s appointments to virtual movie nights and happy hours. It gave us a way to maintain human contact in a time of intense social isolation.
But, there are downsides to technology. A survey recorded that internet use increased 50-70% during the pandemic, and of that, half of the time was spent engaging on social media. That level of engagement with technology has added to the cognitive overload and mental fog.
It’s important to protect your energy as much as possible, and think about what are energy-givers and energy-takers. – O’Meara
Dr. Nobleza stresses the importance of social connection in coping with the pandemic, but encourages off-screen interactions when possible. Try phone calls instead, or if it is possible, meet safely in person – socially-distanced, outdoors preferably but masked indoors, and with the protection of vaccines. If a video call is the only option, Dr. Nobleza suggests using ‘speaker view’ to reduce the stimulatory overload. “Our natural tendency is to look at other people’s reactions and body language, for non-verbal cues,” she says. “But when there’s 5-10 people on a screen, it’s impossible to do that, and it can be really distracting. ‘Speaker view’ allows you to narrow your focus.”
In the age of misinformation, social media can be more like an “emotional vampire,” as Dr. Nobleza describes it, than socially fulfilling. It’s easy to get sucked into conversations and find yourself irritated or even angry. If you struggle with weaning yourself away, try setting a time limit. There are also apps and browser plug-ins that can block you from using websites that can put you in a negative frame of mind.
Protect your Energy
The kind of fatigue people are experiencing now is different from feeling tired – it is physical and emotional exhaustion that makes even the smallest task insurmountable. “It’s important to protect your energy as much as possible, and think about what are energy-givers and energy-takers,” says O’Meara. She says it’s helpful to visualize a battery, which only has so much energy before it has to be charged. At the start of the day, think about how much energy your battery has – identify how you’re going to use it, how much you want left for yourself at the end of the day, and what can help recharge you. Just like the sponge, our battery will look different every day. Some days, you might start off with really low energy and other days, you might hit your low point in the afternoon, and need a recharge then. O’Meara says it’s helpful to take note of those low-points, and see if you can map a pattern for when you feel depleted. For instance, if you notice you hit a slump at around 3 pm, you can try to alleviate that by grabbing a snack, a hot cup of tea, taking a quick walk or even a power nap.
To prevent low-energy states from persisting, Dr. Nobleza says it’s helpful to focus on things that you find naturally engaging. “There’s this concept in positive psychology called a ‘flow state’ which is basically when you’re so intensely engaged in an activity, that time seems to pass by really quickly,” she explains. This might be a certain work task or course material that really gets you in the zone, but it can also be a hobby like knitting, or even a person. “You know when you grab a coffee with someone and you’re chatting and three hours go by and you think ‘Where did the time go?’ That’s a flow state, and it can help replenish energy.” Dr. Nobleza emphasizes that you don’t have to be in these ‘flow states’ for long periods of time; even short bouts help interrupt low-moods and stave off feelings of despair.
Accepting Change Can Help with Anxiety
The ever-changing circumstances we are living in can feel very destabilizing and this is where anxiety thrives: in the unknown and unfamiliar.
“At this point, people are tired of hearing ‘stay positive’ or ‘be patient’ – 20 months of uncertainty is a lot for anyone to deal with,” says O’Meara. “I try to reframe this by accepting that I am not the same person I was before the pandemic, and that some things have remained constants.” While our daily lives and routines have changed, we still have a favorite book, a comforting movie, a food that brings back good memories, or a friend or family member who you can always have a meaningful conversation with. This is a way to stay grounded within our own realities, and help us accept the larger, more difficult reality that the world is not going to magically go back to normal.
You can also ground yourself by focusing on your immediate surroundings, says Dr. Nobleza. “Tune into your senses – what do I see? What do I smell? What do I hear?” she says. “It can help you stay present and focus on neutral things in your space.” This technique can help stop your brain from spiraling into ‘what-if’s,’ which often happens in an anxious state.
Check in – with Yourself, a Buddy, or a Professional
Even as the threat of COVID-19 still lingers, people are feeling safe enough to resume health check-ups and annual exams that were put off during the first year of the pandemic. Dr. Nobleza encourages people to talk to their primary care providers about their mental health and maybe consider getting a referral to see a mental health care provider.
“Therapy is a great place to offload our mental burden, and many of us are carrying more than we’re used to,” says Dr. Nobleza. “A good therapist can really be a cheerleader and help you celebrate small wins.”
Dr. Nobleza and O’Meara also want to normalize regular mental health check-ins, outside of therapy. “Just a minute to ask yourself ‘How am I doing?’” says O’Meara. “This practice needs to be ongoing, just as we look out for aches or pains in our body.”
It can also help to have a buddy system – a person you can do check-ins with regularly. As you make space for these conversations, try to have awareness for where stress and anxiety might be originating for someone. Some have lost loved ones; some have lost their livelihoods; some have lost experiences, like high school and college students; COVID long-haulers are still dealing with health problems.
“There’s this surreal appearance of sameness, because we’ve all been going through this massive, global trauma for so long,” says Dr. Nobleza. “It can make people feel desensitized to carrying this huge amount of stress, but I want people to know that it’s ok if they’re feeling unwell. You don’t have to handle it alone.”
Resources at Jefferson:
- Click here for free, anonymous online mental health screenings
- Student Counseling Center – Center City or call 215-955-HELP to make an appointment
- East Falls Student Counseling Center or call 215-951-2868 to make an appointment
- Emotional Health & Wellness Program for House Staff or call 215-955-HELP to make an appointment
- First Call Employee Assistance Program for all Jefferson employees
- Mindfulness Meditations from Jefferson Health’s Myrna Brind Center for Mindfulness
- Manage your well-being with the Neuroflow App for employees and students
- National Alliance on Mental Health Coronavirus Tip Sheet
- Psychology Today: Find a Therapist
- For the 24/7 National Suicide Prevention Lifeline, call 1-800-273-TALK (8255) or visit suicidepreventionlifeline.org
- College Response for 24-hour free and confidential mental health screenings
- Free meditations from Calm
- Breathe2Relax, a free app for stress management