DO THE GOOD STUFF: Tolerating uncertainty, managing anxiety, and improving mood in the times of COVID-19

Current circumstances sure do feel surreal. All of us face changes to our “normal” and many have valid and significant concerns. It is natural for us to feel anxious in the face of such uncertainty. Major life changes and social isolation are factors that contribute to low mood. However, we do have the ability to do what helps (“the good stuff”) instead of perpetuating the anxiety and worsening mood. My colleagues and I have put together a list of practical CBT-informed strategies to employ during this unprecedented time.

·       Consider your “best dose” of COVID-conversation... In a situation with ever-changing recommendations, it is important to stay informed... yet too much time spend seeking information can amplify anxiety and dampen mood. Some research suggests social media may contribute to negative psychological impact more than typical media sources. But for others, social media might increase feelings of connectedness. Limiting time spend information seeking is highly recommended, as well as only going to trusted sources. At all other times during the day, work to stay present and focused on productive, enjoyable and value-based activities. I suggest you do an experiment or two. Try a no social media day and evaluate your anxiety/mood at the end of the day. Is it better for you to read information in the morning or afternoon

·       Build your tolerance for uncertainty. Nothing in life is certain and we tolerate uncertainty every day (granted we are facing a large amount right now). Uncertainty does not equate to “bad.” Accept that there are things we do not know and cannot know right now. Trying to determine the “unknowable” (or worrying about it) turns pain into suffering. Take it day by day, live in the moment, and practice flexibility.

·       Feelings are not facts. ​Try not to let your anxiety lead you towards excessive responses. Focus on the CDC and WHO recommendations. Use what we DO know as a guide for your actions. Work to resist the anxious or obsessive-compulsive urge to go overboard, focus on doing only what is recommended, not more. 

·       Do the “good stuff.” I can not stress this enough. Our actions are more in our control than our thoughts or feelings. Behavior is where we get the “biggest bang for our buck.” Engage in mood-boosting activity and valued living. Focus on what is in your control. Practice gratitude. Engage in self-care. DO THESE even if you don’t feel like it. Create a “upward spiral.”

    • Mood boosting activity = activities that bring pleasure, physical activities, activities that are novel, social activities, activities that bring a sense of accomplishment, and activities that align with your values

    • Valued living. Do things that align with your values. If you value education, try a free Harvard class. If you value giving, donate to members of the service industry or challenge yourself to find a way to use your strengths in the service of others. If you value community, check on your neighbors. If you love to cook, make a meal for someone. If you value wisdom, write a letter to those in nursing homes.

    • What can you do? Focus on what’s in your control like how you spend leisure time and how much time you engage with media. For me, my children’s boredom is within my control (to some degree) so getting creative about at-home activities has been extremely helpful.

    • “Hunt for good” and let gratitude wash over you. What are you thankful for today? Maybe it’s the sun, maybe it’s your support network, maybe you enjoyed a good book, maybe someone made you laugh, maybe it’s your health, maybe it is happy memories, maybe it’s having a comfortable home, and so on. For me, it was guinea pigs yesterday. Our fairly new pets bring my daughters such joy and entertainment, and we had a “lesson” (using the word very loosely) about guinea pig noises and what they mean. The day before, it was the school librarian reading books via televideo and my girls maintaining a sense of connection to their school. Tonight, I am grateful for a couple of hours to share knowledge that could be helpful to others, and the technology that makes it easy to do so.

    • Self-care. Create a schedule and keep to it. Change your clothes (even if they are comfy!). Sleep. Eat well. Exercise. Practice mindfulness.

·       Creative connection. You are not alone. Social distancing doesn’t have to mean social isolation, and by the way social isolation is not at all good for us. Get creative! Write a letter to someone in your life who made an impact (research demonstrates this is a big mood-booster). Play words with friends or other online games. Schedule time to connect virtually with those that lift you up. Find an online support group. Send funny text messages. Start a blog. Plan social gatherings for when we can connect in person.

·       ASK FOR HELP and GIVE IT. Reach out to your therapist or seek one if you are struggling. Ask for help, you will feel supported when you get it. If someone asks, do what you can – you will feel great. If you are going to the store, ask if anyone needs anything. If you’re down to your last roll of TP, put out a distress call. If you feel alone, tell someone. If you are worried about food, ask for help finding it.

COPING WITH ANXIETY & UNCERTAINTY

2-PART VIDEO SERIES

I sat down with colleagues, Ashley Smith, Amy Jacobsen and Lindsey Murray, to talk about dealing with anxiety and uncertainty during the coronavirus outbreak.

Part 1: For Adults & General Population

Part 2: For Parents

ADDITIONAL RESOURCES

Jon Hershfield’s blog post, “More Going On Than You May Think: COVID-19 and OCD”

IOCDF’s resource page on COVID-19 and OCD

Shala Nicely's blog post, "Managing OCD about Coronavirus"

A resource page full of information from the Unstuck: An OCD Kids Movie filmmakers

Anxiety and Depression Association of America’s resource page on COVID-19 and Anxiety

Time article on activities and structure for kids and families

Washingtonian article on mindfulness strategies

GoZen: Anxiety Relief for Children

·       School closures and anxiety - Dr. Shefali Tsabary

·       Applying Mindfulness to Quell Anxiety - Dr. Elisha & Dr. Stefanie Goldstein

·       Independent Play and Homeschool Strategies - Avital Schreiber-Levy

Amy Jacobsen's blog post, "Coping with Anxiety and Uncertainty during COVID-19