A message from a member of IAPMD’s Clinical Advisory Board, Liisa Hantsoo, Ph.D., research scientist and psychologist at the Johns Hopkins University School of Medicine. Originally posted on March 17, 2020 on Dr. Hantsoo’s blog.

This week, many of my patients have asked me about how to manage stress and keep good mental health during the coronavirus pandemic. Between social distancing, working from home, and school or daycare closures, many people’s routines have been upended. These are a few suggestions that I shared with my patients, and thought I would write about here in case they’re helpful to anyone else.

1. Daily Routines – If you are suddenly working from home, caring for kids who are no longer in school, or have reduced work hours, your daily routine may have gone out the window. Routines are predictable and give structure to our days: alarm rings, start the coffee, hop in the shower, breakfast, get ready for the commute, and so on. Once that’s gone, it can be easy to feel unanchored. So, try to create a new daily routine for yourself. Perhaps you’re not commuting anymore, shuttling kids to the school bus stop, or managing after-work social or school activities. Are there other ways you can structure your day? Maybe without the commute, you have time for a little exercise or a leisurely breakfast in the morning. Maybe at lunchtime you have time to take a walk. Try to plan out your day or week with a similar daily structure, and stick to consistent awakening and sleep times. In cognitive-behavioral therapy (CBT), this is consistent with behavioral activation, the idea that our activities or behaviors have a big impact on our moods. When we do something we enjoy, are good at, or that feels meaningful, we usually have a lift in mood. If we avoid activities or isolate ourselves, it tends to worsen our mood. To make use of this, in CBT we use “activity scheduling” to map out specific activities that we know will bring us enjoyment or a sense of mastery, slotting those activities into our days at specific times. Maybe I know that I always get a good laugh when I talk on the phone with my brother, so I set aside 20 minutes at lunchtime to call him. Maybe I am really great at organizing things and know that I’ll feel accomplished afterwards, so I set aside an hour in the evening to work on organizing my closet. Maybe exercise gives me a boost in energy, so I schedule in time for a jog or a yoga video online. Jot down a list of things that you know make you feel good, have meaning to you, or you’re good at. Then see if you can block off little chunks of time throughout your week to do those things.

2. Social Distancing and Social Connection – Connecting with other people is important for mental health. It gives us emotional support, helps us feel part of something larger than ourselves, and gives us a space to decompress and share our experiences and feelings. Maybe you’re used to chatting with coworkers, meeting up with friends for a drink after work, or seeing your neighbor at the gym. With people working from home, and restaurants, bars, movie theaters and gyms shutting their doors, many of our social connections are being cut off.  This can mean less emotional support, and a loss of belongingness and connectedness. If you are feeling cut off from others, see if you can maintain those ties even from six feet apart! Try calling or texting a friend, or emailing a coworker to see how they’re doing. Having virtual hangouts, group chats or Skype happy hours with friends is another way to stay connected. Try an afternoon Google Hangouts coffee break with a friend, or see if a few friends want to Facetime over a beer after work from their living rooms, instead of the local pub. Also, keep in touch with friends or relatives who are older, immunocompromised, or live alone – they will feel supported knowing that someone is keeping an eye out for them, and it will help them to feel less isolated too.

3. Dealing With Uncertainty – Uncertainty can be scary. Most of us have not dealt with a pandemic of this scale before, nor had our lives so directly affected by us. It’s hard to know what to expect. And it is totally normal to feel anxious or stressed in the face of these changes. However, there is a line between a normal level of pandemic-related anxiety, and anxiety at a level that’s interfering with your functioning. If you are having blips of anxiety related to the pandemic that are relatively minor, try using some acceptance-based coping skills. Remind yourself of what’s in your control, and what isn’t. Then be ready to release what’s not in your control – things like how public health officials are responding to the pandemic, or schools and businesses closing. Instead, focus instead on what you are able to control – practicing handwashing and social distancing, making sure you have a supply of food and medications, setting your daily routine, checking on loved ones. Another technique is practicing mindfulness. This is a skill that focuses on shifting your awareness away from anxiety-producing thoughts, and into a more neutral space, focusing on your breath, movements, or an object. Moving your mind’s gaze away from the tangle of thoughts that can bring anxiety and fear. There are some free mindfulness meditation audio tracks online, including a 20 minute breathing exercise from mindfulness meditation leader Dr. Jon Kabat-Zinn at the UMass School of Medicine (they offer mindfulness resources here). If you are having more severe anxiety that’s affecting your functioning, it’s best to contact a mental health professional for help; the American Psychological Association’s psychologist locator is a good place to start. IAPMD’s team of peer support volunteers are also here for you and available to chat.

I hope that these suggestions were useful. Stay safe and take care of yourself and others, physically and emotionally!