COVID-19: a guide to dealing with stress and anxiety during lockdown

Tuesday, April 14, 2020. Author Paul Rose

Stress anxiety COVID-19

It’s a very disconcerting time, right?

Losing access to the people and places that give us stability and routine. Economic uncertainty. Concerns about our own health and the health of loved ones. Countless questions with “only time will tell” as your answer. It can seem as if we’re living in a dystopian world, bringing a sense of unease that hasn’t been experienced on a global scale for generations.

Naturally, we are all looking for ways to cope. This article takes a look at some of the best ways to manage the stress and anxiety that may arise during lockdown.
 

A brief look at the stress response

One of the reasons we’ve survived as a species is that we evolved different mechanisms of dealing with threats and sudden, unexpected changes in our environment.

Two of these mechanisms include the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis which together orchestrate our “fight or flight” or acute stress response.

Although this response was designed to deal with the threats of potential predators, invading tribes, lack of food, and adverse weather conditions, it is now employed in modern day situations and social interactions.

The physiological responses that once helped you combat or flee from wild animals in the savannah, such as adrenaline release, raised blood pressure and increased heart rate, are activated nowadays in response to Brandon who just cut you off on the motorway, a politically-charged video on your Twitter feed, or, more recently, the constant flurry of information about a pandemic.

Humans have also developed the capacity, using regions in the brain such as the prefrontal cortex and hippocampus, to simulate events and experiences in an imagined future. These ‘what if’ scenarios, which are entirely imagined/perceived, can also trigger our stress response. Such ‘inappropriate’ activation of our stress response leads to feelings of anxiety.

Although the stress response is automatic, we possess neural circuits that can regulate and suppress our stress response.  Deliberate changes in our behaviour and thinking patterns can therefore help to reduce and manage stress and anxiety. For example, simple techniques such as shifting attention to breathing has been linked to reduced activity in brain-circuits that underlie anxiety and reduced experience of negative emotions.

Similarly, we are also able to make changes to our lifestyle to avoid undue activation of our stress response. Below are some of key measures to consider if you're stressed during lockdown. 
 

Remind yourself of what is and isn’t within your control

In any situation, whether stressful or not, we must primarily consider “what is in my control?”

First, ask yourself this question, "Is there anything I can do to improve my present situation?”. If the answer is “yes”, then we can look at positive actions to undertake.

If the answer is “No”, then our experience is likely derived from something that we have no control over, such as the unknown future or other people’s actions.  By understanding and accepting that some things are beyond our control, we can focus our efforts on dealing with those things that are within our control right now.

Make a task or goal list

A seemingly uncontrollable situation can be less anxiety-provoking by first identifying those things that are within your control and then breaking those things down into smaller, manageable tasks.

Setting and accomplishing a simple list of goals each day can instil the feeling that you are in control. It can also help break up the monotony of lockdown.

Even if this is just jotting down on a small list on a phone application or using a diary, structure helps bring clarity.

Personally, I have found that writing a list of actions before going to bed helps put your mind at ease, allowing a better night’s sleep.

  • Start with ONE achievable ‘primary goal’ for the day, then add some ‘nice to have’ goals to complete. Limit yourself to a total of 5 actions.

  • Make sure you are 90% confident that you can achieve this primary goal. Don’t be overambitious - set yourself up to succeed: small wins will lead to big wins.

  • Include smaller daily actions, to benefit your overall wellbeing such as a 15-20 minute walk each day, 30 minutes reading a book, or a mobility routine. 

Here's an example task list:

  • Meal prep veggies (primary goal)
  • Mobility routine (20 mins). 
  • 15-20 mins walk with audiobook after lunch.
  • Do laundry. 
  • Read a book chapter before bed.

 

Take breaks away from technology

Being in the know is helpful, but continually overloading yourself with information may also induce a stress response, negatively affecting your mental and physical wellbeing.

Furthermore, not all information presented to us is helpful. Official government advice, reliable scientific updates and Zoom meetings with loved ones can be useful, mindless social media updates and inflammatory opinion pieces less so.

From time to time, we must be able to take a step back and remove ourselves from the information and social commentary presented to us, especially if this content triggers a harmful psychological and emotional response.

A simple way of achieving this is to limit our time on social media. There are several apps that can help block websites and apps after a certain amount of time. Alternatively, you can simply switch off your mobile devices completely for set periods. Unplug! 

Practise meditation

Meditation has been shown in countless studies to dampen the stress response and improve emotional regulation, anxiety levels, sleep patterns, and mood.  

Much like learning a new language, meditation is something that requires regular practice. You will not be completely ‘fluent” in your first session, but will start to improve and reap more benefits with continued practice. Guided meditation apps or videos are a good place to start.

 

Learn something new

Plenty of time on your hands? Why not stimulate novel neural connections and learn something new? In particular, learning a new skill has been shown to promote neuroplasticity (the structural reorganisation of the brain in response to new cognitive demands) and slow cognitive ageing.

Try to limit the often hyped ‘brain games’, which may minimally improve processing, but overall have no real evidence to support their claims of boosting ‘brain health’. Rather, try improving specific skills that are likely to more concretely benefit your life situation. Choose something that is engaging, interesting and challenging for you, e.g.: 

  • A free online course, video tutorials
  • A language
  • A musical instrument
  • A new cooking recipe
  • Are you an athlete? Consider learning new fundamental movement skills for your sport, such as sprinting mechanics, free throws etc.

The sense of accomplishment from improving such skills, known in Cognitive and Behavioral Therapy (CBT) as mastery, has been linked to improvements in mental health.

 

Exercise

Exercise is by far one of the most effective things that you can do today to cut stress and improve your mood.

A single workout has immediate benefits, increasing levels of “feel-good” hormones such as endorphins and stimulating neurotransmitter (dopamine, serotonin and noradrenaline) systems in the brain known to enhance mood.

Longer lasting neural adaptations to exercise are also shown to boost mental health in the long term. For example, exercise is shown to reduce the activity of the HPA axis in response to psychologically stressful stimuli. Long term exercise can also stimulate the growth of new nerve cells (neurogenesis), which has been linked to improvements in mood.

Try to find something physically active you enjoy doing and do it. If you are able to do this outside, even better.

If you are limited to staying indoors and don’t have access to home gym equipment, consider what you can do to improve other aspects of your physical fitness. It may be difficult to provide a muscle growth stimulus like 'maxing out', but you could work on flexibility, stability or proprioception (body control). 

You can add intensity by introducing sprint variations, plyometrics, single leg work, resistance band work, callisthenics. Let's get creative people!

Schedule daily relaxation activities

We spend a lot of time each day in a sympathetic state, whereby the sympathetic nervous system (SNS) is highly activated. This can be a dangerous place to be, as constantly being in “fight or flight” mode can lead to stress and anxiety, and is linked to an increased risk of cardiovascular disease.  

But we also have the parasympathetic nervous system (PNS), which has opposing effects in the body to the SNS and is responsible for “rest and digest” rather than “fight-or-flight”.

Tapping into our parasympathetic state can help with relaxation, cultivate a feeling of calmness, and improve our rate of recovery. Try to schedule at least 30 minutes a day of activities such as:

  • Being outside in nature
  • Going for a stroll 
  • Deep breathing
  • Slow stretching, yoga sessions
  • Listening to relaxing music
  • Reading
  • Power napping
  • Drinking tea
  • Taking a warm bath
  • Laughing with friends
  • Snuggling with a loved one/pet

 

Try to maintain a healthy diet

In a time of panic, we seek comfort. It’s only natural, but, for a lot of us, that unfortunately means a lot of comfort food. While small amounts are fine, we can easily find ourselves in a vicious cycle of bingeing on crisps and cake while watching Netflix, or taking endless trips to the fridge while working from home.

It's easier said than done: but try not to let your eating habits become sloppy when confined to your home!

Poor dietary habits can exacerbate stress and anxiety. For example, studies suggest a diet that is high in fat and refined carbohydrates can disrupt insulin signalling within the brain, leading to anxious and depressed symptoms.

As we are moving less during lockdown, we also likely need to reign in our energy intake. The energy previously spent pumping iron in the gym, climbing the stairs in the office, performing manual labour, and fidgeting during a board meeting have all lowered considerably. To mitigate the unwanted gains in body fat (which, grossly, occurs when energy expenditure falls below energy intake), we need to adjust the number of calories we consume in our diet.

If you were a regular gym-enthusiast focussed on building muscle mass pre-lockdown, then consider now entering a maintenance phase. We want to maintain our beloved muscle mass, so ensure you’re eating adequate amounts of quality protein, with the rest of your plate filled with high-fiber vegetables, fruit and a small dose of healthy fats too.

The rate at which muscle loss will occur will depend on a variety of factors, but ensuring your diet still contains the sufficient amount of macro- and micronutrients will cover the nutrition factor.

Introducing some small, positive habits into your eating rituals can also quickly add up, helping to reduce total energy intake across the week.

  • Try not to eat all your meals in front of a screen. Sit at your table or get creative and sit like a yogi on cushions.
  • Drink a glass of water before each meal.
  • Eat more slowly, this has been shown to increase satiety.
  • Cook some recipes that you haven’t had the chance to cook before, slow cooking or meal preparation of veggies, for the week.
  • Drink some fruity or green teas throughout the day.
  • Reduce caffeine consumption (especially if it heightens anxiety levels).

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