Clinical Q&A: how can you protect your mental health during the COVID-19 outbreak?

Are you struggling with your sleep, worrying a little more, or feeling anxious during this difficult time? If so, you are not alone. We’ve heard a lot about how to safeguard our physical health (washing our hands, social distancing, etc.), but there has been little advice on how to protect our mental health. I virtually sat down with two mental health experts from our team to get their suggestions.

Jennifer Kanady Ph.D. is the Clinical Innovation Lead for Sleep at Big Health. She received her Ph.D. in Clinical Science from the University of California, Berkeley and specializes in the research and treatment of sleep and sleep disorders.

Michelle Davis Ph.D. is the Clinical Innovation lead for Anxiety at Big Health. She completed her Ph.D. in Clinical Psychology at the University of Texas at Austin, and specializes in the research and treatment of anxiety and related disorders.

1. With social distancing, and even complete isolation, becoming more common, what can individuals do to reduce feelings of loneliness?

Jennifer: Use technology — this may seem obvious but it is hugely important. For example, video chatting with family, friends, and co-workers can help mitigate feelings of loneliness. Facial expressions and body language are important for feeling connected. Try hosting a happy hour, having a dinner party, or playing charades with friends over a video call to maintain a sense of connectedness.

Michelle: It is important to remember that connection is a need that we all have as humans. Even though you may be feeling lonely right now, you are definitely not alone in feeling lonely. Simply knowing this and thinking about the shared experience—or talking to someone else about it—can help you feel more connected to others.

More practically, think about people in your life who may be feeling equally or even more disconnected than you. Focusing on how you can engage with them from a distance will not only help them feel better but will take your mind off of your own loneliness.

2. What are some simple techniques that individuals can implement to protect their mental health without leaving their homes?

Jennifer: A big one during this period is limiting the time you spend engaging with the news. Of course, it is important to stay informed, but you do not need to do a deep twitter dive every day. The more we read the more anxious we may feel without actually learning new information. It is also important to get information from trusted news sources.

Try to maintain a regular routine. During “shelter in place,” we may be tempted to stay in bed all day and abandon usual activities, which can exacerbate mental health concerns. Staying active and keeping a regular sleep-wake schedule, exercise routine, and meal times will all be helpful for protecting our mental health.

Michelle: Exercise. It is one of the most beneficial, evidence-based ways to manage mood, anxiety, and sleep. There are a host of on-demand workout videos or classes you can use, or simply do some pushups, squats, jumping jacks in your home to get your heart rate up.

Also, it’s easy to start feeling down when you’re not in your typical routine. A cognitive-behavioral technique that is helpful for boosting mood is called behavioral activation. This entails scheduling activities throughout the day, particularly those that provide a sense of pleasure or mastery. Even small things such as lighting a candle to enjoy the scent, or doing the dishes to feel productive can boost your mood throughout the day. The key here is to stick with your scheduled activities even if you don’t feel motivated to—the motivation follows the behaviors, in a snowball effect.

3. What advice do you have for dealing with heightened anxiety and worry during this time?

Michelle: When people are worried or anxious, they tend to respond in one of two ways. The first is to respond by doing way too much to try to manage anxiety, such as checking the news excessively or seeking reassurance from others. If you’re an anxious “checker”, schedule a specific, but limited, time each day to read the news.

The second way people respond is by avoiding their anxiety. This may be a problem because you never learn that you can actually handle the anxiety better than you think. While feelings of anxiety can be unpleasant, it is important to remember that we all experience them. If avoidance is an issue for you, one exercise you can try is to have yourself think through the worst-case scenario—which might be really scary in this situation. Ask yourself:

What is the worst thing that could happen?

How would I cope?

Who would I call on for help?

Thinking through the steps you would take and available resources can help you feel more capable and empowered. In either case, doing the opposite of your inclination is usually the best approach.

4. Any specific advice for coping with poor sleep during this time?

Jennifer: Even outside of the current situation, maintaining a regular sleep and wake schedule is a key anchor for good sleep. Circadian rhythms — an important process for regulating sleep and wake cycles — function best under regular conditions.

Additionally, the worry and anxiety we feel during this period can have a negative impact on our sleep. One way to mitigate this worry is to schedule a dedicated worry time. The general idea is that you set aside 10-15 minutes a day, ideally at the same time, during which you just worry. You write down all your worries and get it all out of your system. Then if worries start to creep in while trying to fall asleep or return to sleep at night, you can either tell yourself, “I already worried about that earlier” or “I have time at 11:00 am tomorrow to worry about that.” After some time, your brain will start to learn that it has its own special time to worry and thus worries will be less likely to creep in when you are trying to sleep.

Another thing that can be helpful is creating a wind-down period for the hour or two before bed. Ideally, this should not include electronics, should be done in dim light, and should involve relaxing and sleep-promoting activities. Finally, do your best to keep your bed/bedroom for the S’s—sleep and sex only. This will help to protect the bed-sleep connection, further promoting healthy sleep.

Please note that responses were edited for brevity.