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Mental Health and the Road to Recovery

According to a UK-based study, mental distress rose from 18.9% in 2018/2019 to 27.3% as measured in April 2020, one month after lockdown. Primarily, this reflects what has amounted to an anxiety affliction on a global scale as we all struggle with the uncertainty and danger of a virus we cannot control. The anxiety of COVID itself is magnified for some depending on their circumstances. Some find themselves very isolated and lonely, while others are trying to work online while taking care of their children. Others yet have pre-existing conditions or live with those who do, which makes the virus especially worrisome. As I’ve heard it said, we’re all in the same storm, but we’re riding in different boats — and some boats are more challenging to be in than others.

This sort of anxiety response is not surprising. It reflects a primitive system that evolved to keep us alive in the face of threats. Specifically, anytime we encounter significant threats — for example, imagine some angry person with a weapon heading your way — our bodies immediately go into fight-or-flight mode. Oxygen-rich blood is pumped to your muscles by a heart beating fast and fueled by heavier breathing to oxygenate that blood. Oxygenated blood makes your muscles strong and gives you almost a super-human strength to take on, or escape from, danger. This is the system that allows mothers to lift cars when their children become trapped underneath!

Critically though, the anxiety response evolved to deal with what we call “acute” threats — dangers that suddenly appear, are dealt with, and then are gone. We either take on the weapon-wielding angry person, or we run from them. Assuming we survive, he is no longer a threat, and our systems then return to a relaxed state, and all is fine again.

COVID 19 is the threat that just does not go away. We’re not really succeeding at fighting it, and we can’t run away from it. It’s there every morning when we wake up, and we are reminded of it and the danger it brings with every newscast. Lest we ever start feeling safe, new strains of the virus or other such developments bring the threat right back. This makes the anxiety response chronic. We are all living with our fight-or-flight system partly engaged almost all the time.

When this system is engaged, we have less blood going to our more recently evolved frontal lobes and more flowing to our so-called “reptilian brain,” which is more formally referred to as our limbic system. In a sense, the virus has reduced us to a more primitive version of ourselves. It’s making it hard for us to think rationally or concentrate for long and also causing us to be more emotional and reactive versions of ourselves. This is why we’re now seeing more violent crime, domestic abuse, and divorces.

What’s even worse is that chronic anxiety negatively impacts our immune systems, literally leaving us more open to the very virus giving rise to our anxiety. As suggested by all this, chronic activation of our fight-or-flight system is dangerous, and unless we can get breaks from it, it could lead to a crash.

The good news is there are things we can do to manage this response, and in the process, we can gain a better idea of what it means to be mentally healthy. As I like to say, things like anxiety are no longer other people’s problems. We all feel anxiety now, and many of us are feeling tinges of depression. This is a great time to learn more about these conditions. What do they reflect? What things might we do to prevent them from becoming a major problem in our lives?

At the outset of COVID, I created a free online course on Coursera called Mind Control: Managing the Anxiety of COVID-19 specifically to explain the anxiety response and then give people tips for managing it. Some of the tips are foundational to mental health: eat nutritious food, get regular aerobic exercise, try your best to get a good night’s sleep, and live according to a regular set schedule. Another approach is to learn the skill of summoning relaxation as one cannot be both anxious and relaxed at the same time. With the help of guided relaxation audio tracks, which you can find online, you can learn how to put your body into a relaxed state. As you become good at doing this, you can use this skill to directly counter anxiety when it arises.

Our social connections are also critical to helping us diffuse negative emotions. Before COVID-19, we would organically run into people and have conversations. Those human face-to-face discussions remind us others are there who care. These organic interactions may not happen when we’re all in our homes, so it’s smart to take a more proactive approach. Schedule “social time” when you will call friends or others who perhaps are lonely.

Another great skill to learn right now is to note the connections between things you chose to do and their effect on your mental state. If you watch too much news, it will make you feel anxious. Other activities, though, can take your mind off of the pandemic completely. Learn what they are, and schedule them into your day to give you an escape. Activities such as singing, dancing, and laughing release positive endorphins that counter the effects of stress. Schedule all of these things into your day.

As illustrated above, maintaining mental health can sometimes come down to doing little things in a more planned and mindful way. When you learn these skills, you gain cognitive tools that can help you and your family manage your mental health during COVID-19 and the challenges that await us once this pandemic is in the past. And never forget, it will be in the past!

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Dr. Steve Joordens

Guest Author Ph.D., instructor of a popular free online course on Coursera, Mind Control: Managing Your Mental Health during COVID-19

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