The spread of COVID-19 has changed the lives of millions of people all over the world in the last few months. As the virus has spread, people have had a number of questions circling in their minds- How do I stay healthy and safe during this time? How do I protect my loved ones? What should I do if I do feel ill? How do I maintain my mental health? How do I support myself when I can’t go anywhere outside of my home?

Some of us have had to grapple with these questions in ways we might be largely unaccustomed to, while others of us may feel terrified to be back in a place of worrying about our own or our loved ones’ well-being. As therapists, we have been forced to think about how we can provide support to people who are scared and vulnerable at a time when many of the supports we encourage people to use have closed or have also gone virtual. And as individuals, we feel that fear and concern that comes from that most uncomfortable of companions: uncertainty.

This month, rather than our usual assortment of articles, we are focusing this one article on how to take care of yourself in this period of uncertainty. How do you manage fear, anxiety, sadness, and anger, much of which might be quite understandable, so that you can continue to function day-to-day? How can you practice self-care when you can’t leave your house or apartment for more than a walk or run, if at all? How can you set boundaries with people you are stuck indoors with? And how do you make sure you stay connected to the groups and people who are your supports when you can’t see them in person?

Minding Your Physical Health

Generally when a therapist asks you how you’re feeling, you know to start talking about your emotions, but now is a time when we really want to make sure you’re physically well too! We are not medical doctors and cannot diagnose you with any medical conditions. Fortunately though, there are people who are medical doctors, and many of them have written helpful guidelines to know how to respond based on any physical symptoms you might be experiencing. The Centers for Disease Control and Prevention (CDC) has a helpful guide available online if you are experiencing possible COVID-19 symptoms and are unsure of what to do. If you live in New York City, follow these recommended local guidelines, and if you live elsewhere, check your state or city government website for further information. And no matter what, if you are feeling unwell, call ahead to your doctor or local hospital before coming in so they can take your relevant history and walk you through any local precautionary measures that are in place to help protect you and others.

Keep Those Mooring Lines Tight!

Right now you might be sitting with a temptation to do whatever is most comforting- stay in your pajamas all day, eat comfort foods, leave showering for later (or not at all!), return to or increase substance use, avoid work, put off exercising until later…or to not even realize that we’ve started doing all of those things! While all of those urges make sense (and might even be useful at points- keep reading!), we here at CMC are here to remind you to pay attention to those kinds of reactions. When changes big or small happen in our lives, we are more likely to stop engaging in the routine behaviors that connect us to our goals. Sometimes this can happen all at once, but more frequently it shows up as a slow drift away from those behaviors, like a boat slowly slipping away from a dock and out to sea. This is why we call these behaviors your “mooring lines,” they keep you moored to the “dock” of your goals, whether that means reducing or eliminating substance use, eating in a healthy and balanced way, cultivating meaningful relationships, or whatever might be most meaningful to you. While the temptation to drift might be strong, now is a critical time to stick with those healthy routines.

Well yeah,” you might be saying, “but my mooring lines involved going to my favorite gym class, bringing my dog to a dog park, and spending time with close friends. How exactly should I be maintaining those?” A very fair point, and obviously there are significant challenges to maintaining mooring lines right now. Our ideal options may not be available right now, so the next best thing is going to have to do for now. Missing those post-gym endorphins? Download a fitness app, take live online classes, find guided yoga and pilates session on YouTube, go for a run outside. Wishing you were working from an office rather than a makeshift desk in your living room? Set up your home office as best you can- it may still be in your living room, but make sure you have all the essentials you need for a productive workday with as few distractions as possible (with the understanding that there may be kids, pets, partners, roommates, or other family members around too). Now is a time to get creative and get to problem solving. Identifying what is preventing you from engaging in your healthy daily routines and use some trial and error until you find what works best for you.

Distress Tolerance Strategies

Now all of what we said above doesn’t mean that you should NEVER eat comforting food or hang out in your comfiest pajamas with a cup of hot chocolate. We just want to be thoughtful about when and how we are using those strategies. Most of these strategies (minus any compulsive behaviors) can be very effective when used as a distress tolerance skill. So what is distress tolerance exactly? The idea of distress tolerance is to help us manage situations that are highly stressful and where we notice wanting to act on our intense emotions in ways that may only make things worse, for example by using, engaging in other compulsive behavior, or saying or doing other things we might regret (like yelling at a family member when what we’re really feeling is fear or sadness about the way things are right now). So if your emotions are really strong and you’re going to regret how you act on them, it’s ok to do what you need in those moments. Distract yourself with baking or watching a funny video, soothe yourself with a warm bath or some scented candles and a cozy blanket, imagine how great it will be when this is all over and you get to see your friends in person again, take some deep calming breaths and remind yourself that you are here in this moment.

It’s more than ok to be gentle with yourself and give yourself a break. In fact, it’s essential in times like these. The thing we don’t want to have happen is for people to only use distress tolerance skills! Sometimes you need to take an active coping approach too, especially if your emotions aren’t super intense in the moment. Sometimes we will need to do the challenging things, like push ourselves to exercise when we’re feeling tired or down, or do something enjoyable even when things seem bleak. But when things are too intense and overwhelming? It’s ok to cut yourself some slack and unwind a bit.

Support is Important!

Up until now, we’ve mostly focused on how you can take care of yourself alone, but we want to point out how important it is for everyone to have and to use any available social supports right now. That might mean staying in contact with your therapist for internet-based sessions, or extra FaceTime or Skype conversations with friends and family. Or even just increased texting (yes, this means more screen time, which we all have to find a way to accept for the time being!) with people in your social network. But the more you stay in touch, the better your mental health will be over this period of time. We humans are a social species- we need that connection and closeness, and never more so than during a period of tumult and uncertainty.

Support involves having people be there for us in the ways we want and need, which also sometimes involves communicating when we aren’t getting our needs met. Admittedly, there may be lots of ways that other people in our lives aren’t doing exactly what we would want right now, so picking your battles is going to be important, especially if you are spending 24/7 with people you may not always get along with. That being said, positive communication is going to be a really important skillset during these times! Tell someone specifically what behavior you are responding to and how it’s making you feel- and then be ready to provide a different, specific behavior you’d like to see instead and how that will be beneficial to them. Kids keep leaving their dirty dishes in the sink? Try this one on for size: “Hey guys, I’ve noticed you keep leaving your dirty dishes in the sink, and it’s so frustrating finding that at night when I’ve been working all day. I really need you to clean your dishes before I’m finished with work at 5:00. That way I’ll be less likely to snap at you and we can spend some family time together doing fun things.” Easy, right? (Just kidding- we know it’s anything but).

Stay Connected!

From Zoom conference calls with friends to virtual playdates for kids, staying connected to your friends and family is key to helping you tolerate all of the difficult emotions that come along with being isolated. Set up a regular schedule of connections with those people who you are closest with, and reach out to people who you may not have been as in touch with in the past (but would like to reconnect with). Having regular conversations with people outside of your house can lift your spirits, help you feel connected, and help give you the emotional energy necessary to make it through this period of time. And let’s not worry about screen time right now! We can work on reducing that again when the time comes!

Control What You Can, Accept What You Can’t

Everything we have gone over so far are things that are within your control, and that being said, there are a lot of things that aren’t in your control right now. You can’t control whether someone else walks too close to you at the grocery store, how state or federal governments are responding to this crisis, or the fact that your Amazon Prime package won’t be delivered until late April at this point. Sadly, you also can’t control what will happen to someone if they do get sick. It’s ok to feel any number of emotions in response to this, but what won’t help is trying to control whatever is beyond your control. Never has the serenity prayer of being granted “the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference” rang more meaningful. The more you fight whatever is outside your control, the more you will drain yourself, and the less you will be able to act effectively to address whatever you need to in the moment. Accepting this doesn’t mean you like it or approve of it – it just means that this is the situation you are finding yourself in, along with whatever pain or uncertainty that entails.

It’s OK to Cry

Last but not least, we know that things are hard right now … in a lot of ways and for a lot of people. Now more than ever, we believe in sticking to both pieces of our credo, relying on science and kindness to help ourselves and others. Be kind and gentle with yourself and others, and allow whatever emotions you are experiencing to be present. Treat those emotions too with the kindness that you would show to a treasured friend or guest. All emotions are welcome at the dining table of our experience these days, and the truth is, you may be having many more dinner guests than you are used to! This is ok. It is neither good nor bad, it just is your experience in this moment. And your experience in whatever the next moment brings? That is ok too. This is what it means to be human. We will feel sadness, fear, anger, guilt, shame, and we may even find pockets of joy, humor, contentedness, relaxation, and pride over these next few weeks or months as well. Notice it. Name it. Let it just be there. And if you need to cry? By all means, let yourself whenever you can. Set aside some time each day to let yourself feel, along with whatever bodily reactions that entails.

We at CMC are thinking of all of you during these challenging times, and we are more dedicated than ever to continuing to provide care to those in need. While we so look forward to the day that we get to see many of you again in person, we hope that in the meantime these recommendations will help you to ride out all of the emotional ups and downs during these uncertain and trying times.

Wishing safety, health, and support to all,
CMC