With COVID-19 cases rising and winter on the horizon, we're all likely going to be spending the next several months in a state of life similar to the onset of this pandemic. But the only thing worse than going through lockdown the first time is going through it again — with the knowledge of how devastating each day can feel, especially for those living alone.
"The COVID-19 crisis has heightened attention to the fragility of life, increased awareness of uncertainty, fostered confusion and awakened a sense of helplessness that permeates all aspects of life as we know it," says Mayra Mendez, PhD, LMFT, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center in Santa Monica, California. "The social isolation, or distancing behaviors, that accompany this situation only add to the crisis phenomenon that deeply challenges human need for social connections."
As we prepare to cope with another wave of the COVID crisis, experts are urging a similar level of preparedness for managing the mental and physical effects of pandemic life.
"The pandemic's mental health impacts have begun to be documented, and we know there is a rise of mood disorders such as anxiety and depression, as well substance abuse and domestic violence," notes Sahar Esfahani, PhD, clinical psychologist at Maryland Cognitive Behavioral Treatment Center in Bethesda.
Get tips on how to stay healthy, safe and sane during the novel coronavirus pandemic.
One July review in the journal Globalization and Health found a rise in stress, anxiety and depression among the general population as a result of the COVID-19 pandemic. Another March study in the Journal of Anxiety Disorders linked the COVID-19 crisis to increased fear for loved ones and an overall boost in health-related anxiety.
While it might feel like much of your day-to-day life is out of your control, especially as the pandemic rages on, there are several ways you can prepare your mental and physical health ahead of the winter. Here, experts share their best tips.
1. Build a Consistent Routine
We humans crave routine, and for good reason. Creating a reliable pattern for your days is one of the most helpful behavioral strategies experts tout even without a pandemic.
Indeed, one June 2018 study in The Lancet Psychiatry linked a daily routine to a lower risk of depression.
Esfahani recommends even going as far as scheduling your wake-up and sleep times, as well as when you plan to exercise or take a lunch break. "As the winter months approach during the pandemic, having these habits and routines in place will make it easier for you to complete the tasks that are important to you," she says.
2. Try Mindfulness Meditation
If you don't currently practice meditation — i.e. set aside time to breathe deeply in an effort to relax and slow down your train of thought — it may just seem like one more thing to tack onto your to-do list. But research supports meditation's many benefits.
"Not only does mindfulness meditation help improve your focus and your overall attention span, but it can also significantly help with stress reduction, which is something just about everyone can use right now," says Vernon Williams, MD, sports neurologist, founding director of the Center for Sports Neurology and Pain Medicine at the Cedars-Sinai Kerlan-Jobe Institute in Los Angeles and consulting neurologist for the Rams.
Don't know how or where to start? Merely sitting still for a few moments each day, without distraction, and focusing your thoughts on a central topic — peace, relaxation or happiness, for example —is enough, Dr. Williams says.
3. Incorporate Positive Self-Talk
Whether out loud or in your head, the way you speak and think about yourself has an effect on your mental health.
"The more aware we are about our self-talk, the more space we have to practice helpful, rational-based thinking," Esfahani says.
She recommends taking notice of your thoughts, being mindful of negative self-talk (i.e. catastrophizing, all-or-none thinking, "should" statements) and working to reframe your thoughts to more helpful, balanced conversation.
"For example, try to change 'this will never end' to 'this is hard, and eventually it will get easier,'" she says.
4. Maximize Your Time Outdoors
Though the cold weather may start to limit how much time you can comfortably spend outdoors, it's important to take advantage of sunny days. One June 2019 study in Scientific Reports found that spending at least 120 minutes a week outside promoted overall good health and wellbeing.
"The health benefits from sunshine and vitamin D, particularly during the winter months, are enormous for one's mood," Esfahani says.
Try waking up on the earlier side a few mornings a week and getting outside, even for 15 minutes, so you can enjoy the fresh air and sunlight before getting on with your day.
5. Make Exercise a Must
Your gym may no longer be open, or be a place you're comfortable working out in, but there are many other ways to stay physically active — even in the comfort of your own home. And doing so, according to research, benefits your physical and mental health.
Exercise is one of the best ways you can keep your lungs strong and healthy, according to the American Lung Association, which can be particularly important in the fight against COVID-19. Plus, an August 2018 study in The Lancet Psychiatry found that people who exercise report having 1.5 fewer poor mental health days a month.
And exercise doesn't always have to mean a structured workout (although if that's your thing, you'll find plenty of options in our 20-Minute Workouts hub). Getting outside for a walk counts, as does taking a few trips up and down the stairs in your house, Mendez says.
6. Prioritize Sleep
Considering you're likely spending more time at home than ever before, you may as well use it as a chance to get to bed a little earlier to ensure a quality night's sleep.
"Sleep helps strengthen memory and the building of connections along the brain's neural pathways," Dr. Williams says. "During sleep, our brains perform the 'house-cleaning' of clearing toxins and waste products (like the lymphatic system's actions in the rest of our body)."
If enhanced brainpower isn't enough to convince you, Dr. Williams points out that proper sleep is also crucial in keeping the body's immune system strong, which may come in handy to fight against illnesses such as COVID-19. He recommends aiming for seven to eight uninterrupted hours each night and setting both a bedtime and wake-up alarm to help you stay on track.
7. Aim to Eat a Nutrient-Rich Diet
Scott Kaiser, MD, board-certified family medicine physician and geriatrician at Providence Saint John's Health Center in Santa Monica, California, recommends plotting a plate full of colorful fruits and vegetables to ensure you're getting important micronutrients, vitamins and antioxidants, lean proteins and complex carbohydrates.
"When eating to boost the immune system, you can aim to include foods high in specific vitamins and minerals, like zinc and vitamin C, that are linked to healthy immune function," he says.
What's more, healthy foods might be a boon for your mood. Switching from an unhealthy diet to a healthier one, even for a short amount of time, led to fewer symptoms of depression in an October 2019 PLOS One study.
8. Stay Close to Loved Ones — From a Distance
Even if you aren't able to gather with friends and family in person like you usually would, it's still important to maintain close contact.
"During a time of distancing and social isolation, talking to friends and family on the phone, emailing or texting all reinforce connections and camaraderie," Mendez says. "Sharing thoughts and experiences with trusted others is validating and provides an easy and cost-free way of engaging in a self-care activity."
If you're over Zoom happy hours, try something different: Watch a Netflix show or stream a concert "together," turn on FaceTime and queue up a workout video on YouTube, pick up some stationery that makes you happy and write letters to far-flung friends or join a group challenge and encourage each other toward a specific goal.
9. Write in a Journal
Journaling, or writing down your thoughts, feelings or emotions (whether via pen and paper or keyboard), has shown to be beneficial for one's mental health. Indeed, an October 2018 study in JMIR Mental Health found journaling helped improve mental distress and overall wellbeing in patients with elevated anxiety.
"Writing can be done simply and quickly as thoughts come to mind and when the desire calls," Mendez says. "The idea is to relax with your thoughts and experiences and allow yourself to process the positive as well as the negatives of the day."
Plus, think of it this way: By writing down your day-to-day during a pandemic — no matter how mundane — you're recording a unique time in history.
10. Work on Being More Comfortable With Uncertainty
Uncertainty in life is not new to 2020, or the coronavirus pandemic, even though it may feel as if we're facing more of it.
"COVID has given us the facade of control when we never had it pre-COVID," says clinical psychologist Johanna Kaplan, PhD, director of the Washington Anxiety Center of Capitol Hill in Washington, D.C. "Work on accepting that control is an unachievable goal."
She suggests thinking of areas in your life where you already do this. For example, you don't think about whether your air conditioning will blow out every day, but if it does, you know you can deal with it.
Using that same logic, try not to constantly worry about COVID-19. Instead, you can and should take precautions to not get sick (wearing a mask, social distancing) and have a plan in place to deal with it if it happens. Let that preparedness give you some peace of mind and help ease your stress.
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- Globalization and Health: "Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis"
- Journal of Anxiety Disorders: "Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020"
- The Lancet Psychiatry: "Association of disrupted circadian rhythmicity with mood disorders, subjective wellbeing, and cognitive function: a cross-sectional study of 91 105 participants from the UK Biobank"
- Scientific Reports: "Spending at least 120 minutes a week in nature is associated with good health and wellbeing"
- American Lung Association: Exercise and Lung Health
- The Lancet Psychiatry: "Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study"
- Online Positive Affect Journaling in the Improvement of Mental Distress and Well-Being in General Medical Patients With Elevated Anxiety Symptoms: A Preliminary Randomized Controlled Trial
- PLOS One: "A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial"