No one knows how this ends. The uncertainty may be as unsettling as the virus itself.
As the U.S. imposes restrictions to save lives during the global coronavirus pandemic, people are agonizing over one question: When will “normal” life resume?
People want to know when they can touch again and whisper closely. When they can walk not on quiet trails but through the hum of a crowd – bumping shoulders, inhaling perfume, eavesdropping. They wonder when they’ll be able to send their children to school. They want to know when solitude will become a choice again.
“We are all anxious. We are all tired. We are all fatigued. it’s been all bad news for a long time,” New York Gov. Andrew Cuomo said in a press conference Tuesday. “Our whole lifestyle has been disrupted. Everybody wants to know one thing: When is it over? Nobody knows.”
Psychologists say uncertainty is unsettling because human nature demands predictability. People count on it in daily life, in the structures around them, to function. When they don’t have it, they can become uncomfortable and insecure.
“The things we rely on for stability in our lives are all under siege,” said Melanie Greenberg, a clinical psychologist in California and author of “The Stress-Proof Brain.”
“Our brains are designed to predict what’s going to happen next and to try to prepare for it. In this case, the response isn’t that clear.”
Americans know they are facing a threat, but they aren’t sure exactly how it may impact the economy, the country’s politics or society at large. Public health officials can’t say when social distancing or quarantines will end. Some people don’t know whether they’ll have a job to go back to or a business to reopen. No matter how often someone washes their hands, they can’t ensure they won’t get sick.
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Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, projected millions of Americans will contract COVID-19 and estimates released by the White House on Tuesday project as many as 240,000 Americans may die. If people continue to hunker down, the number of projected deaths fall between 100,000 and 240,000. But health officials caution the models of infection rate vary widely. They, too, are uncertain.
Adding to the disquiet: People can’t use history to ease their fears. Brains learn from past experiences to develop responses to stay safe and to avoid pain. If someone was laid off in the past but got through it, they would know job loss doesn’t have to be catastrophic. If someone got the flu but recovered, they’d know getting it again wouldn’t mean certain death.
But coronavirus is novel.
“Sometimes, we can calm ourselves down by thinking about our history of successfully coping with something similar,” Greenberg said. “There’s nothing like that here. That’s even more unsettling.”
People never know what’s going to happen next. But because they have routines, they make predictions about what is probable and this provides comfort. The pandemic has decimated that.
“We need some certainty to feel fundamentally safe in our lives,” said Nancy Colier, a psychotherapist and interfaith minister. “And yet when an illness comes up or an accident happens, we’re momentarily cast into this reality of, ‘Oh my God, really all we have is this moment.’ That’s actually the only thing that is certain.”
People can worry less by focusing on the present, she says. If someone feels compelled to worry, she recommends to set aside 30 minutes a day for it. When the timer ends, move on.
“It’s totally normal to be struggling amid fear of the unknown, but we don’t have to get stuck there,” Wright said. “We need to let go of thoughts that are tripping us up, like ‘this is unfair,’ or ‘why is this happening?’ Those are all ways that we maintain our fear and fight our reality.”
Dealing with uncertainty takes training. Experts say practicing mindfulness can help. When a person focuses on what they’re seeing, hearing, feeling or smelling in a given moment, the brain can’t worry at the same time. People can avoid catastrophizing by remembering the things they’re doing to keep themselves safe. Statistically, there’s a chance of dying, but it’s still not the most likely scenario.
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Colier says it’s also important to have self-compassion. These disruptions cannot be underestimated.
“This is outside our comfort zone. All the things that we rely on to know who we are, all our roles, all the ways we structure our day have been completely removed,” she said. “We’re being asked to come back to ourselves, to go inside. This is really, really hard for people. So be super gentle with yourself about however you’re managing it.”
Change, Colier notes, often happens on its own accord. This moment, for all its suffering, is an opportunity to reflect – to ask fundamental questions about our lives, our values, even the nature of our realities.
While there is no certainty about the future, this uncertain time offers people the space to grow more certain about who they are and who they want to be. To watch what crumbles. To see what remains.
“It’s an opportunity to really take this moment as if it matters. How do I want to show up for it? It becomes the only important question,” she said. “Adversity is the opportunity for us to change fundamentally. And if you use it in that way, it’s so precious.”
Alia E. Dastagir is a recipient of a Rosalynn Carter fellowship for mental health journalism. Follow her on Twitter: @alia_e
Original Post: https://amp-usatoday-com.cdn.ampproject.org/c/s/amp.usatoday.com/amp/5097190002
Some of the HBR edit staff met virtually the other day — a screen full of faces in a scene becoming more common everywhere. We talked about the content we’re commissioning in this harrowing time of a pandemic and how we can help people. But we also talked about how we were feeling. One colleague mentioned that what she felt was grief. Heads nodded in all the panes.
If we can name it, perhaps we can manage it. We turned to David Kessler for ideas on how to do that. Kessler is the world’s foremost expert on grief. He co-wrote with Elisabeth Kübler-Ross On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss. His new book adds another stage to the process, Finding Meaning: The Sixth Stage of Grief. Kessler also has worked for a decade in a three-hospital system in Los Angeles. He served on their biohazards team. His volunteer work includes being an LAPD Specialist Reserve for traumatic events as well as having served on the Red Cross’s disaster services team. He is the founder of www.grief.com, which has over 5 million visits yearly from 167 countries.
Kessler shared his thoughts on why it’s important to acknowledge the grief you may be feeling, how to manage it, and how he believes we will find meaning in it. The conversation is lightly edited for clarity.
HBR: People are feeling any number of things right now. Is it right to call some of what they’re feeling grief?
Kessler: Yes, and we’re feeling a number of different griefs. We feel the world has changed, and it has. We know this is temporary, but it doesn’t feel that way, and we realize things will be different. Just as going to the airport is forever different from how it was before 9/11, things will change and this is the point at which they changed. The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.
You said we’re feeling more than one kind of grief?
Yes, we’re also feeling anticipatory grief. Anticipatory grief is that feeling we get about what the future holds when we’re uncertain. Usually it centers on death. We feel it when someone gets a dire diagnosis or when we have the normal thought that we’ll lose a parent someday. Anticipatory grief is also more broadly imagined futures. There is a storm coming. There’s something bad out there. With a virus, this kind of grief is so confusing for people. Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety. We’re feeling that loss of safety. I don’t think we’ve collectively lost our sense of general safety like this. Individually or as smaller groups, people have felt this. But all together, this is new. We are grieving on a micro and a macro level.
What can individuals do to manage all this grief?
Understanding the stages of grief is a start. But whenever I talk about the stages of grief, I have to remind people that the stages aren’t linear and may not happen in this order. It’s not a map but it provides some scaffolding for this unknown world. There’s denial, which we say a lot of early on: This virus won’t affect us. There’s anger: You’re making me stay home and taking away my activities. There’s bargaining: Okay, if I social distance for two weeks everything will be better, right? There’s sadness: I don’t know when this will end. And finally there’s acceptance. This is happening; I have to figure out how to proceed.
Acceptance, as you might imagine, is where the power lies. We find control in acceptance. I can wash my hands. I can keep a safe distance. I can learn how to work virtually.
When we’re feeling grief there’s that physical pain. And the racing mind. Are there techniques to deal with that to make it less intense?
Let’s go back to anticipatory grief. Unhealthy anticipatory grief is really anxiety, and that’s the feeling you’re talking about. Our mind begins to show us images. My parents getting sick. We see the worst scenarios. That’s our minds being protective. Our goal is not to ignore those images or to try to make them go away — your mind won’t let you do that and it can be painful to try and force it. The goal is to find balance in the things you’re thinking. If you feel the worst image taking shape, make yourself think of the best image. We all get a little sick and the world continues. Not everyone I love dies. Maybe no one does because we’re all taking the right steps. Neither scenario should be ignored but neither should dominate either.
Anticipatory grief is the mind going to the future and imagining the worst. To calm yourself, you want to come into the present. This will be familiar advice to anyone who has meditated or practiced mindfulness but people are always surprised at how prosaic this can be. You can name five things in the room. There’s a computer, a chair, a picture of the dog, an old rug, and a coffee mug. It’s that simple. Breathe. Realize that in the present moment, nothing you’ve anticipated has happened. In this moment, you’re okay. You have food. You are not sick. Use your senses and think about what they feel. The desk is hard. The blanket is soft. I can feel the breath coming into my nose. This really will work to dampen some of that pain.
You can also think about how to let go of what you can’t control. What your neighbor is doing is out of your control. What is in your control is staying six feet away from them and washing your hands. Focus on that.
Finally, it’s a good time to stock up on compassion. Everyone will have different levels of fear and grief and it manifests in different ways. A coworker got very snippy with me the other day and I thought, That’s not like this person; that’s how they’re dealing with this. I’m seeing their fear and anxiety. So be patient. Think about who someone usually is and not who they seem to be in this moment.
One particularly troubling aspect of this pandemic is the open-endedness of it.
This is a temporary state. It helps to say it. I worked for 10 years in the hospital system. I’ve been trained for situations like this. I’ve also studied the 1918 flu pandemic. The precautions we’re taking are the right ones. History tells us that. This is survivable. We will survive. This is a time to overprotect but not overreact.
And, I believe we will find meaning in it. I’ve been honored that Elisabeth Kübler-Ross’s family has given me permission to add a sixth stage to grief: Meaning. I had talked to Elisabeth quite a bit about what came after acceptance. I did not want to stop at acceptance when I experienced some personal grief. I wanted meaning in those darkest hours. And I do believe we find light in those times. Even now people are realizing they can connect through technology. They are not as remote as they thought. They are realizing they can use their phones for long conversations. They’re appreciating walks. I believe we will continue to find meaning now and when this is over.
What do you say to someone who’s read all this and is still feeling overwhelmed with grief?
Keep trying. There is something powerful about naming this as grief. It helps us feel what’s inside of us. So many have told me in the past week, “I’m telling my coworkers I’m having a hard time,” or “I cried last night.” When you name it, you feel it and it moves through you. Emotions need motion. It’s important we acknowledge what we go through. One unfortunate byproduct of the self-help movement is we’re the first generation to have feelings about our feelings. We tell ourselves things like, I feel sad, but I shouldn’t feel that; other people have it worse. We can — we should — stop at the first feeling. I feel sad. Let me go for five minutes to feel sad. Your work is to feel your sadness and fear and anger whether or not someone else is feeling something. Fighting it doesn’t help because your body is producing the feeling. If we allow the feelings to happen, they’ll happen in an orderly way, and it empowers us. Then we’re not victims.
In an orderly way?
Yes. Sometimes we try not to feel what we’re feeling because we have this image of a “gang of feelings.” If I feel sad and let that in, it’ll never go away. The gang of bad feelings will overrun me. The truth is a feeling that moves through us. We feel it and it goes and then we go to the next feeling. There’s no gang out to get us. It’s absurd to think we shouldn’t feel grief right now. Let yourself feel the grief and keep going.
Original Post: https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief
Social distancing is the most effective tool the United States has to slow the spread of the novel coronavirus, but mental health experts warn that the isolation, combined with the stress of coping with a global pandemic and the disruption summoned by the virus, could brew a toxic environment for people grappling with mental health issues.
Who may be most susceptible to stress during this crisis? Older people, those with chronic health conditions, children and teens, health care workers serving on the front lines of this virus and people grappling with mental health conditions, including substance use, according to the Centers for Disease Control and Prevention.
Even if you’re not in one of those groups, this profound moment of worry, separation, lack of social interaction, job insecurity and possible illness — or worse — can be hard on everyone. The PBS NewsHour asked experts for advice about how to manage the stress of life during the COVID-19 pandemic.
This necessary public health strategy protects vulnerable populations and prevents the nation’s health care system from being maxed out. Certain characteristics of this outbreak– its quick spread and its ability to live on surfaces for days– have made it particularly difficult to contain.
No vaccine or antidote exists specifically to fight the novel coronavirus pandemic that has swept the globe. Since humans have not yet developed immunity to this new respiratory virus, it is very contagious and spreads easily when someone coughs, sneezes, touches their face or contaminates other surfaces. And the symptoms are easy to confuse with the seasonal flu.
The U.S. failed to produce and distribute enough diagnostic test kits before the virus spread within communities and throughout all 50 states and the District of Columbia. Now community transmission is taking place in many states, meaning public health officials can no longer trace a person’s contacts before they became infected. Because there are still not enough test kits to fully know who has the virus, health officials are rationing them out to patients.
For all of those reasons, public health officials say social distancing is the only way to prevent a crush of patients sick with COVID-19, the disease caused by novel coronavirus, from overwhelming the nation’s health care system.
When you socially distance, you stay home and interact only with the people with whom you live. When you go outside, you stay at least 6 feet away at all times from anyone who doesn’t live in your household. You don’t go to your workplace. Your kids don’t go to school, the public playground or have playdates. You don’t visit your friends on the other side of town. You don’t eat at your favorite restaurant to celebrate your anniversary or birthday. You postpone your big wedding.
READ MORE: One simple chart explains how social distancing saves lives
It’s massively disruptive, and for many people, it has been intensely stressful.
No one knows how long this pandemic will last, or how long people’s lives will feel upended. Combined with the stress of job loss, mounting debt, household strains or even not being able to blow off steam at the gym, people may increasingly feel frustrated, bored, angry or confused, said Dr. Lynn Bufka, a psychologist and expert on stress and anxiety with the American Psychological Association.
“If you’re depressed, it’s hard to get the energy about how to do the things you need to do to stay connected to others,” Bufka said. “If you’re anxious, your anxiety is probably already elevated right now, and you have fewer resources to deal with that.”
According to a new poll from the PBS NewsHour, NPR and Marist, nearly a fifth of Americans said they have lost their job or had their work hours cut due to novel coronavirus, and 48 percent said they, or someone in their household, canceled plans to avoid crowds. The Trump administration said it would suspend evictions and foreclosures for certain homeowners. President Donald Trump on Wednesday signed into law the Families First Coronavirus Response Act, which provides some relief, but some critics have said it doesn’t go far enough to cover paid sick leave for workers.
Social distancing can also be very lonely. Many older adults have grappled with solitude and loneliness long before COVID-19, as they are losing loved ones as they age. Nearly one out of three older Americans live alone, and 43 percent of seniors say they feel lonely on a regular basis. But this virus adds a new layer, separating these individuals from the outside world as people respond to the immediate demands of the crisis and remove themselves from daily public life.
For many people who are most vulnerable to the disease, the reality is that “no one’s calling, no one’s checking, they’re running low on food and wondering what happens when their prescription runs out,” said John Auerbach, president and CEO for the Trust for America’s Health, a public health advocacy group.
“People who are already frail and have already had a lot of social isolation are disproportionately people who are at risk for serious illness and death for this coronavirus,” Auerbach said.
Government officials need to ensure basic supplies are met for everyone who needs them, Bufka said, while “reinforcing the sense that we’re all doing this for the greater good.”
The CDC says stress can manifest itself in certain behaviors for adults, including:
Social disruption can be very stressful for children, too. Losing the routine of going to school, learning with friends and teachers and playing on the playground is jarring. Kids may express that frustration in a number of ways, depending on their age, including:
People in isolation should “stay connected and maintain your social networks,” along with your daily routine as much as possible, the World Health Organizationsaid earlier this month. Maybe you can’t go to the office, but you can still take a shower, get dressed and stick to a general schedule.
You should also exercise, eat healthy food and sleep regularly, the WHO has urged, telling the public to “pay attention to your own needs and feelings” during these stressful times.
If you’re consuming endless amounts of news about COVID-19, that can ramp up your anxiety. Set times during the day to check in on developments, and pay attention to news and information from trusted sources to help you prepare and stay safe.
And even if you can’t hug your best friend or visit your loved ones, technology makes it possible to make connections, and still appreciate the ups and downs of being human in these times.
Despite social distancing, “we have opportunities to deepen our relationships,” Bufka said.
Original Post: https://www-pbs-org.cdn.ampproject.org/c/s/www.pbs.org/newshour/amp/health/why-your-mental-health-may-be-suffering-in-the-covid-19-pandemic