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Mental health in time of coronavirus
Ana Perović clinical psychologist and psychotherapist
Mental health in time of coronavirus
In the last couple of weeks, we have witnessed the epidemic of coronavirus (SARS-CoV-2 is the name of the new coronavirus, while COVID-19 is the name of the disease caused by this virus) and the serious shock suffered by the healthcare systems all around the planet. Unfortunately, many Serbian media gave sensationalist reports on the new virus, which left plenty of room for confusion, increased panic and even conspiracy theories. Although a certain level of anxiety is quite normal in these extraordinary circumstances, what we are doing to stabilize ourselves and adequately regulate and channel that anxiety into precautions for our own safety and safety of others is of utmost importance for us, as well as for our community. We will consider here some of the psychological effects that the current pandemic may have on us, as well as certain measures that we as individuals can take to preserve our own mental health and the mental health of our loved ones.

Regulating fear of the unknown and being threatened

One of the main differences in perception of the seasonal flu and coronavirus is that the first one is perceived as a virus which we know sufficiently well. We know its diagnostic criteria and symptoms, we know how it is transmitted, we know how it is treated, whom to address and more or less what we can expect. Coronavirus is currently observed as something partially unknown and threatening which are the two factors which conjoined may contribute to the feeling of unpredictable situation, and accompanying feelings of anxiety, fear, elevated attention and tension. These feelings may particularly intensify in people who otherwise have problems with overcoming situations which include tolerating of uncertainty.

One of the basic ways that we can make the situation more familiar and predictable to ourselves (to the extent currently possible) is to find reliable and precise sources of information which will clarify things, and, in itself, empower us. At the bottom of this text, you can find links to reliable resources we know about, which compile verified and up-to-date information which may serve as guidelines for orientation.

Regulating fear of uncertainty

Although our findings about coronavirus increase each day, the ability of experts to precisely foresee the further course of spreading at this specific moment of the pandemic, as well as the moment when the expansion will reach a plateau is not great. Such situation may additional increase the level of anxiety because such anxiety implies a reduced feeling of control, i.e. of managing one’s own life. As this feeling is one of the fundamental factors of human welfare, we support application of strategies you usually use to better tolerate uncertainty.

If you have noticed these days that your thoughts move towards catastrophizing and a series of different scenarios which may be dangerous to you or your loved ones, and that you have problems stopping them, try, first of all, to take notice of it. One of the common symptoms accompanying anxiety is the attempt of our mind to prepare us for the worst possible scenario so that we can try to regain the feeling of control (“if I am ready for the worst possible scenario, then I am ready for everything” logic).

Considering that our psychological state has a great contribution to our physical welfare (which comes to light the most in crisis situations), we recommend that you try to calm your anxious thoughts in some of the following ways:
- Asking for support from people around you or psychotherapist (in this period, try to do it by audio or video call; many therapists will offer this themselves);
- Practicing techniques of relaxation and stabilization (breathing exercises , grounding exercises ),
- Meditation or exercises that help you release certain thoughts if you judge that they make you more tense,
- Creating your database of available resources (human, informational, healthcare,...).

We almost always have a certain level of control over our own behaviour and some of the choices we make. Try asking yourself: “Over what can I have control now and what brings me back the sense of control?” While replying to these questions, try to observe how you feel and how you breathe. Notice whether answers to these questions make you calm. If that is not the case, try to check your doubts with a person close to you.

Finally, perceiving uncertainty as an integral part of the life we share with the rest of humanity, instead an enemy to be eliminated, may help in changing the perspective and the relation we establish with the state of uncertainty.

Correct assessment of danger

Coronavirus may be dangerous, and the current data on mortality rate are around 4.5%, depending on the geographical region and the method of fighting the epidemics. That is a sufficient reason for taking reasonable precautions to protect ourselves and others. However, these data can be confusing when we try to convert them to terms of assessing the danger of the situation. We can react to such situation by one of the following tendencies:
1. To overestimate the level of danger and threat and to be overcome with the feeling of danger and panic,
2. To feel the need to minimize the sense of immediate danger (as a type of psychological defence) and thereby develop an indifferent attitude toward the situation.

Both approaches can make it difficult for us to take adequate protective measures but in different ways – the first one by overestimating and the second one by underestimating the threat. If you notice that your reactions may be put in one of these categories, you may try to think about questions such as:
- To what can my feeling of overwhelming panic in this crisis situation be connected? Does it remind me of something? What could help me to feel less overwhelmed?
- Why is it important for me to not deal with this topic? Does it happen to me otherwise to not think about the risk of my behaviour to myself and others? What would help me to better see the potential consequences of my neglect and regain the feeling of care for myself and others?

Correct assessment of own capacities for protective measures

In addition to correct assessment of the level of danger, it is very important to adequately assess own capacities to protect ourselves. Psychological research has shown that people tend to overestimate the effect of negative effects on them , and at the same time underestimate how successfully they would deal with such situations. Therefore try, with precautions, to bear in mind that you are probably more psychologically resilient than you think.

The resources listed at the bottom of this text include websites where you can find a detailed description of practical healthcare protection measures. Try to check with yourself how you experience them and how you feel about the prescribed guidelines. If you notice that you react emotionally to some of the measures (resistance, anger, fear or anxiety…), try to talk to a person you trust or a psychotherapist about it. Most protective measures are prescribed to contain spreading of the new coronavirus as soon as possible, but it may happen that some of the measures have specific meaning for you and it might be worth exploring what this is about. For now, the only reliable way not to infect yourself and to prevent infecting others is to isolate from contact with all people, if possible even inside your home. Recommendation of self-isolation may lead to us being in contact with what it means to be left alone and it may be an opportunity to better understand the feelings of being alone and loneliness. We may investigate whether the time spent alone can become quality time with ourselves.

If, however, you feel that prescribed protective measures are insufficient for you to feel safe, try to help yourself feel safer through the resources you would use even outside of this crisis situation.

Balance the quantity of time you spend thinking/talking about this topic

Keeping up with the news about COVID-19, although necessary to some point, requires daily time and attention. Intensive dealing with such topic may, in some cases, take the form of fixation or perhaps lead you to notice that you have become preoccupied with researching this topic. This can be additionally contributed by headlines in the media and content on social networks, as well as the impression that various established life routines and plans in this period change from day to day. In some cases, we may have the impression that our life was put on pause until further notice. At the same time, you have probably had the opportunity to notice that many supermarkets were left with empty shelves which adds to the feeling of mass panic, and even references to some previous social crises such as the state of war.

If you notice that information about coronavirus burden you psychologically, you may try some of the following:
- Avoid consuming information directly after waking up or just before going to bed as we are generally more susceptible to being emotionally involved in the subject, and it might be harder to stop thinking about it. Instead, try including in your morning routine the questions such as: ”What can I do today about preserving my own welfare?” and in your routine before going to bed the questions such as: “With what thoughts (about thankfulness or hope, perhaps) do I wish to go to bed tonight?”
- Limit the time of day you devote to this topic (either by consuming content or discussing it with people) and thereby try to preserve personal limits of space occupied by this topic. If necessary – “mute” some of the notifications you receive. In crisis situations, it is good to have a reminder that life exists, has existed and will exist even outside the boundaries of the current crisis situations.
- Finally, give yourself the right to the time during which, in a safe way, you do not deal with this topic but rather do something you love. This can be particularly important if you are forced to self-isolation or you chose it as a method of protection.

If you have someone who needs additional support on this topic

If you have someone around you who needs additional support in reducing anxiety or perhaps assistance in understanding their own neglect of potential danger, try to offer some of the techniques described above. As solidarity is one of the key factors in crisis interventions, try to be a resource to others, if you are able to do so. This especially applies to situations when there are people in your close surroundings who belong to some of the following populations:

- Elderly: if some of the older family members have problems understanding any of the information concerning COVID-19, try helping them by pointing out false information, simplifying correct data and offering specific guidelines for behaviour in the situation.

- Children and adolescents: Devote some time to explain to children the importance of adopting certain habits so that we can protect ourselves and others from infection by joint efforts. If your child shows a specific emotional reaction to this topic, try naming it and talking about it. Make an effort to be patient for questions of children and adolescents . Also, if your adolescents resist dealing with this topic, try to point out to them that their behaviour could directly save or endanger someone’s life.

- People with anxiety problems: if there is someone around you who tends to worry or panic, try to keep in mind that this situation could destabilize such person. Give this person space to tell you how they feel, try offering compassion and some of the resources mentioned here.

- People who when through crisis situation (bombing, war): if there is someone around you who survived the experience of mass tragedy or quarantine, bear in mind that the current situation could be quite stressful or even re-traumatizing for this person. In that case, it is recommended to point out to this person the differences between the actual situation happening “now and here” and the situation which happened in the past, to help them create emotional distance from traumatic memories.

- People for whom the strategy of self-isolation is not a safe option: as there are many people for whom staying at home is not an encouraging option in this situation, we support you in finding free telephone lines for the victims of domestic violence where they can get advice and legal information.

Source: PsihoBrlog
Ana Perović
clinical psychologist and psychotherapist