No 210 June 2020

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What can we do about it?

< Surviving and thriving in times of pandemics

We don’t need to be passive participants in this environment.  We all have skills and strategies that we can turn to which will assist us during this time, and as things keep changing.  One thing I have seen over my time as a Social Worker working in the bleeding disorders community is that most people have developed skills in resiliency which can and are being utilised at present. Some of the strategies are helpful and some are less helpful and can lead to increased difficulties if we rely on them. Let’s start with the less helpful.

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LESS HELPFUL STRATEGIES


Using alcohol and drugs (including misuse of prescription medication) to cope. 

The Foundation for Alcohol Research and Education (FARE) reported on a national poll by YOUGov Galaxy in April 2020, that one in five (20%) of households reported buying more alcohol than usual since the COVID-19 outbreak in Australia. In households where more alcohol was purchased than usual: 
  • 70% reported drinking more alcohol than usual since the COVID-19 outbreak in Australia 
  • 32% were concerned with the amount of alcohol either they or someone in their household is drinking 
  • Over a third (34%) said they are now drinking alcohol daily 
  • 28% reported drinking alcohol to cope with anxiety and stress 
  • 28% had been drinking alcohol on their own more often 
  • 24% had started drinking alcohol and ended up drinking more than they thought they would have 
  • 20% reported having started drinking alcohol earlier in the day

Alcohol and drugs are not helpful strategies to assist with coping skills.  They instead create additional challenges and stressors – including financial concerns, health impacts, relationship difficulties (including increased risk of violence and abuse) and sometimes legal issues, to name a few.     

Other less helpful strategies include:
  • abuse and violence
  • activities which cause harm to yourself
  • over-eating/undereating/eating foods that are ‘sometimes’ foods all the time (eg, bingeing on chocolate daily).   

These strategies essentially lead you away from the life that you want to live and have additional consequences that cause harm either to yourself or others and do not improve the things causing you stress. 
 

HELPFUL STRATEGIES


Helpful strategies, most often, are ones that increase DOSE neurotransmitters and hormones, which are Dopamine, Oxytocin, Serotonin and Endorphins.  These hormones also counteract the impact of the hormones produced by the fight, flight, freeze response. 

Dopamine – is a ‘motivation reward’ chemical. The most helpful way to get some dopamine flowing is to write a to-do list, and get the jobs on that list done, ticking them off.  You can even jump start (or cheat) by writing down some of the tasks you have already achieved.  Any completed task that gives you a sense of achievement and satisfaction will get the dopamine flowing.   So, for example you might have a list of jobs – worm-and-flea-treat your pet, vacuum the floors, stack the dishwasher/wash up, fix the broken downpipe, weed the garden. These may be easy for you to achieve. Sometimes, some of the tasks may need to be broken down. Or you may have a never-ending to-do list – get started with some easy-to-achieve tasks.   On some days when dopamine levels are particularly low, you might need to start simple and begin with – get out of bed, get dressed, clean teeth, have a shower, eat breakfast, make your bed. All of these achievements will start you off. These all are productive, with the intended consequences being positive.  

Oxytocin – you might have heard it called the love or hug drug.  The ideal source is a 20 second hug with an appropriate, consenting person.  However, in times of physical distancing, this is harder to achieve; and for some people, hugging isn’t their thing, but fear not, we can be more creative and still boost our oxytocin.  
  • Patting and cuddling pets not only gives us an oxytocin boost, but also them. It’s a win-win situation! 
  • Looking at photos of people you love, times that you enjoyed.
  • You can even give yourself a hug or similar. What it will look like is arms crossed in front of you - left hand on right shoulder, right hand on left shoulder. Or you can put your hand or hands on your chest over your heart. It is about finding a position that makes you feel comfort and is comfortable for you. For example, giving yourself a hug by the first example may be impossible for you if you have shoulder or elbow issues, but you can place one hand on your chest, giving you a sense of feeling supported and loved.

Serotonin - one of my colleagues describes actions to increase serotonin as things that make you go MMMMmm, or things that bring you pleasure from your senses.  

Things you see – might be a picture of your favourite place, the ocean, a garden. It will bring a smile to your face.

Things you hear – music is the most popular – playing your favourite songs, creating and listening to a playlist. It might be the ocean, thunderstorms, rain on the roof, birds singing, wind in the trees.
 
Things you can smell – coffee, flowers, favourite perfume (or a loved one’s favourite perfume that brings back positive memories), cut grass.  For me it is rain – (petrichor).

Things you can touch – this one is a bit harder in a pandemic where we are trying to limit touching to reduce spread of a virus. So, massage may be out for many, but feeling the water on your skin in a shower, bubbles in a bubble bath, grass on bare feet, the touch of your favourite shirt, or blanket or even stretching can all assist with serotonin production.  

Things you can taste – chocolate, coffee, cheesecake, taste of food, cup of tea. But the trick is taking the time to savour and enjoy it, eating or drinking mindfully, rather than eating on the go or drinking your tea/coffee quickly.  

A method/strategy called grounding uses your senses and can help bring down feelings of anxiety, for example. It is sitting or standing quietly and noticing 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell and 1 thing you can taste. You can mix these around. For example, you might do 5 things you can hear, and 4 things you can see. Just be aware that it might get a bit tricky finding 5 things you can taste (unless you are eating at the time)! This also brings you into focussing on the present moment.

Endorphins – often called the exercise high. Many people feel the boost of endorphins after exercise.  So, gyms or running aren’t your thing - that’s ok, as that is not all exercise is. Find the activity that suits you and that you can do. Your HTC physiotherapist will be a good source of ideas that are appropriate for you. Think outside the traditional especially at this time – dancing in your lounge room, the comedian Miranda likes to gallop, playing with your children, hula hooping. For those less active souls, a good dose of laughter will also trigger endorphins. Laughter yoga reports that voluntary laughter provides similar physical and psychological effects/benefits as spontaneous laughter. You might even find that trying some of the ‘laughter exercises’ will lead to you laughing spontaneously.  

Gardening - I can’t believe I have missed this one out, as it has been my go-to for managing stress and enhancing my mental health for years.  Gardening has many benefits for mental well-being, not just in times of pandemics. Being in nature, spending time growing, planting and tending to plants connects us with the present, especially when done mindfully. Gardening is also a form of exercise. Beyond Blue published a document – Beyond Blue to Green - about the mental health benefits of green spaces in 2010.  I thoroughly encourage you to read this document if you are interested.  
 
OTHER HELPFUL STRATEGIES

There are also strategies that include meditation and mindfulness.  The Black Dog Institute encourages having a self-care plan on their COVID-19 factsheet.  I would encourage this all the time.  Looking after yourself is extremely important and having a ‘go-to plan’ that you utilise all the time, not just when you are stressed or when the world is experiencing a pandemic, can be very helpful. These can also be useful strategies to add to your toolkit to help with pain!

Many of the posts on social media have been talking about learning new skills.  As someone who is currently studying, I would say from my perspective (which is also supported by many psychologists and social workers) now may not be the time if you are having difficulty with concentration (for example).  However, if you have the space and ability to learn something new, consider using this time for that.  I thoroughly encourage everyone to be kind to yourself first and foremost.  
 

CHALLENGES


If you are struggling, it is important to acknowledge it, reach out for help if you need to and give yourself permission to not be perfect or at the same level as you were pre-COVID 19.  There is no shame in admitting you are struggling, but the key is in being kind to yourself (treating yourself like you would if you were a good friend) and taking some small steps forward, allowing you to grow through the struggle. Sharing that kindness around will also go a long way. Remember family, friends, colleagues have all been experiencing the coronavirus world in their own way and may be struggling too. Take a breath (maybe two or three) before you react and remember that they may be struggling and need your kindness and understanding.  

However, that does not mean that coronavirus is an excuse for all behaviour. Abuse, violence and bullying are never acceptable ways of reacting or responding. Please reach out for help if you are not safe – through the police, a trusted friend, family member, your HTC, for example. 
 

FIND OUT MORE


To end, here are some Australian sites with factsheets, tips and hints to assist you with thriving and surviving during this pandemic, which you can continue to use into the future.  

Black Dog Institute - www.blackdoginstitute.org.au/coronavirus-anxiety-resources
Beyond Blue - coronavirus.beyondblue.org.au
Reach Out - www.au.reachout.com/articles/how-to-deal-with-uncertainty-during-coronavirus
Lifeline - www.lifeline.org.au



If you want some free meditations, Ten Percent Happier have gathered some of the world’s best meditation teachers to share free meditations and podcasts around coronavirus - www.tenpercent.com/coronavirussanityguide 

For those who have sadly lost their jobs or hours of work due to the virus, please check out the Centrelink website www.servicesaustralia.gov.au for JobKeeper and JobSeeker information.  

Please don’t hesitate to reach out to the HTC Social Workers, Psychologists and Counsellors for support.  We are here to help and support you.  
 
REFERENCES

Black Dog Institute. Coronavirus: Resources for anxiety & stress.
Beyond Blue. Coronavirus Mental Wellbeing Support Service.
Townsend M, Weerasuriya R. Beyond Blue to Green: The benefits of contact with nature for mental health and well-being. Melbourne: Beyond Blue Limited, 2010. 
Grow Your Mind - https://growyourmind.life/


 
Topics:

COVID-19 Mental wellbeing

Keywords:

COVID-19 mental health resilience stress

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Date last reviewed: 22 June 2020