• About novel
    coronavirus
    (COVID-19)

Stress, worry and anxiety during coronavirus (COVID-19) situation

Fear and anxiety about an outbreak like coronavirus disease 2019 (COVID-19) can be overwhelming and stir up strong emotions in adults and children. As news about this disease unfolds in the media, along with repeated images and reports of the rising statistics and the impact on people and communities, this situation can be triggering.

Although everyone reacts differently in stressful situations, you or someone you know may experience a range of thoughts, feelings and physical reactions that might fluctuate over time. Such experiences may include:

Thoughts: Worrying thoughts that you have no control, that the worst will happen and that you will not be able to cope

Emotions: Nervousness, helplessness, frustration, irritation and sadness

Physical Sensations: Headaches, muscle tensions, aches and pains, rapid breathing, increased heart rate, stomach upset and other uncomfortable sensations

Behaviours: Changes in appetite, energy, and activity levels, unnecessary isolation from others or withdrawing from enjoyable activities, and disrupted sleeping patterns. Some people might use alcohol or other substances to help them cope.

All of these stress reactions are designed to activate our survival mechanism also known as the ‘fight-flight-freeze’ response. However, at times this can be disproportionate and left unmanaged can negatively impact our health long term.

Strategies to help you manage stress, worry and anxiety

When feeling stressed, worried and anxious it is important to notice, acknowledge and accept how you are feeling and to take some steps to look after your emotional health. Self-care is an important investment towards long term wellbeing. Below are some strategies to help with managing stress, worry and anxiety.

  1. Acknowledge your feelings: It is a natural response to be experiencing an element of worry or fear in a situation such as this.

  2. Put it into perspective: Stay informed with accurate information and follow advice from reputable sources such as government and medical officials. Set limits on media coverage and avoid unreliable reports from social media.

  3. Reframe your perception: Although you might not be able to change the situation, you can change your perception of how you will cope with the stress and worry. Begin by reframing any negative thoughts about the situation. You might find it useful to take a
    problem-solving approach (define the problem proportionately, list possible options each with pros and cons, identify best solutions that are practical and helpful and put them into practice).

  4. Stay connected to others: It is important not to feel you are going through this on your own. Although direct contact is not recommended for anyone feeling unwell, there are still many other ways to remain connected to family, friends and colleagues by using the telephone, skype, zoom and text messaging. Share your concerns about how you are feeling with them and build a strong support network.

  5. Take care of your body: Eat healthy balanced meals and exercise regularly. Put into practice some evidence-based techniques including Relaxation Breathing, Mindfulness Meditation and Healthy Sleep Hygiene. Most importantly, be kind and gentle with yourself.

Relaxation Breathing

Relaxation breathing is a simple yet effective technique that’s easy to learn. It can be practised almost anywhere and can lower your stress levels. There are many apps available online that you can download to guide you through the process. You can try this practise that only takes a few minutes.

  • Sit comfortably with your back straight. Gently place one hand on your stomach and one hand on your chest.

  • Take some slow, deep breaths through your nose and into your belly. Feel your belly rise as your lungs fill with oxygen. When breathing correctly, the hand placed on your stomach should move more than the hand on your chest.

  • Hold your breath for four seconds.

  • Slowly exhale fully through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, while the other hand placed on your chest shouldn’t move very much.

  • Continue this slow, deep breathing pattern for a couple of minutes. Imagine the breath calming your body and clearing your mind. Notice how you feel.

Mindfulness Meditation

  • Find a quiet place.

  • Sit in a comfortable position, either on a straight-backed chair or on a soft surface on the floor where you feel comfortable and firmly supported. Adopt a dignified posture.

  • Gently close your eyes and turn your attention to your breathing. Feel the sensation of the cool air flowing into your nostrils and the warmth of your breath as you breathe out of your mouth. Feel your belly rising and falling with each breath that you take.

  • Bring your awareness to the other sensations that you are experiencing. Feel your body against the chair, the cushion or the floor supporting you. Tune in to the sounds around you. Listen to the sounds that are close by, then listen to the sounds that are far in the distance.

  • If your mind begins to wander, let those thoughts enter your mind and try not to fight them. Notice your thoughts and acknowledge them without judgment. Gently let them go and bring your attention back to your point of focus.

  • Return to the sensation of breathing. Once again feeling the cool air as you inhale through your nostrils and the warmth of your breath as you exhale through your mouth. Feel the rise and fall of your belly with each breath that you take.

  • Adopt an attitude of acceptance toward all parts of your experience.

  • When you are ready, open your eyes and bring yourself to full awareness.

  • Be present with yourself.

Healthy Sleep Hygiene

  • Develop a routine prior to bedtime such as winding down stressful activities, taking a warm shower and listening to a relaxation app.

  • Ensure your sleep environment is comfortable and that it is set at the right room temperature and free of noises and other distractions.

  • Establish a regular sleep/wake schedule. Get up around the same time every morning including weekends and avoid napping during the day. This helps to regulate the body’s clock.

  • If you are unable to get to sleep after thirty minutes, get out of bed and go into another room until you feel tired. Practice deep breathing or listen to a relaxation app. Then return to bed.

  • Avoid nicotine, caffeine and alcohol as these can disrupt sleep. Heavy or spicy meals in the evening can cause discomfort from indigestion that can make it difficult to sleep comfortably.

Supporting children and young people

Parents and caregivers should take the time to talk with children and young people about the COVID-19 outbreak openly and honestly.

Use age-appropriate language to relate information without causing alarm. Don’t volunteer overwhelming information. Listen intently and respond to their concerns. Answer and clarify any questions that may arise. Be developmentally appropriate when discussing the importance of following official advice, particularly around observing good hygiene habits.

Validate your children’s experience and normalise what they are feeling. Reassure them that everything is being well managed and that they are safe. Try to model a calm approach.
Finally, seek help when needed – Call your GP. You can also reach out to a counsellor or psychologist, or contact your EAP.

Resources:

Official government information
www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert

For parents of school aged children
www.health.gov.au/resources/collections/novel-coronavirus-2019-ncov-resources

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: Author. Australian Psychological Society (APS). (2010). Evidence-based psychological interventions in the treatment of mental disorders: A literature review (3rd ed.). Melbourne: Author. NICE. (2011). Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults. London: National Institute for Health and Clinical Excellence. World Health Organization. (2008). ICD-10: International statistical classification of diseases and related health problems (10th Rev.). New York.
Author: Dominique Robert-Hendren, Service Line Director - National Mental Health Programs and Services. RHC, 2020.