A playbook for psychological health during the COVID-19 pandemic

Engage in these simple practices to manage the stress of uncertainty


By Dean Aufderheide, PhD

“The emotional brain responds more quickly to an event than the thinking brain.” — Daniel Goleman

People are freaked out right now. It’s understandable. When things are stressful and uncertain, we tend to react emotionally and assume the worst possible scenarios in our minds:

If we know the right things to do, we can override our brain’s irrational tendencies and manage the stress of uncertainty. (Photo/Pixabay)
If we know the right things to do, we can override our brain’s irrational tendencies and manage the stress of uncertainty. (Photo/Pixabay)
  • My whole family is going to get sick;
  • The economy will never recover;
  • My world is coming to an end.

Folks are fearful and we’re writing the playbook as events unfold. It’s a time of uncertainty and we don’t like it. We don’t like it because uncertainty creates anxiety by letting the rational part of our brain be hijacked.

Our brains are hardwired to react with fear and anxiety when it comes to dealing with uncertainty. A million years ago, that was a good thing. When we saw a stick, we thought snake. It helped us survive in a world filled with danger and uncertainty. But as the rational part of our brain developed, we learned to manage the stress of uncertainty and stop seeing every stick as a snake. Today, we find the emotional part of our brain reacting to the COVID-19 uncertainties as a snake and knocking our rational brain off track. We are in a crisis and psychology tells us that without certainties to help us predict what is probable, we feel out of control.

What can we do to get back on track and manage the stress of uncertainty, maintain good mental health and regain a sense of control in our lives? We start by understanding that feeling anxious about COVID-19 is a normal reaction to an abnormal situation. We start by recognizing that we are not powerless, and we are in control of how we choose to respond.

“It’s totally normal to be struggling with the fear of the unknown,” says Vaile Wright, director of clinical research at the American Psychological Association. “But we don’t have to get stuck there.” If we know the right things to do, we can override our brain’s irrational tendencies and manage the stress of uncertainty.

Here are 10 things you can do to better manage your mental health and take back control.

1. Limit media exposure and access reliable sources

"What gets us into trouble is not what we don't know. It's what we know for sure that just ain't so.”Mark Twain

Imagine you had a dream the country was under martial law and soldiers were outside your door. Weapons drawn, they rushed in and you came face to face with them. They searched the house and then departed, never saying a word. For some reason, they couldn’t see you. You had become invisible to them. What did the dream mean?

Perhaps the martial law represented uncertainty, perhaps the soldiers represented fear and anxiety attacking from the emotional part of your brain, and perhaps your invisibility represented the rational part of your brain protecting you against panic and helplessness.

Dr. Ian Wallace, a psychologist who specializes in sleep and dream research, says that “We use our dreams to resolve emotional tension and particularly emotional uncertainty because human beings are not very good at dealing with uncertainty.”

Why is this important? Psychology tells us feelings of fear and panic flare up when we allow our brains to respond to uncertainty with irrational thoughts and excessive anxiety. Watching television or listening to radio programs that repeatedly emphasize the turbulent spread of COVID-19 or absence of effective treatment just fuels the freaked-out factory and exacerbates anxiety.  While it is fine to have a general idea of what is happening, especially if you live near an area with a high concentration of cases, it's important to limit media exposure. Learn to be invisible to fear. Stay rational. 

2. Practice good hygiene and physical distancing

“If the body requires hygiene, then hygiene is compulsory for the mind and soul.” Dmitry Plsarev

Indecision is not the same as uncertainty, and there are a lot of decisions you can make to protect yourself and your loved ones. For example, wash your hands frequently and thoroughly; sanitize high-touch surfaces; avoid contact with sick people; make sure you have a decent supply of nonperishable food and other supplies and stay home as much as possible. Physical distancing goes against our need for human contact, but we need to stay apart now to come together later. And take your own advice. Ask yourself: “If my friends came to me with this worry, what would I tell them?”

3. Protect yourself and your community by helping others

“When you are kind to others, it not only changes you, it changes the world.” — Harold Kushner

Many of our colleagues are our friends and neighbors. Whether it means helping a vulnerable neighbor get groceries or donating blood, you have an important part to play in helping your community. Think outside of yourself. Understand the stress of uncertainty affects all of us in different ways. Appreciate what you do is important. Realize your acts of kindness are protecting your community and you. In fact, chemicals released in our brains during acts of kindness reduce stress and anxiety, improve mood, decrease blood pressure, protect our hearts and strengthen our immune system. Remember, when you succeed, we all succeed.

4. Be positive and focus on gratitude

"Gratitude and attitude are not challenges; they are choices." — Robert Braathe

Amid the uncertainty, many people immediately imagine worst-case scenarios. Rather than ruminating on the negative, focus on what you value and for that which you are grateful.  Rather than stewing in worries, make a daily "gratitude list" to bolster your psychological resiliency. The name we give something shapes our attitude toward it, so start each day with a conscious choice to have an attitude of gratitude. Research shows that having a positive attitude and practicing gratitude boosts the immune system.

5. Identify resources

“Life is 10% what happens to me and 90% of how I react to it.” John Maxwell

According to a recent survey by the Kaiser Family Foundation, about a third of Americans said the COVID-19 pandemic has caused mental health problems.

As you identify resources you may need to access, psychologists and other mental health professionals around the country are shifting their practices online to increase accessibility. Many have established virtual therapy or counseling via telehealth and some are even holding free online group therapy sessions. De-stressing apps can help more immediately and cost less, too. There are mindfulness apps and an app that helps you track your mood and daily activity so you can keep a healthy mental health schedule.

6. Take control with behavioral medicine

“As you ought not attempt to cure the eyes without the head, or the head without the body, so neither ought you attempt to cure the body without the mind; for the part can never be well unless the whole is well.” — Plato

Pills aren’t the only medicine available to us. Psychology has an array of behavioral medicine techniques science has proven to be effective in managing stress and anxiety. It can be as simple as breathing. One method you can use is called the “4-7-8 breathing” technique. This behavioral medicine involves breathing in through your nose for 4 seconds, holding it for 7 and exhaling through your mouth for 8 seconds. Research has clearly shown it can instill a sense of calm when you feel out of control. Try it. Congratulations, you have just lowered your blood pressure and heart rate, improved your body’s circulation and re-energized your brain with an oxygen boost. Unlike those warnings in commercials, “You can try this at home!”

7.  Get organized and maintain a routine

“Routine is ground to stand on, a wall to retreat to; we cannot draw on our boots without bracing ourselves against it.” — Henry David Thoreau

If you have kids at home, you are probably trying to maintain a routine for them, with a lot of scheduled activities. You would try to create as much normalcy as possible. Strategy is important for adults, too. The key is to focus on the things that are within your control, even if it’s as simple as weekly meal planning, going for a walk, or going to bed and getting up at regularly scheduled times. Fill in vacant time with activities. A friend of mine started gardening. “My garden gives me hope,” she said. “It helps structure my day and gives me a sense of control.” Get organized and establish routines. It will give your days and weeks some healthy psychological structure. I do Bonsai.

8. Eat healthy, exercise and don’t forget how to laugh

“I never could have made it if I could not have laughed. It lifted me momentarily out of this horrible situation, just enough to make it livable.” — Victor Frankl

Eighty percent of visits to a doctor’s office are for medical problems resulting from our lifestyle choices. This is a good opportunity to make good lifestyle choices to help you fight your stress.

A healthy diet and sufficient sleep will help your immune system to function properly, and movement is good for both body and mind. Get at least 30 minutes of physical activity a day and, if are you working at home, get up for a short break every 30 minutes.

And don’t forget to laugh. Watch a funny movie. Share a good joke. Humor allows us to step away from the drama, if only for a few minutes. There is a lot of evidence in the scientific literature of how laughter and humor increases our immune system’s response to stress.

9. Stay connected

“Connection gives purpose and meaning to life.” — Brene Brown

Psychology warns social isolation can fuel anxiety and depression and, over the long term, is even linked to a shorter life span. But just because you may be physically distant from other people, you can, and should, stay connected to them.  

In his book, The Courage to Be, distinguished theologian Paul Tillich reminds us that catastrophic events like COVID-19 take us beneath the busyness and distractions of life and provide us with the opportunity to better understand ourselves and encourage others. If you are a person of faith, for example, you can join a prayer group and comfort each other. We’re all in this together and you don’t have to be alone with your worries.

By being proactive and reaching out to others, you’ll boost your mental health and reduce your stress. For men – it’s not a sign of weakness to reach out to others. It takes courage to recognize our basic human need for connection with others, and it takes strength to reach out. That’s something worth modeling for our children.

10. Let your values guide your actions and find the possibilities in uncertainty

“A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty.” — Winston Churchill

Committed action should be guided by our core values. What do you want to stand for in the face of this crisis? What sort of person do you want to be, as you go through this? How do you want to treat yourself and others?

When my son was a young lieutenant in the military, he learned he was being deployed to Iraq. He had never been overseas and his mother’s concern for his welfare was natural. She encouraged him to consider resigning his commission and going back to graduate school. I called my son on the phone and told him, although he may have a lot of anxiety and stress about the deployment, he had taken an oath, put on the uniform and made a commitment to our country. I told him he needed to fight the good fight, finish the race and keep the faith. And I told him I could promise him one thing — when he returned, he would be a better man…a stronger man. Shortly after he returned, he pulled me aside following a family gathering and simply said, “Thank you, Dad. It did make me stronger.” He went on to another deployment in Afghanistan and will soon be finishing a 20-year career serving our country. I still remember that phone conversation like it was yesterday.

Sometimes our need for certainty, and the fear of uncertainty, becomes so strong we miss out on opportunities to find the meaningfulness that uncertainty can provide in our lives. You may not see it now, but you will be stronger when this pandemic ends because each time you overcome uncertainty, it is a psychological vaccination against the next uncertainty you will face.

You can choose to find your best self during the COVID-19 crisis. You can choose to stand your ground and not surrender to fear and anxiety. You can choose to find purpose and meaning to strengthen your mental health. So, I encourage you, as I do with myself every day, to fight the good fight, finish the race and keep the faith.

You can manage your mental health successfully and; you can take back control by choosing how you respond to your circumstances.


About the author

Dr. Dean Aufderheide is a board-certified correctional psychologist and licensed clinical and forensic psychologist. He is a former president of the International Association of Correctional and Forensic Psychologists and has been the Chief of Mental Health Services for the Florida Department of Corrections for the past 16 years. Dr. Aufderheide also serves as the American Correctional Association’s National Mental Health Advisor and has provided expert witness and consultation to state, federal and international correctional agencies.

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