Covid 19 tips
Tips for how to cope during the Covid-19 outbreak whether in lockdown or on the frontline

• Have a routine, wear “work clothes” if working from home to help build in the separation of work and home.
• Take the time to figure out what’s most important in your life and work on achieving it/spend more time doing it, to balance the not so good things/times.
• Mindfulness vs overwhelming feelings. Mindfulness can give you moments of peace and respite from stress and anxiety. There are lots of free apps; try 'mindfulness Daily', 'Headspace', 'Calm', 'Breethe' or 'Smiling Mind'.
• If something is making you uncomfortable, reflect on it, understand why and learn / use assertiveness to respond appropriately e.g. learning to say “no, because of the following reasons..... “
• Keep in touch with family and friends using the technology available. Try Zoom, Facetime, Whatsapp or Discord. (Discord allows you to play games like Skribbl online in a group. A great way of connecting and having fun)
• Encourage your children to keep in touch with their friends using the technology available (helps kids to play etc and gives parents a break!).
• Keep talking, sharing thoughts AND feelings. If this is too difficult with family or friends or you don't want to worry them, contact Medra to find a counsellor to talk to. We are doing online sessions or phone sessions during lockdown.
• Make a list of what you’re going to do after lockdown and who you’re going to do it with; talk with those people and plan it out.
• Remember what you like about the job and why you’re doing it.
• Take some time to appreciate the “stillness” currently available to us (less traffic noise, more nature).
• Self acceptance and acceptance of that this is an odd time and it’s ok to feel strange/scared/whatever.
• Limit exposure to news / social media to once or twice a day maximum. This helps to limit the feelings of personal anxiety by picking up on the national anxiety.
• Take information only from reputable sources.
• Spend as much time as possible in the garden sowing seeds and growing things- nurturing life in the midst of all this death/despair/uncertainty.
• Make time for exercise, particularly outside if you can.
• Take this time to learn new skills or retrain. Think about who you want to be and what you want to do when all this is over.

Many of us are now in positions where things that matter to us feel more uncertain, which understandably gives rise to our stress response.

Signs of autostress include:

• Chest tightness and feeling like you can’t breathe
  
• Muscle tension, aches and pains
• Headaches
• Difficulty sleeping
• Restlessness and an inability to relax
• Heart palpitations
• Digestive issues

Anxiety is best described as the unhelpful thinking patterns we experience when our mind fixates on threat, uncertainty and negativity.

Anxiety can occur on its own, as a response to stress, or it can trigger stress. When it occurs as a response to stress, it can intensify the stress, and, in worst cases, lead to panic attacks.
It’s important to understand that you cannot control anxiety from occurring – this is your brain’s automatic survival mechanism. What matters is learning how to respond to anxiety helpfully, so that you don’t get carried away by it.

Some unhelpful thought processes

When your mind searches the environment for what you fear (consciously or subconsciously). Threat scanning is often associated with your mind assigning meaning to harmless events.

Examples

• Frequently checking your body for coronavirus symptoms.
• Obsessively checking the news for coronavirus updates.

When your mind jumps to worst case scenarios, i.e., ‘making a mountain out of a molehill’.

Examples

• You feel chest tightness and your mind tells you that you have coronavirus and that your life is in danger.
• Your mind gives you the mental image of losing all the people you love.

It’s important to note that worry is completely normal. It only becomes unhelpful when you focus excessively on hypothetical worries instead of practical worries.

Hypothetical worries include ‘what if’ thoughts and are typically about things you don’t have much control over.

Practical worries concern things you do have control over, and they can help you be more proactive.

If you’re very uncomfortable with uncertainty, you’re likely prone to hypothetical worry and spend a lot of time focused on the future instead of the present.

Examples

• “I know I’m following all the guidelines, but what if I spread the virus?”
• “What if someone gets too close to me at the supermarket and I catch it?”

When your mind tells you that your emotions reflect reality. While emotions can act as helpful messengers, they often aren’t reliable.

Examples

• “I feel scared, so I must be in danger.”
• “I feel guilty, so I must’ve done something wrong.”

When your mind interprets predictions as facts.

Examples

• “I’m going to be stuck inside for months on end.”
• “My mental health will keep deteriorating and I’ll have to go back on meds.”

The media is fully aware that our brains are built to fixate on threat, uncertainty and negativity – and they capitalize on it. Most news sources are negatively biased, sensationalist and speculative in order to win your attention. Anxiety is easily fuelled by consuming this kind of information. To reduce anxiety, it’s important to be aware of and take control over your information diet.

If you’re prone to catastrophising, you may find it helpful to redirect your attention to the facts:

• The vast majority of people only experience relatively mild symptoms.
• Coronavirus is fatal in about two to three percent of cases.
• Health advice for the public is as follows: Wash your hands with warm water and soap for at least 20 seconds: After coughing or sneezing
• Before, during and after you prepare food
• Before eating
• After toilet use
• When you get in from the outdoors
• When hands are visibly dirty
• When caring for the elderly or sick
• After handling animals or animal waste

Use alcohol-based hand sanitizers as a substitute for washing your hands, but do so sparingly.

Maintain a distance of at least 2 metres (6ft) between yourself and anyone who is coughing or sneezing.

Cover your coughs and sneezes and throw your tissue into a closed bin immediately after use.

Avoid touching your eyes, nose and mouth.

Frequently disinfect surfaces, like your desk, phone, tablet, smartphone, and countertops.

Trusted News Sources
We recommend finding and sticking to a credible source on Covid-19, and only check up once a day. Avoid listening to or reading other sources.

If you’re prone to hypothetical worry (i.e., the ‘what if?’ thoughts), you may find it helpful to practice noticing these thoughts and then redirect your attention to things within your control.

Research shows that when we shift our focus to what we can control, we see meaningful and lasting differences in our wellbeing, health, and performance.

So, write down what you have control over. Then, note the things you cannot control using the table below as inspiration. When you have made your list, focus on those things you can control and banish those that are out of your control to the bin.

Remember: You cannot stop hypothetical worries from occurring, but you can control your response to them.

Within My Control
Building resilience
Following the latest information and advice
Focusing on what’s important to me
My information diet
My routine
Relaxation
Cultivating connection
Eating well
Exercising
Seeking and offering support
Voting and activism

Outside My Control
Other people’s decisions
Other people’s health
The news
The government’s actions
Schools opening or closing
The state of the healthcare system
Flights and holidays being cancelled
Traffic
Public transport
Aging
The weather

People who experience anxiety have been shown to have a low tolerance for uncertainty. It’s worth reminding ourselves that uncertainty is an inescapable part of life, and the sooner we become more comfortable with it, the sooner we can reduce mental suffering.

Stoic and Buddhist philosophy both emphasise embracing uncertainty and change as the essence of life. Many people find reading about these topics helpful, stating that practical wisdom helped them shift their mindset and reduce anxiety.

Practical Wisdom Resources

Videos
The philosophy of Stoicism by TED-Ed
Why Stoicism Matters by The School of Life
Buddhist Widsom For Inner Peace by Einzelgänger

Books and Audiobooks
Happy by Derren Brown - Listen to this for free on Audible using their 30 day free trial
Meditations by Marcus Aurelius
Letters from a Stoic by Seneca
Buddhism Plain and Simple by Steve Hagen

Thought challenging is a simple yet powerful cognitive behavioural therapy (CBT) technique for reducing anxiety.

As mentioned, anxiety is best described as the unhelpful thinking patterns you experience when your mind fixates on threat, uncertainty and negativity. Thought challenging helps by broadening your focus to include the bigger picture.

Below are two thought challenging techniques you can experiment with. Keep practicing and discover what works best for you.

The ABCDE Technique

Attention – When you feel distressed, stop what you’re doing and pay attention to your inner dialogue. What is your mind telling you?
Believe? – Do not automatically believe your thoughts!
Challenge – Defuse anxiety by broadening your focus. What’s the bigger picture? Is the thought fact or opinion? What might you think if you were feeling calmer?
Discount – Acknowledge that anxiety has been is dominating your thinking and let the unhelpful thoughts go.
Explore options – What would be helpful to focus on right now? What options do I have available?

The THINK Technique

True? – Is this thought 100% true? If not, what are the facts, and what is opinion?
Helpful? – Is paying attention to the thought useful to me or others?
Inspiring? – Does the thought inspire me or does it have the opposite effect?
Necessary? – Is it important for me to focus on the thought? Is it necessary to act on it?
Kind? – Is the thought kind? If not, what would be a kinder thought?

Writing or typing your thought challenging process is more powerful than trying to do it in your head. We recommend trying out the free CBT Thought Diary app (Google Play, iTunes).

If you’re not used to paying this much attention to your inner dialogue, thought challenging might feel unnatural at first. That’s okay. Over time, it’ll start to feel easier.

This isn’t the most appropriate tool if you’re feeling very distressed, as it can be hard to think rationally when your emotional brain has taken over. Try defusing your emotions with a distraction activity and returning to thought challenging once you’re feeling calmer.

Maintaining structure can work wonders for your mental wellbeing. Routines help you increase your sense of control and defuse feelings of overwhelm.

Planning Tips

Schedule regular breaks. Take time to mindfully drink your tea or focus on your breathing.

Write a weekly goals list. Identify what you need to do to achieve your weekly goals. Break tasks down into smaller steps and cross them off as you go to maintain a sense of progress throughout the day.

Identify 1-3 “Most Important Tasks”. Creating a daily MIT list helps you prioritize your most important and urgent tasks.
Review your crossed off items at the end of the day. Taking stock of your achievements can help boost mental wellbeing.

Try a to do list app. You may prefer a digital format such as Google Keep.

Experiment with productivity techniques such as The Pomodoro Technique and Eat The Frog.

Write your daily to do list the night before. You might find that being able to start work straight away helps increase your productivity. Also, this practice can help you clear your mind and switch off in the evening.

Tidy your workspace at the end of the day. Research finds that cluttered environments interfere with your ability to focus.

Decide on a regular sleep schedule. When it comes to improving sleep, research suggests that maintaining a regular sleep schedule is of high importance.

Create an end of work day ritual. To enforce work-life boundaries, you might find it helpful to create an end of day ritual such as changing into comfier clothes, switching off work email notifications and putting on some music.

Create weekly family traditions. Strengthen family routines through traditions such as “Board Game Fridays” and “Movie Night Mondays”.

Be kind to yourself. You might suddenly have a lot more on your plate. Be mindful of your inner critic, and remind yourself that you can only do the best you can.

Research shows that cultivating gratitude has a plethora of benefits, including:

• Reducing stress and anxiety
• Boosting mood
• Strengthening your immune system
• Improving sleep

Breathing difficulties are associated with autostress. When you have problems with your breathing, you lower the amount of carbon dioxide that’s normally in your blood. This leads to a wide range of symptoms, including:

• Shortness of breath
• Chest tightness
• Tingling or numbness in the arms, fingers, toes, or around the mouth
• Feeling dizzy and light-headed
• Weakness
• Heart pounding and racing
• Heart palpitations
• Sweating or hot flushes
• Headaches
• Feeling sick
• Fatigue

These symptoms can appear out of the blue and can also lead to panic attacks.

Your breathing difficulties may be related to:

• Shallow breathing (breathing in too quickly)
• Over-breathing (breathing in more air as you feel like you’re not getting enough, for example through yawning or sighing frequently)

Some people experience both.

So, let’s take a moment to test your breathing:

1. Put one hand on your chest, and one on your belly.
2. Breathe for a few seconds. Which hand rises?
3. If it’s your chest, you might have developed a habit of shallow breathing.

Although the effects of shallow breathing can be very unpleasant, it won’t harm you, and you can reverse the habit with a daily breathing practice. The next time you feel anxious, take a moment to notice your breathing. Focus on breathing through your stomach so that your belly rises when you inhale and drops when you exhale.

Here’s a belly breathing exercise you can practice for 5-10 minutes a day:

Inhale gently, lightly and slowly count to four, expanding your belly as you do so,

Hold that breath for a count of two,

Slowly exhale though your mouth for a count of six.

This is referred to as ‘belly breathing’. Research shows that practicing regular belly breathing can help people feel calmer within a matter of weeks.

If you are feeling isolated and disconnected check out the Social Connection Planner for constructive ways to get connected.

“Walking is man’s best medicine.” - Hippocrates

Exercise reduces the overall activation of your amygdala and sympathetic nervous system – the parts of your brain and body that generate your stress response.

Research suggests that aerobic exercise (such as walking, cycling, and jogging) provides the same benefits as non-aerobic exercise (such as yoga and pilates).

Studies also suggest you need around 21 minutes three times a week to experience the benefits. So, you don’t have to spend hours doing it – it’s something most of us can fit in to our lives when it becomes a priority.

It’s important to find something that you enjoy when it comes to building an exercise habit. Now more people than ever are interested in fitness, you have endless options. These include ‘bedroom fitness’ resources and tools that make it easy to keep moving indoors.

Here are some ideas. Tick the ones you may be interested in adding to your Stress Resilience Action Plan:

1. Schedule a daily walk.
2. Complete YouTube video workouts.
3. Do a free trial of Les Mills at home workouts.
4. Do online yoga with Yoga with Adriene.
   
5. Do the 5 week strength and flexibility plan from the NHS.
6. Set yourself a challenge to run 5k with the support of the Couch to 5k running plan for beginners.
7. Invest in some indoor exercise equipment.
   
8. Do this 10 minute home cardio workout from the NHS.
9. Find an outdoor gym to visit.
10. Browse Pinterest for indoor workouts.
11. Do an affordable at home cardio workout with a jump rope.
12. Invest in a Fitbit to track your progress.

Don’t forget: Motivation follows action!

There are many therapists currently working via video chat or phone. If you start to feel too overwhelmed emotionally or physiologically, we strongly encourage you to seek the support of a trained professional at Medra 01248 712865 or info@medracounselling.com or login to the Staff Page to access counsellors details.

Adapted from the NHS 'Coronavirus Anxiety Workbook'