As your writer composes this column and as the figure shows, the United States is continuing to experience exponential increases in confirmed cases of COVID-19, also known as the novel coronavirus. That this virus is spreading throughout the country is causing great concern, and, despite the large number of people infected with the virus, there are many, many more Americans who are not sick with the disease, but who are being traumatized by it. Numbering among them might be you, the reader of this column.
Why is a disease affecting others traumatizing those of us without it?
The simple answer to this question is because COVID-19 is stressing us out. Why are those of us still healthy so stressed? The answers to this are not quite so simple. However, any event that we cannot control and that we fear is likely to cause emotional distress. Couple this well-known fact with the additional fact that it is has been over 100 years since the last major pandemic and we have the perfect setting for fear of the many unknowns posed by this disease. This in turn creates uncertainty and anxiety. Humans do not deal well with the unfamiliar, especially if it is threatening our health and welfare. COVID-19 is doing both.
What are the key stress factors in the pandemic?
There are a very large number of factors in this pandemic that serve as stressors. As a semi-retired 76 year old with some history of chronic diseases, your writer is in the more vulnerable group. This certainly influences my list of 10 stress factors that will be elaborated.
- Fear and uncertainty are related factors that produce the stress. It is known that if one becomes infected the hospitalization and mortality go up considerably with age and accompanying chronic diseases like lung, heart, kidney, and impaired immunity.
- Lack of control and loss of routines are factors that have become evident with the pandemic. Certainly what we can do now is vastly different than three months ago and we have no control over many of the factors like being able to go to most stores or church in person. We cannot even be sure there is enough toilet paper.
- Social distancing and quarantine are life-altering ways of living. The fact that our government has the authority/responsibility to enact social distancing polices is unsettling. Isolation may be considered cruel and unusual punishment – akin to putting prisoners into solitary confinement. This totally foreign approach to normal life is more than strange. We have never endured it before.
- Financial insecurity comes with loss of jobs and with the drastic drop in the stock market upon which most retirees depend. The recession that we now find ourselves in only a couple of months after record unemployment and stock market highs is destabilizing.
- Vulnerable susceptibility to the infection for us and our friends and many relatives poses an enormous threat even though the case mortality for the infected is only around 1%. It is the older and chronically ill people who are more susceptible to this disease.
- Dependence on technology has been an ever increasing factor in our lives. Now the dependence on it to communicate with family and friends and to get news and normal conversation and food has required learning new skills like how to order on line and use Zoom, Skype, or other electronic tools. The need to rely on new and sometimes bewildering technology is unnerving.
- The alcohol stores and pharmacies are still open for business and business is “good” I have been told by the local liquor store. Turning to excess alcohol and other medications can add enormous stress.
- Eating properly is essential to good health, but with restaurants closed and grocery stores appearing unsafe proper diet can be compromised and add to the stress.
- Exercise is crucially important to deal with stress, but with many of the health facilities closed and the requirement of staying six feet apart, our exercise routines are interrupted. This, too, compounds the stress.
- Sleep is essential to maintaining mental health. In this time of high stress, insomnia and nightmares are more frequent.
Common Responses to Stress
Everyone will have a unique response to stress. However, there are many common psychological and physiological responses to stress that are worth listing. These are worry, concern for others, worsening chronic health issues, changes in sleep and dietary patterns, difficulty concentrating, new aches, short-temper, anger, denial, resentment, guilt, loneliness, boredom, post-traumatic stress disorder (PTSD) symptoms including intrusive distressing memories, flashbacks, nightmares, changes in thoughts and mood, and being easily startled.
Coping with the Stress
Dealing or coping with stress is not new. All of us have had to do it for some reason in our lives. In fact, the federal government established the Substance Abuse and Mental Health Services Administration (SAMHSA) which has become quite active in this stressful time. They suggest 10 personal strategies you might try in this stressful time to preserve emotional health.
- Self –protection planning gives you some sense of control over this situation. Learn and obey all the rules we have been given regarding self-protection. These include sheltering at home, frequent hand washing, disinfecting materials touched by others, wearing a mask and gloves when in an unavoidable social setting, and staying six feet away from others.
- Social networking is very important. Stay in touch with family and friends frequently by all means safe and possible. Usually this is by phone or some electronic medium. Talk about things that are important to you and them.
- New diversions or even old ones that have been in disuse like reading books or doing all those long put-off home improvements like landscape or simple fix-it jobs are possibilities. Doing this gives you new purpose and new accomplishments that put the pandemic in its place.
- Support others is always an effective strategy to remove the preoccupation with one’s own worries. It has been healthy and refreshing to see so many people expressing support for the frontline medical people dealing up close and personally with the virus.
- Get the facts and do not be obsessed with them. Rely only on trusted sources. It is useful to know if there is community spread in your community. Make the knowledge your power not your fear.
- Ignore rumors that are in abundance. Rumors and unsubstantiated information cannot help allay fear and anxiety: they only intensify them.
- Relax outdoors is proven to reduce stress. Nature is a calming balm. Other techniques can be added such as prayer, deep breathing, yoga, etc.
- Avoid TV and social media which tend to be alarmist. If one spends too much time watching even credible news sources the perception might be gained that the COVID-19 pandemic is going to annihilate the world when in fact very few of the world’s population will get it and even less than that will die from it. It is important to keep a reasonable perspective: this disease is bad, but it will end and most of us will not contract it.
- Take medications as prescribed and do not self-medicate with excess alcohol or other drugs to ease the pain and stress.
- Consult with a physician if you believe you may have the disease, a new one, a recurrent one, or find the stress is overwhelming you.
The Bottom Line
We are living in an unprecedented time. Because everything is not as it used to be, life as we have known it has been totally disrupted. This fact is scary. However, after acknowledging the reasons for the stress and our response to it, we can devise effective ways of managing it and when the pandemic is over we will not only have survived, but prevailed and been strengthened.
MUSC Health has earned a "High-Performing Hospital" designation in geriatrics from U.S. News & World Report for 2018-2019