Managing stress and trauma during the pandemic

Merav Silverman meets with a client via telehealth in her Lyndale dining room, which has become a makeshift virtual therapy clinic during the coronavirus pandemic. Photo by Ian Ramsay

It’s now common to hear the coronavirus pandemic referred to as “unprecedented.” Certainly, our society has never endured a crisis like this one in the modern era.

Yet for the many of us who have previously experienced traumatic events, such as living through a war, a sexual assault or a car accident, this is far from the first unprecedented life-shaping event. In my own life, a close parallel for this current moment is living through 9/11 in New York City — I recall being afraid of bombings on bridges and trains for many months, which reminds me of the daily fear of contracting this insidious virus.

The pandemic is amplifying symptoms and stress reactions familiar to those who’ve experienced these sorts of traumas before. In part, that’s because reactions to the coronavirus pandemic can resemble common post-traumatic reactions. As a clinical psychologist with a specialty in treating trauma-related disorders, I have been thinking not only about the similarities in the responses, but also about resources that we know work well for managing trauma symptoms that are likely to help in this moment.

After traumatic events, some people bounce back quickly but others experience a range of responses, including negative beliefs (such as “other people cannot be trusted” or “the world is really dangerous”), difficulty concentrating and difficulty sleeping.

It’s too early for large-scale studies, but, in our clinic, we’ve seen many people have these reactions in response to the pandemic. My colleagues and I have had more patients report difficulty sleeping and concentrating and increased negative thinking about other people and the world. In particular, many describe thinking the world is a very dangerous place or that other people cannot be trusted to be sufficiently vigilant about social distancing and coronavirus awareness. The novelty of virtual meetings has worn off, the timeline for when life will return to normal is uncertain and there is still much we do not know about this disease — all of which means the increase in mental health complaints is predictable.

Our current moment is particularly challenging for those who’ve experienced previous trauma, since the coronavirus has similarities to a traumatic event, even for those who don’t get sick or lose loved ones. But we also know that some of the tried and true coping skills for post-traumatic reactions are critical for enduring this difficult time.

One of the best things we all can do — particularly people finding themselves more activated right now — is to develop a routine and a schedule. Research has found that we are all more vulnerable to intense, negative emotions when our basic physical needs are not met. Yet it is easy to veer off schedule when you may not have a job to wake up for or a school bus to greet. When you do, physical and mental well-being suffers.

It helps keep the body in a healthy rhythm to set a daily alarm or wakeup window, regardless of whether it’s a weekend or weekday, or whether you have an early Zoom meeting.

Likewise, you can inoculate your body against stress reactions by focusing on eating regular, healthy meals, taking prescribed medications and finding opportunities for daily exercise — whether that’s a walk outside, lifting weights with the canned food you’ve stockpiled or just walking the stairs in your house or apartment.

And it’s extra important to monitor intake of alcohol and other illicit substances right now. While you may have more time and might be looking for diversions or ways to unwind or cope with stress, substances typically further activate negative emotions and stress reactions in the long run.

You may be having negative beliefs about the trustworthiness of other people or the world being very dangerous. It’s important to monitor these thoughts and identify what is true (e.g., it is important to avoid other people to keep everyone in our community safe) with what may be a cognitive distortion (e.g., that other people are trying to spread coronavirus or can never be trusted in the future). Aspects of your negative beliefs may be accurate in the present, but it is important to place them in context, instead of globalizing them.

If you’ve had an increase in nightmares or flashbacks, it could be good to take up a mindfulness practice. Five minutes of focusing on the breath or listening to guided meditations about gratitude or self-compassion can help calm the mind. Insight Timer, a free app with a large library of options, is one of many that can be found online.

A healthy relationship with media consumption (such as not watching or reading the news after 7 p.m.) can also help shore you up for better, calmer and more restful sleep.

This is a challenging time for everyone, particularly those whose traumatic memories are being triggered. Practice self-compassion — it’s OK that you haven’t become a yoga instructor, mastered the art of the French baguette or learned how to quilt — and remind yourself that this feels hard because it is hard.

And, if your symptoms are becoming hard to manage by yourself, many mental health professionals, including the University of Minnesota Outpatient Psychiatry Clinic (tinyurl.com/uofm-psych), are offering telehealth sessions and are accepting new intakes. So seek out help!

Merav Silverman, Ph.D., is an assistant professor of psychiatry at the University of Minnesota, where she specializes in treating trauma. She lives in the Lyndale neighborhood.