Pandemic Stress Management

by James Porter March 26, 2020

The six-step stress prevention model described in this article, was originally developed to help people deal with everyday stress: What psychologists call “the daily hassles.” In these trying Covid19 times, the original six-step model was definitely in need of an upgrade. So, we’ve completely rewritten this approach to proactively managing stress, based on what’s happening in the world right now.

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Step 1: Recognizing stress symptoms

Recognize the symptoms of pandemic stress which include anxiety, not thinking clearly, gastro-intestinal issues, shaking/shivering, panic, depression, sadness, apathy, moodiness, anger, nervousness, insomnia, twitches and tics. Recognize the symptoms of everyday stress, too, including rapid heartbeat, cold hands, dry mouth, perspiring when you don’t expect it, and muscle tension.

Recognize that your pandemic stress symptoms may be layered over your everyday stress symptoms. In other words, if you are not taking proper care of yourself while you are rushing around trying to stockpile food and supplies, you may be getting a double dose of stress. Stress is cumulative. It’s no one straw that breaks the camel’s back. If you can limit your exposure to everyday sources of stress, you might be able to ward off the higher-level Pandemic Stress symptoms, too.

Every time you experience something stressful, cortisol is released into your blood stream. It takes about an hour or so for these cortisol levels (and other stress hormones) to go back to baseline. If you are having trouble concentrating, sleeping, feeling anxious all the time, even panicking, these Pandemic Stress symptoms are being brought about by elevated levels of cortisol in your body. These cortisol levels fluctuate throughout the day and are the highest in the morning. That’s why we often wake up feeling anxious.

When one stressful event is layered on top of another, cortisol levels climb higher and higher (in a stairstep fashion) until we get to the point where we feel so anxious and panicky, we have trouble thinking straight. And some people will panic. These stress symptoms are not a sign -despite what you might think - that the end of the world is near. It’s really a sign that some form of adaptation is needed: That it’s time to do something different.

Here’s what you can do differently:

Stop trying sweep your stress under the rug. With this level of pandemic stress, you just can’t ignore your stress anymore or try to self-medicate your symptoms away. Your sleep has probably already been adversely affected. Do you want your immune system to be adversely affected, too? If you choose to ignore your stress symptoms it will.
Separate out what you can control from what you can’t. One of the main reasons everyone is panicking now is that we feel like our lives are totally out of control. But that’s not true. There’s a lot we still can do.
Know that most Americans cope with their stress counter-productively. They smoke, they drink, they eat emotionally, they spend money (on hoarding ridiculous amounts of toilet paper, for example) or they engage in high risk behavior like: “this virus isn’t going to affect me.” This coping strategy leads to even more stress and more problems. That’s why it’s considered counterproductive.

Let’s address each of these three issues in order:

Get familiar with your stress symptoms. Your stress symptoms are just trying to convey a message. First to stay safe. That’s what your pandemic stress symptoms are trying to tell you. Even a trip to the supermarket is probably going to bring on some (or a lot) of anxiety. Stress is really about memory. It’s there to remind you: Don’t touch your face. Stay six feet away from others. Wash your clothes when you get home. Listen to that messaging! Plus, your everyday stress symptoms may be telling you, OK, it’s time to take care of ME for a change. I deserve a break from all this stress. What can I do to get one? (Answer: Read all six segments of this article.)
Control what you can control and let go of what you can’t. Wash your hands, avoid crowds, turn off your news feed, and stay home as much as possible. But also realize that there are many aspects of this crisis that you can’t control. For your own peace of mind, just let go of what you can’t control like the increased level of risk we all face now that coronavirus is here. Accept it. It’s a fact of life.
Cope with stress productively. Recognize when you are coping with stress counter-productively and instead use all the time-honored ways of coping with stress productively: You may want to exercise more, meditate more, do yoga, take naps, delegate more chores, get organized, etc.

For now, here’s a stress number system, I developed, based on a scale of zero to ten, that can help you monitor your levels of stress throughout the day. This system will help you recognize stress symptoms, take control of what you can control and help you know when to manage your stress productively. Zero is the total absence of stress (like how you might feel after a 60-minute massage) and 10 would be a panic attack. (A panic attack is NOT just feeling panicky, it’s overwhelming; You feel like you can barely function.)

So, what do you think your stress number is right now? How high do you think it’s been in the last week? What would it take to get you to a zero or a one?

This system takes a few days to calibrate, since it’s entirely subjective. But if you monitor your stress over the coming days and weeks you’ll see quite clearly when you are really relaxed (Zero, 1 or 2) and you’ll know when you are really stressed (7, 8 or 9: Not many people will experience a 10, i.e., a full blown panic attack.) Remember what it is you did to get yourself down in the low range. Also notice what makes that number spike. (It could be just thinking about the coronavirus.) We will give you lots of ideas and tools in the next five steps (installments) for how to lower your stress levels any time they climb above a 5 or 6.

Assignment: Keep track of your stress number for at least week. Whenever you feel anxious, make a note of what your number is and what caused you to feel that way. Also notice when you feel relaxed. Make a note of what your number is and what you might have done differently that day, (like ignoring your news feed for one day) to get relaxed. Also notice how on one day, you may THINK you are as relaxed as you can be (and thus assign it a zero or a 1), but a few days later, you notice you feel even more relaxed. Making these comparisons will help you calibrate your stress number system.  Raising your awareness of stress symptoms and your levels of stress are the active ingredients in Step 1.

Step 2: Problem-solving; Avoid unnecessary stress.

Using creative problem-solving to avoid unnecessary stress and make yourself feel as safe as possible.

There’s no solving the problem of a pandemic. It’s here to stay, or at least until the scientists – using their own creative problem-solving methods – come up with a vaccine. The problem we must solve is how do we keep ourselves as safe as possible in the meantime.

We can never make ourselves completely safe, no matter what kinds of threats we are facing: Every time we step off a curb, get into a car, ski down a hill, or fly in a plane we are taking risks. We feel comfortable with a risk to the degree to which we are familiar with it. If you ski regularly, or fly frequently, or drive everywhere, none of these activities are likely to bother you. You’re comfortable with the risk vs. the reward.

The problem we must solve is not only keeping ourselves as safe as possible, but how do we keep ourselves as relaxed as possible given what we know about the Covid19 risk? By washing hands, maintaining social distancing, and avoiding crowds, we are doing all we think we can do to lower the risks. But maybe there is even more that we can do to make ourselves feel safer and more relaxed about the risk at the same time.

In step 2 you will use creative problem-solving to uncover every single opportunity that you can think of to feel safer: Make a plan for how you will shop for groceries, how you will travel about town and how you will interact with family and friends: who you may love dearly, but don’t know where they’ve been or what they might have touched in the last 7-14 days. What will your strategy be to keep you safe, but on good terms, with your immediate family members?

How will you behave with coworkers? If you are still going to work, what kind of plans can you enforce, that will keep you a safe distance from them? Don’t just let casual interactions between you and others happen randomly without having considered your exact plan. What are some of the other things you can do to make yourself as safe as possible?

In this step we will also try to solve the problem of how we can feel as relaxed as possible while going through this crisis. Why not consider turning off your news feed and stop watching so much TV news. Once a day, check to see what’s going on in your local area, and state. That’s really all you need to know. You don’t need the news; you need helpful information. There are many advantages to staying home, so you might as well appreciate them if that’s where you are right now: You will not be so tempted by fast food and coffee shops and you may even have the time to exercise now, or take an afternoon nap. Life has suddenly changed, and not ALL for the worse.

Assignment:  Jot down as many ideas as you can think of, for how you can make yourself feel as safe as possible, including how you will handle meetings with neighbors, friends, family and coworkers. Next make a list of all the things you can do now, to help yourself relax even a little bit during this crisis. Do you need to read every stressful item on your news feed? No, of course not. Think of other ways you can keep yourself in the know without over-exposing yourself to clickbait. Also, try something relaxing today, that you wouldn’t ordinarily do like taking a nap, going for a walk at lunch or listening to a relaxation CD.

Step 3: Cognitive Restructuring

Learn how your thinking can be a major source of stress.

Up until Covid19 came along, it was easy to show people all the ways they would blow their stress up out of all proportion, for example getting stressed out about a traffic jam, a missed deadline or a stain on their shirt. These sources of stress seem almost laughable today. Now that our stress is very real and very threatening, do we still blow it up out of all proportion?

The answer to this question is, YES without a doubt. A technique called cognitive restructuring, that can help you change your thinking on the fly, just might be the key to surviving this crisis with a whole lot less stress.

Cognitive restructuring is a term derived from Cognitive Behavioral Therapy (CBT) and the work of one of the co-founders of Cognitive Behavioral Therapy, Dr. Albert Ellis. Ellis coined terms like awfulizing, shoulding and catastrophizing, to help us understand how our thinking contributes greatly to the amount of stress we experience. He also developed numerous, practical strategies to help monitor and change our thinking when it becomes irrational, muddled or overly pessimistic.

One of these strategies is built on an equation that helps us understand how a stressful event unfolds from beginning to middle to end. The equation shows us how we can take control of a stressful event in the middle, and it’s about as easy to remember as: ABC or A+B=C

A stands for the Activating event. It’s any source of stress. B stands for your thoughts or Beliefs about that event. And C stands for the Consequence of A+B. It’s what you feel inside: At C you might feel scared, anxious, upset, depressed, or tense. So, our A in this case is going to be the very real fear of the Coronavirus. B could be any irrational thought about the virus like “We are probably all going to die.” And C is most likely feeling anxious or even panicky about what might happen to you or your family.

Maybe you have already noticed the teaching point on full display in the above example. Even when the threat is very real, we still tend to exaggerate the severity of it. We are NOT “all going to die.” Of the people who even get the virus (and if you take the warning of sheltering in place very seriously, you can drastically reduce these chances) only a very small percentage, most experts guess about 2% are going to die from the virus, varying up or down, depending on your age and any underlying medical conditions you may have.

Sure 2% is still high, BUT our thoughts can be weaponized against us at B or we can choose to use our thoughts to Dispute our irrational thinking at B. We do this by saying to ourselves at B: The likelihood that I might die from this virus is actually quite low. Let me remain calm and do everything I can do to keep from getting it. But even if I get it, the odds may be as high as 98% in my favor that I’m going to be just fine after my body fights it off. I must also do everything I can do now, to boost my immunity in any way I can by exercising, eating healthy and getting enough sleep.

A week after 9/11, everyone was talking about their renewed fears of flying. Nobody wanted to get back on a plane, ever. But there was one statistician on a talk radio station who explained: Even if you were flying on a commercial jet ON 9/11/01 your chances of dying THAT DAY were about 1 in 400,000. People tend to worry about the wrong things. The ABC equation helps us sort out what’s truly worth worrying about and what isn’t.

You have the power to Dispute your, exaggerated, muddled, irrational, and overly negative thoughts at B. Take the anxiety you feel at A and convert that energy into logical planning at B, and you will have an entirely different outcome at C. Yes, you will still be scared of this virus, as well you should be, but that fear will be offset by the very rational thoughts at B that you are taking all the precautions necessary to protect yourself.

Exercise

Step 1 Become aware of your self-talk at B. Notice what you are thinking about Covid19. Is it exaggerated or is it accurate? Rational or irrational? Muddled or Clear?

Step 2 If it’s irrational, substitute a more accurate, more truthful thought at B: Chances are I’m going to be just fine.

Step 3 If you don’t know whether your thinking is accurate or not, educate yourself on the subject. Don’t trust your news feed to deliver accurate data. Remember, every single headline you see there is designed to scare you into clicking on it. Even if it’s YOUR trusted source of political information, it’s still going to use stress (scare tactics) to get YOU to open that link.

Instead of relying on this kind of hype, (used solely for the purposes of generating more advertising revenue) search on the CDC or other non-profit, trusted websites that aren’t trying to drive revenue and instead, are just trying to deliver accurate information. Once you have good data, use that information to dispute your untruthful exaggerated thoughts and beliefs at B.

Step 4 Act on the accurate information you have now inserted at B.

Remember, cognitive restructuring is NOT the same as positive thinking which is always trying to get you to put a positive spin on a negative situation. Cognitive restructuring is simply trying to take your overly negative spin off of the situation, so you can see that situation for what it truly is.

This is an incredibly empowering idea. The whole world believes that stressors (A) automatically lead to stress (C). That there is no B and therefore, nothing you can do to stop your stress. Now you know that there’s either a rational thought (This virus probably WON’T kill me, especially if I take precautions) or an irrational thought (We are all going die no matter what we do) that you can insert at B. Hans Selye, the Canadian scientist who coined the terms stress and stressor, once said “it’s not so much what happens to you, but how you take it.”

You can choose how you want to respond to Covid19, both in your thinking and in your resulting actions. Just knowing this technique can be life-changing and here, where we are talking about a very REAL threat, it can be lifesaving as well.

Step 4: Mindfulness

Understand the therapeutic value of staying in the present moment.

In step 4 you will learn that there’s a very real therapeutic value to staying in the present moment. When we allow our minds to wander off into the future (from what may be a perfectly safe moment we are experiencing now) we get all caught up in what might or might not happen tomorrow, or the next day, or a month from now.

The present moment can not only be a refuge from anxiety and worry it can also be a refuge from anger and frustration. We get ourselves angry and upset, when we leave the present moment and go back into the past to review something that has already happened and can’t be changed. (Why didn’t I buy some hand-sanitizer while I still could!)

But it’s more of a challenge to stay in the present moment now, with the threat of Covid19 looming large everywhere we look. So, what do we do?

Start a mindfulness meditation practice. Whenever you meditate, you are practicing the art of concentration or staying in the present moment, whether you are focusing your attention on your breathing, the sound of rain on the roof, or the flame of a candle in front of you. So, every time your mind wanders off into the future and lands on some scary thought, you are training it, to come back into the present moment.

As you get better and better at focusing on the now, you will see this improved ability to concentrate, will spill over into other activities too. Paying attention on purpose, when you are doing the dishes, mowing the lawn, folding the laundry or rearranging your sock drawer can all be positively therapeutic.

Anything you find mentally captivating can bring you into the present moment. Writing, reading, knitting, and doing crossword puzzles can all be equally therapeutic: Because it holds your attention in the now. But there are plenty of other activities you can do like going for a walk on a beautiful day, playing a board game, sitting in front of a fire, talking with friends or family that hold your attention in the now, too.

Even getting organized in any way, requires concentration, and will likely lower your stress, both while you’re doing it and afterwards when you experience the direct benefit of what you have accomplished. (Things look tidy, you can find things more easily, etc.)

But you might prefer gardening, working on a creative project, going for a run, or talking to an old friend. These activities can easily draw all or most of your attention and that’s a good thing. That makes them ALL therapeutic practices that you can do to stay in the present moment and out of the doom and gloom scenarios you might be tempted to consider, were you to allow your mind to wander forward or backward in time.

Assignment Part 1:  Make a list of ten activities, that you find relaxing and engaging. Make time for at least one of these activities every day for 15-20 minutes. Just to give yourself a purposeful break from all the Covid19 madness.

Assignment Part 2: If you have never meditated before, try doing a breath awareness exercise for 15 to 20 minutes. (Normally, you might start off with just 5 minutes, but if you feel you have more time for this now, go for it.) Notice every inbreath, every outbreath and the gap between your outbreath and the next inbreath (that’s when your mind tends to wander). Play with that gap. Make it longer, make it shorter. You can even take an occasional long, deep inbreath and a long outbreath and pay attention to what that does in terms of relaxing you as well.

When you first try a breath-awareness exercise your mind is going to wander. Even long-term meditators can struggle with this, especially at times like these. But with practice, you will get better and better at holding your attention on one thing and one thing only. That skill will spill over into your daily activities as well.

Step 5: Resilience

Establish a daily resilience routine.

A daily practice of yoga, exercise and/or meditation may take you 30 to 60 minutes in the morning, but it will help you cope better with stress all day long. This is how stress management morphs into stress prevention. A relaxed body conveys a message to the brain to relax, also. We know all too well how the mind affects the body, but very few people understand how the body can affect the mind. When you create a daily resilience routine, no different than brushing your teeth or taking a shower, you can tap into this benefit, all day long.

Exercise and meditation have been specifically shown to boost the body’s immune system. There is probably nothing more important right now, in the era of Covid19, than having a healthy immune system. When you look for research on yoga, you won’t find all that much, because, there hasn’t been enough interest in it until recently to drive that research. But yoga has been proven to reduce stress and since stress compromises our immune system, we can deduce, that yoga may boost your immune system, as well.

Going to the gym is no longer an option. But there are lots of exercise videos on You Tube. Any kind of workout you want is possible from a variety of calisthenic-based programs to yoga to working out with hand-held weights. You don’t need any fancy equipment to get a wonderful workout. Yes, many of these workouts are just modified calisthenics, but by switching things up, every thirty seconds or so, you will get FULL BODY workout.

Combine a 30-minute workout with 30 minutes of yoga and at the end of the hour, you will feel great. (Be sure to find the right level of challenge for you.) Even on days where the news about the virus just gets worse and worse, you can come away from this hour feeling rejuvenated from head to toe. Many times, you will find, this feeling lasts for the rest of the day. (As long as you don’t check your news feed!) This is what we call inside out stress management. When your body feels good, your mind can’t help but feel good too.

Assignment: Find some free workout programs or yoga programs, of any length, that you can do online. Try out a different one every day for a week, or until you find one program you can stick with. Since you probably won’t be able to consult a doctor before starting, if you’ve never exercised before, be sure to pick a program that’s right for your age and your level of endurance. (When you start to get winded, you have reached your level of endurance.) Don’t forget your cool-down period afterwards. Whether that’s a long shower, a cold glass of water or a hot cup of herbal tea, always enjoy a few minutes after your workout to let all those endorphins start to circulate throughout your body.

Step 6: Social Support

Seek out social support as a hedge against all kinds of stress.

Research shows that this step is the most important step of all. And it’s easy to prove, too. Think about the most difficult times in your life. What is it that got you through those difficult times? Usually it’s the help of friends, family, neighbors, doctors, counselors, support groups and the like. But how do we get social support now, when we are supposed to keep at least 6 feet away from everyone we know? As in step 5, technology really comes to the rescue here. Phone calls, texts, facetime, skype, Instagram, Facebook, can all give you immediate access to friends, family and loved ones.

But it doesn’t end there: As long as you can still take walks in your neighborhood. On nice days you may run into old friends and neighbors, and while maintaining a safe distance of 6 feet, you will able to engage in very satisfying conversations with people that you haven’t seen in weeks, months and even years! Book groups and knitting circles now meet on Skype, Zoom, Facetime and other free meeting software services. Even counselors and doctors are now are being encouraged – even where state laws have previously prohibited it – to “see” patients online.

One of the things you can do on walks is to simply connect with people along the road in any way that you can. The goal is always to make the other person smile or laugh or appreciate what they are doing for themselves, for their children or for the community. Whether it’s an entire family going for a run, or a mom, and a dog, with her three kids, piled on a stroller built for two, there are plenty of inspirational moments, that might inspire you to comment or cheer them on.

Let’s face it, at times like these, we all need to get back to basics. And there’s nothing more basic or more powerful or more therapeutic than social support. We benefit by getting it, but we also benefit by giving it. So every time you connect with another human being, even in some small way like this, YOU WILL FEEL BETTER. It takes our mind off OUR problems and gives a boost of the brain’s feel-good chemicals like oxytocin and dopamine. Remember, whenever you can give social support, even from a safe distance, you absolutely should. It’s therapeutic.

Assignment: Call up an old friend that you haven’t talked to in at least six months. Facetime or skype with a family member who will bring you joy. Call an elderly neighbor or a shut in, just to check in and see how they are doing.

Additional tips for using the Six Steps

Use a 0-10 stress number scale to monitor stress levels throughout the day.
Let go of what you can’t control and focus on what you can control: Do some research on trusted sites like the CDC or the Mayo Clinic to find out what you can do to keep yourself as safe as possible. Then make a list of the top ten ways you can put any reasonable advice you learn about into practice. Do as many things on the list as you can, every day.
Start to notice your thinking around Covid19. Is it rational? Or, is it exaggerated. When you hear yourself say something you believe to be untrue, like I will probably die from this, always correct it with something, that is TRUE, like: If I practice social distancing, my odds of getting the coronavirus are minimized. And even if I get it, I only have a very small chance of dying.
Look for activities that keep you in the present moment like knitting, doing a crossword puzzle or engaging in a hobby that you love. Take up a breath-awareness meditation practice. Let that practice help you: 1. Learn how to concentrate better. 2. Take your mind off doom and gloom. 3. Use your meditation practice to help you fall asleep at night and fall BACK asleep in the middle of the night.
Establish a resilience routine consisting of any combination of exercise, yoga, meditation, deep breathing and visualization. Whatever combination you choose, think of this as managing your stress from the inside out. It’s harder to hang an anxious thought on a relaxed body.
Connect with at least three people in a meaningful way every day. It’s surprisingly easy: All you have to do is find someone to talk to and spend more time listening than you do talking.

The nice thing about this model, is that you don’t have to do every step, in order for it to do you a world of good. Any one step can steer you away from stress almost as much as any other. So, pick a place where you want to jump in and get started. But whatever steps you choose, always emphasize to yourself, the proactive and preventative nature of this approach. When you can catch stress early at the symptom level, you can prevent your day-to-day issues with stress from becoming chronic health problems that can eventually lead to stress-related DIS-EASE.

Jim Porter, CEO of StressStop, is author of “The Stress Profiler,” “Stop Stress This Minute” and “The Thinking Person’s Guide to Managing Stress,” which together have sold over 400,000 copies. Mr. Porter has presented programs on stress at MIT, BYU, Time Inc, The FBI, The CIA, The Smithsonian Air and Space Museum, The US NAVY and the US Army. He has presented at numerous professional conferences including EAPA, WELCOA, IRAE, National Wellness and NCEAPA. He has also appeared on The CBS Morning News, and his work has been reported on by Good Morning America, Ladies Home Journal, The Associated Press, and The NY Daily News. His articles on stress have been published online by Forbes, HuffPost, Apple News, The Journal of Employee Assistance and Inc.