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If you are experiencing, panic, please go directly to “Anxiety Reduction Techniques”
Below, you’ll find tips on anxiety reduction, how to stop nightmares and insomnia, how to help children cope, help with loss and grief, ideas for home activities, and more. As a licensed clinical psychologist CA PSY#15379, I’ve treated many survivors of trauma, and taught Community Mental Health at a university for decades. I’m also a researcher/author, and wrote this in 2018 to offer effective ways, in or following a traumatic situation, to help survivors/responders avoid developing PTSD, cope, feel better and recover emotionally. On 10/17/89, I was in downtown Santa Cruz when the Loma Prieta earthquake destroyed the town, and in 2020, evacuated from the CZU Lightning Complex fire. So while these words may feel like they’re coming from a distance, I well remember the shock, dry feelings of devastation, grief and loss.
This is an unprecedented time in our history. Despite the disruptions to our lives, collective anxiety affects each and every one of us, whether we’re aware of it or not. We’ve all been encouraged to limit interactions with others within 6’, and to therefore stay home as much as possible. That is difficult and shocking. And yet, this is also a chance for introspection, going inward, and re-evaluating life priorities and values as we pull together across the globe.
In late February 2020, right before European countries mandated various forms of lockdown, The Lancet published a review of 24 studies documenting the psychological impact of quarantine (the “restriction of movement of people who have potentially been exposed to a contagious disease”). The findings offer a glimpse of what is brewing in hundreds of millions of households around the world. In short, and perhaps unsurprisingly, people who are quarantined are very likely to develop a wide range of symptoms of psychological stress and disorder, including low mood, insomnia, stress, anxiety, anger, irritability, emotional exhaustion, depression and post-traumatic stress symptoms. Low mood and irritability specifically stand out as being very common, the study notes: https://www.weforum.org/agenda/2020/04/this-is-the-psychological-side-of-the-covid-19-pandemic-that-were-ignoring/ You are not alone.
If in extreme distress, please consider calling the National Suicide Prevention Lifeline at (800) 273-8255 or the National Disaster Distress Helpline, with trained mental health counselors available 24/7, 1-800-985-5990, or text to 66746. Text one word with no spaces, talkwithus; or in Spanish, text one word, hablanos. Please reach out! You don’t need to be actively suicidal to call. Many, many people care and can help!
WHAT TRAUMA FEELS LIKE
Trauma results when we cannot find a place inside or outside of ourselves to feel safe. It is normal to feel numb, confused, lost, sad, angry, and many other feelings during and after trauma. Your sense of safety and security have been attacked. It is very important for you to recognize your own emotional state and take steps to take good care of yourself at this time. If you’ve experienced trauma before this, the current situation may reactivate prior feelings. In the SARS epidemic, 29% of people developed PTSD.
Cognitive difficulties: You may have trouble concentrating, find you experience a briefer attention span, have difficulty solving problems and trouble remembering what you've read or heard. Lack of sleep can compound these difficulties. Cognitive symptoms pass in time. Give yourself plenty of space and time to complete what used to be ‘normal’ activities of the day. Schedule fewer responsibilities. Consider making no major decisions until things are a bit more normal again.
Physical difficulties: Headaches, gastrointestinal discomfort, restlessness, muscle tremors and trembling (from adrenaline), muscle aches, fatigue, shortness of breath or feeling like you're suffocating (from hyperventilation) are all common reactions to trauma. A quick way to eliminate the last two is to breathe in to a count of 4, hold for 2, and breathe out to a count of 4 while consciously focusing on relaxing major muscle groups. You may not be able to start with 4-2-4 if you are very anxious, in which case, start with 2-2-2. Work up to a count of 7-2-7. Stretching, warm baths, and massage (massaging your own feet, arms, hands, and head!) are also helpful. (Other effective techniques to cope with anxiety follow in the next sections.)
Thoughts: One of the most effective methods to help reduce the likelihood of developing PTSD from disaster is to pay close attention to the story you tell yourself about what’s happened to you. We naturally stop telling the story at the point of most fear and danger. This actually makes it harder to recover. Instead, tell the story all the way to the end, when you knew you were safe, and help others to do so, as well. During a current, extended event like the one we are in with the coronavirus, say to yourself, “this is a temporary situation, it will end, and I will be safe.” End every re-telling with “and I was safe and am safe now.”
Feelings: You may feel overwhelmed by sadness and sudden crying, grief, guilt at not treating others better or for surviving, nervousness, restlessness, fear, anger, feeling alone, and/or feeling confused. This is a time to be gentle with yourself and others, while allowing time to pass and allowing the feelings to flow through you as much as possible when they arise. When we try not to feel things, we tend to feel worse. Tell yourself, “This is a normal, temporary reaction to trauma. My feelings cannot harm me. They will pass.”
Behavior: You may find yourself withdrawing from others, spending more time alone, not talking very much. You may have trouble sleeping or awaken in the night, have nightmares, and your appetite may change. You may become irritable with others, startle easily, and avoid places that re-stimulate the original fear. Alternatively, you may feel unable to stop seeking information about what you fear or have gone through. If possible, shelter yourself from such new information, and particularly avoid visuals about it, like video. This is necessary to allow your psyche to absorb what is or has happened and to rest and refuel without re-traumatizing yourself. The unconscious doesn’t know the difference between fantasy and reality: when you watch a video, your limbic system is activated, and part of you believes the trauma is happening again, more intensely.
All of these responses are normal. It is okay, and even appropriate, to feel badly during a crisis, and talking to a trusted person or mental health worker is very helpful.
Read “Your surge capacity is depleted” for more insight into chronic stress.
I FEEL SCARED, NERVOUS, PANICKED
Hyperventilation Syndrome: Panic
For people in the throes of hyperventilation, death feels as though it will arrive at any moment. People suffering from hyperventilation syndrome (I'll abbreviate it as HVS) feel a variety of things. First: mild disorientation, dizziness, feelings of unreality, and/or lightheadedness. Next: heart pounding, racing heart, sweating palms, breaking out in a sweat all over, 'hot flashes,' nausea, feelings of dread, fear of death or fainting or going crazy, claustrophobia (for example, 'if only I can get out of here and get home I'll be okay'), feelings of suffocation/not being able to get enough air. One can have all, or only a few of these.
In normal breathing, one breathes in about the same amount of oxygen as one exhales carbon dioxide. (Carbon dioxide is a byproduct of metabolizing oxygen). Hyperventilation means that you are breathing in more oxygen than you need. You are actually taking in more oxygen than you are exhaling carbon dioxide. Paradoxically, carbon dioxide builds up in your blood. This happens when you take quick, shallow breaths without the accompanying physical exertion that would require more oxygen. And you have no idea you are doing it.
Our ancestors needed the ability to quickly escape from predators and other threats, and to quickly respond to a fleeing animal when hunting. The 'fight-or-flight' response enabled early humans to perform these tasks. In modern day life, we rarely need such a dramatic physical response. Chasing the dog at the beach doesn't require quite the same level of physiological readiness as did running from a charging animal! Nevertheless, our bodies haven't evolved out of the fight-or-flight response, and can’t differentiate between a vivid thought or memory of danger and actual danger. Anxiety triggers the hyperventilation/fight-or-flight response in our bodies, and unless we restore the oxygen/carbon dioxide balance quickly, the symptoms will increase until we pass out and automatically begin breathing normally again. If you regularly suffer from anxiety attacks or panic, an excellent self-help book is Claire Weekes' classic, Peace From Nervous Suffering.
Note: As with any physical symptom, you will want to check with your doctor (many are seeing patients via video) to rule out any medical cause for your anxiety. There are very few physical disorders resulting in panic-like symptoms. At the same time, many (if not most) of us are feeling anxiety, and sometimes, panic, at the quick disruption of what we’ve known to be normal.
Once your doctor has determined your anxiety is not due to a medical disorder, you might be prescribed anti-anxiety drugs. They block the fight-or-flight response, and are to be used only when absolutely necessary and for a limited time, as they are potentially addictive. Alternatively, you can try the exercises below. They’ve been shown by research to be as effective as medication. Let those close to you know you are suffering from anxiety, and that you may need help staying with these techniques when anxiety arises.
ANXIETY REDUCTION TECHNIQUES
For fear, panic, nightmares worry, insomnia, agitation, restlessness, anger: Anxiety in and following trauma arises due to hyperventilation following the very quick, sometimes unconscious, thought, “I’m in danger.” Most of us don’t realize we are hyperventilating, and the symptoms can happen quickly. Symptoms resolve when hyperventilation (triggered by the amygdala and limbic system) stops. These techniques offer several effective ways to do that on your own, without medication, and will help with sleep:
Breathing (1 minute). You can do this anytime, anywhere. If you’re starting to notice physical tension, or any of the signs of hyperventilation, count your breath. Breathe in to 3, hold for 2, out for 3. Repeat for 1 minute. Then, 4-2-4. Then, 5-2-5. Strive for 7-2-7. You may feel yourself fight this at first; you will not pass out, however! Remember, you actually have too much oxygen, so regulating your breathing can only help you. (Sleep is 8-2-8.)
Breathing into a paper bag also works. Although you might be embarrassed to try this, once you begin to notice panic rising, pull out a paper bag and breathe into it, slowly, in and out, for a minute or two (you are filling the bag with carbon dioxide and thereby reducing the amount of oxygen you're breathing in).
5-4-3-2-1 (4 minutes). A cognitive technique, 5-4-3-2-1 requires you to concentrate intently across multiple physical modalities, which, in turn, forces the neurotransmitter norepinephrine (which triggers the amygdala and your overwrought stress response system) to stop surging. It is immediately effective.
Pick a spot you want to look at, and keep your eyes focused on it without moving them at all (blinking is okay) throughout this exercise. Name 5 things you see in your peripheral vision, without moving your eyes; look as far “out” from center without moving your eyes as you can. Next, name 5 things you hear. Listen intently. If you can’t hear 5 things, repeat something, but keep listening intently. Remember, your voice is one! Next, name 5 things you feel -- not emotionally, but physically (your foot on the ground, your hand on your lap, etc.). Make sure you are feeling them, not just listing them. Now, name 4 things you see in your peripheral vision -- don’t move your eyes! 4 things you hear. 4 things you feel. Then, 3… and so on until you’ve finished 1-1-1. Then, sit quietly for a few moments and let your eyes move normally. Most of us notice deep calm between 3-3-3 and 2-2-2. Repeat as necessary. (If you’re around people, feel free to “name” things silently to yourself.)
Relaxation Response (10 minutes). Dr. Herbert Benson developed the well-researched Relaxation Response, which has been shown to help people avoid the almost universally negative physical health consequences of extreme stress by allowing the limbic system to rest. (We now know that stress is also one of a few major, universal risk factors for most mental illnesses.) It is actually not possible to feel anxious when your body is fully relaxed!
Here is the relaxation response method (“tense and relax”). This entire sequence should take about 10 minutes. Practice it once, and preferably twice daily for one week. At various times during your day, recall to mind the feeling of your body at the end of the sequence, and say the word ‘relax’ to yourself. Your goal is to be able to induce the end state into any moment of your day without going through the steps. That tends to take about a week, and it will benefit you throughout your life.
First, if you are alone, audiorecord yourself giving yourself the following instructions, starting with ‘close.’ If someone is with you, have them read the below. Each time you get to the word, “hold,” stop talking for 10-20 seconds. Once you’ve recorded the below, reclining comfortably, play back the recording, tightening each muscle for 10-20 seconds before slowly releasing it. Each time, relax all-of-a-sudden, in one, quick movement. As each muscle relaxes, concentrate on the sensation of relaxation:
Close your eyes tightly. Hold; then relax.
Wrinkle your nose and flare your nostrils. Hold; then relax.
Push your tongue firmly against the roof of your mouth. Hold; then relax.
Make a facial grimace. Hold; then relax.
Clench your jaws tightly. Hold; then relax.
Tense your neck by lifting your head up a few inches until it almost shakes with tension. Hold; then relax completely all of a sudden.
Arch your back. Hold; then relax.
Tense your arms and clench your fists. Hold; then relax. Tense your biceps. Hold; then relax
Tense your stomach muscles. Hold; then relax.
Tense your buttocks and thigh muscles. Hold; then relax.
Point your toes to tighten your calves. Hold; then relax.
Pull your toes up as far as you can. Hold; then relax.
Scrunch your toes. Hold; then relax.
Rest for a few minutes, taking an imaginary journey through your body. Where you find any remaining tension, tense and relax that muscle group until you are completely relaxed. Imagine yourself in a place you love and that soothes you. Imagine every detail of the place, including how relaxed you are when you are there. Then, say the word, ‘relaxed’ to yourself, and rest a few minutes longer (or fall asleep!). In future, you’ll be able to say “relaxed” to yourself, or imagine the place you visualized, and immediately feel the sense of relaxation you feel now.
Meditation. If you have a regular meditation practice, it will help you manage anxiety. If you don’t, consider learning meditation when your situation stabilizes. There are many online resources for meditation education. Practicing the techniques above will give you a head start!
Nightmares. If you and/or your kids are having nightmares, the most effective remedy is to take a few moments to practice the techniques above, until you feel calm. Then, vividly imagine yourself back in the dream, just before the scary part happened. You’re walking down steps, and are perfectly safe, and when you get to the bottom, you’ll be back in the dream before the dream became frightening. Now, vividly imagine a different, positive, safe ending, as if you are making up a new story. Keep that story in your mind throughout the day, imagining it as clearly in your mind as you can. Repeat if new nightmares arise.
Making the new story external by writing it down, telling it to others, or drawing it will also help stop nightmares.
Having children draw their fears with someone—parents, teachers—eliminating danger does NOT work as well, because children are already in the danger. (This technique does work in non-survivor situations, however.) Here is a post from my blog, Creative Dreamers, on how to heal nightmares, and how you can use them for growth.
Intrusive Thoughts. Because you are or were in a dangerous, shocking, or actual life-or-death situation, your mind is replaying what happened or imagining the worst of what could happen in an effort to help you ensure you can find safety. What can be done about these painful thoughts? Take action to gather accurate information about threats you face, and once you have that, limit your exposure to repeated upsetting images and sounds (cable news is particularly overstimulating). Put in place what you need to to protect yourself. (At the top of this document is a link to vetted resources for coronavirus information and resources; also check the CDC and your local County Health Department website.). Accurate information helps you combat irrational thoughts that drive fear.
Practice the anxiety reduction techniques above, regularly. When unwanted and upsetting replays of the traumatic situation arise, slam your palms on the nearest table or floor and shout STOP! and then distract yourself with activities that require as many sensory modalities as possible (hearing, moving, using your hands, scents, and so on). You may need to do this a few times in succession in the beginning. If you are not alone, shout STOP! in your head, and immediately practice a relaxation technique, calming yourself with pleasant images of places you’ve been at happy times, and telling yourself “I am safe,” over and over. (You can add to the power of this technique by snapping a rubber band around your wrist or lightly pinching yourself at the same time as you say “STOP!”).
Distract yourself with the home activities, below...
HOME ACTIVITY IDEAS
* First Night is a celebration of art and community, held around the US on New Year’s Eve. Ring in the New Year with First Night’s virtual program of music, art, dance, and poetry! Check out Monterey’s, from 6 pm PST to midnight on Dec. 31. Kids’ Night Out activities start at 3 pm PST. Monterey’s First Night features performers that are also streamed from Springfield, IL and St. Petersburg, FL. www.firstnightmonterey.org
Updated 1/1/21 (new offerings sprinkled throughout):
* Visit the Palace of Versailles in France! They have a virtual 3D tour of house and gorgeous gardens here: https://www.youvisit.com/tour/versailles
* Take a virtual hike around gorgeous String Lake, Grand Teton National Park. Click on the icons for sights and sounds: https://www.nps.gov/features/grte/stringlake/eHike.html
* See the Butchart Gardens in Victoria, British Columbia, via their virtual photo tour, continually updated: https://www.butchartgardens.com/a-virtual-visit/
* Listen to Julie Andrews and her daughter read their favorite children’s books on their podcast, Julie’s Library, accompanied by music and sound effects to enhance the readings: https://www.julieslibraryshow.org
* Take a calming virtual walk through Filoli Gardens in Woodside, CA: spring https://www.youtube.com/watch?v=hSjt-vmi8fo and summer https://www.youtube.com/watch?v=JC7sCf_5SpY or stroll through their Chartres’ Cathedral Garden, modeled after the rose window of the cathedral in France: https://www.youtube.com/watch?v=YWLJQ8tKWKw In the Bay Area? Filoli is open for the holiday season, with lovely events and social distancing: https://filoli.org
* Check out the most unusual places/events/things in the world, and add to your travel list for the future, at https://www.atlasobscura.com!
* Visit the Portland Japanese Garden, with its 12 acres and 8 separate garden styles, with waterfalls, ponds, bamboo: https://japanesegarden.org/visitvirtually/
* A little twitter magic: https://twitter.com/RexChapman/status/1324904789361242113
* Did you see Father of the Bride, with Steve Martin? The cast came together again for “Part 3--sort of,” a 25 minute coronavirus edition, in September, 2020: https://www.youtube.com/watch?v=zBXL_jSxLuE
* Find a pen-pal! Pen pals are surging since COVID https://subarudrive.com/articles/pen-pal-connections
* Visit LegoLand in Germany and hunt for secret ‘Easter Eggs’: http://www.creationeer.co.uk/StreetSecrets/LegolandHotCold/
* Book list, curated by the UC Berkeley English Department: https://live-english-blog.pantheon.berkeley.edu/2020/03/31/quarantine-book-list-curated-by-the-uc-berkeley-english-department/
* Listen to soothing sounds. Our world is filled with mechanical noises, and stimulating sound. Take a break from that and listen to the sounds of the Rocky Mountain National Park here.
* The Seattle Symphony has restarted their new season, live broadcasting stellar and social distanced performances, where (on their youtube channel) you can join with others from around the world to listen. They are now charging a subscription fee of $12.99/mo., which is wonderful if it is within your means: https://www.seattlesymphony.org/watch-listen/live They do also continue to have FREE online musical performances for the whole family, as well: https://www.seattlesymphony.org/watch-listen/beyondthestage/explore-orchestra-family (‘tiny clips for tiny tots’ and ‘meet the instrument’) and check their site for more free performances as we all go in and out of lockdown.
* Early in the pandemic, the New York Times compiled a list of “films to heal a broken moment”-- stream/rent/buy: Together (2001, Amazon), Mrs. Miniver (1942), The Grand Budapest Hotel (2014, Amazon, iTunes, YouTube), Shoplifters (2018, Hulu, Amazon, ITunes, YouTube). https://www.nytimes.com/2020/04/27/movies/films-to-heal-a-broken-moment.html
* Make art. It doesn’t matter if you are “talented” or not. Expressive art has been shown to reduce anxiety and depression associated with trauma. It’s also fun! There are many online classes and demonstrations for just about any type of art you can imagine, including whittling! https://coolofthewild.com/whittling-how-to-whittle/
* Make a video of yourself playing all the parts of a scene or song from a musical, as this woman did for Belle from Beauty and the Beast. You can share it, or keep it private! https://comicbook.com/movies/news/disney-fan-plays-all-townspeople-beauty-and-the-beast-song/
* Turn your screens off at least 1 hour (preferably, 2) before bed. Screens interfere with stage 4 (deep) sleep, which is required for your body and brain to “renew” each night. Alcohol, marijuana, some prescription drugs and over-the-counter medications interfere with Stage 4 sleep, as well. Check with your pharmacist if this may be happening to you.
* Kids have made their own newspapers! “Celebrations during quarantine (lost a tooth, learned to ride a two-wheeler)...” https://www.washingtonpost.com/graphics/2020/lifestyle/kidspost/kids-newspapers-coronavirus/
* Remember to regularly stay in touch with friends and family on Zoom/Skype/Face Time. Schedule it in. Hang out together while cooking. Share recipes, cook the same things, connect over your largest monitor/TV screen. Read or watch a movie together. Seeking social support during times of crisis has been shown to be the most effective way of coping--even message boards and forums help.
* Watch Olaf from Frozen in a series of sweet short films--new ones regularly added: https://news.disney.com/magicmoments/video/at-home-with-olaf
* How to draw Elsa: https://news.disney.com/how-to-draw-elsa-frozen-2 and Anna: https://news.disney.com/how-to-draw-anna-frozen-2 and Sven: https://news.disney.com/how-to-draw-sven-frozen-2 and to do your hair like theirs: https://news.disney.com/frozen-2-hair-diy
* Learn to draw a variety of Pixar, Marvel, and Disney characters, listen to storytime, learn things you didn’t know about the Haunted Mansion, and make Jabbacado Toast, and more: https://news.disney.com/magicmoments
* Get daylight. Bundle up. Go outside. Walk outside. The earlier in the day you can manage it, the better. (Stay 6’ away from others and wear your mask!) If you find yourself lingering in bed, that’s one behavior that increased vulnerability to depression. Get yourself up, splash your face with water, go outside for a few minutes, and then--if you really need to--go back to bed. Because it’s winter, and daylight hours are fewer, Seasonal Affective Disorder may be a risk for you. Consider investing in a certified SAD light; they make a difference in mood and energy for sufferers. For you, it’s particularly important to get light into your retinas first thing in the morning. Go outside and turn your face to the lightest part of the sky; open a window and look through the screen. Lumens of indoor light can’t match those of the outside, unless the light is a SAD light.
* Keep trying new exercise classes online. Many free ones can be found on youtube, from martial arts to ballet to kickboxing to tap dancing or tai chi. For introverts, many are just one teacher and you. Try to take an online yoga or stretching class daily. Stretch several times throughout the day. This is a great one: https://www.youtube.com/watch?v=v0OzPShRHgM * Take a ballet class with the English National Ballet: https://www.youtube.com/user/enballet
* Turn off your screens as much as you can. Read a paper book or magazine. Reading has been shown to be calming to the nervous system, to improve concentration, empathy, and vocabulary! Reading fiction has been shown to improve mood and empathy.
* Have some legos hanging around? Make a lego challenge calendar, to spark your creativity: https://funlearningforkids.com/lego-challenge-calendar-building-ideas/ (This is a great site for parents)
* Here are over 1,500 free subscriptions to educational/activity resources for K-college due to school closures--also great for parents who are running out of ideas: http://www.amazingeducationalresources.com
* 50 fun things to do with your kids at home: https://www.milehighmamas.com/blog/2020/03/13/coronavirus-50-fun-things-to-do-with-your-kids-at-home/
* Symphony music from around the world you can livestream for free: https://www.bostonglobe.com/2020/03/13/arts/all-classical-music-you-can-livestream-free/
* Remember how you always wanted to start keeping a journal/diary? Now is that time! When this time has passed, you’ll want to look back on what you felt, saw, and thought during this time. Journaling has been shown by lots of research to improve mental health, particularly anxiety and depression. Start with a few minutes a day, and remember--there’s no audience!
* Is there a museum or gallery or garden somewhere in the world that you’ve always wanted to visit? Search youtube, or check out their website. Most have made and posted virtual tours because of the pandemic! Here are 12 such museums and art galleries who’ve made tours you can visit online: https://www.travelandleisure.com/attractions/museums-galleries/museums-with-virtual-tours
* If you’ve toyed with the idea of starting a business, now may be the time. Check out your nearest community or vocational college. Many have a Small Business Administration center; most all offer help getting started, developing a business plan, helping you walk through all the steps you’ll need between now and when you’ve established your thriving new career!
* Libraries across the country have a lot of digital resources: free streaming services, ebooks, video games, and more. Large city libraries generally don’t require residency to use.
CRISIS SELF-CARE STRATEGIES
We can regress to an earlier developmental stage/age when experiencing trauma, which is why physical soothing is so helpful at these times, and why it’s important to especially avoid sounds and visuals of violence, disaster, or upset, including internet, TV and video. Suggestions for each sense:
Find one flower; make a space in your room for your spirit; light a candle and watch the flame; set yourself a nice place at the table using your best things; go to a (virtual) museum; vividly imagine being somewhere beautiful you’ve been; take walks in nature and notice tiny things growing; go outside late at night and watch the stars; look at photographs on instagram or pinterest; watch a dance performance; be mindful of each sight that passes before you, not lingering on any.
Turn the volume down on devices around you. Pay attention to the sounds of nature nearby; sing your favorite songs; hum a soothing tune; play an instrument; call 800 or other information numbers or listen to non-upsetting talk radio to hear a human voice; listen to music that creates a feeling that is the opposite of the one you are struggling with (if feeling sad, play something upbeat; if anxious, play relaxing music); contact someone by phone or FaceTime/Skype/Zoom (texts don’t count!); call Suicide Prevention (1-800-273-TALK nationally) for support, even if you’re not feeling suicidal at the moment. Listen to the sounds of the Rocky Mountain National Park here. (Other national parks have sounds you can hear on their websites, too.)
Use your favorite lotion or cologne; spray fragrance in the air; light a scented candle; burn scented essential oils; put lemon oil on your furniture; boil cinnamon; bake cookies, cake, or bread; smell roses; go outside and breathe in the fresh smells. The natural world is still there, and will support you.
Have a good meal; have a favorite soothing drink such as herbal tea or hot cocoa; treat yourself to dessert; put whipped cream on your coffee; suck on peppermint candy; chew gum; taste the food you eat. If you’re feeling angry, crunch on something, like carrots. Do watch your consumption of refined sugar and carbohydrates, which spike blood sugar and can cause palpitations and other anxiety symptoms. Try eating some protein (nuts, peanut butter, cheese) every time you eat a carbohydrate.
Take a bubble bath; put clean sheets on the bed; pet an animal; have a massage or give one to yourself; soak your feet; put lotions on; put a cold towel on your forehead; sink into a comfortable chair; put on a silky piece of clothing; brush your hair for a long time; hug someone; hug yourself tightly; rub the area over your heart in slow, circular motions.
Do something engaging that takes a little energy: dance, take a walk, straighten up wherever you are, stretch. Avoid heavy exercise, caffeine, and substances, as they can stress your hardworking adrenals and endocrine system.
Practice mindfulness meditation: When you are in intense emotional pain, remember that the peak intensity of emotions (and urges to be self-destructive) lasts about 10 minutes. Breathe into your belly, in through your nose and out through your mouth. Focus your attention on your breath, paying attention to the sound and rhythm of your breathing. Notice how you feel without trying to block, stuff, ignore, or judge your feelings. Keep breathing and let the distressing thoughts flow right through your mind, without clinging to any of them, until you are calm.
TIPS TO REDUCE GENERAL ANXIETY OR DEPRESSION
Supplements. Research on anxiety has found that 5HTP, green tea, and St. John’s Wort help with the “worry” component of anxiety, whereas SamE helps with low energy depression and pain. Check with your pharmacist regarding drug interactions first. Other supplements found by research to relieve anxiety include lavender, kava, and daily fish oil. (Synthetic antidepressants relieve anxiety by depressing brain activity, much like alcohol.) For ADD and generalized anxiety, daily fish oil, avoiding food dyes, zinc supplement (FDA guidelines), daily exercise, and a Mediterranean diet reduce symptoms as well as do amphetamines (Ritalin, Adderall)—and are also associated with good health outcomes, in general. Make sure you are getting enough Vitamin D. It is a leading cause of depression in adults, and is also crucial for the immune system. Many of us can’t synthesize it from the sun (the older we get…). Consider good-quality vitamin D drops. Calcium and magnesium naturally calm the nervous system, and most people don’t get enough of either. Foods with high magnesium include dark chocolate, avocados, nuts, legumes, tofu, seeds, and whole grains. For many people, taking a calcium-magnesium-zinc supplement tablet or powder when anxious or just before bed is very helpful and can help with insomnia, as can Yogi brand Bedtime tea (check with your doctor first if you have a medical condition, and don’t use with sleeping pills or anxiety medication).
Diet. The Mediterranean diet emphasizes:
The diet also recognizes the importance of enjoying meals with family and friends. Try not to deny yourself anything--rather, limit portion sizes and frequency of less healthy foods, but don’t eliminate them. That sets up rebellion in the psyche to the sense of being deprived!
Exercise. Daily exercise has been demonstrated to relieve both anxiety and depression as well or better than antidepressant medication. That doesn’t necessarily mean a trip to the gym: walking at a reasonable brisk pace around the block when you feel anxious reduces anxiety. Make sure to move every day. It appears that the movement of the head has a positive effect on neurotransmitters. We tend to freeze when we are scared or uncertain. Strenuous cardio exercise actually depresses the immune system for ~24 hours afterwards; if you’ve been exposed to possible illness, consider waiting to do cardio until you’re sure you’re not becoming ill.
Thought monitoring. Anxiety is a physiological reaction arising from either a physical condition (rare) or anxiety-provoking thoughts about the future (anxiety is fear about the future). Anxiety and depression often occur together. When you find yourself feeling anxiety, use the following questions from cognitive psychotherapy to ask yourself the following questions about the thought(s) you are having:
Is it true?
Can I absolutely know it is true?
If it were not true, then what?
If it were more true, then what?
How do I feel when I believe it?
Who would I be without it?
FOOD AND STRESS
The body does not distinguish between 'good' and 'bad' stress. It views all stressors as demands--usually only temporary--for more energy output. The body's long-term response to chronic stress is serious.
Here's what happens within a split second when your body responds to a stressor (be it a sharp word or a life-threatening emergency): blood pressure rises and pulse rate increases in order to speed nutrients where they are needed; blood sugar increases to provide instant energy; vitamin C is mobilized to fight infection; B vitamins, calcium, and other minerals ªare drawn from the bones to stimulate muscles; irrelevant body functions slow down (i.e., digestion); sodium content (and water retention) increase to prevent dehydration. Afterwards, protein which was broken down to form blood sugar in the stressful moment cannot be reused as protein. Vitamin C and B vitamins are excreted and no longer available. Minerals cannot be reinstated into the bones. Therefore, people under chronic stress can become deficient in B vitamins, vitamin C, protein and minerals--important for the proper functioning of the body, including the immune system. This is why it is so important to attend to your diet when under, or following, prolonged periods of stress. Make sure to eat in a calm, relaxed environment, since if you are under stress when you eat, you will not completely digest your food.
When the body is forced to draw on reserves of protein for blood sugar for instant energy, protein is taken first from the adrenal glands, then from the thymus and lymph glands, and then from the muscles. People under chronic stress who are not eating enough protein are actually digesting their own muscles in order to physically cope with the effects of stress! Because of the demands stress makes on the body, repeated or prolonged stress can cause a host of physical difficulties, including adrenal exhaustion, heart problems, central nervous system difficulties, and digestive problems. It is also a leading cause of depression.
Coping with stress
Reframing the stressor really does work. Research shows that finding something positive in the stress you are experiencing ("I am learning to cope with difficulties in a new way," “I am going to be able to withstand almost anything after this,” “This disaster is deepening my sense of empathy for others,” and so on) actually reduces the physical response to stress and the length of time it takes to heal from its effects! A large body of research also shows that biological sex affects which coping strategy is more effective for individuals: seeking social support (for females) and making a plan to solve the problem (for males) decreases stress. Because there are so many physical effects, it is crucial to do some type of exercise when under stress, but again, do take it easy when you’ve been very upset. As little as a 10-minute, brisk walk three times a day, four days a week (or 50 minutes of exercise at your own fitness level three times a week--be it running, jogging, or simply walking) can help ease the stress response. Exercise which also teaches you to calm the mind and control the breath, such as a martial art or yoga, can be particularly helpful for anxiety. Meditation training and spiritual or religious study have also been shown by research to reduce the duration, severity, and negative physical effects of stress in adults. Journaling has been shown to be particularly helpful in developing resilience.
HELPING CHILDREN DURING AND AFTER DISASTER
(For children’s nightmares and intrusive thoughts, see Anxiety Reduction Techniques, above.) Children’s nervous systems, like adults’, respond well to physical soothing by family members and other safe adults (gentle, rhythmic stroking of the back, feet rubbing, hugging, hair-brushing, and so on), which has been shown to reduce blood pressure and general anxiety. Here are some recommendations originally from the wonderful nonprofit, Kidpower:
1. Protect children from adult feelings.
Remember that talking about worries and fears creates anxiety without making kids safer. Practicing skills helps to reduce anxiety and increase competence. Protect your children from hearing details, speculation, and media coverage of the virus as much as possible. For example, regarding those who have died, ONLY if a child is likely to hear about what happened, you might say calmly, "We are sad because some people have died from the virus. People are working hard to make sure this virus goes away and never happens again, but this is still very upsetting and scary. Let's practice our hand washing together."
2. Beware of the Illusion of Safety
- which happens when a situation is so familiar that you lower your guard about potential hazards such as traffic, water, animals, and people. Children are sometimes injured or killed when lots of adults are around during a disaster because no one is specifically watching out to protect kids and adults are distracted. Practice with your kids how to stay aware, make safe choices, and get help everywhere they go. Take the time to make safety plans and to discuss, review, and practice safety skills with your children and teens.
3. Instead of talking about the bad things that can happen, help kids practice how to stay safe. For example, just telling kids to be careful is not enough for them to be safe unless they have actually rehearsed many times how to do particular actions safely. Teach children how to sanitize, to cough into their elbows, to wash their hands correctly: https://www.who.int/gpsc/5may/How_To_HandWash_Poster.pdf . Teach children to check first with their adults before they change their plan about who is with them, where they are going, and what they are doing - even with people they know.
4. Support children with their own feelings. Children who know a child who has been harmed or who hear about a disappearance or tragedy can be deeply upset by what happened. Help children regain their emotional safety by listening with compassion, giving them ways to share their feelings such as writing a card or drawing, and empowering them with skills. The recommendations in our article, Helping Children Regain Their Emotional Safety After a Tragedy, are from many mental health professionals.
5. Join with other concerned community members to find solutions, and let your children know you are doing this to make things better.
Here are some Kidpower resources that many parents, educators, and other caring adults have found to be useful in preparing kids to explore their world with safety and confidence without teaching fear:
And this is an excellent compilation of suggestions to parents for their children, from the American Academy of Pediatrics, and Positive Discipline curriculum:
Children will take cues from the adults to see how worrisome the situation is. Adults need to lead with confidence and assurances that everything is being done to keep them safe. Limit exposure to scary or frightening social media images, especially for young preschool and elementary children. Be real and honest when kids ask about questions about the future. Talking points such as, "I don't know what will happen but I do know everybody's doing what they can, and that our family will stick together and we will follow our emergency plan." Try and limit your exposure to social media, while we can sign up for alerts and stay informed, we also can be present in the moment and hold space for our teens and children to check in on how as a family unit we are handling ourselves and practicing our self-regulation skills.
It is important to tell children, without overly alarming them, about disasters ahead of time. Talk about things that could happen during a disaster, such as the lights or phone not working, distance learning being cancelled, or needing to evacuate.
Tell children there are many people who can help them during a disaster, so that they will not be afraid of firefighters,police officers, paramedics, or other emergency officials. Share with them how you find posts on social media filled with hope of the sheer amount of people power out there rising to help one another.
Children respond differently to disasters than do adults. Sometimes it is difficult to tell if/or how severely the child has been affected by the disaster. Here are some common issues that arise in children and how parents can help their children cope after a disaster.
• Children and Their Daily Routines. Disasters disrupt our lives in a variety of ways. All disasters whether big or small can change our routines. From school closures to the need to stay in a shelter, children’s daily routines undergo a number of changes. Children rely on their routines and changes to these routines can lead to anxiety and other problems. Every effort should be made to return to as much of a routine as possible. This can help children adjust and cope to the after effects of the disaster. A Positive Discipline tool like family meetings, where you share compliments and appreciations for one another can be hugely comforting in these moments.
• A Child’s Imagination and Fear. A child’s imagination is a beautiful thing. However, after a disaster this imagination can lead to fear and worry. Parents who stay calm and provide reassurance can help children decrease their worry. It is important to be honest about the situation keeping in mind each child’s age and maturity. Try and dive into your child's world and allow a little bit of comic relief, and silliness help you through these tough uncertain times. That being said, noticing when you have "flipped your lid" or when you are dysregulated is important, be kind and compassionate with yourself. You are doing great and are only human. Deep breaths and hugs go a long way.
After a disaster, it is common for children to be afraid that:
• The event will happen again.
• Someone they care about will be injured or killed.
• They will be separated from their family.
• They will be left alone.
After a disaster, parents should make every effort to reassure children that the event is over, everyone is safe, and that the family will stay together.
Common Behaviors after a Disaster. Children may:
• Go through a personality change. For example, a quiet, obedient and caring child may become loud,
noisy and aggressive or an outgoing child may become shy and afraid.
• Be upset over the loss of a favorite toy, blanket, teddy bear or other items.
• Have nightmares or be afraid to sleep alone or with the light off.
• Become increasingly clingy, and cry and whine more than usual.
• Revert to younger behavior, such as bed-wetting and thumb sucking.
Children’s Psychological Needs Following a Disaster:
Parents should remember that the psychological effects of a disaster do not disappear once the event has passed. Children can show signs of psychological trauma in the form of nightmares or other problems for up to two years. Children need help and support as soon as possible. Some children may not exhibit signs of distress for weeks to months after the disaster, while some may never show such signs. It is important for parents to closely observe children’s behavior. By recognizing problems quickly, parents can access resources for their child to receive extra counseling or attention. Our Positive Discipline support and learning groups can be of support to you, let us know how to best support and hold you along with the many other incredible and local non-profits ready and eager to stand by you.
How Can Parents Help Children Cope After a Disaster:
• Talk with children about their concerns and fears. Allow them time to figure out how they feel about what they have gone through.
• Listen to children’s concerns, fears, and feelings. Don’t judge them for their fears or concerns. Try to understand their feelings despite how irrational you may think they are. Reassure children that the family will stay together and that they will not be left alone.
• The most important role a parent can play in an emergency situation is to stay calm. Provide reassurance through your words and actions.
• Remind children that it is okay to be afraid. They do not need to be brave or tough and that it is okay to cry.
• Include them in recovery efforts. Give them tasks that they can safely get done to empower them and help them see that everything is going to be all right.
• While many things will be out of their control, point out those things they are still in control of and allow them control over simple things such as what to wear, what to eat, or what bed to sleep in.
• Allow them special privileges, such as keeping on a night light while they sleep, for a time after the disaster.
• Find ways to let your children know you love them.
• Turn Off and Log Off. Today, we are forever plugged in to the events around us through television and social media.
While these tools allow us to stay up to date on a disaster, they may have a negative effect on children. Television news stories, especially those with images, will upset children. Repeated news coverage may make them think the disaster is ongoing or occurring again. Social media posts of photos and videos from the child’s community can be more damaging. Also, wrong information posted to social media could hurt children even more. Parents should limit children’s access to TV and social media and make sure that they talk to their children about things seen or read.
Some Helpful Activities:
• Have children draw or paint pictures that show their thoughts and feelings about the event and their experience during and after.
• Have children write a silly rhyme or story about the frightening event.
For example, start with:
• “Once upon a time there was a terrible ___________ and it scared us all. This is what happened: _________
• Make sure to end the story with: “And now we are all safe and sound.”
• Sing or create music with your children. Music helps reduce stress; it’s good therapy.
WHAT SHOULD I DO FOR SOMEONE WHO'S EXPERIENCING A LOSS? (INCLUDING YOURSELF...)
(Note: Some of this last section came from a book I read decades ago, the title of which I sadly can’t remember. I’ve added to it throughout the years.) You may have just experienced many losses: sense of neighborhood, physical contact with friends, pets, livelihood, normality, routine, job, sense of safety, hope. At the least, you’ve experienced what it feels like to have little control over external events. These are all psychological losses, and they may bring up unresolved losses from the past.
WHAT LOSS FEELS LIKE: Along with the obvious feelings of pain and sadness, there are other reactions to loss, such as feeling helpless, fearful, empty, despairing, pessimistic, irritable, angry, guilty, restless; experiencing a loss of concentration, hope, motivation, energy; changes in appetite, sleep patterns, or sexual drive; a tendency to be more fatigued, error-prone, and slower in speech and movement. Any or all of these are to be expected during and after loss. It is part of the body's natural healing process. Encourage your friend to accept them, not fight them.
* Recognize that a grieving person's judgment and concentration will be off for at least the first year. Don't take over for her or him, but encourage your friend to make no major decisions during that time.
* Allow the grieving person to cry. Don't be afraid to offer comfort for fear you will make your friend cry. Tears are healing. (They also release potentially unhealthy levels of cortisol.)
* Remember that the grieving process is not the smooth progression many people assume. It's more like a lightning bolt, full of ups and downs, progressions and regressions, dramatic leaps and discouraging backslides.
* Grieving people often want to 'flee the scene' of the loss. A healing, restorative vacation with friends or family members can be very helpful.
* Realize there are several stages of grieving: shock/denial/numbness; fear/anger/sadness; guilt/questioning; understanding/acceptance/moving on. They do not necessarily occur in any order, and they can come and go.
* Understand that your friend will be absent-minded, forgetful, and clumsy. If your friend was a great organizer and arranged everything, he may not be up to that now. Take over for awhile.
* Encourage your friend to talk about the one who died. You can do this by saying something like "I remember when (you told me) (name) did or said..." Not talking about the absent one does not keep your friend from thinking about them. If the relationship was conflictual, now is not the time to be pointing out those conflicts to your friend. Let your friend work this through with a professional.
* Be there for your friend: a week later, 6 months later, a year later. Be the friend you profess to be—all the time.
* Offer to help. Don't ask how you can help, just DO something. If you bake, take some cookies over whenever you happen to feel like it. Encourage your friend to get out of the house. Call and ask her to go out for lunch or dessert and coffee. If she is having trouble concentrating on work or on studying, offer your help.
* Say "I'm so sorry for your loss. Please let me know what I can do. I’m thinking of you." Do not say: "He was old, he had a long life,” "She is no longer suffering,” (your friend sure is) “I know just how you feel," (no one knows how anyone else feels) "God wanted her to be with him," (so does your friend) "God only takes the good ones," (where does that leave your friend?) "You're strong—you'll make it," (your friend has no choice) "You're young; you'll meet many people in life" (Your friend can't replace the person lost—yes, he can love again but he doesn't feel like that in the beginning and doesn't want to hear it). Listen. Listen. Listen. This will put you in touch with the parts of yourself that block out and try to change the subject when you get uncomfortable. Your friend experiences this disconnect as intense isolation. In my practice, I’ve found this is one of the more painful feelings following loss.
* Do understand that this is not something your friend should get over in a certain period of time. Don't put a timetable on grief—everyone heals at their own pace. Full healing following the loss of a close loved one or family member generally doesn't come for at least 2.5 to 6 years. It can take much longer if the lost one died in a disaster, violently or suddenly, or in the case of suicide.
* Ask how your friend is feeling, and if the response is "fine," say, "Are you REALLY fine?" Your friend will say "fine" because she knows that's what you want to hear, but please make the effort to really find out how she's doing (ask how she is sleeping, eating, and how she is dealing with each day— she needs to tell you).
* Expect to see irritability. It's normal to feel anger towards the one who left us, God, fate, doctors, the stopped up sink, and so on. This is part of healing. Please don't tell your friend she's being unreasonable. Just allow her her anger and listen with love to her ranting and raving.
* Drop a card in the mail if you know your friend is dealing with an anniversary of a birthday, death, or commitment. She is feeling alone and vulnerable; she needs to know you are out there and thinking of her. Anniversaries of 1 month, and years 1, 5, 10, 15 are particularly difficult. By then, most have forgotten the date of loss, but your friend hasn’t.
* Give your friend many hugs, if your friend is comfortable with touch. Ask them to rub their chest in a slow circle. Rub circles on their back, stroke their arms, rub their feet.
* Be sensitive to the fact that people grieve differently. Some cry openly, whereas others cry behind closed doors. Some may not speak of the lost one, but you'll notice them wearing the deceased's shirt, looking at pictures, and so on. This allows your friend to feel close to the beloved.
* Suggest going for a walk, or playing some sport. Depression can be lightened a little by the biochemical changes brought on by exercise, which can also encourage better sleep. Do understand your friend's whole life was changed by this death. Your friend is not only grieving the loss of a loved one, but also the loss of the role that one filled in his or her life (mother, friend, child, father, wife, etc.).
* Allow your friend to talk about his guilt. Even though you may feel he has nothing to feel guilty about, most of us feel guilt about some aspect of our loved one's death. We need to talk about it with someone who will listen, care, and not judge. Talking about our guilt will help us to let it go. Try not to give advice, unless it is asked for. This can be very difficult, because it’s hard to stay with pain in our friend, and to feel that helplessness. Yet, your friend is helpless against their pain, too. Be there with them.
* Understand that not everyone feels comforted by religion. We all have our own spiritual beliefs and now is not the time to push your religion's beliefs. Particularly, in the situation of a lost pet, avoid saying, “Animals don’t go to heaven.” This is just cruel. Instead, listen to your friend's thoughts about where the lost one might be, or the meaning of the loss.
* Be prepared to be rejected. Be prepared for illogical or extreme behavior. Be forgiving. Do not feel the person who is grieving is treating you badly despite your best efforts. Your friend will remember you were there when things settle down. Don't hold a grudge. Try to always keep in mind that what your friend wants the most, you nor anyone else can give: to have the loved one back. Everything else, from sleep, to food, to manners, is superfluous.
* Most importantly: DO follow through if you say you're going to do something for your friend or invite your friend over. At this point, your friend feels there is very little, if anything, they can count on. Let your friend at least be able to count on you.
This, too, shall pass… 💚