6 evidence-based methods to head off COVID-19-related depression and anxiety

A psychiatrist outlines home-based strategies to head off stress and depression during the coronavirus pandemic

By Elisa M Brietzke, MD - May 27, 2020
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The COVID-19 pandemic is stressful for everyone. Fear of getting infected, grief for friends and relatives who have been affected, and financial and social insecurity have impacted an exceptionally large proportion of the population. In addition, the need to adopt social isolation and quarantine measures has accentuated feelings of loneliness.

For parents, the need to help children and adolescents deal with the pandemic and keep learning in the absence of schools can be overwhelming. And for essential workers, especially healthcare professionals, working under unusually adverse circumstances presents a unique challenge.

It’s no wonder that people are feeling overwhelmed. “How can I deal with the need for endless news scrolling?” “How do I manage my stress when I don’t have my test results?” “How do I talk with my kids about the COVID-19 and its impact?”

But even in the face of anxiety, fear, sadness, anger and other negative emotions, during severe crises, it is quite common to see communities overcoming challenges and displaying incredible resilience. Although everyone is different and tips that work for some do not work for everyone, mental health professionals have been suggesting strategies to help different populations cope with emotional and psychological suffering during and after the pandemic.

Finding the best interventions in times of stress

Most of these interventions and treatments are derived from our experience with individuals exposed to other traumatic events, such as wars and natural disasters. They follow classical concepts in psychobiology but also incorporate new advances from the use of virtual online care.

Among the consolidated knowledge, the most important is the concept of “stress.” Research on stress in a medical context was pioneered by an endocrinologist from McGill University, Hans Selye (1907-1982), to designate a set of physiological changes that our body engenders to make us more resistant to perceived danger. These changes include the release of the hormone cortisol, which preserves energy, and the activation of the immune system. For a short time, this reaction is adaptive and potentially beneficial. However, over a longer period, it predisposes us to mental and general medical diseases. For example, it is well known that the continued presence of cortisol in the brain can produce shrinking of the hippocampus, responsible for memory and learning, and which has been shown to be smaller in individuals with depression compared to healthy subjects.

For these reasons, it is important to know the evidence-based interventions to reduce the impact of stress. They can help us to cope with stressful situations, potentially reducing the risk of having mental disorders such as depression and anxiety.

  • Accept that it is normal to feel bad in the current situation. This is a very abnormal moment, and it is almost impossible to not be affected. This is a time to adjust our lifestyle to this acute challenge.
  • Use what worked for you in the past. Although this is a unique challenge, it is probable that the pandemic is not the first bad experience you had in your life. If something helped in the past, it probably will work again. Examples of coping strategies are distraction, praying, taking a warm bath, or reading your favorite book.
  • Practice meditation or mindfulness. These techniques are very efficient and affordable ways to calm down unpleasant emotions. They have proved their therapeutic effect in several studies across the world. Easy ways to practice meditation and mindfulness can be found in apps and on YouTube.

Even doing our best do deal with stress, it is possible that some of us will develop depression and anxiety. Persistent and intense emotional suffering indicates the need to look for professional help. The treatment of depression and anxiety includes medication, psychotherapy and other non-pharmacological approaches:

  • Exercise. This is a powerful way to reduce the effects of depression and anxiety in our mind and body. There is no evidence that one type of exercise in superior to others. Possible things do in periods of social isolation are yoga, walking and running (indoors or out), or just playing a nice song and dancing like nobody’s watching.
  • Keep a regular routine. It is very common that individuals in social isolation start to develop a dysregulation in their sleep-wake cycle. Sleeping too little or too much is a symptom of depression. In addition, regulation of our rhythms is beneficial for the control of its symptoms. Simple attitudes such as having meals and taking a shower every day at the same time helps our body feel sleepy at the regular time.
  • Do not self-medicate with caffeine, alcohol, marijuana or other substances. In moments of emotional suffering, some people use substances to mitigate depression, anxiety, insomnia or lack of energy. These substances are not useful to treat these conditions and can make the depression and anxiety worse.

During the COVID-19 pandemic, some of us can experience severe depression. The psychological pain of depression can be so intense that some people start to see death as a possible exit to terminate it. In case you or someone you know is feeling suicidal, there is a need to seek urgent help, which may include calling emergency services.

Finally, it should be noted that the scientific community is making an unprecedented effort to develop interventions to help us to deal with this pandemic. They include the rapid development of a vaccine, the test of different medications, and interventions to prevent and treat COVID-19 mental health issues.


Dr. Brietzke’s forthcoming books

Dr. Elisa M. Brietzke is a co-editor of two books that will be published by Elsevier’s Academic Press:

  • Book cover Ketamine for Treatment-Resistant DepressionKetamine for Treatment-Resistant Depression: Neurobiology and Applications, with co-editors Gustavo Vazquez and Carlos Zarate, has an expected release date of October 1. This book is intended for neuropsychiatrists and translational researchers, nursing staff, students and administrators. It provides a simple, evidence-based overview for neuropsychiatrists and translational researchers on this medication, its mechanisms of actions, eligibility of patients for treatment, and the preparation and implementation of ketamine clinics.
  • Mental Health and the COVID-19 Pandemic, with co-editors Roger S. McIntyre, Rodrigo Grassi-Oliveira and Kanguang Lin, was just contracted with a tentative pub date in October 2020.

Related stories and resources

Find more resources in the Mental and Behavioral Health section of Elsevier’s COVID-19 Healthcare Hub.

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Contributors


https://www.elsevier.com/__data/assets/image/0020/1018028/Elisa-Brietzke.jpg
Written by

Elisa M. Brietzke, MD

Written by

Elisa M. Brietzke, MD

Dr. Elisa M. Brietzke is a Full Professor in the Queens University Department of Psychiatry, Providence Care Hospital, in Kingston, Ontario, Canada.

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