30 Mar Dealing with the issues related to Covid-19 – How can CBT help?
Dealing with the issues related to Covid-19 – How can CBT help?
Social Isolation – and maintaining general wellbeing
For some of us working from home will include our other family members and pets. The challenge is how to manage your time and keep separate enough if you are in quarantine. For others the isolation is more profound and you might not see another person for days on end. Whatever your current circumstances, the impact on our mental health, living with the uncertainty of when the period of isolation will end, and not feeling that sense of belonging and connectedness can sink a person into feeling depressed.
The signs for depression can be noticing that you are more tired and fatigued, disturbance in your sleep and sleep patterns, lack of motivation and a loss of pleasure in doing anything. Often with the negative thinking comes a sense of hopelessness and helplessness. It is hard to see things optimistically and If you find yourself or hear others saying ‘what’s the point?’ – be mindful, this maybe indicating how you or others are feeling in themselves.
- Reduce time watching the news – think about what you can do with the increased time you have. What hobbies have you neglected, the books or projects around the home you have been putting off….
- Think about what is meaningful to you in your life. Try and adapt the activities you can do within the confines of your home that fit with the values that are important. For example if it is being helpful – how can you still help others now – maybe keeping in touch via phone with your vulnerable neighbour, doing the gardening for someone down the road who is in quarantine and elderly. If an important value is being creative – how to generate projects that excite you and allow for creativity to emerge, using what is available – sewing, cooking, drawing….
- Adapt your normal groups to be online – a book group, exercise class, friendship groups. Look at joining a virtual exercise class or challenge your group to do exercises at the same time – feedback to each other help each other to keep motivated and keep positive.
- Go out for a walk or exercise (with your dog) is still being advised as long as you are keeping 2m away from others– fresh air and green spaces are vital for our sense of wellbeing.
- Eat regularly and adapt to what is available. If you are self isolating for 14 days, ask others to drop shopping to your door – try not to snack and keep up with your regular diet. Be aware of how what you eat affects your mood. Also that your mood affects what you eat. When we are feeling tired stressed or depressed we are more likely to crave sugars and carbohydrates. These can impact on our blood sugar levels, and also our self esteem if our weight starts to fluctuate. We might also turn to other stimulants to manage our mood – alcohol, caffeine and nicotine levels might increase – keep an eye on this in yourself and others, and talk about it to find support for the feelings.
- Find ways to connect with family and friends so you don’t feel overwhelmed – use text messages and voice messages if you don’t feel like talking or video linking. A quick message can help you to feel involved with your family and friends even if you can’t see them or be with them.
- Look online to see if there are any local community sites – there are many popping up on such sites like Facebook. See what others are doing – share this with people you might think need more support.
- If you have underlying mental health difficulties and are feeling like you need support straight away Samaritans are available and also have a messaging service they have set up for people experiencing an increase in distress. https://www.samaritans.org/
- Seeking professional help: you can talk to your GP with a phone consultation for a referral to NHS services or call 111 for advice on uncertainty over physical symptoms. Alternatively you can seek help and advice from BraintrainersUK . Avoid the waiting time to see a therapist via the NHS which unfortunately can be months rather than weeks.
offer an immediate assessment for one to one therapy using CBT via Zoom video linking. Understand how your thinking and behaviours might be increasing the feelings of depression and finding step by step tools to managing your distress.
We have many years experience dealing with people suffering from depression and understand how hard it can be to see through your current situation and find the motivation to make the necessary changes to reduce your low mood. Contact us now to find out how we can help.
Impact of working from home
Coronavirus has accelerated working from home for the majority of us in order to protect ourselves and the wider community. Technology has the capacity to help us adapt to this new reality of course but how easily can we adapt? Of course there are some benefits to working from home – no commute time and less contact with others to spread the virus. But there are challenges to contend with as well that can build one upon another to create a feeling of being unhappy or stressed.
You can miss those small interactions at work the jokes and camaraderie that make up the team and team dynamics. Talking to others as you have a break can be helpful in sorting out small issues as they emerge at work before they become bigger problems. You might find it harder to concentrate and sometimes get waylaid in some minor tasks and find it harder to prioritise and leave household jobs till later. You may also struggle with structure and boundaries if all the family are at home. How do you separate out your work tasks?
- Think about what you need to achieve over the month and break down the tasks that will need to be done each week. Then focus on setting goals for the day and have a way of recording when they are done to increase motivation.
- Look at the results you want to achieve rather than the hours you have to work – this is one of the benefits of working from home, developing the rhythm that works for you
- Find a work routine that works for you and stick to it -get up dressed have breakfast and mealtimes during the day as normal.
- The time you would normally commute can be used to promote wellbeing, consider an energising workout accessed online before work begins and maybe a meditation/yoga app for the end of the day.
- If you can go out into the garden and don’t require access to your computer, consider doing work calls at this time so that you are outside more but still working.
- Plan your work to the times that you know yourself to be more productive and schedule downtime when you know it is more difficult. The 9-5 need not apply, working smarter not harder. However balance this with protected family time.
Anxiety and worry about the future
Worry is something that is defined as a mental activity where we are looking at future based events and situations with a negative outlook. In other words worry is when we are thinking something bad is going to happen and start going over various scenarios of what that might look like. The news about the virus is constantly giving us food for such thoughts as we are being given terrible news of how the virus spreads and the consequences for all of us when it does. This can lead us into a rabbit hole of all the awful things that could beset us and how we might or might not be able to work through them. Of course none of these things are likely to have happened yet to us– but we feel compelled to try and prepare and plan for these terrible events in order to try and prevent them from happening or protect ourselves from the worst of the feelings. You can probably remember when you have been in a state of worry in the past few weeks and recognise that with the worry comes feelings of tension stress and anxiety.
Anxiety is the fear response to what the brain is telling us is a threat. The amygdala in the brain is the centre for the fight or flight response. When we are generating images of dreadful outcomes we may face, the brain switches into the threat mode thanks to the amygdala and sends out signals to the body to respond. So adrenaline and cortisol are released and we feel this in our body as anxiety.
Some of the key signs to look out for – increased breathing and heart rate, tension in the muscles even shakiness, sweating, feeling hot or cold, dizziness and blurred vision. The thinking is also affected as when in a high state of alert, the frontal lobe where rational thinking occurs is not working so effectively and we can lack concentration. We can also find it hard to remember what we were doing and feel that we are generally not able to use reason but feel panicky so that it is much harder to make decisions.
These things are all normal when in the anxiety cycle – but coupled with the unreality of our current circumstances it can feel like we have no control over ourselves just when there is a sense that we have no control on what is happening with the virus. Our mind then tends to try and work a way out of this mess and worries more!!
This is because worry often is fueled by a level of uncertainty. Not knowing what is going to happen next. Not having any experience to guide us on how things might turn out and not feeling confident in our ability to cope with the event when it arises. This is also linked with an element of doubt about when this will end. The intolerance of uncertainty and trying not to feel the anxiety actually sets off a vicious cycle: so we worry more and feel more anxious, feel less in control and more uncertain of ourselves, feel more anxious and worry more. You get the picture……
Recognise that you are not alone with your feelings of anxiety and tendency to worry, understanding the pattern you are in of worry and anxiety is the first step to letting this go.
Seek advice from professionals if you feel overwhelmed with worry and anxiety….
We at BraintrainersUK are highly skilled practitioners using cognitive behavioural therapy to break the chain of worry and anxiety.
If you would like support at this time from one of our CBT therapists – please email us to find out about online individual therapy. CBT is based in extensive research and evidence based practice so you know that the tools we will teach you to combat your anxiety and worry thoughts actually work! There is no long waiting time for an assessment and we will give you clear straightforward advice that can help.
- Acknowledge your feelings. Many of us will go through a whole range of emotions, scared sad, frustrated angry, fearful. It is important to notice and acknowledge what you are feeling rather than pushing these feelings away. Share these feelings if you think it will be helpful, you may recognise then that you are not alone with how you are feeling and that can be comforting.
- And Breathe…. Practising deep breathing and muscle relaxation can help with some of the physical effects of anxiety. Take a moment to slow down your breath – you’ll be surprised how much this can help and use this as a way to calm yourself and take a pause from what is going on around you.
- Take a deep breath in through your nose, allowing your lungs to fill and your diaphragm to expand for a slow count of 3…… Hold the air in your lungs for a further count of 3…… Then slowly breathe out through your nose on a count of 5….. Repeat 2 further times. Once finished allow your breathing to find it’s own rhythm and take note of how you feel without judgement or urgency.
- Ground yourself in uncertain times – in other words use of mindfulness. There is nothing to be gained from worrying about the future or potentially dwelling on things from the past, this can intensify the sense that we have no control. Instead keep your attention and focus on the here and now. Ground yourself in the present moment by drawing your attention to the five senses – sight, sound, smell, touch taste. Use mindfulness apps or meditation guidance to increase your ability to let go of the internal chatter and be aware of what is happening right now.
- Exercise is a good way of reducing the build up of adrenaline and cortisol that will be coursing through our body when we are feeling anxious. Small bursts of energy when we have been feeling anxious are enough to allow the acute symptoms to pass. Find activities that might also be distracting – hoover the room, run up and down the stairs 5 times, follow an online app for a stress buster.
- Recognise the difference between worry and problem solving. We often get caught in thinking about the future thinking we are getting ourselves prepared or fully equipped with all the knowledge but actually does all the worry change anything. Recognise when you are getting caught up in ‘what if’ thoughts and try and follow a grounding technique to let the worry go
- If you are caught in worry all the time – can you plan for some worry time every day? Only half and hour to worry about the things you have noted have come up during the day. See what happens when you try this out
Worries about getting the virus and catastrophic thinking
With news constantly revolving around what the signs and symptoms of Covid-19, we can all start to focus more on our body sensations and begin to notice little changes and variations in how we are feeling that we hadn’t noticed before. With the uncertainty of how we will respond to the virus if we catch it and the catastrophic thoughts that we could die if we do catch the virus, it is not surprising if more of us start to succumb to health anxiety.
A definition of health anxiety would be excessive worry about health concerns coupled with changes in behaviour such as increased monitoring of physical changes, increased checking for symptoms, intrusive thoughts about the consequences of the illness and excessive reassurance seeking in the form of googling, asking for medical advice and reassurance from family and friends. The worry and behavours lead to a vicious cycle of anxiety, as some of the symptoms of anxiety are wrongly attributed to something being wrong and the worry comes from the idea that it is likely that something will happen.
Use of CBT to combat health anxiety has a good grounding in theory. With the help of your therapist you learn to challenge the catastrophic thinking that makes you belief that you are going to catch the illness and the worst outcome(death) is going to happen to you. Finding a balance to the thinking is necessary to recalibrate the likelihood of risk (we are not saying there is no risk) and the ability to cope with the illness if you d get it (which is often overlooked altogether).
Contact us now via email to find out more about how we can help to overcome the feelings of anxiety and doom associated with health anxiety.
- If you are focused on checking for symptoms such as checking your temperature several times per day, try and reduce this. Make a note of how many times a day you are doing this and set a target on what you are aiming for. Allow that you will be anxious at first, but it will pass over time.
- If you are checking the news/social media streams or receiving notifications during the day – reduce this to once per day and turn off notifications. It is a good idea to keep up to date once per day with latest advice from a trusted source such as the NHS or government website . Also think about a trusted news source that will give you facts rather than sensational headlines.
- Set aside some worry time each day and at other times of the day write down your worries to reflect on in this worry time. Only make the worry time about half an hour and once the time is over – switch activities. You are training your brain to let go of worry during the day and find some containment.
HPC Registered Occupational Therapists
BABCP Registered Cognitive Behavioural Therapists
NMC Registered Mental Health Nurses
Get in touch; firstname.lastname@example.org +44 (0) 7510 223561