Coping with Stress and Anxiety
What is Gratitude
In its simplest form, gratitude refers to a ‘state of thankfulness’ or a ‘state of being grateful’.
Cultivating gratitude is one of the simpler routes to a greater sense of emotional well-being.
When we express gratitude, our brain releases dopamine and serotonin, the two crucial neurotransmitters responsible for our emotions, and they make us feel ‘good’. They enhance our mood immediately, making us feel happy from the inside. By consciously practicing gratitude every day, we can help these neural pathways to strengthen and ultimately create a permanent grateful and positive nature within ourselves which builds our inner strength to combat stress.
Gratitude builds emotional resilience by:
- Helping us to see the positive things in life
- Fighting the negative ruminations and rebuilding pessimistic thoughts with optimistic ones
- Staying grounded and accepting the present situation, even if that is a harsh reality
- Identifying and focusing only on solutions
- Maintaining good health by regulating our metabolic functioning and by controlling the hormonal imbalances
- Sustaining relationships and appreciating people who are there for us. As a result, we feel more loved, cared for, and more hopeful.
Gratitude takes practice like any other skill. Here are some ways to cultivate gratitude on a regular basis.
- Write a thank-you note. You can make yourself happier and nurture your relationship with another person by writing a thank-you letter expressing your enjoyment and appreciation of that person's impact on your life. Make a habit of sending at least one gratitude letter a month. Once in a while, write one to yourself.
- Thank someone mentally. No time to write? It may help just to think about someone who has done something nice for you, and mentally thank the individual.
- Keep a gratitude journal. Make it a habit to write down or share with a loved one your thoughts about the gifts you've received each day.
- Count your blessings. Pick a time every week to sit down and write about your blessings — reflecting on what went right or what you are grateful for. Sometimes it helps to pick a number — such as three to five things — that you will identify each week. As you write, be specific and think about the sensations you felt when something good happened to you.
- Meditate. Mindfulness meditation involves focusing on the present moment without judgment. Although people often focus on a word or phrase (such as "peace"), it is also possible to focus on what you're grateful for (the warmth of the sun, a pleasant sound, etc.).
Sources: https://positivepsychology.com/neuroscience-of-gratitude/; https://www.health.harvard.edu/healthbeat/giving-thanks-can-make-you-ha…
The COVID-19 pandemic causes so many of us to cycle through the stress response designed to protect us from threat. To survive, your brain’s limbic system, including the amygdala, shuts down the thinking part of your brain and automatically responds in the moment. It chooses a fight, flight, freeze or fawn response based on what helped you survive in the past. Because a pandemic is not a stress recognized by the survival system, we cycle through the different responses, bringing about a variety of feelings and reactions.
Some feelings you may be experiencing:
- Fear and anxiety
- Apathy or numbness
- Sadness or grief
- Anger
- Hopelessness or depression
- Calm
- Denial
- Exhaustion
- Shame
- Gratitude
No matter what you’re feeling right now, your feelings are valid and serve a purpose. The COVID-19 pandemic is not business as usual, so be gentle with yourself.
Breathing Techniques
Take a deep breath in. Now let it out. You may notice a difference in how you feel already. Your breath is a powerful tool to ease stress and make you feel less anxious.
If we can control our breathing and take a moment to notice the sounds around us, our brain will receive the message we are safe in this moment and begin to come out of survival mode and back into connection/thinking mode. The more we do this, the stronger this reaction will be and more grounded we can feel through this pandemic.
Try the following techniques:
Deep Breathing
Most people take short, shallow breaths into their chest. It can make you feel anxious and zap your energy. With this technique, you'll learn how to take bigger breaths, all the way into your belly.
- Get comfortable. You can lie on your back in bed or on the floor with a pillow under your head and knees. Or you can sit in a chair with your shoulders, head, and neck supported against the back of the chair.
- Breathe in through your nose. Let your belly fill with air.
- Breathe out through your nose.
- Place one hand on your belly. Place the other hand on your chest.
- As you breathe in, feel your belly rise. As you breathe out, feel your belly lower. The hand on your belly should move more than the one that's on your chest.
- Take three more full, deep breaths. Breathe fully into your belly as it rises and falls with your breath.
Equal Time for Breathing In and Breathing Out
In this exercise, you'll match how long you breathe in with how long you breathe out. Over time, you'll increase how long you're able to breathe in and out at a time.
- Sit comfortably on the floor or in a chair.
- Breathe in through your nose. As you do it, count to five.
- Breathe out through your nose to the count of five.
- Repeat several times.
Once you feel comfortable with breaths that last five counts, increase how long you breathe in and breathe out. You can work up to breaths that last up to 10 counts.
Modified Lion's Breath
As you do this exercise, imagine that you're a lion. Let all of your breath out with a big, open mouth.
- Sit comfortably on the floor or in a chair.
- Breathe in through your nose. Fill your belly all the way up with air.
- When you can't breathe in any more, open your mouth as wide as you can. Breathe out with a "HA" sound.
- Repeat several times.
Sources: https://themighty.com/2020/04/covid-19-emotions-trauma-response/?utm_source=media_partner&utm_medium=facebook&utm_campaign=Gottman_Institute&fbclid=IwAR2ve2pKLLFpC9dhSJX97g14K-5ZPA9jJN3DYZxdxGnkai11MQf0c3tHVBM; https://www.webmd.com/balance/stress-management/stress-relief-breathing-techniques#1
Humans are social beings. Our social groups provide us with an important part of our identity and teach us a set of skills that help us to thrive. During this disease pandemic, feeling socially connected is more important than ever. The benefits of social connectedness shouldn’t be overlooked.
Benefits of Social Connectedness
Improve your quality of life
- One study showed that social connection is a greater determinant to health than obesity, smoking, and high blood pressure. And social connection doesn’t necessarily mean physically being present with people in a literal sense, but someone’s subjective experience of feeling understood and connected to others.
Boost your mental health
- Friendships offer a number of mental health benefits, such as increased feelings of belonging, purpose, increased levels of happiness, reduced levels of stress, improved self-worth and confidence. A study conducted at a free health clinic in Buffalo, New York found that respondents with insufficient perceived social support were the most likely to suffer from mental health disorders like anxiety and depression.
Help you live longer
- Research has shown that social connections not only impact your mental health, but your physical health as well. A review of 148 studies (308,849 participants) indicated that the individuals with stronger social relationships had a 50% increased likelihood of survival. This remained true across a number of factors, including age, sex, initial health status, and cause of death.
Decrease your risk of suicide
- There are a number of factors that put people at higher or lower risk for suicide. One of these factors is connectedness, which the Centers for Disease Control (CDC) defines as “The degree to which a person or group is socially close, interrelated or shares resources with other persons or groups.” Relationships can play a crucial role in protecting a person against suicidal thoughts and behaviors.
It is still possible to form social connections during times of social (physical) distancing. We can be grateful to live in a time of technology whether connecting through virtual means, like hosting a virtual dinner party to celebrate birthdays or have an after work virtual get together to stay connected. Or we can also connect with more traditional means like using the telephone, sending a letter or leaving a neighbor a written note.
Source: https://www.mindwise.org/blog/uncategorized/the-importance-of-social-co…
There are many things we can do as individuals or families to stay active and support our mental health while also being ND Smart and following social distancing guidelines. Of course a lot of what works for you or your family will depend on personal circumstances. See 25 ideas below!
- Start a gratitude journal.
- Call, text, or chat online with friends or loved ones.
- Enjoy the beauty of North Dakota – take a hike, a bike ride, or rive a scenic route.
- Read a book. E-Books or check out materials are available through local libraries.
- Do a virtual museum tour!
- Museums from home: https://mentalfloss.com/article/75809/12-world-class-museums-you-can-visit-online
- Go to the zoo online.
- Go to a virtual amusement park!
- Disney World: https://disneyparks.disney.go.com/blog/2018/ 03/disney-parks-launches-first-ever-360-degree- panoramas-on-google-street-view/
- Lego Land: https://legoland.dk/en/accommodation/ hotel-legoland/virtual-tour/
- Sea World: https://www.visitorlando.com/en/things-to-do/virtual-tours/seaworld-orlando
- Check out online recreational exercise facilities for live streaming videos from workout instructors.
- Dance to fun guided songs such as The Cha-Cha Slide, Cupid Shuffle, Hokey-Pokey, Chicken Dance, etc.
- Listen to your favorite music from the past.
- Write a letter or make a card for a neighbor.
- Family Game Night!
- Watch a craft tutorial on YouTube and make a craft for someone.
- Pray/meditate/watch online church services.
- Talk to your therapist/counselor via a telehealth program.
- Plant a flower or herb garden.
- Find a recipe and cook something new.
- Start an online book club with a friend.
- Play or learn to play a musical instrument.
- Make a scrapbook – document this time.
- Read a favorite childhood book.
- Play a video game.
- Do a guided meditation through an app or online video.
- Do a scavenger hunt or have a picnic in your backyard.
- Use sidewalk chalk to draw pictures and write encouraging messages.
Source: https://www.tcn.org/news/2020/3/24/coping-with-the-quarantine-100-self-…
For most of us, we’re reaching the first anniversary of when we first felt major impacts from COVID-19; schools closed, businesses sent workers home, we were urged to “socially distance”, and toilet paper was nowhere to be found. A year on, we find ourselves with some hope. Cases are slowly dropping, vaccination rollout is going well, and we’re starting to see glimmers that we might be able to get back to somewhat of a normal life.
But resuming our old activities often comes with some additional stress. How do we actually get back to “normal” after such a challenging year?
Start small and enjoyable.
If you’ve been strictly distancing for the last year, jumping right back into grocery shopping on a Saturday afternoon is likely to be an intense, stressful experience. When you’re ready to resume some in-person activities, start small and enjoyable. Dipping your toes back into the water of socializing is a little easier if you have one friend over for coffee, or perhaps go out for breakfast on a weekday with one or two people.
Slowly expand your world
Rather than jumping right into busy restaurants or going to public events, expanding slowly can help with the anxiety. This might mean starting to see one or two friends or family members initially and slowly expanding this circle until you’re back to seeing all of your important people.
Enjoy the outdoors
Guidance from experts is that outdoor activities are lower risk than indoor activities. As the wonderful North Dakota winter eases off, doing as much socializing as possible outdoors will help keep things low-risk, and help us soak up as much good weather as we can.
Follow public health guidance
Current public health guidance encourages us to continue masking, avoiding heavily crowded places, washing our hands frequently and staying home if we feel even slightly unwell. While your individual circumstances may allow for cautiously resuming in-person activities, continue following the guidance of your local public health in order to keep yourself and others safe.
Trust your instincts
Having some anxiety is inevitable after the last year. We know from other natural disasters that the emotional recovery can take a long time after the risk has passed, so be patient with yourself if you’re finding making decisions about resuming in-person activities stressful. It’s okay to take extra time if you need to, and to be cautious. Trust your instincts.
Social Connection
Humans are social beings. Our social groups provide us with an important part of our identity and teach us a set of skills that help us to thrive. During this disease pandemic, feeling socially connected is more important than ever. The benefits of social connectedness shouldn’t be overlooked.
Benefits of Social Connectedness
Improve your quality of life
- One study showed that social connection is a greater determinant to health than obesity, smoking, and high blood pressure. And social connection doesn’t necessarily mean physically being present with people in a literal sense, but someone’s subjective experience of feeling understood and connected to others.
Boost your mental health
- Friendships offer a number of mental health benefits, such as increased feelings of belonging, purpose, increased levels of happiness, reduced levels of stress, improved self-worth and confidence. A study conducted at a free health clinic in Buffalo, New York found that respondents with insufficient perceived social support were the most likely to suffer from mental health disorders like anxiety and depression.
Help you live longer
- Research has shown that social connections not only impact your mental health, but your physical health as well. A review of 148 studies (308,849 participants) indicated that the individuals with stronger social relationships had a 50% increased likelihood of survival. This remained true across a number of factors, including age, sex, initial health status, and cause of death.
Decrease your risk of suicide
- There are a number of factors that put people at higher or lower risk for suicide. One of these factors is connectedness, which the Centers for Disease Control (CDC) defines as “The degree to which a person or group is socially close, interrelated or shares resources with other persons or groups.” Relationships can play a crucial role in protecting a person against suicidal thoughts and behaviors.
It is still possible to form social connections during times of social (physical) distancing. We can be grateful to live in a time of technology whether connecting through virtual means, like hosting a virtual dinner party to celebrate birthdays or have an after work virtual get together to stay connected. Or we can also connect with more traditional means like using the telephone, sending a letter or leaving a neighbor a written note.
Source: https://www.mindwise.org/blog/uncategorized/the-importance-of-social-co…
There are many things we can do as individuals or families to stay active and support our mental health while also being ND Smart and following social distancing guidelines. Of course a lot of what works for you or your family will depend on personal circumstances. See 25 ideas below!
- Start a gratitude journal.
- Call, text, or chat online with friends or loved ones.
- Enjoy the beauty of North Dakota – take a hike, a bike ride, or rive a scenic route.
- Read a book. E-Books or check out materials are available through local libraries.
- Do a virtual museum tour!
- Go to the zoo online.
- Go to a virtual amusement park!
- Check out online recreational exercise facilities for live streaming videos from workout instructors.
- Source: https://www.tcn.org/news/2020/3/24/coping-with-the-quarantine-100-self-…
- Dance to fun guided songs such as The Cha-Cha Slide, Cupid Shuffle, Hokey-Pokey, Chicken Dance, etc.
- Listen to your favorite music from the past.
- Write a letter or make a card for a neighbor.
- Family Game Night!
- Watch a craft tutorial on YouTube and make a craft for someone.
- Pray/meditate/watch online church services.
- Talk to your therapist/counselor via a telehealth program.
- Plant a flower or herb garden.
- Find a recipe and cook something new.
- Start an online book club with a friend.
- Play or learn to play a musical instrument.
- Make a scrapbook – document this time.
- Read a favorite childhood book.
- Play a video game.
- Do a guided meditation through an app or online video.
- Do a scavenger hunt or have a picnic in your backyard.
- Use sidewalk chalk to draw pictures and write encouraging messages.
Source: https://www.tcn.org/news/2020/3/24/coping-with-the-quarantine-100-self-…
Grief and Loss
In the age of COVID-19, physical distancing is driving a wedge in those moments of connection. One of the most time-tested ways of coping with grief is to practice social connection. Now, individuals are coping with grief and sorrow alone, socially isolated and without the physical comfort we often need from friends and family.
Ways You Can Support Someone Grieving During the Coronavirus Crisis
- Don’t minimize what someone is going through
- Validate their feelings
- Let them know whatever they are feeling is perfectly normal
- Make an effort to reach out regularly: Touching base could go a long way, even if you simply send a card, email or text.
- Ask them what would help: Never impose what you know works for you on them.
- Listen but don’t try to fix the situation: All too often, we offer quick fixes or minimize a person’s feelings because of our own discomfort in watching them grieve. But the best thing we can do is be a witness to their pain, acknowledge it and hold that space with them.
- Host a virtual memorial, candle-lighting or storytelling event
- Encourage them to get professional support: Visit https://findtreatment.samhsa.gov to search for treatment available close to you.
Missing Final Moments
The act of saying goodbye to a loved one often begins well before a funeral or burial. For many people, the days and hours at the end of a loved one’s life are especially poignant. With strict isolation measures in place in most hospitals, people are missing out on those final farewells. That’s true when people die from COVID-19, but also from more familiar causes such as heart attacks or cancer. While critical to slowing the spread of the disease, those measures also make it hard for mourners to come together to grieve.
Some people have begun filling that void with virtual funerals, but technology is an imperfect substitute for an in-person embrace. Being in close physical proximity with friends or other mourners helps us produce feel-good hormones like oxytocin, dopamine and serotonin. When people aren’t physically present to say goodbye and grieve with other mourners, they may be more likely to experience a sense of ambiguous loss, where it’s hard to get closure. There’s often a lot of frustration and helplessness, because people feel disempowered.
Prolonged Grief Disorder
Such difficult circumstances may increase the odds that an individual experiencing bereavement will develop complicated grief, also known as prolonged grief disorder. Prolonged grief is an intense grief that is distinct from depression but endures and interferes with normal functioning. Prolonged grief is marked by persistent longing and sadness for the deceased, and a sense of disbelief or inability to accept the lost. Without treatment, prolonged grief increases the risk of substance use, sleep disorders, impaired immune functioning and suicidal thinking.
Sources: https://www.apa.org/topics/covid-19/grief-distance; https://www.huffpost.com/entry/ways-to-support-someone-grieving-coronav…
Coping with the Pandemic with a Behavioral Health Condition
If you experience Seasonal Affective Disorder (SAD) - a type of depression that's related to changes in seasons – this fall and winter may be a bit more challenging because of the COVID-19 pandemic.
Symptom of SAD
- Feeling depressed most of the day, nearly every day
- Losing interest in activities you once enjoyed
- Having low energy
- Having problems with sleeping
- Experiencing changes in your appetite or weight
- Feeling sluggish or agitated
- Having difficulty concentrating
- Feeling hopeless, worthless or guilty
- Having frequent thoughts of death or suicide
- Oversleeping (specific to winter-onset SAD)
- Appetite changes, especially a craving for foods high in carbohydrates (specific to winter-onset SAD)
- Weight gain (specific to winter-onset SAD)
- Tiredness or low energy (specific to winter-onset SAD)
Tips for Taking Care of Yourself
- Think back to practices that helped back in the spring. Even though things are continually changing, think back and identify practices and routines that were helpful. Write them down so you can refer to them when you are feeling anxious or sad.
- Talk about your concerns with friends and loved ones. When you share your difficulties, fears and struggles about the upcoming season with a loved one, you are reminded that you aren’t as isolated as the winter months might make you feel. You may also find that your loved ones have similar struggles and you can think through coping strategies together.
- Maintain a healthy lifestyle. Exercise can be particularly helpful for easing symptoms of depression. Bundle up in your cold-weather gear and head out for a quick walk. If that isn’t possible, search for free at-home exercise videos and spend some time taking care of your body.
- Plan ahead for the holidays. Holidays will look very different for many families this year because of the pandemic. Take some time to identify new, safe ways to celebrate, reminisce and reconnect with loved ones. Think about it as an opportunity to do new things, rather than feeling as though something has been taken away.
If you are experiencing symptoms of SAD, reach out to a professional for additional support.
- Call Project Renew at 701-223-1510 (M-F between 8-5pm CT) to receive free support services.
- Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for free and confidential emotional support for individuals in suicidal crisis or emotional distress 24 hours a day, 7 days a week.
- Find behavioral health treatment services near you by searching the Behavioral Health Treatment Services Locator: https://findtreatment.samhsa.gov/.
- COVID-19 Potential Implications for Individuals with Substance Use Disorders
- Recovery Talk: Talk with a trained peer support specialist in North Dakota with lived experience in addiction to chat and receive support. (844) 44TALK2
- Resources on opioid overdose and access to naloxone
Preventing Suicide
The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, and prevention and crisis resources for you or your loved one. Call (800) 273-TALK (8255).
Find more information here - Suicide Prevention: How to Help a Loved One
