Taking Care of Your Mental Health in the Times of COVID-19

It’s been almost a year since I last shared an update. I think back about this post and laugh to myself. Oh, I was so naive, so full of hope still, unaware of what was to come. 

I don’t want to go into too much detail — mostly because I don’t want to dwell on the past so much. But I will share enough. 

The point of this article is to share how I overcome one of the scariest months in my life and have turned my life around. I think that some of these lessons learned and distress tools can be used during this crazy time in recent history, the global COVID-19 pandemic.

Some background about my own mental health journey

2019 started off really terrible (family medical issues), got worse (lost my job), and then worse (freelancing woes) and worse (client woes) over the summer, and just when I thought I couldn’t take anymore, I was forced to take care of myself (#selfcare) in order to take care of a family member who had medical issues. And once all of that was taken care of, good things came my way.

I’ve been feeling really good this year. While it hasn’t been entirely easy, I’m feeling much happier and more satisfied both creatively and professionally — I even feel more creative now. 

I bring all of this up because the last several weeks in the United States (and months in the rest of the world) have been really stressful. 

For those of us in a first world country that have never experienced anything like this — yet we’ve watched plenty of zombie movies — this can feel like a really terrible horror film. Maybe even a cheesy 90’s disaster movie, like Dante’s Peak or Twister. (Not hatin’ on them, I like those movies a lot. I can quote a lot of Twister.)

For those who’ve maybe never experienced depression or anxiety before, this can feel really scary not understanding how or why you’ve come to feel that way. 

For others (like myself) who’ve been battling depression, anxiety, and other disorders our entire lives, this situation is clearly not helping.

COVID-19 is here. What now?

It’s tough to remain positive when the headlines in the news are scary. But here’s the thing — you don’t need to be positive. You just need to keep a level head and keep your shit together enough to survive.

In 2019, in the middle of all the stress that came with life changes, I began suffering from panic attacks. They quickly escalated to two to three times a day. They started with, I don’t think I can get that assignment written in time because I overbooked myself to Oh my god, I have an email. 

I didn’t know I was having panic attacks at first. They kind of snuck up on me because they weren’t what I would think of as a panic attack.

I remember vividly getting ready for bed and walking around my bedroom. I started mentally thinking of the things on my to-do list when my knees buckled and nearly fell to the floor. The blood on my face drained as my heart raced; I grabbed my chest and sat on my bed trying to comprehend what was happening while also trying to get my heart to stop racing. It was scary. 

This continued for months. I remember feeling very helpless and wondered if I could ever get back to having a normal life. 

How to take care of your mental health

I had heard the term self-care before. It’s so overused in pop culture, but what does it really mean? Netflix and chill until the panic attacks go away? Nah, it doesn’t work that way.

The problem with “self-care” is that it implies that you don’t actually need any skills to cope with stress when in reality, giving myself a spa day couldn’t solve any of my problems then (though it still would feel reeeeeally good), and it’s not going to solve them now. 

I knew that I needed to take action to help myself but I wasn’t entirely sure what that required, so I did research. Here’s what I did. 

Professional help

Find a therapist or a psychiatrist — or if you’re like me, you might need both. 

A therapist or counselor can help you work through your problems, anxieties, fears, traumas, anything. It can feel a bit like dating, finding the right one, but don’t feel bad about “shopping around” for a therapist. You need to be able to trust this person and feel comfortable being your most vulnerable self. 

Fortunately, with technology, you can try services like BetterHelp and Talk Space (don’t worry, those aren’t affiliate links). I personally haven’t tried either of these services, but they do advertise on a lot of podcasts. I bet you can find a promo code by searching the web and try one or both at a discount. 

A lot of therapists are also doing video sessions now since COVID-19 so you may be able to find a therapist in your area that takes your health insurance, too. 

A psychiatrist will be able to prescribe you medication. In my first session, we had a 90-minute evaluation where we went over my medical and personal history. It was intense, but I was able to start the lengthy process to switch medications, and today, I’m feeling really good. Telemedicine services are popping up all over the country, so you may be able to get an appointment at an office near you but not have to go in person.

You can also see your family physician if you need anti-depressants, mood stabilizers, or anxiety medication. However, it took me five years and a visit to a psychiatrist to finally feel better with the right med combination. It might just be best to go to a specialist from the start.

Unfortunately, our shitty healthcare system makes all of this way more complicated.

National Suicide Prevention Hotline

The crisis hotline can be reached by phone 1-800-273-8255 or via chat on their website suicidepreventionlifeline.org 24/7. It’s free and confidential.

Learn Distress Tolerance Skills

I had zero idea on how to handle anxiety or stress or panic attacks. I felt hopeless and scared and couldn’t even picture what a few days from now would be like. I researched a few tactics and discovered DBT, dialectical behavior therapy.

Now, I’ve never been to a DBT therapist, so I can’t say I’m an expert or even that experienced, but I can point you to two books that changed my life. The first, The Dialectical Behavior Therapy Skills Workbook for Anxiety: Breaking Free from Worry, Panic, PTSD, and Other Anxiety Symptoms (again, not an affiliate link). I read this book from beginning to end. 

I checked out this workbook on my Kindle from my public library and liked it so much that I eventually bought myself a physical copy. Not only did it help me understand how anxiety worked and how it presented itself in my mind and body, but it gave me tools on how to cope. For example, mindfulness (I’ll cover that below) has helped me become more present and give less attention to any racing thoughts. 

The four core skills you’ll learn in this book are:

  • Mindfulness: This helped me become more present and give less attention to my racing thoughts.
  • Acceptance: I learned about radical acceptance and self-compassion and try to practice nonjudgement.
  • Interpersonal Effectiveness: I learned how to communicate my needs better and not let things bottle up inside.
  • Emotion Regulation: I am better about identifying what I’m feeling before letting my emotions take control.

I’m not perfect, but at least I have something that I am working toward.

Similarly, the second book The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance gave me even more exercises to practice. 

I took notes from these books and articles I read online and wrote them in a pretty notebook that I keep by my desk. I review that notebook frequently and try some exercises when I’m feeling overwhelmed.

I also wrote down some things on notecards and stuck them to the wall in front of my desk so I can read them when I work. For example, I have:

  • “Practice observing thoughts, feelings, emotions, sensations, judgment with compassion and without judgment.”
  • “Picture your thoughts as train cars going by.”
  • “Picture your thoughts as ocean waves.”
  • “Thoughts are just thoughts.” 

 And several others. 

I also wrote down a bunch of affirmations for myself that were relevant at the time. (I was struggling with avoidance and procrastination behaviors because of my anxiety.) Here are a few:

  • “I make useful contributions.”
  • “I act now.”
  • “I have, or can quickly get, all the knowledge I need to succeed.”

You can make affirmations about whatever you’d like, as long as they lift you up and make you feel better. Remember, give yourself some compassion and lay off the judgment. Talk to yourself as if you were talking to a good friend. 

Mindfulness and Mediation

Eye roll, amirite? I used to be like you, and then I finally gave it a real shot — because of the DBT books — and I can say that it got me through some very hard times. 

I needed guidance, so I went with the Calm app with I use daily. (I haven’t been keeping up my mediation practice, but now is the time to start it back up again.) Most of the meditations are 10 minutes which I have found to be the perfect amount of time. If I need more, I just select a few more lessons. 

For those of you new to meditation, Calm is so good at teaching you the fundamentals as well as the why. I was under the impression that I didn’t have the attention span and was too restless, but like anything else, it requires practice. I highly recommend the following series to start:

  • 7 Days of Managing Stress
  • 7 Days of Calming Anxiety
  • 7 Days of Focus
  • 21 Days of Calm
  • How to Meditate (30-day series) 

Aside from meditations, there’s music, soundscapes, and sleep stories. I use it every day for their soundscapes, and I’ve fallen asleep to Stephen Fry’s “Blue Gold” sleep story several times. I believe that’s their most popular one. 

Sign up for the free trial on the app and give it a try. 

Don’t want to use an app? Here are some other breathing exercises I do often:

  • Boxed breathing: This is all done in counts of four for as many rounds as you need.
      • Inhale for four counts.
      • Hold for four.
      • Exhale for four.
      • Hold for four.
      • Repeat.
  • Sigh exhales: I took this from yoga class. You can sit, stand, lay down. You just need to have a straight back. I don’t know what this is actually called so I made up a name.
      • Take a deep inhale.
      • Exhale and let out a sigh.
      • Repeat.
  • Forward bend exhales: Again, took this one from yoga.
    • Bend forward and hold the back of your calves. You can keep your knees slightly bent. The goal isn’t to stretch your legs but your back. (Here’s an explanation from Yoga Journal.)
    • Hold onto each elbow and let your body weight just hang a bit. You should feel your shoulders drop and muscles loosen.
    • Take deep inhales and exhales in this position.
    • Optional, you can move into a standing half bend and stretch your arms upward in a salute and bring them back down in mountain pose

But ultimate, your goal should be to remain present and calm. This isn’t a competition, especially with yourself. 

With time and practice, your racing thoughts can be more manageable. You’ll notice yourself spiraling much earlier in the process and can take yourself through some exercises to calm the fuck down.

Create a plan for yourself

I’m a writer, so I love writing things down. Literally. I have so many notebooks, notecards, two dry erase boards in my office, lots of post-it notes, and more. I try to be all-digital, but there’s just something so satisfying about writing something down. It also makes me remember the information, too. 

When I have having panic attacks triggered by tasks, I had a notecard that gave me instructions on how to handle the situation. I read it every time and now it’s in my brain for me to remember and apply to other situations. This is what my card, still on my wall, reads:

Stressed about the task?

            • Break it down into steps.
            • Do one thing at a time.
            • It’s ok to feel overwhelmed. 
            • Can you delegate?

Things to do/ask:

            • When was the last time you ate food or drank water?
            • Have you meditated?
            • Have you stretched?
            • Does this have to be done now?
            • Does it need to be in this order?
            • What is your reward for getting this done?

It’s a messy notecard, but it got the job done. 

I also have a bright blue post-it on my wall that reads: “Don’t worry. You’re great. :)” And honestly, that little happy face does make me smile.

Figure out your mental safety plan and write it down. Stick to your wall, your mirror; keep it in your purse. Just make sure you have it ready for when you really need it.

Stay safe and mentally healthy

I don’t really know what prompted me to share this today, but I hope that if anyone reads this that you feel like you got something out of it.  I don’t claim to have all of the answers. Our brains are far more complicated than that. But I was always frustrated by the vague advice on websites so I just want to do my part and share what has helped me in the past. I may even do a follow-up in the future as I continue on my mental health journey — there’s always more work to do!

Stay safe everyone! Please follow the CDC’s guidelines on protecting yourself and others from COVID-19.