During this novel coronavirus pandemic, lots of emotions are running high. Anxiety is one that fits the situation but also feels overwhelming when it gets intense or out of hand. If you need more ideas for how to cope or for how to build new coping skills during this time, here are some things to try:

1) BREATHE

This can seem scary to think about in the midst of a pandemic from a virus that affects our lungs, but breathing, and doing it deeply is key to managing anxiety. When we are anxious, we breathe more quickly and shallowly, sometimes even holding our breath for short periods. This not only deprives us of oxygen, but maintains our feelings of anxiety. Slow, deep breaths physiologically induce a calming affect in our bodies, along with a host of other benefits.

Simple breathing techniques have you focus on belly breathing- relaxing and expanding your belly and diaphragm on the inhale and very slowly exhaling. Lengthening your exhales is what stimulates your vagus nerve and calms your body.

2) GROUND YOURSELF

For some people, when they are anxious, focusing on their body or their breathing can make them feel more anxious. If this is the case for you, keep trying to breathe slowly, but move your attention to something outside of your body as you do it. Notice everything you can hear around you. Can you count all the red or purple things you can see? Noticing your environment in the present with your five senses can help ground you in the present moment and help you feel less anxious.

3) FOCUS ON WHAT STAYS THE SAME

When something like a pandemic disrupts our routines, the amount of change and uncertainty in itself can cause anxiety. While it is helpful to acknowledge the changes and the losses that come with them, if you are ruminating or unable to focus on anything else, it's time to do something different. Try moving your attention to what is staying the same. If you are social distancing at home, your house and immediate surroundings are likely the same. Your dog or cat is still just as happy to see you. The sun still rises and sets. If you are evacuating a college dorm or are otherwise not in your same surroundings, try to find an object (a special item from home, a fidget, etc.) to take with you.

4) DISCERN WHAT IS WITHIN YOUR CONTROL

With the level of disruption we have seen lately, it is normal to feel a loss of control. Often while we are searching for as much normalcy and stability as we can, we can find ourselves fighting to change things that are actually outside of our control. Or we might feel helpless, like we should be doing more, when in fact, there is nothing more to do. This can also be balanced with giving help when and where you can. Medical mask-making groups are popping up around the country as a way for people at home to help in a tangible way and make meaning out of the situation.

When in doubt about what to do, remember the classic serenity saying: "May I have the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."

5) COPE AHEAD

When danger, threat, or uncertainty looms in the future, we often anxiously avoid that danger - physically and mentally. We will ruminate about a disaster happening, feel anxious, and then rinse and repeat. A solution to this - coping ahead - means cautiously approaching (in your mind) a visualization of the threat occurring. The part that makes this different than garden-variety ruminating is that you imagine yourself coping well!! This doesn't mean imagining the catastrophe not happening or an unlikely positive result, but that you imagine the bad thing happening and you responding well. For coronavirus this may mean thinking about the steps you might take if you or a loved one contracted the virus. You would breathe, and call your doctor, and take medicine, and stay present, and you would take each step along the way as best you can. Even when something stressful or dangerous happens, we can prepare for handling it the best way we can with the coping tools we have. At the end of the day, practice doing what you can control and let go of the rest.

6) CHANGE YOUR BODY CHEMISTRY

When we experience anxiety (and other emotions) our heart rates, blood pressures, and breathing rates increase. If we are preparing to fight or flee a physical threat, this is a helpful response. But if you are anxious or panicking chronically and about things out of your control (like the coronavirus), it is more helpful to work on strategies to calm your body. We can do this through activities that change our body chemistry. Getting your heart rate up with physical movement (think jumping jacks or running in place) increases serotonin and all kinds of other helpful brain chemicals and decreases stress hormones like adrenaline and cortisol.

We humans also have a reflex called the mammalian dive reflex. Doctors even take advantage of this to help with some types of tachycardia. In short, dunking your face in ice water (or putting a bag of frozen peas on your face) and holding it there for several seconds will lower your heart rate and slow your breathing rate. When you are panicking or anxiously ruminating this tip can help immensely.

7) MODIFY YOUR SELF-CARE

Being stuck at home while social distancing can really hinder your normal ways of taking care of yourself. If you have kids or other people now at home with you, you may not be able to get your usual time and space alone. Other self-care places like gyms and spas are closed. These changes call for creativity in self-care. Try to maintain some routine and normalcy. Keep getting your morning shower (maybe on most days ;), and get dressed. Meet with your bookclub at the same time, just via Zoom now. Play the games you'd usually play in person with your friends, but now online. Do your own nails. Find a workout online. Our schedules, routines, and places of solace have been greatly disrupted in a time when we need them the most, so don't give up on self-care, get creative.

Our blog has a post from Susannah with more self-care ideas.

8) BE MINDFUL OF YOUR EXPOSURE

For the most part social distancing is about managing our physical exposure to the coronavirus, but to minimize your anxiety it’s important to also be mindful of your mental and emotional exposure to coronavirus – the news, gossip, thoughts, etc. Try to schedule just 1 or 2 times a day to check the news instead of constantly scrolling or listening to it throughout the day. Also choose your news sources wisely. I love to watch (or listen to) one of the late-night comedy shows. It gives me the headline news, but with a dose of humor to help mitigate my anxiety about the content. You can’t control the news or that people everywhere are talking about coronavirus, but you can limit the types and amount of your exposure to it.

9) REACH OUT FOR SUPPORT

Sheltering in place at home can make it hard to find the social support you need, but it doesn’t eliminate your options. Therapists (like us!) are moving to video sessions online to be accessible during this crisis. Support and therapy groups are popping up too. You could also start a text thread or Marco Polo group with your friends to stay in touch. Get vulnerable with safe friends and family by letting them know how you’re doing, what you need, and how they can help. If you need support (and we all likely do during this pandemic) get creative and ask for what you need.

10) ACCEPT REALITY

At the end of the day, the more we fight or deny the reality of the situation we are in, the more we will suffer emotionally. Accepting reality looks like continually making the conscious choice to recognize the facts of your current situation, and acknowledging that it is what it is. This is not to be confused with approval of or liking the situation, nor is it giving up. Accepting facts about your reality doesn't mean you like what's going on. Accepting the reality of coronavirus may mean taking a deep breath and acknowledging you can’t just run out to the store, instead of feeling angry about it. It's accepting you can't see your friends, and letting yourself feel sad about it before coming up with a creative alternative. This isn't an easy thing to do, but it can help you feel more peaceful and less anxious or angry in the present.

11) BE PRESENT

In our current situation with the pandemic, a lot of our fear and anxiety comes from "future tripping" or ruminating about possible outcomes or the unknowns in the future. Working on staying mindfully in the present moment can help reduce anxiety. One way to do this is to focus on just one thing in the moment. While multitasking may feel more productive in the moment, it can actually lead to more anxiety. Try saying to yourself, "right now I'm just washing this dish," or "just this email," or "just this conversation." There is freedom in only having to do one thing at a time.

If you’ve tried these coping skills and are still feeling unmanageable anxiety and/or having panic attacks, it may be time to reach out for help from a therapist.