If I had to sum up the theme of what I am hearing from patients, friends and colleagues it is this: “2020 has been the worst year ever and I have no idea what is coming next.”
Now, certainly no one can argue that this year has been a doozy. As of this writing there have been almost 9 million cases of COVID-19 in the US alone and almost 230,000 Americans have died. These numbers were unfathomable only 6 months ago. Additionally, there have been the economic ramifications, job losses, food insecurity and other traumas associated with the global pandemic. Many relationships are under tremendous strain. On one end of the spectrum, many couples and families are experiencing all new levels of togetherness as they socially distance and quarantine together, often working and schooling from home. Many parents are juggling work with suddenly homeschooling kids. People may be longing for the quiet, mundane daily commute that they used to dread. For introverts this togetherness can bring up all new challenges. On the other end, there are those quarantining alone. Many people, including seniors, those who have lost a partner from divorce, widowhood or breakups are either alone or parenting kids on their own. For many singles, dating is even more fraught than it was a few months ago. Loneliness, isolation and depression are increasing for those without a safe “pod” and for extroverts this is especially challenging.
The external worries are not limited to the pandemic. Political discourse is uglier than ever. The election looms less than a week away and no matter where one falls politically the majority of the country is fearful that the “other side” will win. Many worry over the ramifications of the outcome. Add to this increased awareness of racial and social inequities and the protest movements in person and on social media.
My anxiety is increasing just writing this down. No wonder so many people are experiencing insomnia, increased anxiety, depression, substance use and other symptoms of a life feeling uncertain and out of control.
There is no magic button to push that would take away the chaos of 2020 (believe me if there was I would have already pushed it!). What we can focus on is developing skills to help manage the “what is” and decrease the the anxiety of the “what ifs”.
I have already mentioned some (but probably not all) of the negative things that have happened this past year. But life is neither fully black or white. There is always sweet within the bitter and bitter within the sweet. One exercise is to try to challenge the “all or nothing thinking” that we often slip into like old fuzzy slippers. Rather than focusing on a statement like “2020 has been the worst year ever” perhaps something such as “2020 has been really hard. But I really have valued the time I have had to spend with my kids building puzzles and cooking homemade meals together.” Take some time to jot down on paper a list of the highlights of the last six months. I bet if you try you can find at least one or two. Did you get to binge an especially good show? Did you learn to bake sourdough? Pick up knitting? Perhaps you saved money that you would have normally spent on gas or travel or eating out. Did you read more? Commute less? Get a COVID puppy? See if you can identify the daisies hidden within the weeds.
When things feel uncertain and worry takes over we often feel out of control. Feeling out of control often stems from losing touch with what falls within and without our locus of control. There is much right now (as always) that we have no control of. Focusing on those things will increase anxiety and depression symptoms. For example this year, on top of everything else, has brought a record number of tropical storms and hurricanes to the Southeast and Gulf Coast. And there is little I can do to change that unpleasant reality. So what if instead of focusing on that I chose to try to focus on what is in my control. If I live in a hard hit area I can focus on preventative measures such as emergency preparedness, buying a generator, making sure my roof is strong and secure, buying water and canned goods etc. Begin making a two column list with what you can and can’t control over any situation you find yourself ruminating on and try to make the list longer on the side where you do have some control.
Some people have a more comfortable relationship with uncertainty than others. Most of us know someone who just seems “Zen” when everything around them is messy and chaotic. While to some extent this is a gift of temperament this is also also a skill that can be cultivated. Even the most anxious amongst us have developed the ability to live with uncertainty in some areas of life. We just don’t notice that we do it. Every time we go to sleep we do so with faith that we will wake in the morning. Every exhale comes with the trust that there will be a future inhale. For most of us, each time we go outside we don’t worry about getting struck by lightning, hit by a car or mugged at gunpoint. While all these things are theoretically possible living a full life requires us to turn down the volume on those worries so we can function in the world. So the ability to live with uncertainty is present in some areas but triggered in others. Note where those areas lie. Is it the inability to control others choices? Health worries? Financial worries? Try to take a non-judgmental note of where your personal worries tend to fall. Jot them down on a list. Note how frequently and if they happen at any particular pattern such as time of day or when hungry, tired, after watching the news or interacting on social media.
Take healthy steps to manage stress and anxiety
Stress and anxiety will come. Sadly, it is inevitable for us all. Thankfully there are many tools in the toolbox to learn to manage them to increase the joy in your life.
Self Care- Self care looks like different things for different people and at different times. It can be as mundane and lovely as a bubble bath, listening to your favorite music, eating your favorite meal or something that might be harder to achieve such as identifying areas you would like to evolve professionally or communicating healthy boundaries to a friend or family member. We often put ourselves last on our list while really as the adage about the flight attendant reminding us to put our own oxygen mask on reminds us, we can’t help others if we don’t attend to our own needs first.
Sleep- Nothing is more annoying to someone who is having sleep problems than to be told to get more or better sleep. “If I could I would,” we think. That said there are some steps that can increase the quantity and quality of sleep. Unplug at least an hour before bed. Research is clear that for many reason the screens we surround ourselves with all day long impact our sleep. The light and physical stimulus as well as the mental noise all have the ability to impede sleep. Limit caffeine consumption after mid morning if possible. A warm bath before bed, calm reading or mellow music can help. Some people find certain herbal teas or aromatherapy such as lavender to be helpful. Discuss with your doctor if an over-the-counter or prescription medicine may be helpful.
Healthful Eating- Okay, being told to eat healthy when that is an issue may be even more annoying than the sleep thing. But there is a strong body-mind connection. Notice non-judgmentally if eating certain foods trigger certain emotions or vice versa. Do you tend to eat ice cream after you fight with your boyfriend? Or do you yell at your kids after you forget to eat dinner? Again write down the patterns you notice without blame or shame. The more awareness we have about our relationship with food the more we can choose to work toward changing them.
Meditation- For many people the thought of meditating feels impossible. “How can I clear my mind when my mind is always so noisy?” There are so many ways to practice mindfulness, relaxation or meditation. And perfection is not the goal. It is called a practice for a reason. Download an app like Headspace, Calm or Om or watch a free video on YouTube. Many local universities offer classes in Mindfulness Based Stress Reduction (MBSR).
Exercise- Your gym may be closed but the options for exercise are everywhere. Finding a free online yoga class, walking that COVID puppy, dancing in your bedroom, running on the beach or riding an indoor or outdoor bike are just a few options. But moving your body will help your mood, calm your mind and help with a sounder sleep at night.
Reach out- Now is the time to communicate what you are feeling. Consider contacting a licensed therapist to explore talk therapy. If your symptoms feel especially debilitating consider discussing medication management with your primary care physician.
Get a check up- Don’t forget addressing your physical needs. Many people have deferred their general healthcare out of concern for COVID. Consider scheduling that dentist, primary care, mammogram or other medical appointment you put off.
Be kind to yourself. Seriously. Give yourself a break. It has been a rough year. Try to imagine how you would speak to or comfort a close friend who came to you for some support. I am guessing you wouldn’t tell him, “Bob, frankly you deserve it. You are a lousy, lazy person who will never be happy or achieve your goals.” So why do we speak to ourselves this way? Be at least half as patient, understanding, compassionate and kind to yourself as you would be to that troubled friend. This is a practice that we can all benefit from practicing more often.
