Coronavirus Grief: How To Cope With Loss During A Pandemic

So much has changed with the coronavirus (Covid-19) pandemic. Stay-at-home restrictions to prevent the spread of the virus have meant that we’ve had to find new ways of working. Schools have adjusted to online classes. Socializing has been severely restricted. We’ve had to change how we shop, exercise, worship, eat out, and play.

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Then, just as we thought the worst might be over, a resurgence of cases has plunged us back into uncertainty and fear. Research is showing that the pandemic is having a major psychological impact. People are experiencing more anxiety, and depression is on the increase. Not too surprising given the loss of a sense of safety. Our lives are no longer so predictable. We feel less in control. Our freedoms and security have diminished. 

A reaction to the loss of our normal routines - or to the loss of hope that they might return soon - is grief.  Grief is the emotional pain that comes with loss. It’s not just a normal reaction to death. We grieve when any attachment is severed. We can feel strong attachments to work and certain places and things. So, when we lose these attachments, we can experience strong emotions. This can make it hard to cope and even harder to move on. We can easily become stuck in grief because the loss was so sudden and unexpected. 

There is no normal grief reaction. Everyone deals with grief in their own way but it’s common to feel numb, angry, or sad. There is often a period when sleep is impacted, you may not feel like eating, you feel weak or tired all the time. Ironically, at a time when routines can provide a sense of continuity, we have to deal with finding new ones. 

If you are experiencing strong emotions, pay attention to what you’ve lost as a result of the pandemic. Maybe you’ve lost a job, your home, the opportunity to see grandchildren, a cherished family reunion, the ability to get the treatment you needed for a health condition. The losses might be big or small. They may be cumulative. Whatever you’re grieving, think about how you’ve dealt with loss before. What helped? What are your strengths? Are there specific people you can reach out to for support? Maybe you know people who are going through a similar situation. Talking to others about your experience can help you to feel supported. 

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If you’re struggling to make sense of a loss, try writing about it, perhaps in a journal or in an email or letter to a close friend or family member (you don’t have to send it). Expressing your true thoughts and feelings can be a cathartic experience. At the same time, try to limit how much time is spent listening to news about the pandemic. Constant reminders of what you’ve lost will only exacerbate negative feelings and fuel anxiety. If you can, try to create new routines, especially around sleep, exercise and diet. If you’ve lost your job, how can you structure your day so that you feel productive? Finally, pay close attention to any behaviors that might help you cope in the immediate term but are ultimately unhealthy. Notice if you are drinking more or relying on other substances to help get through this difficult time. 

Finally, it’s important to know that you don’t have to go through this time alone. If you think it might be helpful to talk to a professional about your loss, reach out to a grief counselor or therapist. And checkout the resources on grief.com.

Finding The Right Meditation App For You

Back in 2012, I started teaching a mindfulness class to adults wanting to find a way to feel calmer and better able to manage their emotions. I used to hand out a list of useful websites from which people could download helpful recordings of guided meditations and other exercises. Well, since then, mindfulness has gone from fringe to mainstream. There are now numerous mobile apps that turn your phone into a pocket mindfulness coach and they can really help to keep you on track as you build a regular mindfulness practice. If you have an Apple watch, there is a useful app, called Breathe. For your smart phone, take a look at the following:

  • Headspace.  One of the first really useful mindfulness apps, Headspace provides a free 10-day trial and an introductory course that takes only 10 minutes a day. If you decide to continue, you get access to much more content, including a program designed to help with relationships and personal health.
  • Calm.  With Calm you can customize your experience by choosing the background scenery and noise that fits with your idea of a peaceful, soothing virtual retreat. It provides guided meditations, some of which are free while others require a subscription.
  • Buddhify.  This app asks you what you are doing so that it can tailor a solo or guided meditation just for you. So if you are hanging around waiting for a friend or taking a quick break at work, Buddhify will create that peaceful moment.
  • Whil.  If you prefer a mix of traditional meditation practices with video yoga sessions, then this app is for you. It can also pick a practice for you based on your mood, your intention, and the amount of time that you have to spare.
  • Insight Timer.  This app allows you to choose your preferred interval time, ambient noise, and ending bell sound. It will also let you see in real time who else around the world is using the app to meditate.

New Year Resolve?

I'm not a big fan of new year resolutions.  While I do think it is a good idea to set goals and a timeframe within which to achieve them, I personally have always had a hard time sticking to a new year resolution for more than a week or two. It is usually at this point that I give up and feel like I've let myself down - not a great way to feel at the start of the year. I think part of the problem is the way we think about the commitment. I tend to fall into the trap of telling myself that I should be sticking to this or that resolution, which then makes me feel guilty if I fail to follow through. I sometimes wish that the word 'should' could be removed from the English language. It has such a powerful influence over the way we feel. When we tell ourselves that we should be doing this or that, we place such an inordinate amount of pressure on ourselves. Try to pay attention to your thoughts and notice if the word 'should' is part of them. If so, try to replace it with a less judgmental term. Instead of "I should go to the gym today," how about "it would be great to go to the gym today, but if I can't make it today, I'll try to go tomorrow." Or instead of "I should get to work earlier," how about "it would be nice to get to work earlier if I can." Such small changes can really affect the way we view ourselves. Instead of guilt-tripping or shaming ourselves, we allow ourselves to be human.

Psychological First Aid

The horrific fires in Sonoma, Napa, and Mendocino counties last month, as well as the terrible recent mass shootings, have reminded me of the importance of psychological first aid. While first responders are there to provide immediate physical aid, trained mental health providers are often quickly on the scene responding to immediate emotional distress and mitigating possible long term consequences. Several of my colleagues helped out in Sonoma after the fires and I feel very proud of them.

I was asked recently what kind of help do mental health professionals provide in these kind of emergency situations. A key role is to help disaster survivors become aware of the resources within themselves to cope and to help themselves. Humans have a remarkable capacity to recover emotionally if they have access to support, usually from family and friends, and to their own emotional tools or coping mechanisms. But people also need to know that their reactions are likely very normal. Very often, after a disaster, people experience extreme emotional reactions that confuse or worry them. In fact, these reactions are a temporary way for the mind to try to cope after something terrible has happened. For example, we may become hyper-vigilant or easily startled, we may have difficulty with concentration or memory, or we may have trouble sleeping or feel irritable. These are very normal reactions to the situation and it helps for people to know that they won't feel like this forever. In fact, most people will go back to their normal level of functioning in four to six weeks. 

But a major benefit of having highly trained professional mental health providers on the scene after a disaster is the fact that they can spot the people who may have a harder time recovering. The quicker that professional help can be provided to someone who is struggling, the greater the likelihood of recovery. At the very least, it can help to minimize long term issues.

Finally, psychological first aid is sometimes needed by other disaster responders. Their work is emotionally draining and, if we don't take care of the emergency workers, they can't take care of the community. The ultimate goal is to leave communities with the emotional tools they need to rebuild their lives and to get through any lingering mental health effects.

 

 

Postpartum Support

Several years ago, I treated a young mom who had postpartum psychosis, a rare illness that can cause delusions and paranoia. Fortunately, it was not so serious that she needed to be hospitalized and, with appropriate care, medication, and time, she made a full recovery. Unfortunately, not enough attention is given to postpartum mental health risks and there is still tremendous stigma surrounding the topic. While greater attempts are being made to screen for depression during pregnancy and, again, after the birth, there is still so much more that could be done. This article in the Washington Post states the case well. I'm really glad to hear that a wonderful colleague of mine, Dr. Katy Lonergan, who has specific training in this area, is about to start a group in SF for new moms who might be struggling with postpartum depression or anxiety. I know this will be a wonderful resource.  More details here. 

Cultivating Gratitude

I love this article on gratitude and one person's experience of writing down five things to be grateful for every day for a week. As mentioned in the piece, gratitude is a key component of a field of psychology called Positive Psychology. We don't often think of gratitude as something that can transform our lives. In fact, we may really only give it our attention at Thanksgiving. But cultivating gratitude has been shown to be one of the most effective ways to boost happiness and transform our lives in a meaningful way.

Addressing Dementia Risk

A recent article in the Washington Post notes that up to one-third of the world’s dementia cases could be prevented by addressing factors such as education, hypertension, diet, hearing loss and depression over the course of a person’s lifetime. The article stems from the recent publication of a new report presented at the Alzheimer’s Association International Conference in London this month.

It states that around 47 million people have dementia worldwide, and that number is projected to triple by 2050. The global cost of dementia in 2015 was estimated to be $818 billion, a figure also expected to rise with the number of cases.

The report, by the Lancet Commission on Dementia Prevention and Care,  identifies nine risk factors over a person’s life span, including years of education before age 15; hypertension, hearing loss and obesity in middle age; and smoking, depression, physical inactivity, social isolation and diabetes in late life. The Lancet team considered each factor separately and also looked at how they related to one another to calculate how much modification of each could potentially affect a person’s dementia risk.

 

We Can't Always Be Happy.....And That's OK

I sometimes hear people say that their goal is to "just be happy." I think it's useful to think of happiness as just one emotion that, like good weather, will come and go. We can't always be happy, and it's ok to feel sad or angry or anxious every now and then. The issue is when an intense, negative emotion lingers to the point of impacting our mood. In this sense, while emotions are like constantly changing weather, our mood is more like the climate, slowly changing over time. Anyone who's experienced a depressed mood knows that it can take a while for it to pass. It can also be helpful to realize that happiness is not just one thing. We experience different types of happiness, which are not always complementary. For example, we may be happy that we have a good job and earn a decent living, but working hard may mean less time for fun activities. While it's impossible to have happiness in all aspects of life, understanding this can help you enjoy the happiness that has touched you. And recognizing that no one "has it all" can cut down on the one thing we know impedes happiness: envy.