Looking after your mental wellbeing
The COVID-19 pandemic is likely to put many people under extreme pressure at some moments in time, and so there is an increased risk of mental health problems when dealing with the challenges of the pandemic.
It is very normal to experience a wide array of emotions whilst dealing with the crisis. You may experience feelings of guilt, shame and anxiety. You may also experience intrusive upsetting thoughts; these are likely to subside.
Equally, you may experience psychological growth, where you see a boost in your resilience, self-esteem and values as a result of the challenges you’ve faced.
Once the crisis is over, it will be extremely important to take time to reflect and learn from the difficult challenges, to create a meaningful, rather than a traumatic narrative (Greenberg et al., 2020). Those who manage others should also provide an ongoing space for the facilitation of this process of reflection (please see section for ‘healthcare team leaders’).
Now, more than ever, is a time to take steps to protect your mental health and wellbeing, and that of your colleagues, friends and family. The following provides some guidance and further resources on managing your wellbeing during this time.
Good relationships are important for our wellbeing and they provide a source of emotional support. Be compassionate with yourself and others.
In times of isolation, make the most of technology to keep in touch with friends and family. Video call apps such as Zoom and FaceTime are useful.
Take time each day to connect with others. Arrange a set-time to have a meal together, and try turning off the TV to play games with your children, family or friends.
If the news or social media are making you feel anxious, take some time away from them. Use credible, evidenced-based sources to stay informed.
Talk to your colleagues, your manager, or someone else that you trust about how you are feeling. They are likely to be feeling the same as you are; you can support each other.
When we say ‘be kind to yourself’, what does that even mean? This poster, shared with kind permission of Dr Zoe Ayres, discusses some tips for self-care during this difficult time.
Create a schedule
By planning your days you can concentrate on the things you can control. The important thing here is to give yourself a degree of accountability (figure out what is essential for you), yet be forgiving if you do not achieve everything you aim for. Consider a checklist of fun things for you to do.
Make sure to stay connected with both your family and friends as well as your work colleagues. Not sure who to talk to? There is a great online community. Also, if you are feeling anxious over the news, schedule in limited time to ‘connect’ with the world to avoid over-exposure. Getting tired of too many social Zoom calls? Be honest with your friends!
Let go of the guilt
Our ability to work at the same capacity as before the pandemic is (for the most part) gone. Try not to compare yourself to pre-pandemic you. If you are not as efficient as before, people will understand. Make sure to build in enough breaks. Only manage a few hours solid work? That’s ok.
Right now our health, and the health and welfare of our family must, and should, come first. It’s ok to put off that assignment temporarily if you need to get food, look after family etc. If you are struggling, consider what charities and funding bodies may be available to you for support. Think about starting any work calls genuinely asking how people are.
Stop comparing yourself
It is difficult to not compare ourselves to others, but everyone’s experience right now is different. It is important to realise people put the ‘best’ version of themselves on social media. Concentrate on doing what you enjoy. Not all hobbies have to be Instagram worthy.
Even if it is just a minute per day, taking the time to reflect and be present can be calming. There are some excellent apps like Headspace (and more below) to get you started. Mindfulness that works for one person will not necessarily work for another. Trial and error is involved – keep trying!
Physical health is intrinsically linked with mental health. Endorphins released during sport can lift our mood. If it’s getting outside for a run, or lifting tin cans of beans in the house, or stretching, doing a little bit of exercise is important. If you are pushed for time there are some great 15 minute workouts online. Back ache from working from home? Try some stretches.
It is ok to not be feeling ok right now. YOur feelings are valid. Many people are thinking that other people ‘have it worse’ or ‘there are other bigger problems right now’. This is not true. You deserve help too. Seek help from medical professionals, support groups, and/or the online community.
A note from the poster author: It is a privilege to be able to spend time on self-care and I want to acknowledge this. Self-care strategies vary from person to person.
Regular physical activity is a great way to boost your wellbeing.
Find an activity that you enjoy and one that suits your schedule. Try building this into your daily routine.
There are plenty of (free) ways to get active without attending the gym. Go for a walk or run, try gardening, or find online classes. Here’s some inspiration: https://www.nhs.uk/live-well/exercise/free-fitness-ideas/
If, as a key worker, you normally drive to work or take public transport, try walking or cycling instead.
Taking time to become more ‘present in the moment’ may help you reduce stress and anxiety.
When we are busy, it is very easy to disconnect from the world around us, and become absorbed in our own thoughts.
Take 10 minutes out each day to pay attention to your thoughts, feelings and the world around you. What can you see, hear and feel? This can be as simple as noticing the weight of your feet on the floor when you’re walking.
Become aware of your breathing to help you relax. There are guided relaxation and breathing exercises available on YouTube and apps available to download, as well as general mindfulness and meditation apps including:
Calm, an app for sleep, meditation and relaxation, with over 50 million downloads worldwide.
Headspace, which helps you to learn a mindful approach to life, and improve mood and sleep while reducing anxiety.
Balance, the world’s first personalised meditation audio programme which assembles individualised plans based on your personality, feelings and mood.
Maintain a routine as much as possible. Eat a healthy, balanced diet and keep hydrated. Avoid using alcohol, smoking, or drugs to cope with your emotions.
If you’re working long shifts, make sure to take regular breaks whenever possible, and prioritise time-out between shifts. Spend time on something that you enjoy like listening to music or watching a Netflix series to take your mind off the current crisis. Get outdoors where you can (of course adhering to current physical distancing guidance).
Practising good sleeping habits will help enhance your quality of sleep and may provide solutions to sleep difficulties you may be experiencing.
Tips for practicing good sleep hygiene:
- Go to bed and wake up at more or less the same time every day
- Go to bed when you’re tired and avoid spending too much time awake in bed
- Ensure your bedroom is quiet and comfortable for sleeping. Minimise light and noise, and ensure the room is not too warm or cold for you
- Keep your bed for sleeping – not eating, working or watching TV
- Unwind before bed: if possible take a bath 1-2 hours before bed, or practice your breathing exercises, or do some light stretching. Have a calming, caffeine-free hot drink
- Avoid alcohol, nicotine and caffeine 4-6 hours before bed
- If you’re unable to sleep after 20 minutes, get up and try something non-stimulating and relaxing, such as sitting on the sofa with the lights off, and go back to bed to try again when you feel sleepy
Although avoiding technology before bed is a useful technique, there are several apps available that can help with relaxation and aid you to drift off to sleep:
Sleepio is an evidence-based sleep improvement programme that uses cognitive behavioural techniques to help improve poor sleep. It’s free for NHS staff until the end of this year.
Pzizz uses a mix of music, voiceovers and sound effects based on the latest clinical research to improve sleep at night or take power naps during the day.
Sleepstation is a six-week online course for people with sleep problems. It’s individually tailored and provides access to sleep experts who will offer advice and support throughout. The programme is free with a GP referral, or otherwise courses start at £95.
Without being able to go out so often, and with many schools and workplaces having closed down, many of us are experiencing much greater amounts of time in the company of family and flatmates. This can be a positive experience for many and provides an opportunity to have valuable time together. However, for others this can be more difficult. People may now lack access to private space if they need to discuss personal matters with friends or professionals; they may have no external space; and many households will be struggling economically and with the anxiety of illness or isolating relatives.
Staggering exercise between housemates allows time away from one another, while rotating around the rooms of the house, developing a structure and timetable for activities, and taking part in online activities, can all help.
There have been concerns particularly about increasing rates of domestic violence during the pandemic and we’ve collated some national and regional advice and guidelines:
- Practical advice for staying at home – Mind
- Government support for victims of abuse during coronavirus
- Getting help for domestic violence – NHS
- Covid19 tips – Refuge
- Domestic abuse advice from Birmingham City Council
- Advice from West Midlands Police
- ‘My housemate refuses to social distance’ – advice from the BBC
This is a very difficult time for the whole community, but especially for those who face the challenge of caring for a family member or loved one during the pandemic.
Forward Carers is a support organisation for those with caring responsibilities and, while their usual group activities are currently suspended, the organisation has compiled a ‘Definitive Guide for Carers‘ which covers:
- Protecting someone you care for
- When you need to stay away from the person you care for
- What you should do if you feel unwell
- Advice for paid carers
- Managing caring with returning to work
- How to manage refurbishment or adaptive work in your home
- Looking after yourself
Managing emotion and troubling thoughts
We can’t always control what’s happening around us, but to some extent, we can choose how we respond.
- Identifying and challenging unhelpful thinking habits: If you are thinking“It’s all my fault, I’m not good enough”. Ask yourself:
How does this make me feel and act? Is it true? What is the evidence? Is it helpful? What would I say to a friend having this thought?
- Using my resources: What are my strengths? How can I draw on these to get through?
- Moral dilemmas: Be prepared to face situations that may cause moral distress, where you feel unable to provide the best possible care, for example if a relative of yours is in a care home. Acknowledge and talk through any difficult feelings you may be experiencing (e.g. guilt) with friends and family and draw on their support too.
- Acceptance: You won’t be able to control all things, but focus on the things that you can control. Be kind to yourself when things don’t work out as you’d hoped.
- Glass half full? Reflect on things that are going well, and celebrate the successes or small wins. Remember this will not last forever and the pandemic will end.
Helpful links and resources
- NHS 5 tips to improve mental-wellbeing
- Mental health flyer from NHS Birmingham & Solihull
- Resources from Birmingham City Council
- Psychological First Aid (WHO)
- Sleep hygiene
- Tips to manage wellbeing
- Searchable catalogue of resources from Forward Thinking Birmingham
- WHO COVID-19 Pandemic coping with stress Leaflet
- Self-help guides
- Coping with stress during the pandemic – National PTSD centre
- National Institute for Health and Care Excellence. Post-traumatic stress disorder. NG116. 2018
If you have had COVID-19, or are a researcher looking for patient perspectives, a new Facebook group has been established to discuss all aspects of research, for engagement, involvement and participation purposes. It can be found at Covid Research Involvement Group UK – please note it is not affiliated with our BHP members.