We’ve been speaking with Chris Smith, a Cognitive Behavioural Psychotherapist with over 10 years’ experience in counselling and Cognitive Behavioural Therapy (CBT), about how Covid-19, the current strain of Coronavirus, affects those of us with mental illness and what we can do to support our mental health.
We know this is a scary time. Experiencing increased levels of anxiety is understandable, especially with the speed at which advice and reports are changing. For those of us with mental illness, the anxieties and worries can start to take over and make day to day life really difficult.
This isn’t a guide on how to avoid catching Coronavirus. For those in the UK the NHS keep their website up to date with the latest advice. The Government website has the latest information including their recommendations, too. If you’re outside the UK please check your country’s official and trusted sources.
This is a guide to how we can look after our own mental health during a scary time.
Chris says the most important thing is to go back to basics and work on maintaining our mental health where we currently are. This may not be the time for difficult behaviour experiments, nor the time to push ourselves into positions where we feel uncomfortable. We might need to put some of the interventions we’re trying out on hold and focus on not getting any worse and looking after ourselves.
Good therapy should be a collaborative process. If you have one, talk to your mental health professional(s), particularly if you feel any of your current behaviours could be dangerous.
How Do We Maintain Our Mental Health During The Coronavirus Pandemic?
Chris Smith explains “If we’re anxious it’s important to remind ourselves that a big part of anxiety is about asking the ‘What If?’ questions. The anxiety we experience is often about us not being able to tolerate those questions.”
When we’re anxious we often overestimate the level of threat and underestimate our ability to cope.
We can help maintain our mental health by making some of those uncertainties a bit more ‘certain’. Problem solving can help us with this.
Stay focused on current worries – let go of some of the hypothetical worries. Hypothetical worries haven’t happened yet and might never happen. We can deal with them when and if they become current and we have the ability to affect the outcome.
• Distraction techniques can help us to shift our focus.
• Writing our worries out can help to get them out of our heads. Seeing them can help us process them. This is particularly helpful if we’re struggling to sleep because of thoughts running through our mind.
• From there we can then think of possible solutions. Write down any solutions you can think of. There are no wrong or silly answers, they can be as wild and wonderful as you like. Out of those ideas you may start to find some solutions that work for you.
• Look at your worries and gauge them as short, medium, or long term. Organising them in this way allows us to look at which we need to address first.
• Tackle short term worries first; things that are happening in the immediate future. They take priority.
• If possible, try to let go of some longer-term worries. As with hypothetical worries, if we can’t let it go, then we could write a plan. This can make the uncertainty feel a bit less scary and out of control.
Chris also reminds us to think back to previous times when we’ve been worried about things. How did we get through those difficult times? Are there any skills we could use again now?
Remember – we are far more capable than we give ourselves credit for. We have a 100% success rate for getting through previous times of crisis.
Obsessive Compulsive Disorder And Coronavirus
Many people with Obsessive Compulsive Disorder (OCD) have specific routines. These can be connected to hand washing, and the recent news might mean our routines spiral and get out of control.
• Chris’ advice was to discuss your worries with your health care professional if you have one. If you don’t have a therapist, he recommends that we follow the current government guidelines. Follow the 2 Happy Birthday Rule/20 second rule when hand washing and wash your hands when you get home and into work.
• Chris also reminds us “Your current rituals have kept you safe up until now – there’s no need to add or take away from these currently. As we’ve said previously, now isn’t the time to try and push yourself with big behavioural experiments unless agreed with your therapist. Now is all about maintaining our current balance”.
• If we excessively wash our hands they might start to chap, which can lead to open wounds. This can make us more susceptible to catching a virus, so if you’re worried about chapping skin speak to your pharmacist and ask for a cream to use after hand washing to protect your hands.
• When we feel things slipping try to bring ourselves back to that and the NHS advice. Also, remember the responsibility is not all on us – everyone is following these rules and it is good sound advice that is coming from the global medical community so we can be sure it is safe.
Chris added that not all OCD is about contamination or organisation, but the current Coronavirus situation means that people whose rituals and obsessions relate to contamination would be better to maintain rather than seeking to overcome. If you’re undertaking treatment for other OCD related issues, then you’re likely safe to carry on with treatment.
Generalised Anxiety Disorder/GAD
We understand that the uncertainty around whether schools and workplaces will close is causing additional anxiety so we asked Chris what his recommendations would be.
• Create several contingency plans connected to your areas of uncertainty. The difficulty with this situation currently is that it is ever-evolving so having more than one plan can help you feel better prepared.
• Remember the focus here is all about maintaining our current mental health.
• Having a plan in place, even if it later becomes unworkable, can help to reduce our anxiety levels in the moment. If the situation changes then you can revisit at that time and put new plans into place.
• Speak to your medical professional if you feel you are struggling to control your anxieties.
Many of us are worried that our depression will spiral if we have to self-isolate due to Coronavirus.
• It’s important to let ourselves feel our emotions. Being isolated and stuck inside can cause low mood in anyone; we need to be gentle with ourselves.
• Plan some meaningful activities we can do in the house. Write that book we’ve always planned, learn a language, listen to a long-forgotten album collection. Whatever it is, it’s about giving ourselves purpose.
• Stick to existing routines where possible. Go to bed and get up at your normal time. Try to avoid daytime naps if they’re unhelpful. If you don’t have any existing routines, it might be helpful to make one.
• Where possible try not to slip into negative behaviours. We know the behaviours we tend to slip into during our lowest times. It’s important we try to avoid behaviours we’ve moved away from during our recovery.
• We can still use our gardens (if we have one). Try to get some time outside every day; sitting outside with a cuppa in the morning, watching birds on the feeders; try and make it part of your routine. If we don’t have a garden, opening our window can give us a welcome breath of fresh air.
• Plan calls with friends and loved ones, reach out to online support groups, and be aware of social media use during this time. It’s more important than ever to focus on positive interactions and avoid things that add to our feelings of worry or sadness.
• During this time we can really focus on self-care. Do something nice for yourself every day. Remember we have LOADS of self-care ideas for different scenarios.
For those of us who experience health anxiety, a news story such as Coronavirus can be a terrifying time. We asked Chris what we can do to lower those anxieties.
• It can be easy to assume everything we come down with now, every cough, sneeze, tickle, ache and pain, is because of Coronavirus. However the symptoms laid out by the government and experts for this strain of Coronavirus are very black and white. The NHS online 111 page can guide you through a symptoms check if you want to be sure.
• Identify our own triggers and acknowledge our own anxieties. From there we can take steps to avoid these triggers; it may mean limiting our social media use and muting certain pages as well as avoiding the news for a while.
• If suitable explain your anxieties to loved ones and colleagues and ask them not to speak to you about Coronavirus.
• Make a plan of what we will do if we do become ill. Where we will stay, what we will need to have access to, who will look after any dependants we may have (children, elderly relatives, etc).
• Having a plan in place can lower any anxieties we have around becoming ill ourselves.
• If you do become ill follow the current NHS advice.
Access to Medication And Treatment During The Coronavirus Pandemic
Many of us are worried about whether we will still be able to access our medication and any support we need.
• Most GPs will allow repeat prescriptions to be arranged over the phone or via an online app or website. In most cases, prescriptions can be sent directly to your preferred pharmacy. Speak to your surgery about this now so you can get it set up in case of self-isolation.
• Many pharmacies offer a delivery service. Contact your pharmacy and see if this is something that can be set up.
• Friends, loved ones and neighbours could also help. They could put them through your letterbox or leave on your doorstep if you’re self-isolating. The NHS has advice for people collecting prescriptions on behalf of others.
• If you have a private therapist the British Association For Counselling And Psychotherapy (BACP) have issued guidance for their therapists regarding Covid-19. Speak to your therapist directly for more details.
• NHS services are dynamic and will evolve as the situation develops. At the time of writing most trusts are still seeing patients as normal. Some trusts are moving towards implementing telephone appointments so you still have access during periods of isolation. Contact your own therapist or service provider for more information.
• 111 mental health services should remain unaffected throughout the coronavirus pandemic, as should access to the Samaritans email support and to online support organisations. If you’re concerned keep a list of contact details with you.
A Final Word From Chris
Chris finished by telling us “I’m a big fan of Winnie the Pooh. I often remind myself of what Christopher Robin told Winnie the Pooh. His words were:
You are braver than you believe,
Stronger than you seem,
And smarter than you think”
Embrace our inner Pooh Bear and remember we’ve all come through tough times before and we are all still here. Sometimes we all need a reminder of that.
Coronavirus can be scary. Use this time to really focus on upping our self-care and making sure we are looking after ourselves in the very best way we can.
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