how to cope up with stress during this pandemic essay

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COVID-19 Pandemic and Stress: Coping with the New Normal

Anjana bhattacharjee.

1 Dept. of Psychology, Tripura University, Suryamani Nagar, Tripura, India

Tatini Ghosh

COVID-19 is the new face of pandemic. Since the discovery of COVID-19 in December 2019 in Wuhan, China, it has spread all over the world and the numbers are increasing day by day. Anyone can be susceptible to this infection but children, older adults, pregnant women, and people with comorbidity are more vulnerable. The spread of coronavirus resulted in closures of schools, businesses, and public spaces worldwide and forced many communities to enact stay at home orders, causing stress to all irrespective of their age, gender, or socioeconomic status. The sudden and unexpected changes caused by the outbreak of coronavirus are overwhelming for both adults and children, causing stress and evoking negative emotions like fear, anxiety, and depression, among different populations. The aim of the paper is to ascertain how stress during this pandemic inculcates various psychological health issues like depression anxiety, OCD, panic behavior, and so on. Further, the paper is an attempt to identify different general as well as population specific coping strategies to reduce the stress level among individuals and prevent various stress-induced psychological disorders with reference to different theories and research articles.

COVID-19, also known as coronavirus disease, is a severe respiratory disease first discovered in Wuhan, China, in December 2019. Since then, it has spread globally. The World Health Organization declared it a “Public Health Emergency of International Concern” on the 30 th of January 2020. There were more than 365,000 confirmed cases worldwide by October 2020 ( World Health Organization, 2020 ). According to report by the Ministry of Health and Family Welfare, Government of India (2021), since the inception of COVID-19 in India, there were more than 10,130,000 cases till february 2021. Even though vaccination has started in India and many parts of the world, the COVID-19 cases are still increasing day by day. The common symptoms of coronavirus are fever, cough, shortness of breath, and in some cases no symptoms at all. Anyone can be susceptible to this infection but children, older adults, pregnant women, and people with comorbidity are more vulnerable to this virus ( World Health Organization, 2020 ; National Institute of Mental Health and Neurosciences, 2020 ).

According to the National Institute of Mental Health and Neurosciences ( NIMHANS, 2020 ) the sudden lockdown and restricted mobility, along with isolation and social distancing during the starting of the pandemic, has caused stress, boredom, irritation, adjustment disorder, frustration and aggressive behavior. The sudden drastic change in known usual life acted as a gateway for increasing mental illness. A study shows that any severe epidemic or outbreak in society generally has severe negative effects on the society as well on the lives of humans ( Dodgen et al., 2002 ).

The unexpected outbreak of COVID-19 and its related consequences are causing severe changes in our lifestyle. These sudden changes can be overwhelming for both adults and children causing stress and evoking negative emotions like stress, fear, anxiety, depression among different populations. Several studies stated that the most prevalent mental health issues reported during the pandemic are stress, anxiety, fear, anger, insomnia, and denial. These issues were seen among different population groups ranging from children to older people, frontline workers, and people with pre-existing physical and mental health issues ( Roy et al., 2020 ; Torales et al., 2020 ). Different studies found that stress, anxiety, and depression coincide with the COVID-19 pandemic and due to the ongoing pandemic, there is an increase in the prevalence rate of these mental health issues around the globe ( Mohindra et al., 2020 ; Xiao et al., 2020 ).

A study comprising of 113,285 participants from India, China, Spain, Italy, and Iran revealed that among this surveyed population, the prevalence of depression, anxiety and stress was 20%, 35%, and 53%, respectively, during the pandemic and it seems to be increasing day by day ( Lakhan et al., 2020 ). A similar study found prevalence of post-traumatic stress among the general population has increased from 23.88% to 24.84% during the pandemic ( Cooke et al., 2020 ). A study on racial and ethnic disparity of stress and other mental health conditions during COVID-19 showed that Hispanic adults have four times higher prevalence of psychological stress and mental health issues than any other ethnic groups in the United States, along with increases in substance use and suicidal ideation ( McKnight-Eily et al., 2021 ). Wu et al. (2020) reported in a study that life stress, especially stress associated with uncertainty, has led to mental health disorders. The higher the level of perceived uncertainty stress, the greater the prevalence of mental health disorders. The study further found that the prevalence of mental health disorders due to the COVID-19 pandemic was 22.8%.

Abbott (2021) investigated stress caused by the COVID-19 pandemic and its related consequences and found that there is an increase in prevalence of stress, anxiety, and depression in the U.S. population from 11% to 42% due to this pandemic. The surge in stress among people is also during the rise of new COVID-19 covariant cases. A recent study showed an association between high level of stress, anxiety, and sleep disturbance and the period of social distancing ( Esteves et al., 2021 ).

Currently, several vaccines are being produced and vaccination has started, resulting in the discontinuation of lockdown orders in most countries. Educational institutions and workplaces are reopening and people are returning to the new normal life, maintaining social distancing. Recently Ministry of Health and Family Welfare (2021) reported a sudden surge during December 2020 in COVID-19 cases all over the world, due to a new covariant of COVID-19 virus that was first, testified by the Government of United Kingdom (UK) to World Health Organization (WHO). The new variants are reported to be more infectious and spread more easily among people. This is again aggravating the situation and increasing stress in people even after being vaccinated due to excessive fear and uncertainty.

The objectives of this article are two-fold. First it explores how stress plays a significant role in increasing the number of mental health problems during this pandemic. Second, it tries to identify different general as well as population specific coping mechanisms for dealing with this stressful situation with reference to different theories (both on stress and coping) and research articles.

Methodology

This paper reviews secondary data available through conceptual models, various past journals, research papers, and other useful websites related to coronavirus pandemic and its psychological effect on people. Finally, the paper extensively reviews different articles related to psycho-social coping mechanisms to reduce stress level among individuals.

When conducting this review research, related articles were focused on and keywords like “coronavirus,” “coronavirus and mental health,” “COVID-19,” “stress,” “psychological disorder,” and “coping strategies” were used. In order to identify articles that focused on specific terms like, “stress,” “pandemic and mental health,” “depression,” “anxiety,” “post-traumatic stress disorder,” and other related terms were used. The databases that were used for identifying related articles were Google Scholar, Medline, PubMed, NCBI (National Center for Biotechnology Information), and various other journals. Figure 1

PRISM diagram of systematic literature review process.

The systematic review started with 1137 articles, which were screened and reviewed and some were removed on different grounds. Finally, 106 articles were selected for the review article based on aims and objectives of the paper. The selection process of different articles is shown in the following PRISM flow chart. Finally, conclusions have been made on the basis of findings from different reviewed articles. Figure 2

Table showing discussion.

Theories of Stress

Hans selye’s theory.

In the year of 1930s, 1940s, and 1950s, Han Selye elaborated on the Walter Cannon’s theory of fight-or-flight reaction to stress and named it general adaptation syndrome (GAS). In this theory, Han Selye explained GAS as a physiological reaction to stress consisting of three stage reactions, namely: alarm reaction stage, resistance stage, and exhaustion stage ( Selye, 1956 ). When a person faces a stressful situation, alarm reaction stage is initiated. During this stage the body prepares itself for fight-or-flight reaction and makes the necessary physiological changes in body. If the stressor persists, the body progress to the second stage (the resistance stage), where the body reacts in an opposite way of alarm reaction and tries to repair the body from any damage. If the stressor still continues, in the third stage (exhaustion stage), the body’s energy is depleted and the person succumbs to various mental and physical health issues caused by the extreme stress. Selye (1991) further stated that prolonged exposure to extreme stress can cause mental and physical illness, or even death.

The transactional model of Stress

The transactional model of stress developed by Lazarus and Folkman (1984) explained that the feeling of stress is cumulative in nature. The amount of stress we experience is the result of our thoughts, feelings, emotions, and behaviors attached with our evaluation of our external and internal demands. When the demands of the external and internal environment exceed the resources we possess, it causes stress. If the situational demands are more than that of the available resources, it causes stress in multiple ways: acute, episodic or intermittent, and chronic, which further result in physical and mental dysfunction.

Conservation of resources (COR) theory

This theory ( Hobfoll, 1989 ) proposed a framework of stress and what resources are needed to be conserved for physical and mental well-being, in the face of stressors. According to COR theory, the primary motive of human beings is to conserve resources and tools that would help to maintain their overall well-being. COR states that there are four primary kinds of resources (e.g., objects, conditions, personal characteristics, and energies) that help in fostering and protecting well-being. It proposes that individuals lacking in resources will be more vulnerable to experience stress and those with abundant resources will be resilient to stress ( Hobfoll et al., 1996 ).

Holmes and Rahe’s model of stress

Holmes and Rahe’s (1967) developed a model of stress associated with major life changes, which cause stress and ultimately may result in illness. The model states that there is a positive correlation between stress inducing major life changes and illness. In other words, with an increase in major life events, there is greater likelihood of developing subsequent illness.

Stress-disease model

According to the stress-disease model by Kagan and Levi (1971) , there are several components explain how stress can lead to disease. First, stressors or stressful situations (both social or psychological stressors), second, the individual psychobiological programming (genetic and predisposing factors, learning, and previous experiences), third, how an individual reacts to stress. When the three components work together, it leads to the fourth component, that is, precursors of disease, which ultimately leads to the final outcome which is physical illness. This model explains how different physiological pathways can act as a mediator between stress and physical illness/disease ( Levi & Kagan, 1971 ).

Stress-Induced Mental Health Problems During COVID-19

Humans are social animals and it is a human tendency to establish social interactions with others. Due to COVID-19, our social interactions have been cut down, thus resulting in psychological distress ( Usher et al., 2020 ). Brodeur et al. (2004) revealed that the pandemic is severely affecting our mental health and there is an increase in web searches for loneliness, anxiety, depression, suicide, and divorce. Similarly, other studies also showed that epidemic and post-epidemic situations can cause psychological problems like stress, anxiety, and stigma as well as long lasting effects like post-traumatic stress symptoms and physical conditions like migraines and headaches ( Bhugra, 2004 ; Brooks et al., 2020 ; Cheng et al., 2004 ; Duan & Zhu, 2020 ; Fan et al., 2015 ). Post-traumatic stress disorder is a serious concern in the times of the COVID-19 pandemic, and females were found to be more prone psychological problems ( Alshehri et al., 2020 ; Bridgland et al., 2021 ).

In a recent study, Dubey et al. (2020) revealed that the current pandemic situation has not only affected the health of people but also badly affected the economy of the country. It has caused fear amongst people, which they have termed as “coronaphobia.” Many studies have revealed that stress, anxiety, fear, depression, and other psychological disorders are very commonly experienced during pandemic situations. The pandemic stress has a devastating effect on mental health ( Kumar & Nayar, 2021 ; Montano & Acebes, 2020 ; Van Bortel et al., 2016 ). Many studies over the past few decades proved that the impact of psychological stress is harmful for the immune system and the body’s response to vaccines, and these findings are applicable for COVID-19 vaccine as well ( Madison et al., 2021 ; Xiang et al., 2020 ).

A study by Shrilatha and Durga (2020) revealed that during this pandemic there was a rise in the use of social media and smartphones to is more than four hours a day, and the most used app was found to be WHATSAPP . Along with the increase in social media use, the use of other apps like ZOOM and HOUSE PARTY are also increasing since people are working from home ( Chanchani & Mishra, 2020 ). Even though social media helps in connecting with others from home, still there is a big disadvantage to it. During the coronavirus pandemic, social media is overloaded with misinformation and rumors that create more stress, fear, and panic among all ( Kumar & Nayar, 2021 ). Fear of COVID-19 due to misinformation results in the spread of maladaptive, obsessive-compulsive behaviors. Fear of contamination and regular washing of hands are common symptoms of OCD. Stress during COVID-19 and unavailability of proper treatment and therapy can lead to initiation and maintenance of OCD ( Adams et al., 2018 ).

The study of Kashif et al. (2020) revealed that along with the spike in screen usage, there has been a spike in cyber-crime during the coronavirus period. It has been further reported that personal data have also been stolen and hacked. Similar studies showed that there has been an increase in the number of cyber-crimes and cyber frauds since the first case of coronavirus in China and cyber fraud can lead to fear, panic, and stress ( Gross et al., 2016 ; Lallie et al., 2020 ). At such critical times, when hard earned money is lost, it can cause mental distress that may further develop severe psychological disorders. Hence financial loss and hardships can lead to psychological distress ( Bradshaw & Ellison, 2020 ).

Increased stress also plays a key role in substance abuse and addiction ( Sinha, 2001 ), and the stress, anxiety, and increased isolation lead people to indulge in use of psychoactive substances (like smoking, drugs, and alcohol drinking) and other substance dependent behaviors (like excessive use of social media, online gaming, and pornography). This results in substance abuse disorders during the pandemic ( Clay & Parker, 2020 ; Columb et al., 2020 ).

According to the WHO (2020) , due to the current pandemic and related measures taken to control it like social distancing, lockdown, etc., there has been a rise in the hazardous use of alcohol and drug, as well as suicidal ideation and attempts. Similarly, studies by Cheung et al. (2008) and Gardner et al. (2020) showed that pandemics can increase the rate of suicide among older adults. Not only isolation and loneliness but also death of a near one from COVID-19 are also risk factors for the suicidal ideation of an individual ( Sahoo et al., 2020 ). Figure 3

Summary of review on stress induced mental health problems during COVID-19.

Theories of Coping

Haan’s model of coping, defense, and fragmentation.

Norma Haan (1963) proposed a triarchic model of coping and described how the ego processes different stressors of daily life by using coping, defense, and fragmentation. She proposed in her model that “ego process” is a psychological approach in dealing with the stressors of daily life, which ultimately helps in sustaining a realistic connection with the self and the environment ( Haan, 1969 ). Haan (1993) defined three ways of dealing with stressors: coping, defense, and fragmentation. Coping is an effort to overcome the hardships of life by reaching out and within self for resources. Defense is an unconscious mechanism that greatly helps in reducing anxiety from harmful stimuli. Fragmentation is a method to adapt or accept failure when the stress is too extreme to handle/cope and may result in psychotic behavior. Thus, by controlling belief or behavior (defense), an individual can cope with the stressors, whereas when coping or defense fails, fragmentation occurs ( Haan, 1977 ).

Lazarus and Folkman’s theory of coping

Lazarus and Folkman propounded a theory of coping with stress ( Folkman & Lazarus, 1885 , 1991 ; Lazarus & Folkman, 1984 ), and the theory emphasized how coping transactionally interacts with cognition and emotion. According to the theory ( Lazarus & Folkman, 1987 ), there are two types of coping, namely: problem-focused coping and emotion-focused coping. Problem-focused coping deals with focusing with the problem, planning, and taking action and steps proactively about the problem, which may include gathering resources, seeking social support, or taking action to change or to overcome the problematic situation. On the contrary, emotion-focused coping deals with focusing more on the emotions, while dealing and managing the emotions caused due to the stressors. Emotions can be dealt by meditation, yoga, venting out frustrations, focusing on the positive, etc. Folkman (2013) explained that coping involves resorting to both cognitive and behavioral responses to manage the internal and external stressors.

The Hardiness Theory

Kobasa (1979) had defined hardiness as a personality type that helps in overcoming stress related illness. Hardiness is a general feeling of being satisfied with the environment. Maddi and Kobasa’s (1984) , hardiness theory of coping emphasizes that a hardy person would view stressful or challenging situations as a meaningful and interesting situation and an opportunity for personal growth. Such kind of outlook towards challenges helps people to remain healthy during stress. According to the theory, there are three ways to adhere to hardiness as coping: First, “controlling” the beliefs that can influence their environment; second, “commitment” and deep involvement in their tasks and duties; third, viewing “challenges” as an opportunity for growth and working for it.

The sense of coherence theory

Sense of coherence (SOC) ( Antonovsky, 1987 ) refers to a coping technique to deal with life stressors and emotional distress. It a feeling of confidence that both internal and external environment are predictable. According to the sense of coherence theory, there are three elements that are necessary for coping with daily life stressors: comprehensibility, manageability, and meaningfulness. People with weak SOC have a pessimistic outlook that things will go wrong in the end, whereas people with strong SOC have a good understanding of life and anticipate that all will turn good in the end. By successfully applying the elements of coherency, it is possible to cope with stress without hampering the physical health.

Stress and coping social support theory

The stress and coping social support theory by Cohen and Wills (1985) explained that social support acts as a coping method that protects the people from the stresses of life and the harmful physical effect of stressors. The theory further suggests that social support promotes adaptive appraisal and coping techniques in dealing with stressful events ( Thoits, 2010 ). According to Glanz et al. (2015) there are four types of social support that assist in coping with stress: emotional support comprising love, care, understanding; information support referring to information, guidance, and counseling; appraisal support referring to providing evaluative help; and finally, instrumental support referring to the physical or action-oriented help.

Suggestive Coping Strategies (General and Specific) During Pandemic

General psycho-social coping techniques.

According to various reports by International and National Institutes, like Ministry of Health and Family Welfare, Government of India, 2021 ; National Institute of Mental Health & Neurosciences (NIMHANS), 2020 and World Health Organization, 2020 , different psychological coping strategies have been suggested to reduce stress levels among individuals and to prevent various psychological disorders. COVID-19 has increased people's psychological burden and caused severe stress, which has challenged the resilience and coping ability to overcome hardships ( Polizzi et al., 2020 ). So, it is very requisite of the moment to foster and practice some psycho-social coping strategies to overcome stresses associated with COVID-19.

• 1. Psycho-education refers to educating people about various psychological disorders and their consequences. A study showed that psycho-education has helped people to deal with psychological disorders more successfully than those who were not given psycho-education ( Vieta, 2005 ).
• 2. Acceptance is an important coping mechanism to deal with stressors. If acceptance of the prevailing circumstances is not there, then it can lead to a negative coping strategy known as denial, which is very dangerous. In denial, the person will not follow any guidelines and it may affect others as well. One study shows that acceptance is a good way to cope with stressors and their harmful physical effects ( Lindsay et al., 2018 ).
• 3. Practice Positive Thinking. One negative thought leads to another and it creates a chain reaction of negative thoughts. To break this cycle, positive thinking practice should be adopted. Positive thinking refers to the process of focusing on positive emotions and positive behavioral habits. One study on positive thinking shows that it helps in coping with stress, anxiety, and other psychological disorders as well ( Naseem & Khalid, 2010 ).
• 4. Cognitive redefinition is a psychological coping strategy to redefine or change the way we see, perceive, and feel about any situation or events. Instead of perceiving this current pandemic situation as something very stressful, cognitive redefining can help in perceiving this as time to reconnect with family and to indulge in creative activities and self-care. One study shows that cognitive redefinition or change in mindset is helpful in dealing with stressful situations ( Crum et al., 2013 ).
• 5. Limiting Social Media and News. According to The Centers for Disease Control and Prevention, too much information and news about the COVID-19 pandemic can be overwhelming and upsetting, and it can cause panic among the people. So, it has been suggested to limit social media use and listening/reading news about the current pandemic situation. It has also been suggested by WHO to read about it from trusted sources only, as, factual information can help lessen fear and panic.
• 6. Proper Sleep Hygiene. The current pandemic situation is very crucial for everyone and it is very important to be biologically fit so as to reduce the risk of COVID-19 and its associated issues. Studies proved that having proper sleep hygiene can help in dealing with stress, anxiety, mood disturbances, and other mental health problems associated with the current pandemic ( Jakupcak et al., 2020 ; Thoits, 2010 ).
• 7. Physical Fitness. It has been reported that regular physical exercise not only boosts physical health but also helps in mental health by reducing stress, anxiety, and depression. It would be helpful to do regular physical exercises at home during this pandemic to stay fit both physically and mentally ( Altena et al., 2020 ; Muraki et al., 1993 ; Sunder et al., 2020 ).
• 8. Spending Time on Hobbies. Currently, we are either locked at home or have restricted mobility due to the pandemic situation. So, there is an immense amount of time for us at home now. We can utilize the time by indulging in various activities like cooking, painting, gardening, etc. One study shows that people who indulges in hobbies in their leisure time are less likely to have mental health issues than those who do not have hobbies ( Jeoung et al., 2013 ). Reports by NIMHANS advised people to indulge in various activities so as to distract themselves from the constant worrying about the situation.
• 9. Work life Balance. During the current COVID-19 outbreak when many people are working from home to avoid contamination, it has become very important to maintain work–life balance. Work–life balance is the process of maintaining a proper balance between work and other activities of daily life in a way that one does not hamper the other. Studies also prove that maintaining a proper work life balance boosts positive mental health and reduces anxiety and depression among employees ( LaBrie et al., 2010 ).
• 10. Healthy Daily Routine. Day-to-day routines have been disrupted during the COVID-19 pandemic, and it negatively hampers our both physical and mental health. Various reports show that unhealthy life styles impede our physical and mental health whereas healthy lifestyle like eating healthy, getting enough sleep, focusing on positive thoughts, etc. can boost healthy mind and body ( Haar et al., 2014 ; Takeda et al., 2015 ).
• 11. Mindfulness Practice. Mindfulness refers to the state of physical and mental awareness of a person, without being affected by the surroundings. There are various mindfulness techniques like meditation, physical exercise, yoga, guiding imagery and spiritual practices. Studies also show that mindfulness practices help in dealing with mental and emotional disorders and also boost physical health ( Call et al., 2014 ; Koenig, 2010 ; Mayo Clinic, 2020 ; Melnyk et al., 2006 ).
• 12. Following Government Guidelines. It is being advised all the time to follow the Government guidelines to curb the COVID-19 outbreak. Some of the guidelines by the Ministry of Health and Family Welfare, Government of India suggest to maintain social distancing, wear face coverings whenever outside, wash hands using soap regularly and avoid public gathering.
• 13. Professional Help. Urgent professional help has to be sought if the person is not able to deal with the sudden life changes and if it is severely hampering their physical and mental health. If people are suffering from any kind of physical and emotional disorder, professional help like consulting a psychologist, counselor, or psychiatrist is advisable ( Wang et al., 2020 ).
• 14. Avoid Stigmatization. There has been negative attitudes and stigma about mental health exist. Due to stigma attached to mental health and mental health care providers, people hesitate to express their mental turmoil or stress, which further leads to serious psychological conditions. So, it is suggested to avoid stigmatizing mental health or mental health professionals and seek help whenever needed ( Yang, 2007 ).
• 15. Good Social Support. Studies reveal that people who have good social support are less likely to have any psychological disorders. People with good social networking will have less or no depression, suicidal thoughts, or suicidal risk in the future ( Duan & Zhu, 2020 ). So, it is important to have good social support during this pandemic situation and to stay connected with family or friends through various online mediums.

Specific coping techniques

Besides the above-mentioned general coping strategies, which are suggested for everyone irrespective of any sociodemographic differences to cope up with a stressful life, there are certain coping techniques that are being followed by people belonging to specific age, gender, and community.

• • Age Specific Coping. People of different age groups face different levels of stress, and hence, their coping techniques are different as well ( Paykel, 1983 ). Cognitive behavior therapy seems to help in reducing PTSD, stress, depression, and anxiety among youth during periods of crisis and improves resilience ( Chen et al., 2014 ) whereas, avoidant coping seems to escalate PTSD ( McGregor et al., 2015 ). Youth also seem to apply approach coping and habitual coping styles ( Steiner et al., 2002 ); active coping followed by social coping and avoidant coping style (Brown et al., 2015). Further studies revealed that older adults seem to prefer problem-focused coping in terms of stressful events ( Chen et al., 2017 ); proactive coping ( Pearman et al., 2021 ); adaptive and active strategies of coping ( Kuria, 2012 ).
• • Gender Specific Coping. Several studies have reported gender-differences in terms of coping strategies ( Matud, 2004 ; Ptacek et al., 1994 ). Men seem to resort to approach coping style (Gan et al., 2009), problem-focused approach ( Sinha & Latha, 2018 ; Tolor & Fehon, 1987 ), rational, detachment and rumination coping style ( Matud, 2004) , and cognitive hardiness ( Beasley et al., 2003 ), whereas women are found to use emotion-focused coping style ( Loukzadeh & Mazloom Bafrooi, 2013 ; Manna et al., 2007 ), avoidance coping style followed by approach coping style ( Gan et al., 2009 ), planned-breather leisure coping method ( Tsaur & Tang, 2012 ), active coping strategies ( Lin, 2016 ), and social support ( Linnabery et al., 2014 ).
• • Community Specific Coping. There are variations in the use of coping strategies based on community and racial differences. White Americans are found to use approach behavior coping style, whereas African-Americans are more likely to use avoidance cognitive coping style ( Anshel et al., 2009 ). Similarly, African-American young adults were found to resort to avoidance coping style in comparison to White young adults, who prefer problem-focused coping ( Van Gundy et al., 2015 ). White women seem to use a self-directing coping style, whereas African-American women more often use religious coping ( Ark et al., 2006 ).

COVID-19 is the new face of the pandemic, and it has put the whole world into a pause. It has become a threat to the entire civilization. The COVID-19 pandemic not only affects physical health but also severely affects the mental health of people, whether infected or not. Nationwide lockdowns, social isolation, and restricted mobility have increased the prevalence of mental health problems, and people all over the world are suffering from loneliness, feelings of helplessness, hopelessness, anxiety, stress, and adjustment disorder. Not only these, dependency on social media and alcohol and other psychoactive substances has increased, which further raises the incidents of domestic violence or intimate partner violence. So, healthcare providers should give attention to both physical and psychological well-being of the people. Hence, it is the need of the hour to follow all the physical measures suggested by the healthcare professionals to prevent COVID-19, along with practicing psycho-social coping strategies for better quality of life and overall sound health and well-being of the individual.

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

Tatini Ghosh https://orcid.org/0000-0002-7221-9381

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Trusted Health Information from the National Institutes of Health

4 strategies for coping with pandemic stress

Find ways to support your family and yourself.

Exercise helps your body release mood-boosting endorphins.

  Joshua Gordon, M.D., Ph.D.

"We've been emphasizing all along the need to take care of yourself physically, meaning eat right and sleep right," says Joshua Gordon, M.D., Ph.D., director of the National Institute of Mental Health. Just as important is supporting your mental health, he says. These strategies can be helpful even when the pandemic is over.

Here are some ways to promote mental wellness:

• Make time for movement: Take a walk or join an outdoor exercise or online dance class. Exercise helps your body release mood-boosting endorphins and connect you to others safely. Make sure to follow Centers for Disease Control and Prevention guidelines for your activities to keep yourself and others safe.
• Get mental rest: Just as you need to get enough sleep, you also need mental rest to recharge your body. Try a new hobby or do something creative to give your mind a break from work and other stressors. 
• Set goals: It can be hard to feel motivated during extended social isolation. Set smaller, achievable goals to help keep you focused and feel accomplished. For example, agree to read one book a month, take a walk twice a week, or cook dinner at home for a full week.
• Seek out a professional: For people with new or existing mental health concerns that are getting in the way of your daily life, reach out to a health care provider. "It's important to recognize that when you're having such anxiety and depressive symptoms that you're having trouble working, caring for your children, or functioning every day, that's the time when you need to reach out to those around you and seek help," Dr. Gordon notes.  

July 20, 2021

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COVID-19: Stress and Anxiety

[Additional essays and videocasts regarding psychological ramifications of the COVID-19 virus outbreak can be found at: https://communitiescollaborating.com/[

The COVID-19 virus knows all about the human psyche. The virus is aware that we experience stress and become anxious when we keep a distance from other people and are forced to isolate ourselves from direct, physical contact with the people we love and cherish. Under conditons of stress and as we become more anxious, our vulnerability also increases — leaving us even more anxious. A vicious cycle . . . and a cycle that we need to stop!!

This essay includes material prepared by members of the Global Psychology Task Force–a group of experienced professional psychologists from around the world who have come together to address the psychological ramifications of the COVID-19 virus. They have prepared a website (www.communities collaborating.com)  that incorporates essays, video clips and links to other references that address these ramifications. This essay is derived from the content of this website.

Stress Ruts, Lions and Lumens

We start with a brief video presentation by Dr. William Bergquist, a member of the Global Psychology Task Force. He has titled his presentation: “Stress Ruts, Lions and Lumens in the Age of the Pandemic”:

Reducing the Stress and Anxiety

This essay concerns the way to reduce the stress and anxiety. In addressing this psychological dynamic we turn to both the anxiety aroused by those who have tested positive for the virus and those who have not been tested or have been tested and are negative but still worry about the physical and psychological health of other people in their life, as well as their own economic health and the economic and societal health of their community and country.

https://www.vox.com/identities/2020/3/21/21188362/manage-anxiety-pandemic

We turn now to someone who have been infected by COVID-19

Managing the Anxiety as Someone Who Has Been Infected

The anxiety associated with any major illness is quite understandable and is not in any way a sign of weakness. There are many ways in which to address this anxiety–such as looking to loved ones for support (even if they can’t be physically present), reducing other sources of stress in one’s life, identifying daily plans for dealing with the virus–and most importantly taking actions that enable you to feel less powerless and victimized.

It is perhaps best to turn from these general recommendations to the insights offered by someone who has been infected and struggled for a lengthy period of time with the infestation and related fever and isolation. This person is Dr. Suzanne Brennen-Nathan, one or our Global Psychology Task Force members. Suzanne is a highly experienced psychotherapist who has specialized in the treatment of trauma in her clinical practice. Who better to reflect on the illness and offer recommendations then someone “who has been there” and has expertise in the traumatizing impact of a major illness like COVID-19. Suzanne has been interviewed by Dr. William Bergquist, another member of the Task Force:

Managing the Anxiety as Someone Who Hasn’t Been Tested or Is Negative But Still Fearful

What about those of us who have not tested positive for COVID-19 or have not been tested at all. At the heart of the matter in facing the challenges associated with the COVID-19 virus — whether these challenges be financial, vocational or family related–is the stress that inevitably is induced when we think about, feel about and take action about the virus’ threatening nature.

We therefore begin this statement about action to be taken with an excellent presentation by one of our task force members, Christy Lewis:

https://youtu.be/1JL9oknNqVk

To begin a cross-cultural reflection on the psychological ramifications of the COVID-19 virus, we offer an essay on the way in which one of our Task Force members, Eliza Wong, Psy.D., works with highly anxious clients in her home country: Singapore.

Dealing with Anxiety during COVID-19 in Singapore

We hope these perspectives on stress and anxiety in the age of the COVID-19 virus invasion provides some guidance for you in better understanding the psychological impact of the virus and identifying actions you can take to help ameliorate this impact.

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Am I coping well during the pandemic?

Professor of Psychology, The University of Melbourne

Disclosure statement

Nick Haslam receives funding from the Australian Research Council.

University of Melbourne provides funding as a founding partner of The Conversation AU.

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The pandemic has posed unprecedented challenges. Many of us have lost work, gained carer responsibilities and grappled with social isolation. Experts have warned of a looming wave of mental illness as a result.

Research suggests they’re largely correct. Surveys in Australia , the UK and the USA point to rates of depression, anxiety and suicidal thinking substantially higher than in previous years.

But over time, people have changed how they have responded to the threat of COVID-19. Google searches have shifted from the harm of the pandemic itself to ways of dealing with it, such as exercising and learning new skills.

This pivot points to a new focus on coping with COVID-19.

Many ways of coping

Coping is the process of responding effectively to problems and challenges. To cope well is to respond to the threat in ways that minimise its damaging impact.

Coping can involve many different strategies and it’s likely you have your own preferred ones. These strategies can be classified in many ways, but a key distinction is between problem-focused and emotion-focused strategies.

What’s the difference?

Problem-focused coping involves actively engaging with the outside world. This might mean making action plans, seeking further information about a threat, or confronting an adversary.

Emotion-focused coping, in contrast, is directed inward, attempting to change how we respond emotionally to stressful events and conditions, rather than to change them at their source.

Effective emotion-focused strategies include meditation, humour and reappraising difficulties to find benefits.

Less effective emotion-focused strategies include seeking distractions, denial and substance use. Although these tactics may stave off distress in the short term, they neither address its causes nor prevent its longer term effects.

Which is best?

Neither of these coping strategies is intrinsically more or less effective than the other. Both can be effective for different kinds of challenges.

Problem-focused strategies are said to work best when we can control the problem.

However, when we face an immovable challenge, it can be better to adjust our response to it using emotion-focused strategies, rather than battling fruitlessly against it.

Coping strategies during the pandemic

Physical activity and experiencing nature can offer some protection from depression during the pandemic. One study even points to the benefits of birdwatching .

But there’s more evidence around coping strategies to avoid. Rising levels of substance use during the pandemic are associated with greater distress.

Eating too many snacks and accessing too much COVID-related media have also been linked to higher levels of stress and depression. So these should be consumed in moderation.

How can I tell if I’m not coping well?

We should be able to assess how well we are coping with the pandemic by judging how we’re going compared to our previous normal.

Think of yourself this time last year. Are you drinking more, sleeping poorly or experiencing fewer positive emotions and more negative emotions now?

If the answer to any of these questions is “yes”, then compared to your previous normal, your coping may not been as good as it could be. But before you judge your coping critically, it’s worth considering a few things.

Your coping is relative to your challenge

The pandemic may be shared, but its impacts have been unequal.

If you live alone, are a caregiver or have lost work, the pandemic has been a larger threat for you than for many others. If you’ve suffered more distress than others, or more than you did last year, it doesn’t mean you have coped less well — you may have just had more to cope with.

Read more: Your coping and resilience strategies might need to shift as the COVID-19 crisis continues

Negative emotions can be appropriate

Experiencing some anxiety in the face of a threat like COVID-19 is justified. Experiencing sadness at separation from loved ones under lockdown is also inevitable. Suffering does not mean maladjustment.

In fact, unpleasant emotions draw our attention to problems and motivate us to tackle them, rather than just being signs of mental fragility or not coping.

We should, of course, be vigilant for serious problems, such as thoughts of self-harm, but we should also avoid pathologising ordinary distress. Not all distress is a symptom of a mental health problem.

Read more: 7 mental health coping tips for life in the time of COVID-19

Coping isn’t just about emotions anyway

Coping isn’t all about how we feel. It’s also about action and finding a sense of meaning and purpose in life, despite our distress. Perhaps if we’ve sustained our relationships and done our jobs passably during the pandemic, we have coped well enough, even if we have sometimes been miserable.

Read more: 7 science-based strategies to cope with coronavirus anxiety

Coping with COVID-19 has been an uneven contest

Social distancing and lockdowns have left us with a reduced coping repertoire. Seeking emotional and practical support from others, also known as “social coping”, is made more difficult by pandemic restrictions. Without our usual supports, many of us have had to cope with one arm tied behind our backs.

So remember to cut yourself some slack. For most people, the pandemic has been a unique challenge. When judging how well we’ve coped we should practise self-compassion . Let’s not make things worse by criticising ourselves for failing to cope better.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

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• Published: 15 July 2021

How have people been coping during the COVID-19 pandemic? Patterns and predictors of coping strategies amongst 26,016 UK adults

• Meg Fluharty 1 &
• Daisy Fancourt 1  

BMC Psychology volume  9 , Article number:  107 ( 2021 ) Cite this article

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Individuals face increased psychological distress during the COVID-19 pandemic. However, it’s unknown whether choice of coping styles are influenced by COVID-19 in addition to known predictors.

Data from 26,016 UK adults in the UCL COVID-19 Social Study were analysed from 12/4/2020 15/5/2020. Regression models were used to identify predictors of coping styles (problem-focused, emotion-focused, avoidant, and socially-supported): model 1 included sociodemographic variables, model 2 additionally included psychosocial factors, and model 3 further included experience of COVID-19 specific adverse worries or events.

Sociodemographic and psychosocial predictors of coping align with usual predictors of coping styles not occurring during a pandemic. However, even when controlling for the wide range of these previously known predictors specific adversities were associated with use of specific strategies. Experience of worries about finances, basic needs, and events related to Covid-19 were associated with a range of strategies, while experience of financial adversities was associated with problem-focused, emotion-focused and avoidant coping. There were no associations between coping styles and experiencing challenges in meeting basic needs, but Covid-19 related adversities were associated with a lower use of socially-supported coping.

Conclusions

This paper demonstrates that there are not only demographic and social predictors of coping styles during the COVID-19 pandemic, but specific adversities are related to the ways that adults cope. Furthermore, this study identifies groups at risk of more avoidant coping mechanisms which may be targeted for supportive interventions.

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The coronavirus (COVID-19) pandemic has had diverse negative psychological effects globally. Individuals have experienced a wide range of adversities due to the virus, including those relating to the virus itself (such as experiencing illness oneself, concerns for friends and family, and bereavement), financial adversities (including loss of work or income, and inability to pay bills), and challenges in meeting basic needs (such as accessing sufficient food, medicine, and safe accommodation) [ 1 ]. Recent research has highlighted substantial increases in mental illness and loneliness during the COVID-19 pandemic [ 2 , 3 ]. Whilst some of these experiences reflect those reported during previous pandemics [ 4 ], COVID-19 is causing greater concern due to the global scale, heavy lockdown measures implemented, and long time scale predicted [ 5 ].

As a large proportion of the global population has experienced some form of psychological distress during the pandemic, there have been calls for more research exploring factors that help to buffer against or exacerbate experiences [ 6 ]. This is particularly important given there are projected long-lasting effects of the COVID-19 pandemic alongside limited mental health resources available [ 7 ]. However, there were inequalities in those who were more likely to be negatively affected by pandemic-related stressors, with certain groups including younger adults, women, people from Black Asian Minority Ethic (BAME) groups, and people living alone experiencing poor mental health [ 4 ]. Differences in mental health responses are likely be influenced by differences in individuals’ use of various coping strategies. Therefore understanding coping strategies could help to identify the social and personal resources required by individuals to mitigate psychological stress as COVID-19 continues, and in future pandemics.

Coping is broadly defined as the conscious or unconscious cognitive and behavioural strategies an individual employs to manage stress [ 8 , 9 ]. Numerous coping strategies have been identified, including self-distraction, active coping, denial, substance use, use of emotional support, use of informational support, and behavioural changes. These different coping strategies are often categorised into different groups. For example, 'approach' strategies typically focus on the stressor and one’s actions towards it (e.g. seeking emotional support or planning to resolve and reduce stressors)[ 10 ], while by contrast, 'avoidant' strategies seek to avoid the stressor and ones reaction to it (e.g. withdrawing from others, substance use, and denying the reality of the stressor) [ 11 , 12 ]. Additional groupings of focus on whether activities are 'emotion-focused' (aiming to manage emotional distress; e.g. denial, venting, emotional support) or 'problem-focused' (efforts to modify the problem at hand; e.g. informational support, active coping) [ 13 ]. There is much debate as to whether certain strategies are more beneficial than others. For example, avoidance strategies may be helpful in reducing short term stress, but are generally considered harmful from the perspective of physical well-being as no direct actions are taken to reduce the stressor, leaving the individual to feel helpless or self-blaming [ 11 , 14 , 15 , 16 , 17 ].

Previous studies have identified a range of predictors for coping style choice. Evidence suggests lower SEP is associated with greater use of avoidant strategies. These individuals have increased likelihood of exposure to stressors across the life course and may have less efficient coping strategies as a result of the social resources needed to combat stressors as well as less access to social support [ 18 ]. Personality type may influence coping strategy choice indirectly (influencing severity of stressors and effectiveness of coping) or directly by facilitating how individuals engage or disengage with threats and stressors (e.g. threat sensitivity in neurotic individuals may result in disengagement, while highly social extraverts may seek more supportive coping) [ 19 , 20 ]. Furthermore, the way individuals react to stressors can have long term health effects [ 21 , 22 ]. Avoidance strategies are typically at the core of depression and anxiety [ 23 ], which is why the most effective therapies (i.e. cognitive-behavioural therapy) focus on cognitive reappraisal and problem solving responses [ 24 ]. For example when faced with a traumatic event, adoption of avoidant strategies are associated with later mental health problems. This is particularly pertinent when considering individuals’ psychological responses to adversities during the COVID-19 pandemic as it is possible that coping strategies may be influenced solely by existing traits. However, it is also possible that the unusual and adverse circumstances of the pandemic may affect individuals’ coping resources and alter usual psychological responses [ 25 ]. It is vital to understand these patterns and predictors of coping strategies in order to identify who is most at need of additional psychological support.

Therefore, this study examined predictors of coping strategies amongst adults during the COVID-19 pandemic. Specifically, we explored (i) whether sociodemographic predictors of coping strategies align with usual predictors not during a pandemic, (ii) whether psychosocial factors including individuals’ roles during the pandemic, their living situation and their health status affected their use of coping strategies, and (iii) whether specific adverse experiences during the pandemic predisposed individuals to using more avoidant coping strategies above and beyond trait sociodemographic and psychosocial factors.

Participants

Data were drawn from the COVID-19 Social Study; a large panel study of the psychological and social experiences of over 70,000 adults (aged 18 +) in the United Kingdom (UK) during the COVID-19 pandemic. The study commenced on 21st March 2020 and involves online weekly data collection from participants for the duration of the COVID-19 pandemic in the UK. The study is not random and therefore is not representative of the UK population. But it does contain a well-stratified sample that was recruited using three primary approaches. First, snowballing was used, including promoting the study through existing networks and mailing lists (including large databases of adults who had previously consented to be involved in health research across the UK (e.g. UCL BioResource and Health Wise Wales), print and digital media coverage, and social media. Second, more targeted recruitment was undertaken focusing on (i) individuals from a low-income background (recruitment via via Find Out Now, SEO Works, FieldworkHub, and Optimal Worskhop, (ii) individuals with no or few educational qualifications, and (iii) individuals who were unemployed. Third, the study was promoted via partnerships with third sector organisations to vulnerable groups (e.g. UKRI MARCH Mental Health Research Network), including adults with pre-existing mental health conditions, older adults, carers, and people experiencing domestic violence or abuse.

Questions on coping were asked during a week-long module that was introduced in week 8 of the study 09th to 15th May. A total of 29,882 participants completed these questions in addition to all completing a detailed questionnaire on baseline sociodemographic factors and weekly data on experiences during COVID-19 during the period from 21st March until 15th May. Those who responded 'prefer not to say' to gender (0.43%) and income (9.4%) variables were set to missing, and we excluded participants who were missing data across any of the predictor variables (n = 3,302). An additional 390 participants were excluded as they did not have a baseline wave used to derive survey weights (although took part in the demographic part of the survey at later waves), which left a total complete case analytical sample size of 26,016 (Additional file 1 : Table S1).

Coping strategies

Coping was assessed by asking ‘how have you been coping during lockdown’ and measured using the 28-item brief-COPE questionnaire; a short version of the original 60-item scale. This scale determines primary coping styles as either approach or avoidant and covers the following domains of coping: self-distraction, active coping, denial, substance use, use of emotional support, use of instrumental support, behavioural disengagement, venting, positive reframing, planning, humour, acceptance, religion, & self-blame [ 26 , 27 ]. In line with previous research, we used a previously-derived 4 factor model for our analyses: problem focused coping (active coping, planning), emotion focused coping (positive reframing, acceptance, humour, religion) avoidant coping (behavioural disengagement, denial, substance use), and socially supported coping (emotional support, instrumental support, and venting) [ 28 ].

Sociodemographic predictors

Six sociodemographic predictors were collected at baseline interview: (1) gender (male vs female), (2) age group were chosen to represent younger, middle, and older ages (18–29 vs 30–59 vs 60 +), (3) ethnicity (white vs BAME), (4) educational attainment (General Certificate of Secondary Education (GCSE) or lower (qualifications at age 16) vs A-Levels or vocational training (qualifications at age 18) vs undergraduate degree vs postgraduate degree), (5) low household income (< £30,000 per annum vs ≥ £30,000 per annum), and (6) employment status (employed vs student vs inactive vs unemployed).

Psychosocial predictors

Eight psychosocial predictors were collected at baseline interview: (1) area of dwelling (urban vs rural), (2) living status (alone vs not alone with children vs with others no children), (3) household overcrowding (alone vs with others-not overcrowded vs with others- overcrowded), (4) keyworker status was derived from responses to the question 'Are you currently fulfilling any of the government’s identified 'keyworker' roles?' (keyworker vs non-keyworker), (5) mental health condition (reports of a diagnosis vs none), (6) long term/pre-existing physical health condition or disability (reports of a diagnosis vs none), (7) number of close friends (continuous 1–10 +), (8) Social support was measured using an adapted version of the six-item short form of Perceived Social Support Questionnaire (F-SozU K-6) [ 29 , 30 ]. Each item was rated on a 5-point scale from “not true at all” to “very true”, with higher scores indicating higher levels of perceived social support. Minor adaptations were made to the language in the scale to make it relevant to experiences during COVID-19 (see Additional file 1 : Table S2 for a comparison of changes).

Two psychosocial predictors were asked as repeated questions each week and responses for this analysis were taken from week 8 of the study: [ 9 ] personality was measured using the Big Five Inventory (BFI-2), which measures five domains and 15 facets: Extraversion (sociability, assertiveness, and energy level), Agreeableness (compassion, respectfulness, and trust), Conscientiousness (organisation, productiveness, and responsibility), Nervousness (anxiety, depression, and emotional volatility), and Openness (intellectual curiosity, aesthetic sensitivity, and creative imagination) [ 31 ]. Each item uses a 5-point scale ranging from “strongly disagree” to “strongly agree”, with higher score indicating greater levels of each domain. Finally, [ 10 ] Loneliness was measured using the 3-item UCLA-3 loneliness, a short form of the Revised UCLA Loneliness Scale (UCLA-R) [ 32 ]. Each item was rated with a 4-point rating scale, ranging from “never” to “always”, with higher score indicating greater loneliness, scores were averaged across each week.

Adversity predictors

Repeated questions each week assessed participants’ experience of adversities and responses for this analysis were taken from week 8 of the study: (1) Covid-19 status (positive/suspected vs none); (2) experience of one of a number of specific adversities including financial adversities (yes to any of the following: whether participants had lost their job or been unable to work, their partner had lost their job or was unable to work, or they had experienced a major cut in household income), challenges meeting basic needs (yes to any of the following: whether participants had lost their accommodation, they had been unable to access sufficient food, or they had been unable to access required medication), and virus related adversities (yes to any of the following: whether in the past week the participant had suspected or diagnosed COVID-19, somebody close to them was hospitalised, or they had lost somebody close to them) [ 33 ]; and (3) adversity worries were captured from two questions that asked participants to select which of a list of items had caused them major stress in the past week financial stressors (yes to any of the following: losing your job/unemployment), stressors relating to meeting basic needs (yes to any of the following: your own safety/security, getting food, and getting medication), and stressors relating to the virus (catching or becoming seriously ill from COVID-19) [ 34 ].

We used fixed-effects ordinary least squares regression models to identify predictors of coping styles. 3 additive models were applied to each of the coping styles in a forward stepwise selection. Model 1 included sociodemographic variables, Model 2 additionally included psychosocial factors (Model 2), and Model 3 additionally included experience of specific adverse worries or events.

Complete model specifications are as follows:

Model 1 : [coping style ~ sociodemographic predictors]

Model 2 : [coping style ~ sociodemographic + psychosocial predictors]

Model 3 : [coping style ~ gender + sociodemographic + psychosocial + adversity predictors]

To account for the non-random nature of the sample, data were weighted to the proportions of age group, gender and educational level on the basis of Office for National Statistics (ONS) population estimates [ 35 ]. A cross-sectional weight variable was created for all participants at baseline using the Stata user-written command ‘ebalence’ [ 36 ]. All analyses were carried out in Stata version 16.0 (Statacorps, Texas).

Characteristics of the study sample (both unweighted and weighted samples) are shown in Table 1 . 51% of participants in the weighted sample were female, 91% were of white ethnicity, 45% aged 30–49, and 60% were in full time employment.

The use of problem-focused coping in the sample range from − 0.75 to 1.38 (M =:  0.01, SD = 0.50) with skewness of 0.25 and kurtosis of 2.57, Use of emotion-focused coping ranged from − 1.45 to 1.59 (M = 0.00, SD = 0.66) with skewness of 0.14 and kurtosis of 2.77. Use of avoidant coping ranged from -0.45 to 1.48 (M = 0.08, SD = 0.53) with skewness of 0.98 and kurtosis of 3.20, while use of socially supported coping ranged from -0.91 to 1.71 (M = -0.01, SD = 0.67) with skewness of 0.37 and kurtosis of 2.53.

Women were more likely to use all coping strategies than men (Table 2 [Model 1]). Older adults were less likely to use avoidant and socially supported coping strategies. There were no associations observed for coping strategy by ethnicity. Higher educational attainment was associated with more use of problem-focused, emotion focused, and socially supportive strategies. People who were ‘inactive’ in terms of employment (i.e. retired or home-makers) were less likely to use problem or emotion-focused coping. In terms of SEP, lower SEP (indicated by not owning a home and having lower household income) was associated with greater use of disengagement strategies, while low income was also associated with less use of active and supportive strategies.

Even when controlling for sociodemographic predictors, individuals living in over-crowded households were more likely to use avoidant strategies, whilst individuals living alone were more likely to use a range of coping strategies (Table 3 [Model 2]; full results available in Additional file 1 : Table S3). Individuals living in rural areas were less likely to draw on avoidant or support strategies. Individuals who were lonely were more likely to use a rage of coping strategies, as were those with social support although this was protective against avoidant coping. Keyworkers were less likely to use problem-focused or emotion-focused coping strategies. People with a diagnosed mental health condition were more likely to use avoidant coping and supportive coping, while those with a health condition used supporting strategies. All personality types were generally associated with greater use of all strategies, with the exception, and conscientiousness being associated with lower levels of support, and avoidant, strategies.

Specific events and worries

Even when controlling for the wide range of sociodemographic and psychosocial factors in models 1 and 2, specific adversities were associated with use of specific strategies (Table 4 [Model 3]; full results available in Additional file 1 : Table S4). Experience of worries about finances, basic needs, and events related to Covid-19 were associated with a range of strategies, while experience of financial adversities was associated with problem-focused, emotion-focused and avoidant coping. There were no associations between coping styles and experiencing challenges in meeting basic needs, but Covid-19 related adversities were associated with a lower use of socially-supported coping.

Unweighted analyses for all models are provided in Additional file 1 : Tables S5–S7.

This study explored predictors of coping strategies during the COVID-19 pandemic. Active coping strategies were more common amongst women, older adults, people with higher educational attainment, people who were employed, people with higher income, but was less strongly predicted by psychosocial factors.

Problem-focused and emotion-focused coping strategies were more common amongst women, people with higher educational attainment, and those in school, but less strongly predicted by psychosocial factors. Supportive coping strategies were similarly more common in women, and people with higher education but also amongst younger adults and people with higher income. People living with others were more likely to draw on support strategies, as were people who lonely, who lived in urban areas, and who had a diagnosed mental health condition. Avoidant coping strategies were used more by women, younger adults, and people of lower educational attainment and lower socio-economic position, as well as people living with others, and people with mental health conditions and people who were more lonely.

The demographic predictors of coping including gender [ 37 , 38 ] and age [ 39 , 40 ], and age align with usual predictors of coping styles not occurring during a pandemic. For example, women scored higher on a range of coping styles compared to men [ 37 ]. Older adults were less likely to use lower engagement avoidant and socially supported strategies, which may result from accumulated experience with stressors leading to the adoption of more pro-active approaches [ 39 , 40 ]. Further, there were no apparent differences in coping styles depending on ethnicity. This slightly contrasts with previous studies, which have suggested that individuals from BAME groups are more likely to use alternative coping styles such as religion [ 38 , 41 , 42 ]. But as religion was incorporated within emotion focused coping, this finding may have been obscured. Socioeconomic predictors of coping strategies echoed previous studies, with disadvantaged groups more likely to use avoidant coping strategies [ 18 , 43 ]. Therefore, this study found that the usual demographic predictors of coping strategies were preserved during the COVID-19 pandemic, suggesting that individual’s traits and socio-economic circumstances are at least partly responsible for differences in management of stressors during the pandemic.

However, over and above trait demographic factors, a number of psychosocial factors were also found to influence use of coping strategies. Diagnosed mental health conditions were associated with a heightened use of avoidant coping strategies, echoing previous studies [ 22 , 23 , 25 ]. Although, we also found evidence that people with depression and anxiety turned to supportive coping during the pandemic. This could have been as a direct result of schemes such as Mutual Aid groups, which explicitly tried to support individuals with mental health problems, and a heightened awareness of supporting mental wellbeing during the pandemic. Our findings that keyworkers made less use of problem and emotion-focused coping strategies go against previous research, which suggests that workers in areas such as nursing employ active coping to maintain psychological health and resilience [ 44 , 45 ] However, one potential explanation for this divergence is that a number of keyworkers in the current study unexpectedly found themselves in critical roles (e.g. supermarket employees, delivery and transportation drivers) and lacked previous training or experience in developing specific supportive emotion regulation responses unlike medical professionals, who have been the focus of much of the previous research on coping strategies [ 46 , 47 ]. Our research mirrors previous work showing that overcrowded living is associated with increased avoidant coping strategies [ 48 ]. Additionally, one study of living alone during the pandemic found an increase in substance use coping, although this study did not examine other methods beyond substance use [ 49 ]. With regards to loneliness, increased loneliness in our study was associated with a range of coping styles, which is also supported by previous evidence [ 50 ]. But social support as a coping predictor outside clinical populations [ 51 , 52 ] has not typically been examined. Here we found it associated with decreased avoidant coping, but further research is needed to understand whether this relationship is an artefact of the COVID-19 context or a more general indicator of social predictors of coping styles.

What is most notable, however, is that certain specific events related to the Covid-19 pandemic were also associated with the use of different coping strategies, even after adjusting for sociodemographic factors, and psychosocial characteristics. The finding that events involving Covid-19 adversities were associated with less socially supported strategies, while worries about these events were associated with a range of coping strategies. This suggests that individuals’ have a more positive outlook of how they envision handling certain situations versus the trauma of actually experiencing them. This is supported by previous research showing that people respond more positively in their coping styles to hypothetical situations than to situations for which they have prior experience (such as bullying). The decreased probability of using socially supported coping strategies could underlie the relationship being reported between worries and adversities relating to the virus during the pandemic and poorer levels of depression and anxiety shown in other research [ 34 ]. This is concerning because coping styles aimed at addressing the problems directly have been associated with positive affect and less association with negative affect, while avoidance styles display the opposite [ 53 ]. Coping styles are thought to initiate, modulate, and maintain affective responses, therefore avoidance coping is the least beneficial as it blocks attempts to address the stressors/problem and further blocks awareness that the situation may change. While this can be an effective short term strategy for distracting and resting from a stressor, prolonged reliance on avoidance coping may be harmful as the situation is not changed and individuals are engaging with the stressor for prolonged periods which in turn maintains negative affect [ 53 , 54 , 55 ].

This paper demonstrates that there are not only demographic and social predictors of coping styles during the COVID-19 pandemic, but specific adversities are related to the ways that adults cope. Whilst there are some concerning patterns suggesting that certain groups are at greater risk of using avoidant coping strategies, there is also evidence that individuals can change their coping strategies over time. So coping could be a target for interventions designed to improve mental health during the pandemic. Two approaches could be considered here. First, whilst changing demographic predictors is not a feasible intervention, it is possible that interventions targeting psychosocial factors or specific adversities could provide support. For example, supporting individuals in developing their social networks has been shown to help individuals engage with positive coping during the pandemic [ 56 ]. Second, previous studies have shown that techniques such as Cognitive Behavioural Therapy, stress management apps, and seeking social support can be used to increase adaptive coping strategies [ 23 , 57 , 58 ]. This shift has been found not just to change in-the-moment coping, but also to enhance psychosocial outcomes. For example, lonely individuals who learn more active coping strategies are able to reduce their loneliness [ 50 ]. Similarly, people with mental health problems have been found to experience a reduction in negative symptoms when shifting from avoidant to adaptive coping through the use of cognitive behavioural therapies [ 24 ]. This has been shown specifically for people in isolation too: improvements in mental health have been found for people in prison if they manage to adopt new coping strategies [ 59 , 60 ]. Given the evidence in this study of clear socio-demographic predictors of coping strategies, such interventions could be specifically targeted at individuals in more deprived areas, and those experiencing financial loss [ 61 ].

This study has a number of strengths including its large sample size, its longitudinal tracking of participants used to identify adversities and worries across the first 8 weeks of lockdown, and its rich inclusion of measures on psychological and social experiences during COVID-19. We measured coping using the brief-COPE, a large validated measure. Further, a large portion coping literature is centred around specific traumatic events (e.g. health diagnosis, war, or abuse) and therefore it’s difficult to determine general population versus specific event predictors. However, in our three models we separated out known trait predictors from COVID-19 specific predictors. However, there are several limitations. The study is not nationally representative, although it does have good stratification across all major socio-demographic groups and analyses were weighted on the basis of population estimates of core demographics. Whilst the recruitment strategy deliberately over-sampled from groups such as individuals those from a low-income background, individuals with no or few educational qualifications, and individuals who were unemployed, it is possible that more extreme experiences were not adequately captured. Coping was only measured at one timepoint and therefore, we were not able to examine changes in coping strategy across time. Furthermore, it is possible that individuals experiencing highest levels of adversities including bereavement during the pandemic may have dropped out prior to week eight when the measures on coping were asked, or the sampling may have been selective towards individuals more likely to engage with positive coping strategies as undertaking a weekly questionnaire was arguably an approach-focused strategy. Nevertheless, we had good spread across possible responses for each of the measures included in the coping questionnaire and the sample remained heterogeneous.

Overall our study shows that a combination of trait demographic factors, psychosocial factors, and factors specific to experiences during the first UK lockdown in the COVID-19 pandemic predicted coping strategies. People most at risk of using avoidant coping strategies included those of lower socioeconomic position, with mental health conditions, higher rates of loneliness, and those experiencing COVID-19 related adverse events relating to finances and basic needs. This is noteworthy as the same groups have been identified as having poorer mental health experiences across this period, suggesting that one’s coping strategies could play an important role in how effectively individuals manage to cognitively and behaviourally manage stress during pandemics. It also highlights the importance of both providing specific support that will reduce individuals’ use of avoidant coping strategies such as digital or mutual aid [ 56 , 62 ], and supporting and educating individuals (in particular those most at risk of adverse mental health outcomes) in how to use supportive coping strategies. Such work will be important as the COVID-19 pandemic continues and in the future to help mitigate the adverse psychological effects of such events.

Availability of data and materials

The data was taken from the Covid-19 Social Study ( www.covidsocialstudy.org ), which is not currently open access (May 2021) but will be made available on a third-party archive following the end of the pandemic. Analytical code is available on Github: https://github.com/UCL-BSH/coping-predictors .

Abbreviations

Coronavirus

Black Asian Minority Ethic

Socioeconomic position

United Kingdom

General Certificate of Secondary Education

Perceived Social Support Questionnaire

Big Five Inventory

Office for National Statistics

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Acknowledgements

We are very grateful to all participants in the COVID-19 Social Study.

This Covid-19 Social Study was funded by the Nuffield Foundation [WEL/FR-000022583], but the views expressed are those of the authors and not necessarily the Foundation. The study was also supported by the MARCH Mental Health Network funded by the Cross-Disciplinary Mental Health Network Plus initiative supported by UK Research and Innovation [ES/S002588/1], and by the Wellcome Trust [221400/Z/20/Z]. DF was funded by the Wellcome Trust [205407/Z/16/Z]. The researchers are grateful for the support of a number of organisations with their recruitment efforts including: the UKRI Mental Health Networks, Find Out Now, UCL BioResource, SEO Works, FieldworkHub, and Optimal Workshop. The study was also supported by HealthWise Wales, the Health and Car Research Wales initiative, which is led by Cardiff University in collaboration with SAIL, Swansea University. The funders had no final role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. All researchers listed as authors are independent from the funders and all final decisions about the research were taken by the investigators and were unrestricted.

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MF and DF developed the study concept. MF performed the data analysis and drafted the manuscript. DF provided critical revisions. All authors read and approved the final manuscript.

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Meg Fluharty is a Research Fellow in Statistics & Epidemiology at The Department of Behavioural Science and Health, University College London.

Daisy Fancourt is an Associate Professor of Psychobiology & Epidemiology at The Department of Behavioural Science and Health, University College London.

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Additional file 1..

Provides demographic characterics (Table S1); comparison of origional and revised F-SozU K-6 Questionnaire (Table S2); full model results (Tables S3 & S4), and unweighted models (Tabled S5–S7).

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Fluharty, M., Fancourt, D. How have people been coping during the COVID-19 pandemic? Patterns and predictors of coping strategies amongst 26,016 UK adults. BMC Psychol 9 , 107 (2021). https://doi.org/10.1186/s40359-021-00603-9

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Coronavirus Disease 2019

7 ways to cope with covid-19, practical methods to reduce your stress today..

Posted April 2, 2020 | Reviewed by Ekua Hagan

• What Is Anxiety?
• Take our Generalized Anxiety Disorder Test
• Find a therapist to overcome anxiety

How do we keep anxiety , fear, and paranoia at manageable levels with a virus that has (at the time of this post) infected 905,279 individuals worldwide?

The battle seems like it is outside of your home against some microscopic enemy, but the struggle actually starts inside your mind. Anxiety steals away our joy and peace by consuming our focus and kicking our imaginations into overdrive. We begin to create worst-case scenarios in our mind, which is like making a down payment on horrifying misfortunes that will never occur.

Specifically, with COVID-19, individuals are struggling with disquieting thoughts, such as worrying about infecting loved ones, dwelling on possible death, and feeling concerned for vulnerable populations. COVID-19 is a fast-moving, ever-shifting precipitant of anxiety that can send us spiraling quickly.

Ideally, we want to identify our anxiety snowball while it is still small and forming, but we cannot always catch the bullet before it takes off. You might be sitting in your home or work environment, trying to quarantine and stay safe, when panic about COVID-19 abruptly hits you. This is fairly common. Like an inflated beach ball held underneath the water that is suddenly let loose, anxiety can explode to our mind’s main stage from seemingly out of nowhere. Luckily, there are tools and resources that help you learn to process anxiety with wisdom .

If you are feeling stressed or anxious, these seven ways of coping will help you manage your emotions. These coping strategies will not always feel natural, but they are science-driven pathways to becoming a healthier person. Ask yourself, “How is what I’m doing helping me get to where I want to go in life?”

Taking a hard look at our actions, thoughts, or emotions can be a difficult process. Yet, resisting or suppressing our emotions actually creates paradoxical outcomes, such as aggravating our fears instead of making them vanish. Thus, these coping strategies embrace and approach our stressors head-on to build resolve, grit, and resiliency. It is normal to find it difficult to be consistent when starting a new routine. Give yourself plenty of self-compassion because, when it comes to coping, the most important step you can take is always the next one.

Strategy #1: Assess the Four Pillars

Ensuring we have a rock-solid foundation for basic health needs is a must. These four pillars are the foundation for emotion regulation , and they are like the legs of a table. If the emotion -regulation table is unstable, then it is difficult to use other coping methods and build ourselves up. The four pillars consist of sleep hygiene , nutrition , staying physically active , and social support . Let us begin by simply reflecting on our emotion-regulation table’s stability.

• Do you maintain a regular sleep schedule and practice other healthy sleeping habits (e.g., using naps with care, limiting light exposure from LED screens before sleep)?
• Do you maintain a healthy balance of nutritious foods (e.g., vegetables, fruits, whole grains, healthy protein)?
• Are you able to exercise regularly (e.g., 150 minutes per week of moderate-intensity aerobic activity) and stay somewhat physically active during your day?
• Are you self-isolating from others? Are others perceiving you as emotionally withdrawn?

These questions assess our basic human needs and are good starting points for developing coping strategies. Moreover, with COVID-19 disrupting many people’s sense of normalcy, these assessment questions are particularly useful.

Strategy #2: Emotion-Based Coping

Here is the good news about emotions: Emotions are momentary. Emotions can rise up to be tidal waves, but they will pass. Emotion-based coping strategies help you stay upright through the emotional waves by matching your actions to your feelings.

1. When you are sad , melancholy , or depressed , try something slow and soothing like:

• Taking a hot bath while listening to soothing music
• Curling up under a blanket with a good book
• Practicing yoga
• Calling a friend to just talk about things you like

2. What if you are angry , frustrated , or restless? Then you can try:

• Cleaning your house
• Making Play-Doh models and smashing them
• Cranking up loud music and dancing
• Ripping up a photo or drawing of someone who is making you angry

3. When anxiety is gripping you, then you can try:

• Calling out your worries by saying them out loud
• Breathing and placing your hand on your heart to measure your heartbeat
• Discharging your tension with some laughter by watching a funny video
• Noticing the unhelpful, lifeless thoughts that do not give you vitality (e.g., "What will happen tomorrow?")

Strategy #3: Grounding

When we have intense emotional pain or overwhelming anxiety, grounding helps anchor us to the reality that is occurring in the present moment. In short, grounding provides distance between us and our negative feelings. Grounding can be broken down into mental, physical, and soothing strategies (Najavits, 2002).

1. Mental grounding could involve:

• Describing your environment in detail using all five senses (e.g., the walls are beige, the fan is whirring, the chair is firm)
• Playing a “categories” game (e.g., thinking of types of dogs, listing famous cities)
• Saying a safety statement out loud to yourself (e.g., My name is ____; I am safe right now. I am in the present, not the past. I am located in ____; the date is _____.)

2. Physical grounding might entail:

• Digging your feet into the floor
• Carrying a small object (e.g., rock, ring, cloth) to touch and focus on
• Running cool or warm water over your hands

3. Soothing grounding examples include:

• Putting up inspiring songs or quotes in your environment to act as reminders
• Thinking of things you are looking forward to next week
• Saying a coping statement (e.g., "I can handle this; this feeling will pass.")

To get the most out of grounding strategies, it is recommended that you try grounding for 20-30 minutes, practice often, and create your own methods of grounding. What is one creative way you could anchor yourself to reality?

Strategy #4: Deep Breathing

Deep breathing , also called diaphragmatic breathing, is a sure-fire method of managing your body’s response to anxiety and stress. Anxiety and stress attack your nervous system and send you into a “fight, flight, or freeze” response that wears down your body with a multitude of physical symptoms (e.g., shortness of breath, racing heart, trembling, dizziness, sweating).

To maintain control, Navy SEALs are trained in a method called box breathing because it helps them calm their minds and bodies when under stress. Box breathing entails inhaling slowly for four seconds, holding your lungs full of air for four seconds, exhaling for four seconds, and holding your lungs empty for four seconds. This GIF is one of many that helps with the timing of box breathing. If anxiety had a version of “stop, drop, and roll,” then the first action (or the “stop” action) of managing anxiety is to breathe. This method is simple yet effective in slowing down a stress response. It just takes practice.

Strategy #5: Mindfulness

Mindfulness boosts our immune system, increases positive emotions while reducing stress, and facilitates healthy relationships in couples and families. Mindfulness is a mental superpower of being mentally active, accepting, and open to the moment to moment process. In short, we tune in to what we are sensing, feeling, and thinking as it occurs in the present moment without giving it any judgments of “good” or “bad.”

Guided mindfulness meditations , mindful eating practices , and mindful walking are a few ways to strengthen this mental muscle. Other methods are already included in this post. Most fundamentally, all mindfulness practices have a three-step process of awareness, attention , and acceptance. Regarding anxiety with COVID-19, try noticing your thoughts without judgment, attuning to how these thoughts impact your being and breathing as they inevitably fade with time.

Strategy #6: Altruism

A plethora of research has consistently supported the notion that focusing efforts to help other people helps cultivate better emotional health. Given the COVID-19 precautions that limit contact, helping may look a little different, like calling to check in on a friend, sending encouraging texts, or sending uplifting videos to others.

Get creative! If you have a neighbor that is holed up alone, consider asking if they will download a social media app or ship them one end of a walkie-talkie so you can talk to each other while in your “forts.” Perhaps you are financially able to send care packages to other people, tip extra if you order delivery, or donate to charities .

Altruism reminds us of the good in humanity and why we prosper in a healthy community. Fred Rogers is often quoted saying, “When I was a boy, and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’”

Strategy #7: Understanding Our Problems

We need awareness and insight to start making changes in our lives. Regardless of our problems, we typically find four major elements that contribute significantly to the issue (Harris, 2009). Knowledge is power, and elaborating upon these four major elements gives us the insight we need to bring about change.

1. First, there is an entanglement with thoughts.

• What memories, worries, self-criticisms, or other unhelpful narratives do we dwell on?
• What thoughts do we allow to hold us back, push us around, or bring us down?

2. Second, what feelings are we struggling against?

• What are the emotions, urges, or sensations we are experiencing?
• What emotions are we ignoring, fighting, suppressing?

3. Third, what life-draining actions are we doing?

• What keeps us stuck, wastes our time or money, and drains our energy?

4. Fourth, what challenging situations are we avoiding?

• What have you quit, put off until later, or stayed away from?

You can begin to answer these questions by 1) writing out a short summary of the problem you are facing, and 2) describing how it affects your life, and what it stops you from doing or being. What problems have COVID-19 caused in your life? How do these problems keep you from being your best self?

COVID-19 is a furnace of strife that is forging “new normals” around the world. While there is space for genuine concern, we can also find ourselves spiraling in unhelpful thoughts and reverting to ways of coping that get us nowhere. These seven ways of coping will help you come out of this forging process as a new person. Where would you like to begin?

Written by David K. Mosher M.S., a doctoral candidate at the University of North Texas who is currently finishing his internship at the Texas Woman’s University counseling center. He studies positive psychology with specific foci in religion/ spirituality , humility, forgiveness , awe , and other virtues. He has earned awards for both scholarly works and teaching excellence during his graduate career , and he has published over 20 research articles in peer-reviewed journals.

Emmons, R. A., & Shelton, C. M. (2002). Gratitude and the science of positive psychology. Handbook of Positive Psychology , 18 , 459-471.

Harris, R. (2009). ACT made simple: A quick-start guide to ACT basics and beyond . Oakland, CA: New Harbinger.

Najavits, L. (2002). Seeking safety: A treatment manual for PTSD and substance abuse . New York, New York: Guilford Publications.

Jamie Aten , Ph.D. , is the founder and executive director of the Humanitarian Disaster Institute at Wheaton College.

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How to Ease Stress During the Coronavirus Pandemic

Like many, your anxiety level may be high right now. These expert tips can help you feel calmer.

We are a nation physically separated from each other but united by stress and worry when it comes to our health and that of loved ones. Every day, we head into battle, working to keep our homes stocked with food and other needed items, strategizing about money, and trying hard not to focus on the uncertain future.

Not surprisingly, many of us are also scared, frustrated, grieving, and quite likely, anxious.

In a nationally representative CR survey of 2,164 U.S. adults conducted between April 2 and 14, 76 percent of Americans said they were extremely or very concerned about the widespread transmission of COVID-19—the disease caused by the coronavirus—in the U.S. and an additional 17 percent were moderately concerned.

Also, in an American Psychiatric Association-sponsored survey of 1,004 American adults, taken in mid-March, 57 percent of people reported being worried about running out of supplies and 68 percent about the pandemic's long-term economic effects .

It may help to know that this anxiety so many of us are feeling is a response to stress, a situation we perceive as dangerous, challenging, or unfamiliar.

In an acutely stressful circumstance, like when a car is barreling toward you, your body goes into fight-or-flight mode, spurring you to quickly jump out of the way. This is thanks to a rapid increase in stress hormones like epinephrine and cortisol, which cause your heart rate to speed up and your breath to come faster, as your body prepares to react.

“Some stress response is normal,” says Dana Rose Garfin, Ph.D., assistant adjunct professor at the Sue & Bill Gross School of Nursing at the University of California at Irvine, who studies how negative health events and community disasters affect health. “It reminds you to be on guard leaving the house, to remember not to touch your face. You want that to kick in.”

But when stress is constant, as it is for many people right now, it can lead to constant activation of the fight or flight response, which in some people, can hike the risk of an anxiety disorder .

Both may cause shortness of breath, chest pain, heart palpitations , nagging worry about the future, agitation, restlessness, trouble sleeping , weight gain, and ruminating—rolling the same thoughts over in your mind repeatedly. These negative effects can be debilitating for anyone, but especially for those who already have a mental health issue like an anxiety disorder, who may experience them more intensely.

Though stress and anxiety may seem inescapable at the moment, all the experts we spoke with said you can take steps to reign them both in. "You can learn resilience,” says Shevaun D. Neupert, Ph.D., a psychology professor at North Carolina State University. But in the current situation, experts say, you may need to think slightly outside the box. “It’s important to recognize that our lives are very disrupted right now, and your tried-and-true coping strategies may not work. Be okay with that and look for new ones,” Neupert adds. Here, traditional strategies along with some newer actions that may help to relieve stress.

The Basics: Eating, Sleeping, Exercise

Getting enough sleep, exercising regularly, and eating a healthy diet can help you manage stress and reduce anxiety, and may help maintain a strong immune system . These goals may seem unreachable when you’re stressed out, but they don't have to be.

It’s easy right now to eat for emotional reasons, particularly if you’re prone to that, according to Joyce A. Corsica, Ph.D., director of outpatient psychotherapy and director of bariatric psychology at Rush University Medical Center in Chicago. Before you give in to a food craving, ask yourself whether you're really hungry or whether you're actually feeling frustrated, sad, empty, or lonely. Once you identify the feeling, it's easier to consider better choices, Corsica says. Here, other strategies for reinforcing healthy eating .

Whether you go to the gym regularly or like to walk, jog, or ride a bike outside, your exercise regimen has probably been disrupted, too. That means you’re probably not getting your usual stress-relieving dose of the feel-good neurotransmitters endorphins that exercise provides. But most areas still allow solitary outdoor walks and runs (as long as you socially distance), and today, there are more ways to exercise indoors than ever. And you may not need a whole lot of physical activity to improve your mood; even a 15-minute walk can make a difference.

And though it’s not surprising that stress can keep you from sleeping well, a lack of sleep and an abundance of stress can create a vicious cycle: lying in bed awake can lead you to ruminate even more, and those swirling thoughts can further keep you from dozing off.

Basic bedroom sleep hygiene —keeping the room cool and dark, staying off electronics before bed—is a good place to start. Some sleep apps may be helpful as well, by blocking out outside noise, for instance.

Breathe . . . Deeply

Stressed-out people tend to take quick, shallow breaths, which further exacerbates the fight-or-flight response.

Interrupting that cycle through a conscious effort to breathe slowly and deeply—aiming for five to six deep breaths per minute—just for a quarter-hour or so a day is a surprisingly effectively way to relieve feelings of anxiety and stress.

“Deep breathing slows down your physiological stress response,” Garfin says.

Corsica recommends diaphragmatic breathing, a form of slow, deep breathing that involves a purposeful expansion and contraction of the diaphragm and belly. A small study published in Frontiers in Psychology in 2017 found that people who engaged in 15 minutes of diaphragmatic breathing 20 times over 8 weeks showed improved attention and mood, and lower levels of the stress hormone cortisol, compared with a group who didn’t do the breathing sessions.

Want to try? The Cleveland Clinic is one source for online instruction in the technique . The University of Michigan’s Michigan Medicine provides video instruction .

Focus on the Short-Term

It's hard right now not to wonder how the pandemic will resolve, but thinking shorter-term has been found to be a more useful way to handle the stress, according to a study led by Neupert and published in the journal Personality and Individual Differences.

“My lab’s study found the best recipe for dealing with everyday stressors is to try to simultaneously plan ahead about what you can control and stay in the moment mindfully,” she says. “That means recognizing what’s going on in the present without trying to change it. That’s what we found was the best combination for resilience to stress.” These findings might be especially relevant now, she says. Mindfulness—which has been defined as staying focused on the present—has long been known to help reduce stress, and there are techniques you can use to get better at it, such as yoga (you can search for "yoga for anxiety" or "restorative yoga" online, and if you're new to yoga, here's how you can get started ) and meditation (the UCLA Mindful Awareness Research Center provides free online guided meditations ).

Mapping out and following a plan for the week or just the next day can also help, by giving you a better sense of control, experts say. Clinical and forensic psychologist Paula A. Madrid, Psy.D., of New York City, recommends creating a daily schedule of simple, reasonable actions to take: call a friend, try a new recipe, work in the garden. If you’re working from home, shower and dress, says UC Irvine's Garfin.

Look to a Positive Future

It may feel like we've all spent an eternity social distancing , but the pandemic will eventually end, Madrid points out. And while there’s no way to know what details of your life may change permanently, it’s fine to put your imagination to work in a positive way.

“Project your mind to the future, to a year or even a few months from now, to give you a sense of relief from the present,” Madrid says.

Planning a future winter vacation or figuring out the details of your next landmark anniversary party can remind you that there are happy activities to look forward to down the road.

Working on projects or skills that you can use after the pandemic—learning a language, taking an online knitting class, or reorganizing your home—may also be helpful, says Corsica: “Tasks that distract you in the here and now but also benefit you in the future are wonderful.”

Keep Up Key Connections

Whatever communities are most important to you—whether it’s your religious congregation, gym buddies, or book group—try to stay in touch.

You may not be going out, but technology today provides us with multiple ways to connect with other people. For instance, your gym or house of worship may be holding livestream or recorded sessions online. And you can “see” friends and family on your smartphone, tablet, or computer by using video conferencing services like Google Hangouts, Skype, or Zoom, many of which offer free versions (be aware, though, of potential privacy concerns ).

If you miss catching a favorite show with a friend, innovations like Google Chrome’s free Netflix Party extension let you share that experience long-distance, too. Playing online group games like Words with Friends can also help you feel connected. “Try to find whatever ways you feel comfortable with to stay socially connected,” says Neupert. “Reach out via phone, text, video conference when you find yourself missing a social connection or feeling lonely.” That said, you may feel you’re getting too much contact with others, especially if your family is large and your home is small. “You don’t usually spend this much time with anyone,” Garfin points out. Make sure to carve out private time for yourself, and let each member of your family do the same.

Limit Your Intake of News

Watching and reading endless news stories about the pandemic? Getting accurate information is crucial for well-being during quarantine, according to a review of research published online in February’s The Lancet. Having the right info about the real risks of contracting COVID-19 and the reasons for self-quarantining and social distancing can also help keep you from catastrophizing, experts say.

At the same time, too much information—even if it's correct—can be overwhelming. “Staying glued to the TV, watching the exact same press conference three times, is probably one of the worst things you could do,” Garfin says.

How much is too much? Madrid’s rule of thumb is “Do not watch the news more than an hour a day.”

And limit the number of media options to those that you really need. Stick with trusted, science-backed sources like the Centers for Disease Control and Prevention and news from your state or local government and health department sites, which can advise you on issues such as park closings or transit changes in your area. If you're frustrated by the ever-changing guidance and advice, know that it's normal in a new situation. As experts learn more about the coronavirus, you can expect guidance to change again.

iStock-1182830885 iStock-1182830885

Find a Way to Nature

Feeling a connection with nature has real, restorative effects on your sense of well-being and, according to a 2019 study from University of Michigan at Ann Arbor, even 20 minutes can measurably reduce levels of stress hormones.

That’s especially true if you can get a little exercise while you’re outside. “It’s helpful to take walks for mental and physical health within social distancing guidelines,” Garfin says.

But if you're stuck indoors, research suggests that soaking in a view of a natural setting—trees, a lawn, a garden—can reduce stress symptoms, as can exposure to household plants or herb gardens. Even sitting near a window that provides sunlight can help improve your sleep and quality of life, which in turn can ease feelings of anxiety. And a small 2015 study from the Netherlands found that gazing at photos of nature helped people recover from stressful events. No pictures of forests or fields on hand? Try a virtual tour of a national park or live cams of waterscapes .

Do Good to Feel Good

Hardship can be easier to bear when you feel it's for the good of the larger community, according to the authors of The Lancet review about quarantines.

Research also shows that giving to others in some way—whether it’s sewing masks, food shopping for an at-risk neighbor, or talking a not-so-tech-savvy friend through setting up FaceTime—can make you feel happier and less stressed, Neupert notes. (Here, a rundown of ways to help .) "And it’s a two-way street," she adds. "People you reach out to can benefit you, too."

Know When to Get Expert Help

Some of us may need, or simply want, more support in coping with anxiety or sadness.

Seek help right away if you've thought of harming yourself or others. If you don't have a mental health provider, call 911 or the National Suicide Prevention Lifeline at 800-273-8255, which offers free, confidential help.

For others, "if you realize that your thoughts, behaviors, or feelings are preventing you from feeling like you’re functioning or able to get through a day, that’s a sign to reach out,” says Neupert, including “if you’re having trouble getting out of bed, or you’ve lost interest in activities, or you feel really hopeless.”

Fortunately, finding counseling or a medication consult via phone or computer is far easier than it used to be. The American Psychiatric Association (APA) has been training its member doctors in telehealth, and regulations on telehealth have been temporarily relaxed.

If you have a therapist or psychiatrist, ask whether he or she can “see” you virtually (check your insurance coverage first). Many health insurers are also now offering telemedicine services , or your primary care provider may be able to recommend a mental healthcare provider who does virtual counseling.

Your local hospital may also have sliding scale mental health services, and some local health department websites offer contact information for social service resources. Companies, like Amwell and MDLive, offer telehealth psychiatry as well as psychological therapy . (Costs vary depending on insurance; out-of-pocket fees are usually less than $100.)

The National Alliance on Mental Illnes s has a long list of mental health resources, including hotlines and warmlines—for non-emergency situations. The APA has a resource list as well, along with advice for families of those who are struggling emotionally.

Additional reporting by Nadia Torres

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The Covid -19 pandemic has had a substantial impact on the lives of people around the world. It has disrupted work, education, health care, the economy, and relationships, with some groups more negatively effected than others, especially children and front-line workers.

Some people have benefited from changes like remote learning and work, while others face a mental health crisis.

Even as the pandemic wanes, there are still uncertainties. In addition, much remains unknown about the effects of long Covid .

Adapted from APA’s Stress in America survey and the Monitor on Psychology 2022 emerging trends report

Resources from APA

COVID-19 impacts on doctoral education

Research was affected, but psychology graduates had fewer disruptions than those in other fields

Antidepressant use during and after the COVID-19 pandemic

Use skyrocketed among teen girls and young women, but there was no such rise among teen boys and young men

Changes coming to psychology practice after COVID-19

Now that the covid -19 public health emergency has ended, psychologists should prepare for changes coming to telehealth practice

The reality of pediatric long COVID

Psychologists are playing an integral role in research and interventions to support children in their recovery

More resources about Covid -19

Crowds, obedience, and the psychology of group behavior, with Stephen Reicher, PhD

The challenge of long COVID, with Tracy Vannorsdall, PhD, and Rowena Ng, PhD

Ambiguous loss and the “myth of closure,” with Pauline Boss, PhD

Back to the office? The future of remote and hybrid work, with Tsedal Neeley, PhD

More podcasts about COVID-19

News from APA

Statewide pandemic restrictions not related to psychological distress

Exposure to Covid -19 a stronger predictor of distress than state restrictions six months after pandemic began

COVID-19 pandemic led to increase in loneliness around the world

People around the world experienced an increase in loneliness during the Covid -19 pandemic, which, although small, could have implications for people’s long-term mental and physical health, longevity, and well-being

People wrongly believe their friends will protect them from COVID-19

People may feel less vulnerable and take fewer safety precautions about Covid -19 when they are with, or even just think about, their friends instead of acquaintances or strangers

Coping with COVID-19 stress easier with a dose of humor

Funny memes may help people cope with the stress of the COVID-19 pandemic, making viewers feel calmer and more content

More news about COVID-19

COVID-19 resources for practitioners

Find the latest advocacy updates, reimbursement and licensing/regulatory guidance, and other information to help navigate the changing government, industry, and public responses to Covid -19.

Crisis hotlines and resources

Need to talk to someone? View this list of crisis hotlines offering confidential telephone counseling or search for a psychologist near you.

Continuing education

Prolonged Grief Disorder: An Integrated Multicultural Perspective

Discusses the diagnostic criteria for prolonged grief disorder, a framework of grief, how adaption to loss can be derailed, and the influence of the Covid -19 pandemic on the incidence of prolonged grief disorder.

Another Kind of Long Covid : The Psychosocial Impact of Covid -19 on Neuropsychological Development

Identify ways that psychosocial changes during the Covid -19 pandemic may have altered the development of cognitive, emotional, and social skills, and discuss the implications for long-term functioning.

Structural Predictors of Underemployment During COVID-19 Pandemic: A Psychology of Working Perspective

Explain the effects of the Covid -19 pandemic on underemployment in this article from The Counseling Psychologist , Vol. 50, No. 4.

Feeling Down in Lockdown: Effects of COVID-19 Pandemic on Emotionally Vulnerable Individuals

Discuss the unique impact that Covid -19 had on college age students, and explain how the pandemic impacted college students with pre-existing internalizing symptoms and psychopathology during prepandemic and lockdown in this article from The Counseling Psychologist , Vol. 50, No. 3.

Magination Press children’s books

What to Do When the News Scares You: A Kid’s Guide to Understanding Current Events

Unstuck! 10 Things to Do to Stay Safe and Sane During the Pandemic

A Kid’s Guide to Coronavirus

Journal special issues

Vaccine Hesitancy and Refusal

Asian America and the COVID-19 Pandemic

Risk Perception, Decision Making, and Risk Communication in the Time of COVID-19

Mitigating the Impact of the Pandemic on Families and Couples

COVID-19: Uncovering Mental Health

Groups in a Dangerous Time: Virtual Work and Therapy in the COVID-19 Era

COVID-19: Insights on the Pandemic’s Traumatic Effects and Global Implications

Telepsychotherapy in the Age of COVID-19

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Read these 12 moving essays about life during coronavirus

Artists, novelists, critics, and essayists are writing the first draft of history.

by Alissa Wilkinson

The world is grappling with an invisible, deadly enemy, trying to understand how to live with the threat posed by a virus . For some writers, the only way forward is to put pen to paper, trying to conceptualize and document what it feels like to continue living as countries are under lockdown and regular life seems to have ground to a halt.

So as the coronavirus pandemic has stretched around the world, it’s sparked a crop of diary entries and essays that describe how life has changed. Novelists, critics, artists, and journalists have put words to the feelings many are experiencing. The result is a first draft of how we’ll someday remember this time, filled with uncertainty and pain and fear as well as small moments of hope and humanity.

• The Vox guide to navigating the coronavirus crisis

At the New York Review of Books, Ali Bhutto writes that in Karachi, Pakistan, the government-imposed curfew due to the virus is “eerily reminiscent of past military clampdowns”:

Beneath the quiet calm lies a sense that society has been unhinged and that the usual rules no longer apply. Small groups of pedestrians look on from the shadows, like an audience watching a spectacle slowly unfolding. People pause on street corners and in the shade of trees, under the watchful gaze of the paramilitary forces and the police.

His essay concludes with the sobering note that “in the minds of many, Covid-19 is just another life-threatening hazard in a city that stumbles from one crisis to another.”

Writing from Chattanooga, novelist Jamie Quatro documents the mixed ways her neighbors have been responding to the threat, and the frustration of conflicting direction, or no direction at all, from local, state, and federal leaders:

Whiplash, trying to keep up with who’s ordering what. We’re already experiencing enough chaos without this back-and-forth. Why didn’t the federal government issue a nationwide shelter-in-place at the get-go, the way other countries did? What happens when one state’s shelter-in-place ends, while others continue? Do states still under quarantine close their borders? We are still one nation, not fifty individual countries. Right?

• A syllabus for the end of the world

Award-winning photojournalist Alessio Mamo, quarantined with his partner Marta in Sicily after she tested positive for the virus, accompanies his photographs in the Guardian of their confinement with a reflection on being confined :

The doctors asked me to take a second test, but again I tested negative. Perhaps I’m immune? The days dragged on in my apartment, in black and white, like my photos. Sometimes we tried to smile, imagining that I was asymptomatic, because I was the virus. Our smiles seemed to bring good news. My mother left hospital, but I won’t be able to see her for weeks. Marta started breathing well again, and so did I. I would have liked to photograph my country in the midst of this emergency, the battles that the doctors wage on the frontline, the hospitals pushed to their limits, Italy on its knees fighting an invisible enemy. That enemy, a day in March, knocked on my door instead.

In the New York Times Magazine, deputy editor Jessica Lustig writes with devastating clarity about her family’s life in Brooklyn while her husband battled the virus, weeks before most people began taking the threat seriously:

At the door of the clinic, we stand looking out at two older women chatting outside the doorway, oblivious. Do I wave them away? Call out that they should get far away, go home, wash their hands, stay inside? Instead we just stand there, awkwardly, until they move on. Only then do we step outside to begin the long three-block walk home. I point out the early magnolia, the forsythia. T says he is cold. The untrimmed hairs on his neck, under his beard, are white. The few people walking past us on the sidewalk don’t know that we are visitors from the future. A vision, a premonition, a walking visitation. This will be them: Either T, in the mask, or — if they’re lucky — me, tending to him.

Essayist Leslie Jamison writes in the New York Review of Books about being shut away alone in her New York City apartment with her 2-year-old daughter since she became sick:

The virus. Its sinewy, intimate name. What does it feel like in my body today? Shivering under blankets. A hot itch behind the eyes. Three sweatshirts in the middle of the day. My daughter trying to pull another blanket over my body with her tiny arms. An ache in the muscles that somehow makes it hard to lie still. This loss of taste has become a kind of sensory quarantine. It’s as if the quarantine keeps inching closer and closer to my insides. First I lost the touch of other bodies; then I lost the air; now I’ve lost the taste of bananas. Nothing about any of these losses is particularly unique. I’ve made a schedule so I won’t go insane with the toddler. Five days ago, I wrote Walk/Adventure! on it, next to a cut-out illustration of a tiger—as if we’d see tigers on our walks. It was good to keep possibility alive.

At Literary Hub, novelist Heidi Pitlor writes about the elastic nature of time during her family’s quarantine in Massachusetts:

During a shutdown, the things that mark our days—commuting to work, sending our kids to school, having a drink with friends—vanish and time takes on a flat, seamless quality. Without some self-imposed structure, it’s easy to feel a little untethered. A friend recently posted on Facebook: “For those who have lost track, today is Blursday the fortyteenth of Maprilay.” ... Giving shape to time is especially important now, when the future is so shapeless. We do not know whether the virus will continue to rage for weeks or months or, lord help us, on and off for years. We do not know when we will feel safe again. And so many of us, minus those who are gifted at compartmentalization or denial, remain largely captive to fear. We may stay this way if we do not create at least the illusion of movement in our lives, our long days spent with ourselves or partners or families.

• What day is it today?

Novelist Lauren Groff writes at the New York Review of Books about trying to escape the prison of her fears while sequestered at home in Gainesville, Florida:

Some people have imaginations sparked only by what they can see; I blame this blinkered empiricism for the parks overwhelmed with people, the bars, until a few nights ago, thickly thronged. My imagination is the opposite. I fear everything invisible to me. From the enclosure of my house, I am afraid of the suffering that isn’t present before me, the people running out of money and food or drowning in the fluid in their lungs, the deaths of health-care workers now growing ill while performing their duties. I fear the federal government, which the right wing has so—intentionally—weakened that not only is it insufficient to help its people, it is actively standing in help’s way. I fear we won’t sufficiently punish the right. I fear leaving the house and spreading the disease. I fear what this time of fear is doing to my children, their imaginations, and their souls.

At ArtForum , Berlin-based critic and writer Kristian Vistrup Madsen reflects on martinis, melancholia, and Finnish artist Jaakko Pallasvuo’s 2018 graphic novel Retreat , in which three young people exile themselves in the woods:

In melancholia, the shape of what is ending, and its temporality, is sprawling and incomprehensible. The ambivalence makes it hard to bear. The world of Retreat is rendered in lush pink and purple watercolors, which dissolve into wild and messy abstractions. In apocalypse, the divisions established in genesis bleed back out. My own Corona-retreat is similarly soft, color-field like, each day a blurred succession of quarantinis, YouTube–yoga, and televized press conferences. As restrictions mount, so does abstraction. For now, I’m still rooting for love to save the world.

At the Paris Review , Matt Levin writes about reading Virginia Woolf’s novel The Waves during quarantine:

A retreat, a quarantine, a sickness—they simultaneously distort and clarify, curtail and expand. It is an ideal state in which to read literature with a reputation for difficulty and inaccessibility, those hermetic books shorn of the handholds of conventional plot or characterization or description. A novel like Virginia Woolf’s The Waves is perfect for the state of interiority induced by quarantine—a story of three men and three women, meeting after the death of a mutual friend, told entirely in the overlapping internal monologues of the six, interspersed only with sections of pure, achingly beautiful descriptions of the natural world, a day’s procession and recession of light and waves. The novel is, in my mind’s eye, a perfectly spherical object. It is translucent and shimmering and infinitely fragile, prone to shatter at the slightest disturbance. It is not a book that can be read in snatches on the subway—it demands total absorption. Though it revels in a stark emotional nakedness, the book remains aloof, remote in its own deep self-absorption.

• Vox is starting a book club. Come read with us!

In an essay for the Financial Times, novelist Arundhati Roy writes with anger about Indian Prime Minister Narendra Modi’s anemic response to the threat, but also offers a glimmer of hope for the future:

Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.

From Boston, Nora Caplan-Bricker writes in The Point about the strange contraction of space under quarantine, in which a friend in Beirut is as close as the one around the corner in the same city:

It’s a nice illusion—nice to feel like we’re in it together, even if my real world has shrunk to one person, my husband, who sits with his laptop in the other room. It’s nice in the same way as reading those essays that reframe social distancing as solidarity. “We must begin to see the negative space as clearly as the positive, to know what we don’t do is also brilliant and full of love,” the poet Anne Boyer wrote on March 10th, the day that Massachusetts declared a state of emergency. If you squint, you could almost make sense of this quarantine as an effort to flatten, along with the curve, the distinctions we make between our bonds with others. Right now, I care for my neighbor in the same way I demonstrate love for my mother: in all instances, I stay away. And in moments this month, I have loved strangers with an intensity that is new to me. On March 14th, the Saturday night after the end of life as we knew it, I went out with my dog and found the street silent: no lines for restaurants, no children on bicycles, no couples strolling with little cups of ice cream. It had taken the combined will of thousands of people to deliver such a sudden and complete emptiness. I felt so grateful, and so bereft.

And on his own website, musician and artist David Byrne writes about rediscovering the value of working for collective good , saying that “what is happening now is an opportunity to learn how to change our behavior”:

In emergencies, citizens can suddenly cooperate and collaborate. Change can happen. We’re going to need to work together as the effects of climate change ramp up. In order for capitalism to survive in any form, we will have to be a little more socialist. Here is an opportunity for us to see things differently — to see that we really are all connected — and adjust our behavior accordingly. Are we willing to do this? Is this moment an opportunity to see how truly interdependent we all are? To live in a world that is different and better than the one we live in now? We might be too far down the road to test every asymptomatic person, but a change in our mindsets, in how we view our neighbors, could lay the groundwork for the collective action we’ll need to deal with other global crises. The time to see how connected we all are is now.

The portrait these writers paint of a world under quarantine is multifaceted. Our worlds have contracted to the confines of our homes, and yet in some ways we’re more connected than ever to one another. We feel fear and boredom, anger and gratitude, frustration and strange peace. Uncertainty drives us to find metaphors and images that will let us wrap our minds around what is happening.

Yet there’s no single “what” that is happening. Everyone is contending with the pandemic and its effects from different places and in different ways. Reading others’ experiences — even the most frightening ones — can help alleviate the loneliness and dread, a little, and remind us that what we’re going through is both unique and shared by all.

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How I’m coping with the pandemic

Leah blogs that while the coronavirus crisis has caused her anxiety, it has also made her realise how lucky she is.

Since the coronavirus pandemic hit I have experienced a huge amount of emotions. There has been a lot of anxiety , particularly surrounding my parents and grandparents who are all high risk due to health problems and age, but also surrounding my own health as I have asthma. I have, alongside the rest of the country, felt a huge amount of uncertainty and stress . It has ranged from where am I going to be able to get my essential items from, to what is happening with my therapy and my son's nursery. A surprising and consistent emotion I have felt though has been gratitude and it has also been one of the things that I think is helping me most through this.

I can lose sight of what I have and get caught up with the stresses of day to day living.

Despite having bipolar disorder, post-traumatic stress disorder and severe social and generalised anxiety , I consider myself to be very lucky. I have a wonderful and supportive family, my son is a constant source of love and light and I have a nice, safe home. Like anyone else, as day-to-day life goes on, I can lose sight of what I have and get caught up with the stresses of day to day living.

Over the period of social distancing, and now lockdown, I have found myself looking more closely and more mindfully at my life and my relationships with my friends and family. I have had the time to sit with myself without distractions of normal day-to-day things, like getting my son to nursery or doing the weekly shop.

I have spent time thinking about people in this country and also this world who are currently suffering far more hardship than I am. Children who are not cared for properly who are now unable to use school as a place of sanctuary, the elderly who are now isolated in their homes. I have friends of mine whose businesses are currently in jeopardy, and others whose income has just drastically changed. Then, of course there are those all over the world who have lost people they love from this deadly and merciless virus. My younger brother died at the age of 12 from a severe asthma attack, and so I am able to empathise with the agony of losing someone you love. While we still have those we love and care about we remain lucky.

We have used resources online to do music classes and exercising.

Reminding myself of the worldwide struggles going on at the moment enables me to gain a helpful perspective that for me has been grounding when I have felt my anxiety spiralling out of control. I am able to use this time to immerse myself in my family. We have used resources online to do music classes and exercising. We have spent time baking and cooking, and being creative. We are making sure we use our daily exercise to get out and walk as a family, and we have even used Skype to take my Mum with us as she is not allowed out of the house at all due to being extremely high risk.

Although I wish this situation was different for the entire world, I am choosing to be grateful for the time we have. It has felt different, almost like a microscope has been placed on how I am using my time, how much I am noticing about my life and what I could be doing differently.   Of course it has also been of paramount importance that I prioritise the things that help my mental health . For me self-care includes journaling, reading, a hot bath and getting enough sleep.

It is early days in our lockdown, and I will remain incredibly anxious about my family until I know we are all safely through the other side. My therapy that helps me deal with my trauma has stopped until further notice. My mental health support has not stopped, but has been taken down to the bare minimum and everything will be over the phone unless there is an emergency. I do not know if anyone I love will get coronavirus, and nobody knows how long this lockdown will continue on for.

I am going to try to remind myself that we are all in this together.

I know all these things are going to prove more and more of a challenge for me the longer this continues. I do not think being positive all the time is possible. Amongst all of this I am still dealing with the normal struggles I have with my mental illness, some of which certainly feel exasperated because of everything going on, but I am going to try on the days when it feels hardest to remind myself that we are all in this together; to remind myself of the wonderful people who are working hard within the NHS and essential services who are putting themselves at risk to support us all; to remind myself of all the reasons I am lucky and all the things I am grateful for.

I know for sure when all this is over I am going to go and see my family and we will all truly appreciate the time together like we never have before, and I cannot help but think that is a gift. Until then, let's all stay safe and stay home.

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Coping With Stress During COVID-19

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It is natural to feel stress and anxiety during the COVID-19 pandemic. Learn how you and your loved ones can cope with stress.

How can I find a vaccine location near me?

There are three easy ways to find a nearby location where you can get the COVID-19 vaccine:

Search  vaccines.gov ( vacunas.gov ). 

Text your zip code to  438829 .

Call 1-800-232-0233 . 

(TTY 888-720-7489)

Care for Yourself

Understand how stress can affect you..

Stress Can Cause:

• Feelings of fear, anger, sadness, worry, numbness or frustration
• Changes in appetite, energy, desires and interests
• Difficulty concentrating and making decisions
• Difficulty sleeping or nightmares
• Physical reactions, such as headaches, body pains, stomach problems and skin rashes
• Worsening of chronic health problems
• Worsening of mental health conditions
• Increased use of tobacco, alcohol and other substances
• It is natural to feel stress, anxiety, grief and worry during the COVID-19 pandemic. Below are ways that you can help yourself, others, and your community manage stress.

Learn healthy ways to cope with stress.

• Take breaks from the news.
• Take deep breaths, stretch, or meditate.
• Try to eat healthy, well-balanced meals.
• Exercise regularly.
• Get plenty of sleep.
• Avoid excessive alcohol, tobacco and substance use.
• Continue with routine preventive measures (such as vaccinations, cancer screenings, etc.) as recommended by your healthcare provider.
• Make time to unwind. Try to do some other activities you enjoy.
• Connect with others. Talk with people you trust about your concerns and how you are feeling.
• Connect with your community- or faith-based groups. While social distancing measures are in place, try connecting online or by phone.

If you or someone you care about is using alcohol or drugs to deal with stress:

• Contact your healthcare provider.
• Locate virtual treatment and recovery programs .
• Take medicine as prescribed. Continue your therapy, treatment, or support appointments.
• Call the National Drug and Alcohol Treatment Referral Service (1-800-662-HELP) to speak with someone.

Care for Your Child

Calm and confident parents provide the best support to children.

Watch for behavior changes in your child Not all children and teens respond to stress in the same way. Some common changes to watch for include:

• Excessive crying or irritation in younger children.
• Returning to behaviors they have outgrown.
• Excessive worry or sadness.
• Unhealthy eating or sleeping habits.
• Irritability and “acting out”.
• Poor school performance. Avoiding school.
• Difficulties with attention.
• Avoidance of activities enjoyed in the past.
• Unexplained headaches or body pain.
• Use of alcohol, tobacco or other drugs.

Ways to Support Your Child

• Talk to your child about COVID-19. Answer questions in a way that your child can understand.
• Reassure your child that they are safe. Let them know it is okay if they feel upset. Share how you deal with stress.
• Limit your family’s exposure to news coverage.
• Try to keep up with regular routines. Create a schedule for relaxing or fun activities.
• Be a role model. Take breaks, get plenty of sleep, exercise and eat well. Connect with your friends and family members.
• Spend time with your child.

For more information, see COVID-19 Parental Resources Kit .

If you are in crisis, get immediate help.

• National Suicide Prevention Lifeline : Call 1-800-273-TALK (8255) for English or 1-888-628-9454 for Spanish.
• National Domestic Violence Hotline : Call 1-800-799-7233 or text LOVEIS to 22522.
• National Child Abuse Hotline : Call 1-800-4AChild (1-800-422-4453) or text 1-800-422-4453. 
• National Sexual Assault Hotline : Call 1-800-656-HOPE (4673) or connect online .
• Veteran’s Crisis Line : Call 988 then Press 1, use the Crisis Chat or text 838255
• Disaster Distress Help : Call or text 1-800-985-5990 (press 2 for Spanish).
• The Eldercare Locator : Call -800-677-1116 – TTY Instructions
• The Trevor Project has trained counselors who specialize in talking to LGBTQ youth who are in crisis. Call the Trevor Lifeline at 1-866-488-7386 or text START to 678-678. 

Download Stress Management Tips

Coping With Stress While Staying at Home | PDF Format

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Economic Impact of COVID-19

Below are some helpful resources for how to deal with the economic impact of coronavirus.

Visit benefits.gov to find government benefits related to unemployment assistance, healthcare, and food and nutrition.

·      Call 211 for local resources. Or visit 211search.org  or  findhelp.org  to search for local resources online.

Find your local food bank at feedingamerica.org/find-your-local-foodbank . Call first to check requirements.

Support all the urgent humanitarian needs of the American Red Cross.