January 21, 2022

Suffering from Surge Stress? 9 Things to Do Right Now

Mental health impacts of “doing everything right” amid a massive rise in COVID-19 weighs heavily on immunocompromised people, parents, essential workers and more

You’ve got your masks. You’ve got your vaccines and your boosters. You’re being careful, doing everything right, trying to keep yourself and your family safe.

And yet, you don’t feel safe. Or COVID-19 found its way into your home despite your best efforts. Or you’re watching a loved one suffer because their underlying health, their age, or their delay in getting vaccinated made them more vulnerable.

It’s easy to feel depressed, betrayed, distressed or even victimized right now.

Oh, and it’s cold and dark outside, and the holidays are over. And if you have children in school or daycare, you worry every day about sending them – or you’re coping with having them at home because of a closure or a close contact.

But there are still things you can do to bolster your mental health right now, says Michelle Riba, M.D., a professor of psychiatry at Michigan Medicine and member of the U-M Depression Center.  In her work as a psychiatrist specializing in the mental health of people with cancer at U-M’s Rogel Cancer Center, she knows that it’s important to focus on things you can control when things around you seem to be spiraling out of control.

The current surge of Omicron COVID-19 cases weighs especially heavy on the patients she sees, and on those who have other situations that make them especially prone to a severe case of COVID-19 if they catch the disease, or who just want to avoid it if at all possible. 

“It’s worse now than it was a year ago,” she says. “People have been socializing, but now some are isolating again to avoid the virus. They don’t feel safe even if they’re triple-vaccinated and healthy, because they’re worried they could be the person who passes the virus to someone who’s more vulnerable.”

On the other hand, she adds, “Other people are saying ‘everyone will get it’ and just resigning themselves. But there are people with certain medical conditions who really, really shouldn’t get it because they could get seriously ill or die even if they’re vaccinated. And the more cases there are, the more likely these people are to get exposed, including by someone they live with who unknowingly brings the virus home.”

No matter which group you fall into, the first thing to do is to acknowledge and recognize the emotions that you’re feeling, she says.

Then, she advises trying some of these key steps to help you get through this time.

1.    Take control by getting vaccinated or boosted, and encouraging others to do the same. Vaccination, including booster doses, is the most powerful way to reduce the chance of getting a severe case of COVID-19. Research shows a booster dose of vaccine can really reduce the chance of severe disease if you catch the Omicron variant, so everyone over age 12 should get a booster as soon as they’re eligible.  Immunocompromised children age 5 to 12 can get a third dose too, starting a month after their second dose.

If you or your relatives or friends aren’t fully vaccinated, or you haven’t gotten your children over age 5 vaccinated yet, now’s the time for them or you to talk with a trusted medical professional about any concerns or hesitations.

If a fear of needles or going into public places right now is holding you or someone else back, talk with a medical provider about ways to decrease anxiety and use self-talk to get through a quick vaccination that could keep you from getting seriously ill in the short- and long-term.

2.    Balance the risks and benefits of in-person activities – but consider all the benefits. It’s easy to focus on the risk of getting sick, especially if you’re immunocompromised or have avoided COVID-19 until now. But the mental health benefits of in-person social interactions and school, as well as hobbies, sports, faith-related activities and clubs, are crucial too.

With a good-fitting mask and vaccine protection, and good ventilation, Riba advises, you can engage in the ones that are most important to you. If you can do them outdoors, bundled against the cold, all the better. It may be tempting to just huddle indoors as the path of least resistance, but getting out and seeing people and doing things even for a short time, in a safe way, can really help.

“We’re at that point where we all have to make compromises in order to get through this together, and not take unnecessary risks, but also work to avoid becoming too fearful,” she says. “So, go to work, school or the store, but not to a large party or a bar right now. Control your risk, within reason.”

And of course, in-person medical care is important to keep up with, and is safe, she notes. Don’t be afraid to enter medical settings to seek vaccinations, testing, medical exams for chronic conditions or new symptoms, physical therapy, cancer screenings like mammograms and colonoscopies, and scheduled operations and procedures. Make sure you’re masked when you go, and if any providers aren’t masked, ask them to do so in your presence.

If you or any of your loved ones have a mental health condition, find useful tips for coping with pandemic stress in this toolkit developed at the start of the pandemic by the Department of Psychiatry. 

3. Keep moving. January is usually a time when people start on new exercise routines and resolve to get healthy. But if you’re avoiding the gym right now because of the infection risk during this surge, that can be hard. Riba notes that years of research shows that movement, exercise and physical activity of all kinds is important for mental health. And it doesn’t have to be planned.

So be spontaneous if the weather warms up a bit or the sun comes out – invite a friend for a walk in the middle of the day or just go by yourself with some music on in your headphones. Go to a big indoor space such as a mall or museum, during non-peak hours, and walk around including taking the stairs instead of the elevator or escalator if you are able. Walk up and down the stairs in your house or apartment building.

Getting outside during daylight hours can really help your circadian rhythms, which can help you sleep and improve your mental state, Riba says. If you aren’t able to get enough daylight, or you have a tendency to develop seasonal depression in winter, consider getting a light box to add simulated daylight to your life.

4. Stay up-to-date but don’t fixate: Trying to stay on top of pandemic-related news has become a habit for many people, but “doomscrolling” on social media and news sites can become an unhealthy habit. Peel yourself away from screens, turn off app alerts on your smartphone, and take a break from one or more social media platforms. Allow yourself a scheduled “news break” each day with a time limit when you will check trusted sources of information.

5. Don’t give in to guilt. If you’ve avoided COVID-19 until now, but you or someone you live with or care for has come down with it, don’t feel guilty or ashamed. The Omicron variant is extremely contagious, the number of people who are sick right now is very high, and people can be infected and able to spread the virus without knowing it. Even people who have been taking precautions are getting sick.

So, don’t beat yourself up or dwell on where you caught it. If you know who you got it from, reassure them that you know they didn’t do it on purpose. If you or your sick loved one are vaccinated, be grateful that the vaccine probably made the illness less severe.

Focus on taking care of yourself or your loved one, and do what you can to keep others in the household from getting sick. Follow guidelines for quarantine and isolation to keep from spreading it to others. Make sure to tell the medical professionals who provide your or your loved one’s usual care – especially if you or they are immunocompromised, unvaccinated, too young to get vaccinated, or have multiple health conditions including diabetes, heart disease, asthma or lung disease, or depression. There are new medications that can be used in the most-vulnerable people to try to prevent an infection from turning into a severe case, but they’re most effective when taken in the first days of an infection.

If you think you or your child may have exposed someone else to COVID-19, make sure to tell them as soon as possible so they can act. They may have an underlying condition that puts them at higher risk, or they may live with someone who’s immunocompromised or not vaccinated, and the sooner they know, the more they can do. If you and they

6. Give yourself, and others, some grace. The pressure of trying to have a “normal” life amid a major surge is really affecting some people, Riba says. “Give other people, and yourself, grace right now,” she says. “This is like a relay race – if you’re tired or fatigued, give the baton to someone else to carry it. If you just can’t get up the energy to make dinner, figure out with those you live with what you and they can do to ease the burden. That could be takeout, or having someone else take the lead, or just eating cold cereal or peanut butter and crackers for dinner. It’s not perfect, but remember, at least everyone’s OK and fed.”

7. Express yourself. Keeping your feelings bottled up, so that they burst all at once in anger, crying or recklessness, is a real danger, Riba notes. Rage, sadness, betrayal, loneliness and hopelessness are legitimate emotions right now, and can bounce around in your head and get worse as they go. They can also affect you in unexpected ways including physical symptoms like headaches, stomachaches and fatigue.

Riba likens it to soldiers who experience combat weariness, after being in a danger zone for a long time. This can lead them to let down their guard. “That’s when bad things happen,” she says. “So if you’re that weary and burned out, it’s better to say it and get some help.”

Find someone you can talk to, in person or by phone or video chat, not just texts or over social media. If you have a therapist, or can find one to see virtually, lean on them – but don’t be afraid to open up to a trusted friend or relative. 

8. Connect. A lot of people are feeling the same way you are, and supporting one another even if it’s just to share a laugh, catch up on movies or shows you’ve watched recently, or have a regularly scheduled call or video chat, can go a long way toward alleviating the stress. Join in with your faith community, both in-person while masked or virtually.

Reach out to an older relative you haven’t called in a while, just to say hello. Tell your friends you’re holding a virtual “open house” on your favorite video chat platform on a certain day and time, and invite them to drop in and chat even for a few minutes. Just because the weather and the pandemic are keeping you inside doesn’t mean you can’t connect.

9. Serve your community. Even if it feels like selfishness and lack of caring are prevailing right now, that’s not true – it’s just amplified above the quiet acts of caring and service that happen out of the spotlight every day. If you can give blood, donate items, food or money to charity, help a local refugee resettlement effort, buy from a child’s fundraiser or do in-person volunteering, you can help keep those quiet but vital efforts going – and reassure yourself that there are more people who care for the community you live in.