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Worried or Anxious?

Here you can find some guidance, and essential mental health advice for coping in these difficult times

The outbreak of COVID-19 may be stressful for people. Many people may feel fearful on anxious, and this is a very natural reaction to something that is unknown to most of us.

By learning some basic strategies and tools to improve our own emotional resilience, we can stop ourselves from feeling overwhelmed. We can also be there to support or friends and family, and pull together as a community (even through the internet), to maintain much needed social connections and emotional support

Why do we feel worried or anxious at a time like this?

Although everyone reacts differently to stress, the scale of pandemic feels ‘bigger’ than all of us. We read in the news that people all over the world are affected, and we also read lots of news that is incomplete, or gives an alarmist perspective on it. Of course when you hear that so many people are ill it sounds horrifying – but that’s largely because most of us cant even really imagine or evaluate this scale or scope.

Often psychologists or counsellors use rational or factual information to provide a grounding perspective when people feel stressed or overwhelmed, but when we are talking about a global phenomenon, the same kind of thinking is not as effective.

Anxiety can make us feel helpless, powerless, even vulnerable, and this can discourage us from taking steps we need to, in order to improve.

Recognizing stress

Its important to recognise when you are stressed. Its likely that reading this or other articles relating to COVID-19 that you may not have previously experienced a mental health condition, or other persistent stress, and therefore you may not be familiar with the signs. We can all look out for each other, including our family members, colleagues, and friends, and be aware of what to look for:

  • Ruminating thought patterns
  • Undue frustration or aggravation
  • Fixation or overt concern about yours or other people’s health
  • Difficulty sleeping
  • Difficulty concentrating

If you have any pre-existing mental health condition, increased stress may manifest as increased or changing symptoms.

Emotional Self-care Strategies

Healthy Habits

Getting into good routines and maintaining structure and orderliness in your life during an unsettling time is a great way to support your’s and other’s mental health..

Mindfulness and Relaxation Techniques

Even if you have never given these techniques a try before, they are simple to learn and an excellent way to combat stress and negativity

Cognitive Reframing / Challenging

Based upon cognitive behavioural therapy, there are a wide range of self-help strategies that can use to help support your emotional wellbeing at this time.

Healthcare / Frontline worker

If you are working on the frontlines in the medical or related fields, then you may be subject to particular strain. Read our guidance on how to practice emotional self-care.

Healthy Habits

Create a daily routine

Many of us are used to structuring our lives around going to work, taking the children to school, or doing activities in the community.
Try not to let yourself become undisciplined and focussed, even though you are stuck at home. Even if you have a small home, find ways to create order and add routine to your day. This will help boost self-esteem, make you more productive, be able to think more critically.
Irregularity or changes to diet, sleep patterns, and periods of inactivity can have a knock-on effect on your physical health – and lead to mental decline.

Our top tips:

  • Get to bed on time – just because you don’t have to physically go to work in the morning, its good practice to stick to your old sleep regime.
  • Do some exercise – even if you do something simple like jumping jacks in the front of the television, even doing 10 minutes of light exercise a day is good for your body. It promotes endorphin production, and helps you to maintain a regular sleep cycle. Click here for some basic exercises you can do at home
  • Resist overeating / binging / consuming alcohol – increases in these unhealthy behaviours is a common reaction under stress – but it can be highly counterproductive. You might feel like you are getting a quick fix and feel more relaxed, but it is likely to make you more mentally sluggish, less disciplined, and so ultimately less psychologically resilient


Avoid watching too much news

If you didn’t spend all day sat in front of television or computer watching the news before the COVID-19 outbreak, then its probably not best to do so now. We all want to keep up to date with important news about COVID-19, but MHA Sarawak don’t recommend constantly checking the web for updates, or spending too much time preoccupied with health concerns, as this can lead to high levels of stress, anxiety, and feelings of hopelessness. We have provided some sources HERE that we have verified as trustworthy places to get up to date information relevant to Sarawak.

Our top tips:

  • Only consume what you can handle – if you are feeling overwhelmed or stressed then switch off and find something to distract you. You can turn off notifications from news apps, and find something entertaining to watch instead
  • Limit yourself to a few sources – don’t keep searching the internet exhaustively for updates. Trust in a few local sources, and plan to check these perhaps once a day – news travels fast, but not that fast!
  • Don’t google your symptoms – the Ministry of Health website gives very simple and easy to understand description of the symptoms of COVID-19. Unfortunately forums and message boards online are full of other worried people speculating about the condition – so do yourself a favour and stay away from these sources. Just because the COVID-19 pandemic is presently an issue, coughs and colds, and other minor ailments will still be affecting people, so try not to overreact.


Acknowledge your worries

Its important for us to recognise the psychological impact that isolation and fear may be causing us. We should also be on the look out for these signs of stress in others. Taking time to collect your thoughts and identify what you are feeling and thinking. This is an important first step towards several ways of helping yourself cope in these tough times. A key principle is not just ‘sitting on’ your feelings, or trying to bury them. Our cultural values often tell us to bury our concerns and put on a brave face, however this false positivity can have a toxic effect, and cause us to repress our feelings and suffer as a result. You are not the only person who is feeling particularly stressed at the moment, and it is nothing to be embarrassed about.

Our top tips:

  • Check in with yourself regularly – this means performing a mental health check on yourself, or engaging family members in talking about how they are. Pay attention to the things that would normally bother you, or that you may struggle with if you have an existing mental health condition. Be aware of any changes to yourself, your feelings or stress levels, and even changes in appetite and sleep. For instance if you are feeling cramped or claustrophobic around the same people all day, be aware of that, and give yourself some alone time, or respect others wishes to do so.
  • Practice self-compassion – being kind and forgiving to yourself is an important step in processing difficult feelings. We may experience feelings or thoughts that seem irrational to us, but by being compassionate and allowing ourselves permission to explore these feelings, we give ourselves room to work on them, and to help heal. Consider how you would treat someone who you loved if you thought they were scared, anxious, or stressed at this time .. you would likely try to communicate with them and listen empathically. We can do that for ourselves as well! For more on self-kindness, also known as self-compassion, read this eBook
  • Keep a record of your worries – this might sound an unusual thing to do. Why would I write down when I am worried, and what I am worried about? The simple answer is that sometimes our worrying thoughts can go round and round in circles, with us often stuck in a mental loop. One way to escape this is to put feelings down in words – to make concrete the thought or feeling in order to help acknowledge it. For some people just identifying with a feeling in a simplified and more tangible way can go a long way to reducing the rumination and stress associated. This technique is also the first step cognitive reframing / challenging, which you can read more about HERE . Use this exercise to allow yourself to ‘let it go’. If a feeling is causing you stress, write it down, and then ‘let it go’ for now. You can always come back to it, but you can also feel free to carry on with your daily routine.


Getting the essentials

It is important to recognise that your physical and psychological needs have not reduced or altered just because there is a pandemic. You are still the same person with the same innate needs that you had last month. Human ‘wellness’ is affected by a lot of different things, and you are also unique and have your own unique needs.

Make sure you aren’t going without essentials – you still need access to the regular food, medicine, medical check-ups, and other basics. If you are worried about going out in the community, find out whether medicine or food can be delivered. Several services have become very popular during this COVID-19 outbreak – even in Sarawak! If you regularly saw a doctor, psychiatrist, counsellor, or nurse, find out whether they are still operating, and what alternative services they are offering during this time. Most clinics, hospitals, and pharmacists will remain open during the Movement Control Order, as will food and grocery shops

We also have psychological needs, and are still motivated by the same emotions, triggers, and circumstances. Don’t let COVID-19 dwarf your usual emotional and motivational responses. So why not treat yourself? – just not all the time. Rewarding yourself for completing a work task with a break or a snack is a justifiable motivational technique for normal daily life. The important thing is to reward achievement. It can be hard to maintain being ‘you’ when your routine and lifestyle are interrupted by COVID-19, so consider your values – who you are, who you want to be, what you want to achieve, etc. When you do something good, feel free to reward yourself (in moderation of course!)

Part of our key psychological needs is being sociable, so read below about ‘Staying Connected’.


Staying Connected

Don’t call it social distancing – although this is the common term, what we should be aiming for is ‘physical distancing’, which is being enforced through the Movement Control Order. This doesn’t have to restrict us socially. This is because in these difficult times, we need to be socially connected to people more than ever for support! Social isolation is bad – particularly for the elderly, those with existing mental health conditions, and for those people who may have already come into contact with COVID-19. If your friend or relative has been infected or quarantined, they need someone to talk to now more than ever.

Although some people respond by recoiling from social engagement when they are stressed, it is often not a healthy response. If you notice yourself not maintaining communication with people you would normally be in regular contact with, we urge you to reach out and have a chat – there really is no excuse, as technology offers so many ways for us to connect, to talk, to play games or share other activities online! If you are worried about someone else, you can reach out and help them to access digital communication tools.

While younger people may be very familiar with Facetime, Whatsapp, Skype, or playing games online, older people may have less knowledge. If you are in a household with someone older, then why not take some time out of your day to help them learn how to contact their friends through social media. A large body of research points to the immense physical and mental health benefits of such social connections.

Our social networks are a great source of resilience, because they are one our primary sources of social capital – and essential resource not just for our emotional stability and identity construction, but also for us to access opportunities in life. We shouldn’t try to shirk our social responsibilities at times like these, because when the pandemic passes and we can safely commune in public again, we want the world to be as we left it, and for our communities to continue to thrive as they did. For parents, it especially is important to maintain a sense of calmness and peace for our children’s benefit. Although COVID-19 may have delayed their matriculation, their education is still a priority, as it is supporting their access to the friends and community to ensure their continued emotional and social development.

Never forget that social connections help us to stay healthy. Studies have demonstrated the effect of social isolation on deteriorating physical health in people of all ages. Because some studies in recent years have identified that the online world and social media often lacks the wholeness and safety of social life in the community, it is important that we all make an effort to support healthy and supportive online dialogue during this time that is a challenge all across the world. Be a good digital citizen, be responsible, don’t spread fake news, and be kind and considerate to others. More information on digital citizenry can be found HERE

Healthcare / Frontline Workers

As a healthcare worker in the frontline of this pandemic crisis, it is possible that you have been exposed to heightened stress and trauma to the situation. You might have been under considerable work demand, and may be feeling exhausted or burnt out, and you may possibly feel a great deal of responsibility and worry.

Many studies have shown the healthcare workers often experience acute psychological impacts after an outbreak or disaster like this. So please don’t worry, you are not alone, and you should not feel ashamed.

You may also be concerned for your own health, having possibly been exposed to many patients with the condition. Having the most expert knowledge and understand of the current crisis may not necessarily prompt you to take the necessary steps to look after your own wellbeing.

MHA Sarawak recommend that frontline healthcare workers dedicate adequate time and provisions to look after your own self-care. Below are some recommendations from medical establishments in Sarawak.

 

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Cognitive Reframing / Challenging

The COVID-19 pandemic is affecting people the world over in many different ways – including physically, emotionally, economically, socially, and psychologically. In order to keep going when faced with a scenario that appears overwhelming, it is important to take time to critically assess and challenging our assumptions. If we don’t do this, then it is very easy for us to get trapped in a process of ‘catastrophizing’ – i.e. becoming consumed by the negative, and only being able to see negative outcomes or feel negative thoughts.

Although fear and worry may seem like natural and obvious thoughts, our physiological response to these feelings (often described as ‘fight or flight’) magnifies the dangers. We need to take back control of our thoughts and our feelings, in order to maintain our wellbeing and to continue to function effectively. Cognitive and behavioural psychology offers us a wide range of psychological techniques that we can employ to defend ourselves against these intruding and overwhelming worries, and to redirect our behaviour to being more productive and healthy minded.

 

Our top tips:

Focus on what you can control – at this time, even for those of us with medical training, a pandemic can seem very much ‘out of our control’; however that isn’t really true. If we watch the news and look at the alarming statistics of mortality, or if we spend our times speculating about when the Movement Control Order will cease, then we are only thinking about things outside of our control – and that isn’t good for us because we can end up feeling powerless, hopeless, and fearful.
Medical evidence has shown the enormous positive impact that good hygiene, physical distancing, and reducing outside access to emergency trips can make – so be a champion of yours and your family’s physical health – and own that effort.
Similarly you have a lot of control over how you work and what you do during the MCO. Invest time and creativity in establishing a constructive and positive working environment at home that helps you keep a routine, and help you feel a sense of accomplishment through your increased productivity.

Challenge negative thoughts – it might sound cliched, but it is a proven cognitive technique. While altering behaviour is easier than stopping ourselves think negatively, we can learn to recognise negative thoughts or assumptions, and critically assess them. For instance, if you noticed yourself thinking: “I’m sure my husband will get ill because he doesn’t have the strongest immune system” … you can learn to break down and analyse a thought like this:
1)  “Sure” – how are you sure? Does your husband get ill all the time, or just sometimes?
2)  “will get ill” – what are the causes of the illness? Has he had any contact with anyone infected? If not, then why would you suspect he would get ill?
3)  “doesn’t have the strongest immune system” – this is an example of an oversimplification of a very complex and multifaceted biological system. Drawing simple conclusions can often cause us to see things in ‘black and white’ terms – and lead to negative feelings and increased worrying.

Reframe your thoughts – imagine that the frame only shows you some of the picture. Try to see the other possible interpretations of the larger picture.
“I can’t do this task because of MCO” -> “But I can do this task instead
“I don’t know what will happen next week” -> “But I do know what is happening today
“I’m spending less time working than I should” -> “I’m finally spending more time with the children

You won’t feel anxious forever – more than anything, it is important to remember that the worry that you are feeling is an emotion – a state of feeling that is not permanent. If you do find yourself feeling depressed or anxious, be kind to yourself, and allow yourself to non-judgmentally recognise the moment. Just because you’re thinking something negative, it doesn’t make it true.

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Mindfulness and Relaxation Techniques

If you’re feeling extra stress and anxiety these days due to COVID-19, you’re not alone.
When we feel stressed, relaxation techniques can provide us a useful mechanism to cope with our feelings. Whether we are experiencing an intense stress or anxiety feeling such as panic, or whether we are just being aware that the current pandemic situation causes us to feel generally heightened levels of stress or anxiety. Thankfully there are many excellent easy to follow resources out there to introduce you to these techniques. It often best to try a few techniques out, and find out what works for you – see the links below:

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Mental Health Association Sarawak
2991, Block 10 KCLD, Wisma Keretapi
Q3A, Bormill Commercial Centre,
93200 Kuching, Sarawak
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