Mental health and coping during COVID-19

The outbreak of COVID-19 may be stressful for people and communities. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children.

Everyone reacts differently to stressful situations. The emotional impact of an emergency on a person can depend on the person’s characteristics and experiences, the social and economic circumstances of the person and their community, and the availability of local resources. People can become more distressed if they see repeated images or hear repeated reports about the outbreak in the media.

People who may respond more strongly to the stress of a crisis include:

• People who have preexisting mental health conditions including problems with substance use

• Children

• People who are helping with the response to COVID- 19, like doctors and other health care providers, or first responders Additional information and resources on mental health care can be found at the Substance Abuse and Mental Health Services Administration (www.SAMHSA. gov)

• Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Hotline: 1-800-985-5990 or text TalkWithUs to 66746.

• People with deafness or hearing loss can use their preferred relay service to call 1-800-985-5990.

Reactions during an infectious disease outbreak can include:

• Fear and worry about your own health status and that of your loved ones who may have been exposed to COVID-19

• Changes in sleep or eating patterns

• Difficulty sleeping or concentrating

• Worsening of chronic health problems

• Increased use of alcohol, tobacco, or other drugs People with preexisting mental health conditions should continue with their treatment plans during an emergency and monitor for any new symptoms. Additional information can be found at the Substance Abuse and Mental Health Services Administration Coping with these feelings and getting help when you need it will help you, your family, and your community recover from a disaster. Connect with family, friends, and others in your community. Take care of yourself and each other, and know when and how to seek help.

Call your healthcare provider if stress reactions interfere with your daily activities for several days in a row.

Things you can do to support yourself:

• Avoid excessive exposure to media coverage of COVID- 19.

• Take care of your body. Take deep breaths, stretch or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep and avoid alcohol and drugs.

• Make time to unwind and remind yourself that strong feelings will fade. Take breaks from watching, reading, or listening to news stories. It can be upsetting to hear about the crisis and see images repeatedly. Try to do some other activities you enjoy to return to your normal life.

• Connect with others. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships.

• Maintain a sense of hope and positive thinking.

Share the facts about COVID-19 and the actual risk to others. People who have returned from areas of ongoing spread more than 14 days ago and do not have symptoms of COVID-19 do not put others at risk.

What are quarantine and social distancing?

• Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

• Social distancing means remaining out of places where people meet or gather, avoiding local public transportation (e.g., bus, subway, taxi, rideshare), and maintaining distance (approximately 6 feet or 2 meters) from others.

Sharing accurate information can help calm fears in others and allow you to connect with them.

For parents:

Children react, in part, on what they see from the adults around them. When parents and caregivers deal with the COVID-19 calmly and confidently, they can provide the best support for their children. Parents can be more reassuring to others around them, especially children, if they are better prepared.

Not all children respond to stress in the same way. Some common changes to watch for in children:

• Excessive crying and irritation

• Returning to behaviors they have outgrown (e.g., toileting accidents or bedwetting)

• Excessive worry or sadness

• Unhealthy eating or sleeping habits

• Irritability and “acting out” behaviors

• Poor school performance or avoiding school

• Difficulty with attention and concentration

• Avoidance of activities enjoyed in the past

• Unexplained headaches or body pain

• Use of alcohol, tobacco, or other drugs There are many things you can do to support your child:

• Take time to talk with your child about the COVID- 19 outbreak. Answer questions and share facts about COVID-19 in a way that your child can understand.

• Reassure your child that they are safe. Let them know it is OK if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.

• Limit your child’s exposure to media coverage of the event. Children may misinterpret what they hear and can be frightened about something they do not understand.

• Help your child to have a sense of structure. Once it is safe to return to school or child care, help them return to their regular activity.

• Be a role model; take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members and rely on your social support system.

Learn more about helping children cope.

For responders:

Responding to COVID-19 can take an emotional toll on you. There are things you can do to reduce secondary traumatic stress (STS) reactions:

• Acknowledge that STS can impact anyone helping families after a traumatic event.

• Learn the symptoms including physical (fatigue, illness) and mental (fear, withdrawal, guilt).

• Allow time for you and your family to recover from responding to the outbreak.

• Create a menu of personal self-care activities that you enjoy, such as spending time with friends and family, exercising, or reading a book.

• Take a break from media coverage of COVID-19.

• Ask for help if you feel overwhelmed or concerned that COVID-19 is affecting your ability to care for your family and patients as you did before the outbreak.

For people who have been released from quarantine: Being separated from others if a health care provider thinks you may have been exposed to COVID-19 can be stressful, even if you do not get sick. Some typical reactions after being released from COVID-19 quarantine can include:

• Mixed emotions, including relief after quarantine

• Fear and worry about your own health status and that of your loved ones who may have been exposed to COVID-19

• Stress from the experience of monitoring yourself, or being monitored by others for signs and symptoms of COVID-19

• Sadness, anger, or frustration because friends or loved ones have unfounded fears of contracting the disease from contact with you, even though you have been determined not to be contagious

• Guilt about not being able to perform normal work or parenting duties during quarantine

• Other emotional or mental health changes