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6th August 2020 

Coronavirus Support

During this period of social distancing, I am not able to offer my normal face to face sessions. During this period I will be offering counselling via secure video link or telephone. Once this crisis has passed I will be returning to face to face work in my normal way.

Coronavirus and the associated isolation is creating new challenges for us all. Here are some tips on managing difficult feelings while in isolation.


Ways to Manage Feelings of Anxiety While in Self-Isolation

Anxiety comes from the fight, flight, freeze portion of our brain – the amygdala. An anxiety response is a normal instinct to keep us safe. Unfortunately for many of us that response is triggered too easily or more excessively than we need. This is not our fault! Coronavirus is a real threat, so an anxiety response is reasonable. The difficulty comes when we can’t regulate that fear. We become over anxious and may start to catastrophize (assume the absolute worst) or become anxious about things that are no threat at all. Repressed anxiety can lead to anger, intrusive thoughts or depression. It puts a strain on relationships and erodes our self-confidence.

Here are some ideas to help you re-regulate when anxiety becomes more than a passing thought.

  • When we become very stressed, our vagus nerve becomes over stimulated and stops being as effective in keeping our blood pressure and heart rate under control. Ultimately this can make us feel dizzy, weak or faint because our blood pressure can drop too much. Cold water can help (drinking very cold water, splashing your face or taking a cold shower). This works by switching the focus of the vagus nerve to adjusting to the cold and allows our parasympathetic activity to increase in our brain, regulating our blood pressure and heart rate and calming us.

  • Reality check. Your feeling is real, but is it in proportion to the situation? A thought is just a thought, thinking something doesn’t make it real. Take a moment to consider if your response is the same as your friends would make.

    Your initial response may be ‘yes’ but take a moment to really think about that. Is your feeling based on what has actually happened today, or is it grounded in your fear of what could happen?

    Try self-talking in a more positive frame, acknowledging what is fact and what is fear.

    If your response is based in fear, acknowledge that fear. All feelings are valid and important, being disproportionate, doesn’t mean they should be ignored. It doesn’t help to affirm the feelings, but it does help to support and comfort yourself in experiencing that feeling.

    Consider if your fear is a response to something from the past – your feelings about the current situation, may actually belong in an event from the past, a family script or a way of being.

  • Exerting yourself physically reduces stress and anxiety.

    This could take the form of jumping, throwing, running, speed walking or dancing.

    Following an exercise routine online is an option – there are lots to choose from.

  • Fresh air and being outside in whichever way you can will help.

    If you are social distancing (and while government regulations allow) try getting out for a walk, run or cycle ride each day.

    If you are self-isolating, try spending time in your garden.

    If you are in the highest risk group or are having to totally self-isolate, and cannot be far enough away from others anywhere outside, maybe you could open a door or window and let fresh air in.

  • Try chewing, maybe crunching on an apple or carrot or try a favourite flavour of sugar free gum (sugar gums are bad for teeth). Chewing helps lower cortisol levels (the hormone triggered by stress).

  • Our feelings and senses are triggered in the same part of our brain. Anything affecting our senses in a positive, calming, soothing or uplifting way can help to calm anxiety. Soothing scents (perfume, candles, aromatherapy, cooking etc.) can be very helpful.

  • Breathing exercises. There are a range of breathing exercises to be found online. One of my favourites is the 5 – 7 method, which helps to slow your heart rate and re-engage your parasympathetic nervous system, allowing it to create a calm, relaxed feeling in your body and mind.

    Slowly breath in through your nose to the count of 3 and then gently exhale to the count of 5. Repeat this several times and then increase your in breath to 4 and your out breath to 6. Again, repeat several times before increasing to 5 for the in breath and 7 for the out breath. If you have a higher lung capacity you can increase this in further increments, but you shouldn’t feel uncomfortable at any point. You can do this for just a few moments, and it will help, but to maximise the effect, taking 10 minutes to very slowly increase the increments can be particularly beneficial.

  • If you catch anxiety building you may be able to distract yourself with a favourite activity.

  • Tidy a draw, room or cupboard. Making order in our surroundings can help our minds feel more ordered too.

  • Any kind of mindful activity. In its simplest form mindfulness just means being in the moment.

    Some people love meditation and mindfulness practice, if you are in this group you may already have a mindfulness routine or you can use one from YouTube or an app such as Headspace or Calm (many more are available, I do not endorse any one site or app).

    You could try paying attention to something for a moment – maybe notice how a shaft of sunlight is reflecting on the glass of your window, or making a shadow on your lawn, look at a tree and notice the leaves, stroke a pet and pay attention to the feel of their warmth and softness (or not) of their fur.

    Try craft or art of some kind – it’s very hard to be fully immersed in an artistic activity without giving it your full attention. If you don’t feel creative consider adult colouring.

  • Grounding yourself. There are many grounding techniques you can find online, this is just one.

    Take your shoes off and place your feet firmly on the ground, sitting comfortably upright. Slowly breath in and out a few times. Be fully conscious of the floor beneath your feet, the chair beneath you, your hands on your lap or by your side. Can you feel fabric, or a hard surface? Tense and relax your toes, hands and whole body.

    Imagine tension running down you’re your head, through your body, down your legs and feet and out into the ground.

    Notice any sounds around you, if you feel warm, cool, hot etc. Be aware of being in this moment, separate from worries or events in your life.

    Remind yourself that in this moment, you are safe.

  • Remember, even in isolation, you do not have to struggle alone.


  • Ways to Manage Feelings of Depression While in Self-Isolation

    If you are feeling suicidal, and do not feel able to keep yourself safe, seek help immediately. Help can be found via friends, family, GP, A&E, The Samaritans and online support groups. The Samaritans is available 24 hours a day 365 days a year on the Freephone number 116123 or by email [email protected]

    Coping with low mood and dark thoughts is hard at any time, but during periods when we are deliberately cut off from others (such as during lockdown), it is particularly difficult.

    Our emotions are controlled in the limbic system in our brains (the feeling part). This includes the hypothalamus, hippocampus, amygdala and limbic cortex. People may tell you to cheer up, but it isn’t as simple as that. When we are depressed we find it very difficult to regulate our emotional responses. The thinking part of our brain (the cortex) becomes disconnected from the feeling parts of the brain when we are very stressed or very low. This makes it very hard for us to think rationally when we are depressed. We need other ways to help us and enable that connection in our brain to start up again.

    Many people need counselling and or medication to help lift them back to a place where they can manage for themselves again. There is no shame in asking for help – if you had a broken leg you would be happy to have doctors, nurses and physios helping you, this is no different.

    Self-Care Box
    Boosting the limbic system can be one way to help. Our feelings and our senses both operate from the limbic system so we can affect our emotions by choosing to stimulate our senses (touch, sight, sound, smell and taste). Think of things that lift you, soothe you or generally make you smile. Many of these will be linked to our senses and exposing ourselves to these can lift our mood – for a while at least.

    When we are low it is hard to find the motivation to do anything so it’s helpful to think about these things before we need them.

  • Maybe you could put together a playlist of music you enjoy and keep it on your phone so you can access it at any time.

  • Maybe a photo gallery (possibly also on your phone and around you at home) of people or pets you love and who love you.

  • You may enjoy a favourite scent, perhaps a loved one’s perfume, chocolate, coffee or the smell of a particular flower. Get something that smells of the thing you love so you can access it at any time – scent can instantly transport us.

  • Keep a favourite food or drink handy – maybe an aromatic cup of tea, or a welcoming piece of chocolate and really be aware of the sensation of eating or drinking that favourite thing.

  • Do you have a pet you love to stroke or a favourite blanket that feels so soft and cosy?

    Each person will have their own set of things that lift and boost them, think about what yours can be and get some things together or write them down so they are easy to get when you feel low.

    Staying Connected
    Human contact is very important, and is restricted during lockdown. If you are shielding this is particularly hard. You may feel it’s too exhausting to talk to people, but this is depression, not you. Try not to let depression take over your life, even if it feels hard try to keep contact with those who care about you. Remember the person isn’t going to be able to ‘fix’ you but they can care for you. No one person is likely to meet all your needs – reach out to a network of people who can jointly support you.

  • Try to have face to face contact with someone each day (even if it has to be by video call for now).

  • If you do live with someone else, ask for a hug. This causes an oxytocin release, which in turn stimulates the production of the feel-good hormones dopamine and serotonin.

  • Stay connected via texts, emails, calls etc.

  • It’s OK to ask people to check in on you – they may not have realised how low you are feeling.

  • Use social media sensibly – if it’s helping you, then brilliant! But if everyone else seems to have life sorted – remember people only post the glossy things they want others to see. Often even the most glamourous seeming online life can actually feel very bleak in reality.

  • Try to keep up with social activities. Even in full lockdown it is possible to maintain contact with groups – maybe even to move an activity online.

  • Join a support group. Talking with others who know how you are feeling can be very helpful.

  • Find ways to support others. It’s amazing how good it feels to do something good for someone else even when we are very low.

  • Care for a pet or a garden – nurturing something gives a valuable sense of being needed.

  • You are not alone. Try checking out the YouTube Clip ‘I had a black dog, his name was depression’.

    Exercise
    Physical exercise, and particularly being outside, is the very best treatment for depression.

  • Stress suppresses the production of neurons in our brains which reduces the ability of neurotransmitters to pass messages between our neurons. Exercise increases the production of neurons, synapses and nerves making us feel better.

  • Serotonin creates feelings of happiness and security. A reduction of serotonin affects our mood regulation, appetite and sleep pattern resulting in many of the signs of depression. Exercise causes a release of serotonin in our brains, boosting our mood.

  • Dopamine, which affects how motivated we feel and how we perceive reality, is also released during exercise and is part of the brain’s feel-good system.

  • Endorphins are realised when our heart rate rises in exercise. These help our brain to modify its response to stress, pain, anxiety and depression.

  • Sunlight boosts serotonin, so any outdoor exercise has this added benefit.

    If exercise seems beyond you, set small goals. Can you just step outside into your garden or onto the street? Maybe you can walk as far as a post box?

    If you feel physically able to exercise but can’t get motivated, maybe agree to exercise with a friend, that way you get human contact too.

    Reality Check
    Although it is very difficult to think logically when you are depressed, try considering what you might say to a friend feeling as you do, or ask yourself how you would think about the situation if you didn’t have depression.

    Do Things You Enjoy
    We all feel better doing things that give us pleasure. There may be a pile of boring things piling up, but take some time each day to do something you love too.

    Self-care is really important – looking after yourself can take many forms – a bath, a walk, reading a book, playing sport, taking part in a spiritual activity, doing craft, watching a film – the list is endless.

    Keep alcohol to a minimum – alcohol is a depressant so although it may feel better in the short term it will make depression worse.

    Mindfulness
    Any kind of mindful activity. In its simplest form mindfulness just means being in the moment.

  • Some people love meditation and mindfulness practice, if you are in this group you may already have a mindfulness routine or you can use one from YouTube or an app such as Headspace or Calm (many more are available, I do not endorse any one site or app).

  • You could try paying attention to something for a moment – maybe notice how a shaft of sunlight is reflecting on the glass of your window, or making a shadow on your lawn, look at a tree and notice the leaves, stroke a pet and pay attention to the feel of their warmth and softness (or not) of their fur.

  • Try craft or art of some kind – it’s very hard to be fully immersed in an artistic activity without giving it your full attention. If you don’t feel creative consider adult colouring.

    Get Outside
    Although the full scientific reason is not fully known yet, all research shows that being outside, and particularly in nature, improves self-esteem and reduces depression, anger and tension.


  • Ways to Express Frustration and Anger Safely While in Self-Isolation

    We all feel angry sometimes and when we are restricted, or in close proximity to others, moments of anger are more likely to occur.

    Anger is often a secondary emotion that covers pain or sadness and suppressing anger can lead to anxiety, depression, stomach upsets, sleeplessness, headaches and many more difficulties.

    Here are some ideas to release anger that can be carried out within the lockdown restrictions. You may have additional ideas of your own.

  • If you can exert yourself physically that is the most effective way to release anger healthily.

    A few examples could include: jumping, stamping, punching a pillow, running, speed walking or dancing.

    An aerobic exercise routine online could help – anything that raises the heart rate.

    If you have a garden, or reinforced floor, a slam ball could be a good form of anger release – and good exercise at the same time – they cost in the region of 20.

    If you have enough space in the garden, hitting or kicking a ball with force is a great.

    You could try tearing multiple sheets of paper or cardboard, kicking empty cans or popping or stamping on bubble wrap.

  • Write down your feelings, preferably by hand. Journaling can be a great way to get your feelings out of your system. If you are writing about someone in your household, you can always shred the paper once you have finished.

  • Draw or paint your feelings. Start by creating a frame on the paper and draw inside the frame – crazy as it sounds, this helps to contain your feelings. Drawing or painting can also be soothing.

  • Breathing exercises. There are a range of breathing exercises to be found online. One of my favourites is the 5 – 7 method, which helps to slow your heart rate and re-engage your parasympathetic nervous system, allowing it to create a calm, relaxed feeling in your body and mind.

    Slowly breath in through your nose to the count of 3 and then gently exhale to the count of 5. Repeat this several times and then increase your in breath to 4 and your out breath to 6. Again, repeat several times before increasing to 5 for the in breath and 7 for the out breath. If you have a higher lung capacity you can increase this in further increments, but you shouldn’t feel uncomfortable at any point. You can do this for just a few moments and it will help, but to maximise the effect, taking 10 minutes to very slowly increase the increments can be particularly beneficial.

  • Acknowledge your feelings. Even if nobody else seems to, allow yourself to feel validated.

  • Aromatherapy oils can help to calm you – check with a midwife first if you are pregnant.

  • Singing – find a playlist with plenty of energy and sing along as loudly as you can.

  • Scream – maybe sit in the car for privacy, and let that anger flow out of you.

  • Lie on your bed and kick your legs like a toddler having a tantrum.

    No one thing works for everyone, and this is not an exhaustive list, see what feels OK for you and give it a try.


  • Ways to Process Bereavement and Grief During Lockdown

    Bereavement is what has happened to you, mourning is what you do and grief is what you feel. In order to start grieving and move on to a different, but meaningful way of living, we need to fully mourn the loss of our loved one. Separate from ‘stages of grief’, it is thought that we have six ‘reconciliation needs of mourning’ (Wolfelt, 2016). These include:

  • Acknowledging the reality of the death
  • Moving toward the pain of the loss
  • Remembering the person who died
  • Developing a new self-identity
  • Searching for meaning
  • Receiving ongoing support from others

    Having these needs met helps us to acknowledge our loss and start the process of grieving.

    Funerals are a vital part the grieving process because they provide a framework that facilitates mourning. A lack of funeral may leave the bereaved person feeling they have ‘unfinished business’, that they have not said goodbye properly, or even that the person has not really gone. This can make grief especially hard.

    If you were not able to be with your loved one during their last days, and especially if no family or friends were allowed to be with them, the loss may feel particularly traumatic.

    Not having the ritual of a funeral will be very hard, but it is possible to create a form of substitute ritual from your own home to help recreate ways to get your reconciliation needs met. There isn’t a right or wrong way to approach this, but I have included some possibilities here.

    Acknowledging the reality of the death and moving toward the pain of loss

    This may sound obvious, but there is a difference between knowing someone has died and really connecting with that deeper, feeling level of understanding. Without a funeral, it can take much longer to reach that point.

  • Give yourself permission to feel and to cry. Our culture doesn’t encourage the open display of emotion, but during funerals it does. This display of emotion is very beneficial. Many people try to hold back tears, but this is just repressing your grief. Repressed grief can turn into anxiety, anger or depression or can express itself in physical illness. Expressing whatever you feel is healthy.

  • Lighting a candle at a particular time or day may give a focus for acknowledging the death or remembering the loved one. This could become a repeating ritual if you wish.

  • Saying a poem, religious reading or prayer may help to give you a focus.

  • Remembering the person who died and receiving ongoing support from others.

  • Talking to others who loved the person, about the loved one who has died, sharing memories, stories and photographs.

  • Repeating the death story – what happened and how you feel – as frequently as you need. This helps you make sense of what has happened on a gradually deepening level.

  • At a funeral, most people have a eulogy. Creating a remembrance book or box may help. You could ask people to post or email memories or pictures and you could write about your loved one, or put in the loved one’s favourite poem or lyrics of a favourite song. Sympathy cards or mementos could also be included.

  • If you use any online media, you may like to set up a group ‘chat’ or blog in memory of your loved one.

  • You may like to make a playlist of your loved one’s favourite music, or tracks you shared together or remind you of your loved one.

  • Arranging a page in a remembrance book can help. At Easthampstead Crematorium (our local crematorium) the remembrance book can be accessed online at any time. https://www.remembrance-books.com/easthampstead/book-of-remembrance.html. There is a charge for the initial entry but not for viewing the page. Many other crematoriums offer a similar service.

    Searching for meaning

  • Journaling can help. This involves writing about your feelings. It is helpful to look back on; but if you are concerned you may want to write something you wouldn’t want others to read, it is still valuable to write it down and then burn or shred the paper afterwards. Hand writing is usually the best way as it engages different parts of the brain than using a computer or tablet.

  • Perhaps you could plant bulbs, a plant or a tree in memory of your loved one (online delivery is still available). This provides a living reminder of the one who has died and gives you a focus to care for. It may be possible to put a small plaque by the plant.

  • Some people choose to donate to charity, and / or ask others to, in memory of the loved one.

    Developing a new self-identity

    Most of us identify ourselves in relation to others. We may be a spouse, a child, a sibling, a parent, a grandchild, a friend, a colleague, a classmate, a team member etc. etc. When someone dies that role shifts. Of course, we will always be that person in one way, but now it is defined from a different angle. For example, if you are a spouse and that person dies, you will now be defined as a widow(er). A funeral helps with this, because implicitly people around us are saying they acknowledge our loss and they recognise the change that has happened to us.

    Depending on the relationship, some people literally feel a part of them is lost when someone they love dies. Having friends and family around us to recognise our continued, but changed, existence is an essential part in helping us accept our altered identity.
  • Accept contact from others in ways and at times that feel manageable to you. This could be a video link, telephone call, card or letter.

  • Allow yourself to reach out to others.

  • Accept support that may be offered by your community.

    This is not an exclusive list, anything that gives you permission to grieve, an opportunity to share memories of your loved one and a chance to concentrate on your loved one will be hugely beneficial in allowing the necessary process of grief to take place.


  • Loneliness

    Human beings need social connection. Being part of a social tribe is part of being human, and most of us feel safest being part of a group. This is a result of our early evolutionary patterns when we hunted prey to sustain ourselves and worked together to fight off predators that could kill us. Being isolated, and the subsequent feelings of loneliness, triggers an anxiety response in us designed to make us seek out more social contact to keep us safe.

    The amount of social contact we need varies from person to person. Feelings of loneliness develop when our individual need for social contact is not met. Loneliness is not about being alone – many people are very happy living alone or enjoy their own company. However, if you don’t feel understood or cared for, you can feel very lonely even within a family or social group.

    It has been understood for a long time that elderly people who live alone can be particularly vulnerable to loneliness, and they are. It is estimated that across the UK, 2 million people over the age of 75 live alone and 1 million of those can go a month without speaking to anyone. Despite this, recent studies show that the loneliest group in the UK are aged 16 – 24. Don’t assume that because someone is young, or does not live alone, they can’t be lonely. This age group have a greater need for social contact than any other.

    It may be obvious that a person who lives alone may be in need of a call, but remember it is often the person everyone else turns to who can be most in need of support – loneliness affects everyone! If you have a friend like this, reach out to them!

    During this period of social distancing and isolation, more than ever, send that message, form an online group, pick up the phone, write an email or letter, send a card, let the people you care about know that you are there, thinking about them, and feel grateful to have them in your life.

    The sense of isolation generated by feeling lonely can lead on to more significant problems with our mental health. Reaching out to a friend to say you need help, takes courage and can feel overwhelming, but if you don’t let people know you are struggling they may not see it. If loneliness has evolved into feelings of anxiety, depression, loss of confidence or self-esteem or has brought up reminders of bereavement or trauma, then counselling may help you address these feelings with a therapist alongside you.

    Reaching out can help to reduce loneliness one person at a time.