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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Physical exercise, and particularly being outside, is the very best treatment for depression.
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.
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.
Any kind of mindful activity. In its simplest form mindfulness just means being in the moment.
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.
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.
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.
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:
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.
Searching for meaning
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.
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.
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.