The outbreak of coronavirus disease 2019 (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.
CHIMO Helpline - Help is just a phone call away: 1-800-667-5005
Hope for Wellness Helpline – The Hope for Wellness Helpline offers immediate mental health counselling and crisis intervention to all Indigenous people across Canada: 1-855-242-3310
It is natural to feel stress, anxiety, grief, and worry during and after a stressful situation. Everyone reacts differently, and your own feelings will change over time. Notice and accept how you feel. Taking care of your emotional health during a disease outbreak will help you think clearly and protect yourself and your family. Self-care during a stressful situation will help your long-term healing.
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
Coping with these feelings and getting help when you need it will help you, your family, and your community recover from a disease outbreak.
People with preexisting mental health conditions should continue with their treatment plans during an emergency and monitor for any new symptoms. If you experience stress reactions in response to the COVID-19 outbreak for several days in a row and are unable to carry out normal responsibilities because of them, contact your health care provider or your local addictions and mental health centre (see below for contact information).
- Addictions and Mental Health
- Community Addictions and Mental Health Centres
- Alcohol Consumption and COVID-19
- Grief and Mourning During the COVID-19 Crisis
- Children and Youth
Things you can do to support yourself:
- Take care of your body - Try to eat healthy, well-balanced meals, exercise regularly and get plenty of sleep. Avoid alcohol and other drugs.
- Take breaks - Take deep breaths, stretch or meditate. Make time to unwind and remind yourself that strong feelings will fade. Try to do activities you usually enjoy. Maintain a sense of hope and positive thinking.
- Connect with others - Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships.
· Stay informed– When you feel that you are missing information, you may become more stressed or nervous. Watch, listen to, or read the news for updates from officials. Be aware that there may be rumors during a crisis, especially on social media. Always check your sources and turn to reliable sources of information like public health authorities.
- Avoid too much exposure to media coverage of COVID-19 - 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 enjoyable activities and return to normal life as much as possible and check for updates between breaks.
- Seek help when needed– If you experience stress reactions (feelings or behaviors) in response to the COVID-19 outbreak for several days in a row and are unable to carry out normal responsibilities because of them, contact your health care provider or your local addictions and mental health centre.
- Impacts of COVID-19 on Substance Use – CCSA is the go-to place in Canada for trusted information on COVID-19 and substance use.
For more information about how to take care of your emotional health during this stressful time, check out these sources:
- Mental Health and the COVID-19 Pandemic – Centre for Addiction and Mental Health
- Living with worry and anxiety amidst global uncertainty – Psychology Tools
- Canadian Mental Health Association of New Brunswick – offering free webinars and other resources on topics related to coping with COVID-19
- Calm - Calm is an award-winning app for Sleep, Meditation and Relaxation. During the COVID-19 pandemic, they are offering a range of free resources.
- Coping with stress during the 2019-nCoV outbreak – World Health Organization
- Hope for Wellness - The Hope for Wellness Helpline offers immediate mental health counselling and crisis intervention to all Indigenous people across Canada
Community Addictions and Mental Health Centres
Social distancing can be very difficult. Physically connecting with loved ones outside of our household may not be an option right now. This can increase feelings of isolation, anxiety and depression. When some people experience too much stress, they may feel a loss of control, excessive worry and other negative emotions. This can increase cravings and increase use of alcohol or drugs. By managing our stress and anxiety, we can maintain positive mental health as the pandemic evolves.
Pay attention to whether your alcohol intake is increasing, as this can happen when people feel isolated and anxious. It is important to remember Canada’s low-risk drinking guidelines. Stay in tune with your feelings. It can be helpful to think about the acronym “HALT”. This handy acronym reminds us to take a moment to “halt” and make sure we are not feeling Hungry, Angry, Lonely, or Tired as these basic needs can go unmet during period of higher stress and anxiety and increase cravings.
Make a point to reach out and get support from friends and family members through phone, video or even text messaging. You can replace alcohol use with healthy options like completing household tasks you have been putting off for a while, taking the time to read a book, cooking meals or learning something new like exercising or meditating.
If you are in recovery, it is important during this time to maintain your contact with your addiction and mental health counsellor by keeping all your appointments. You should not postpone your appointments until after the outbreak is over. All the Addiction and Mental Health services across the province remain open. Your clinician may even be able to offer telephone or video appointments.
The COVID-19 crisis has significant impact on normal grief and mourning. Losing a loved one is hard enough. Losing a loved one at a time of never-seen-before change and limitations may seem overwhelming. The global COVID-19 pandemic has disrupted the grieving process for many across New Brunswick. Those dealing with losing a loved one are also faced with travel restrictions, isolation and limits on gatherings keeping them apart from family and friends when they need them most.
Steps to Help Yourself and Your Family Rebuild
While the rest of the world appears to have been put on hold to try to contain the impact of COVID-19, if you’ve recently suffered the loss of a loved one, the grief may seem even bigger. Grief and pain do not pause just because almost everything is closed, and we are told to maintain social distancing. In fact, grief can become worse when the world is in a state of panic. Fortunately, just as grief doesn’t take a break, neither does healing. And you are not alone in your grief.
Here are some ideas to help yourself and your family recover during this time of grief:
- Take Care of Your Physical Health
Grief is already challenging to our bodies by disturbing our sleep, decreasing (or increasing) our appetite, and creating pain. Grief may interfere with our motivation to exercise and cause us to neglect personal hygiene. It’s important to take little steps to improve and maintain your physical wellness.
- Eat small amounts of healthy foods more frequently
- Have a warm cup of tea or another favourite non-alcoholic beverage
- Have a warm bath
- Go for a walk outdoors
- Rest when tired
- Maintain a regular bedtime, but don’t fret if you don’t fall asleep
- Let yourself cry
- Take Care of Your Emotional Health
Mourning is a necessary part of healing after a loss. The feelings must be felt in order to heal. But we can’t heal all at once. We need to pace our grief. Usually people find ways to distract themselves when the pain feels overwhelming. However, this is much more difficult to do when most things are closed and we are told to stay at home. One strategy suggested by Dr. Darcy Harris is to create a “grief drawer or box”. This involves filling a drawer or box with mementos of your loved one (pictures, clothing, personal items, etc.). Whenever you are ready to do the work of mourning, you take out this drawer or box and spend a set amount of time with these items (any amount of time you choose). This time is for you to mourn openly. When the time is over, you close the drawer or box until next time you feel the need to grieve openly. Afterwards you do something else (go for a walk, watch a movie, call a friend).
- Take Care of Your Cognitive Health
Grief can make us feel like our brains are mixed up. People often complain of memory problems and troubles staying focused. This is a natural way for the brain to protect us from becoming overwhelmed. This can be even more complicated when regular routines and structures are upended by the COVID-19 crisis. Be gentle with yourself at this time. Use lists to remind yourself of commitments and responsibilities. Say no to things that are overwhelming to you right now. And allow yourself to spend time in respite from the usual demands of life.
- Take Care of Your Social Wellness
People are social beings, but we are currently being told to practice physical distancing. Even though it may not be possible to be physically available to each other, we still need ways to find support. Video calls, phone calls, emails, texts, and letters are all methods to reach out and meet our need for social connection. Don’t be afraid to reach out to friends and acquaintances. You may be pleasantly surprised to hear the joy in the voice of friends who aren’t sure how to contact you in your grief.
- Take Care of Your Spiritual Health
Maintaining spiritual health is about looking after the needs of your soul. This isn’t necessarily about your religion (although it can be). Grief often leads us to thinking about the meaning of life and other existential questions. We may struggle with our faith or lose hope for a joyful future. This is made even worse by the anxiety caused by the COVID-19 situation. Again, it is important to remain gentle and compassionate with yourself, and consider the following ideas:
- Support from safe and understanding people (friend, clergy, etc.)
- Talk about "normal" things - take a break from talking about COVID-19
- Talk about the person you lost
- Talk about things you are looking forward to in the future
Remember that healing takes time, be patient with yourself and with the journey.
Changes in Traditional Funerals, Burials and Gatherings That Are Part of the Traditional Grieving Process
In addition to the ordinary grief mourners experience at a time of loss, the restrictions in place due to COVID-19 are having a significant impact on those who lose a loved one. Visitor or travel restrictions make it impossible for some to be with the dying person at home, in the hospital or nursing home. Requirements to modify or cancel public funerals, burials, and gatherings that are part of the traditional grieving process introduces an additional trauma and component to the grieving process. It is important for you and your family to find ways to meet your mourning needs and honor the person who died while making any necessary adjustments to keep everyone safe.
- Spending time with the body of a loved one
Before cremation or burial, spending time with the body of a loved one who has died can help mourners truly and fully acknowledge the reality of the death. It also provides a last chance to say goodbye. If restrictions made it impossible for you to be with the dying person before their death, spending time with the body at the funeral home may be helpful, if this is possible (check with the funeral home).
- Try to have an initial funeral service in a timely fashion
Because funerals provide mourners an opportunity to outwardly express feelings and emotions about their loved ones, they help people start on a healthy mourning path. Anything that delays the funeral also delays the natural healing process. It is therefore helpful to have a service shortly after the death if at all possible. Consider having a small, brief service now, with the closest mourners present (following physical distancing guidelines), followed by a larger memorial service later on.
- Consider having a small ceremony wherever you are
If you cannot be close to the person who died, it is still helpful and healing to hold a small ceremony right now wherever you are. Simply gather a few close friends or family members, display photos of the person who died, light a candle, say a prayer or read a text aloud that is meaningful to you, play music if you’d like, and share thoughts and memories.
- Use technology to foster closeness and participation
At a time of great loss, we want our loved ones close. If the pandemic is making this impossible, the next best thing is to use technology to reach out to the people you care about to share news of the death, support one another, and discuss funeral planning. Video calls, phone calls, emails, texting, social media, and handwritten letters all work.
Technology can and should also be used to help overcome any limitations of the funeral service itself. Services can be live-streamed or recorded and made available online later. Obituaries, guest books, and video tributes can be placed online. Mourners can video themselves talking about the person who died, recording their condolences, or even recording themselves reciting a poem, playing a hymn on a musical instrument, or singing a meaningful song. Social media is also very effective at helping keep everyone up-to-date about details and providing chances for far-flung friends and family to support one another. And turning to technology is also a good way to involve others in the funeral-planning process.
- Plan a larger service and/or reception when pandemic restrictions have lifted
Even if you must delay a larger public gathering right now, those who want to support you will still be happy to attend months from now. There is no time limit. Everyone understands that the pandemic is affecting everything.
How to Support Others Who Are Grieving
With this impact on funerals, burials, gatherings and other celebrations of life, it is important that extended family, friends and the community remain engaged and offer other means of support to comfort those grieving a loss. Below is a list of ways to stay connected with mourning families and provide support:
- Use the phone to call a friend and check in to see how they are doing
- faceTime, Skype, Zoom to see your family member or friend and have a conversation, touch base and remain present
- Send a text message or email to show support and express condolences
- Write a sympathy card, condolence message or note
- Sending appropriate condolence gifts or meals
- Commemorate the departed loved one by planting a tree in memory of and send a note
- Make a donation in the name of their loved one to one of the many charities in need right now
We know that COVID-19 is probably on your mind. Everyone is talking and worrying about it. And all your favourite activities and places are being cancelled or closed. So how are you supposed to deal with all of this? Here are some tips:
1. Keep active
It is important for both your physical and mental health to do 30 minutes of exercise a day. This can include going for a walk, stretching/yoga, playing active video games, or having a dance party! It doesn’t matter what it is, as long as it gets you moving! Do something you already love to do or try something new! Maybe even set a new goal for yourself, such as being able to do 10 push-ups, being able to touch your toes, or learning a new dance routine. Share your goal with others and post pictures or updates of your progress so others can cheer you on!
2. Have fun
Do things that make you feel good. You could go outside and play or stay in to read a book. Be creative and make a craft. Draw, write or make music. All of these things can help you feel good and relax. You might even find some fun things online that will allow you to continue to participate in activities you enjoy. For example, some dance companies are starting to offer free live dance classes online. Or some musical artists are streaming live concerts. See what you can find!
3. Keep a routine
Even though you may have nowhere to go, with school and activities cancelled, it’s important to keep a fairly regular routine. On weekdays, change into daytime clothes (save the pajamas for the weekend). Create a schedule for each day, including things like physical activity, learning, fun, connecting with friends and family, and quiet time. If you need help, check out https://mommyhood101.com/daily-schedule-for-kids for some ideas. It’s also very important to sleep, exercise, and eat healthy food every day.
4. Exercise your brain
Just because school is cancelled, doesn’t mean you have to stop learning. Continue doing some form of learning every week day. Your teachers may send home some things that you could do or you can find learning activities on line. For example, Khan Academy offers free and fun online learning for kids. Check them out at www.khanacademy.org.
5. Try to stay calm
It is normal to feel worried about COVID-19 or sad about how it is affecting your life. Learn some ways to cope with the feelings by checking out www.kidshelpphone.ca.
If you think you are getting too stressed and might need some help, here are some options:
1. Talk to your parents, or another adult that you trust
2. Contact Kids Help Phone for help:
a. Visit their website at www.kidshelpphone.ca
b. text TALK to 686868 to chat with a volunteer Crisis Responder 24/7.
c. Call 1-800-668-6868.
6. Keep in touch
Even though we are all being asked to keep our distance from each other, that doesn’t mean you can’t connect with family and friends. In fact, it’s very important for your mental health to keep in touch. Use technology to help you contact your friends and family regularly. Connect using the phone, social media, FaceTime or WhatsApp, etc. Whatever works for you and your family. Maybe you can even teach a grandparent how to use one of these options so that they can stay in touch!
7. Help out
Knowing your family has a plan can help you feel more safe and secure. Talk to your family about the plans they are making to keep your family as safe as possible. Ask them if there is something you can do to help. They might put you in charge of some tasks around the house, like making sure everything is kept clean.
8. Know the facts
It can be helpful to learn more about COVID-19, how to protect yourself, what the symptoms are and what to do if you feel sick. There is a lot of information out there about COVID-19, but it’s important to make sure you are getting your information trustworthy sources.
But, don’t spend too much time watching, reading, or listening to news stories. It can be upsetting to hear about it too much.
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 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
- 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.
Responding to disease outbreaks is both rewarding and challenging work. Sources of stress for emergency responders may include witnessing human suffering, risk of personal harm, intense workloads, life-and-death decisions, and separation from family. Stress prevention and management is critical for responders to stay well and to continue to help in the situation. There are important steps responders should take before, during, and after an event. To take care of others, responders must be feeling well and thinking clearly.
People with preexisting mental health conditions should continue with their treatment plans during an emergency and monitor for any new symptoms.
If you are a front-line health service provider and would like to contact a psychologist at no cost, please visit Canadian Phycological Association (https://cpa.ca/corona-virus/psychservices/).
Here are some important steps responders can take to ensure they are able to do their job and cope with challenging situations:
Preparing for a Response:
- Try to learn as much as possible about what your role would be in a response.
- If you will be traveling or working long hours during a response, explain this to loved ones who may want to contact you. Come up with ways you may be able to communicate with them. Keep their expectations realistic and take the pressure off yourself.
- Talk to your supervisor and establish a plan for who will fill any urgent ongoing work duties unrelated to the emergency while you are engaged in the response.
During a Response:
Understand and Identify Burnout and Secondary Traumatic Stress
Responders experience stress during a crisis. When stress builds up it can cause burnout and secondary traumatic stress. Recognize the signs of both of these conditions in yourself and other responders to be sure those who need a break or need help can address these needs.
· Burnout – feelings of extreme exhaustion and being overwhelmed. Signs of burnout include:
o Sadness, depression, or apathy
o Blaming of others, irritability
o Lacking feelings, indifference
o Isolation or disconnection from others
o Poor self-care (hygiene)
o Tired, exhausted or overwhelmed
o Feeling like:
o A failure
o Nothing you can do will help
o You are not doing your job well
o You need alcohol/other drugs to cope
· Secondary Traumatic Stress – stress reactions and symptoms resulting from exposure to another individual’s traumatic experiences, rather than from exposure directly to a traumatic event. Signs of secondary traumatic stress include:
o Excessive worry or fear about something bad happening
o Easily startled, or “on guard” all of the time
o Physical signs of stress (e.g. racing heart)
o Nightmares or recurrent thoughts about the traumatic situation
Use Responder Self-Care Techniques
Self-care techniques can help prevent and reduce burnout and secondary traumatic stress.
- Wherever possible, limit working hours to no longer than 12-hour shifts
- Work in teams and limit amount of time working alone
- Take a break from media coverage of COVID-19
- Write in a journal
- Create a menu of personal self-care activities that you enjoy, such as spending time with friends and family, exercising, or reading a book
- Talk to family, friends, supervisors, and teammates about your feelings and experiences
- Practice breathing and relaxation techniques
- Maintain a healthy diet and get adequate sleep and exercise
- Know that it is okay to draw boundaries and say “no”
- Avoid or limit caffeine and use of alcohol.
It is important to remind yourself:
- It is not selfish to take breaks
- The needs of survivors are not more important than your own needs and well-being
- Working all of the time does not mean you will make your best contribution
- There are other people who can help in the response
Responding to disasters can be both rewarding and stressful. Knowing that you have stress and coping with it as you respond will help you stay well, and this will allow you to keep helping those who are affected.
After a Response:
- Allow time for you and your family to recover from responding to the outbreak
- Ask for help if you feel overwhelmed or concerned