Concerns about our personal situations or those of our loved ones during the COVID-19 pandemic can be extremely stressful. Add in the constant flow of news about COVID-19 and stress and anxiety can skyrocket, even for the most laid-back person.

During stressful times, it’s important to remember each one of us reacts differently depending on our background, personalities, communities and social connections — and that’s okay.

However, stress can be destructive as well as affect the immune system. Therefore, taking steps to reduce your stress in a healthy way is vital. To do this, you first need to recognize the signs of stress and anxiety, identify your concerns, find solutions to alleviate those concerns and know if you need additional assistance.

Challenges of Stress and Anxiety

The cognitive and emotional impact of COVID-19 can take a big toll on your mental health and the mental health of your loved ones. That’s why it is important to know the signs of stress and anxiety.

Stress and anxiety symptoms in adults can include:

• Difficulty concentrating
• Low motivation
• Fear and worry about your own health and the health of your loved ones
• Changes in sleep or eating patterns
• Worsening of chronic health problems
• Increased use of alcohol, tobacco or other drugs
• New or worsening symptoms for people with pre-existing mental health conditions
• Feeling overwhelmed
• Tension, upset stomach, jitters
• Compulsive behaviors, such as obsessively checking the latest COVID-19 news
• Anger or frustration
• Feelings of distress or sadness
• Being withdrawn

When it comes to stress and anxiety in children, not all children and teens respond the same way. Signs can vary and include:

• Fear
• Confusion
• Excessive crying or irritation (especially in younger children)
• Regression with outgrown behaviors (such as bedwetting)
• Excessive worry or sadness
• Unhealthy eating habits
• Poor sleep habits
• Irritability and acting out
• Poor school performance or school avoidance
• Attention issues
• Poor concentration
• Avoiding enjoyed activities
• Headaches or body pain
• Use of alcohol, tobacco or other drugs (in teens)

Solutions

The current situation is inherently and undeniable stressful for everyone. The following are methods to help you manage your COVID-19 stress and anxiety:

1. Prepare. Preparing for a range of possible scenarios and having adequate supplies can help you feel calmer. Determine how you will handle situations in advance. Decide how you will get help if needed with such tasks as food delivery, transportation, and medical care. However, remember to keep things in perspective. Use credible sources, like WHO and the CDC to better understand what actions you should take.
2. Manage your expectations. Be realistic with goals, for both ourselves and others. It is unrealistic to expect everyone to suddenly become exceedingly productive because activities and commutes have been eliminated. Go easy on yourself and others. Adapting to new situations takes time.
3. Understand what makes you feel safe. Feeling a sense of safety is different for everyone, which is okay. Don’t compare yourself to others and what they feel is safe. A quick grocery trip may feel safe for your neighbor but you may only feel safe with grocery delivery.
4. Daily routines. Whether you are able to keep your daily routines or need to create new ones to accommodate changes in your day, routines are valuable. They are important ways to maintain stability during our unstable times.
5. Establish work boundaries. One of the most important things you can do when working from home is to set clear boundaries. Explain the rules to those in your home about what they can and cannot do during your work time and set up consistent work hours. When the workday is over, leave work at the office and turn off your computer or put it to sleep.
6. Make health a priority. Get exercise, stretch, meditate, practice yoga, eat healthy, avoid alcohol and drugs and get plenty of sleep. Learn simple daily physical exercises to perform at home to maintain mobility and reduce boredom.
7. Get outside. Sit outside for a while and get some fresh air and vitamin D. Take a walk. Exercise and sunshine both help with mental health.
8. Take information breaks. Set boundaries and take time outs from scanning social media and watching, reading, or listening to news stories. When seeking information updates, schedule when you will view updates and then avoid looking for information outside of those times.
9. Relax. Take time to do activities you enjoy, such as video games or crafts.
10. Stay social. Despite social distancing and stay-at-home orders, it is especially important to connect with others during this time. Call, text, email or video chat with friends and family. Talk to trusted friends about what you are feeling. Keeping up with connections outside of your home are vital for your mental health.
11. Avoid rumors. There are a lot of rumors and speculation in the media and on social media around COVID-19 that can heighten stress and anxiety. To deter these effects, only seek information from trusted sources, such as WHO and the CDC.
12. Determine what you can control. Focus on what you can do, such as washing your hands and taking your vitamins. Realize what you cannot control and let it go. It’s important to remember you can only control yourself.
13. Accept. By recognizing, acknowledging, and accepting the reality of the situation, you can better handle what arises.
14. Be mindful. When you find yourself worrying about something that hasn’t happened, gently bring yourself back to the present moment.  Mindfulness is a helpful way to reduce stress. To ground yourself in the present moment, sit quietly and focus on your breathing and senses. There are numerous resources available on the Internet to help you if you need assistance with mindfulness and meditation techniques.
15. Be compassionate. Despite the stress of the situation, instead of reacting instinctively, take a quick moment before reacting and take a deep breath. In that breath, you will find it easier to practice compassion when you are pushed to your limits. Remember, compassion isn’t just for others but for yourself as well.
16. Self-care. It’s easy to ignore your own needs during stressful situations. However, you can help others better when you take care of yourself first. Pay attention to your own needs and feelings. Engage in healthy activities and pursuits that bring you joy and help you rest and relax.
17. Continue treatment. If you or a loved one has a pre-existing health or mental health condition, it is important treatment plans continue. In addition, you should also keep an eye out for any new or worsening symptoms. If those occur, contact your health or mental health professional.
18. Shift negativity. By shifting the way you think and speak, you can reduce the stress associated with negative talk. Instead of saying, “I’m having a hard time” switch it to “I am having a hard time, but I will get through it.”
19. Get busy. When you find yourself with a lot of time on your hands, it’s helpful to get busy. Get organized, start a new hobby or clean out the garage. Being productive helps you achieve a sense of accomplishment and allows you less time to focus on the negative.
20. Remain hopeful. Keep a broader view of the situation and look at it long-term. Be grateful for what you have right now and take satisfaction in your accomplishments, even small ones. Look to your spirituality and your personal beliefs and values.

During stressful times, children often become more attached and demanding of parents. The following methods are recommended to help children and teens with the stress and anxiety from COVID-19:

1. Talk to your children. Take time to talk to your children and teens about the COVID-19 outbreak. Make sure your explanations are clear, helpful, honest and age-appropriate.
2. Listen. Let your children talk and ask questions about COVID-19. Fill them in on correct information to reduce their worries. Share facts and answer questions in a way they can understand. Addressing their concerns together can help ease their anxiety.
3. Provide accurate information. Figure out what your children know about COVID-19, and give them accurate information about how to reduce catching it. You may have to ask about specific concerns to make sure they have correct information.
4. Focus on prevention. Keep the focus on prevention. Encourage and praise healthy hand-washing and other prevention measures, but avoid criticism and harsh correction if they are not perfect.
5. Be calm and confident. Children use cues from adults to manager their emotions during stressful times. Children and teens react the way they see the adults around them react. When adults react to COVID-19 in a calm manner, children will do the same.
6. Tell your child they are safe. Let them know it is okay if they feel upset. It may be helpful to share with them how you deal with your own stress. That way they can learn how to cope from you.
7. Limit media and social media. Children may misunderstand what they hear and see and become scared. To reduce the chances of this, limit their COVID-19 media and social media exposure.
8. Keep routines. Routines are important and comforting. Try to keep up your child’s regular routine or create new ones. Create a schedule for learning activities and one for fun activities. If it can be done safely, encourage your child to continue to play and socialize with others, even if only within the family or via video chat. Routines and safe socializing are just as important for teens. Encourage your teen to create routines that work for them.
9. Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members. Children model what they see.
10. Help your child express their emotions. Every child has their own way of expressing emotions. Help your child find positive ways to express their feelings, such as sadness and fear. Often, using a creative activity, such as playing or drawing, can help your child express their emotions.
11. Keep children close. Children kept close to their parents and family often feel safer than those that are not. If you must separate from your child, make sure you have regular contact with your child, such as regular scheduled phone calls or video chats.

Know when to get help

If you or a loved one is struggling with stress and anxiety and it gets in the way of daily activities for several days, it may be time to get assistance. It is okay to reach out for support. You don’t have to go at it alone with worry and stress. For assistance, please visit UHD’s Employee Assistance Program (UTEAP), HealthSelect BlueCross BlueShield of Texas Mental Health or HealthSelect Virtual Mental Health Visits.