Chat Transcript: Ways to maintain your mental health during the coronavirus outbreak

Mar 24, 2020

Licensed clinical psychologist Dr. Andrea Bonior was online for a special chat about maintaining your mental health during the outbreak. Read on for the full transcript.

Read some of Andrea's previous live chats here. You can also follow her new advice series, Ask Dr. Andrea, at The Lily, here.

Get mental health tips and an early glimpse at Dr. Andrea's next book "Detox Your Thoughts" here and follow Dr. Andrea on Facebook or Instagram.

Hi, all.

It is good to be back here, more than you know. But oh, how I wish it wasn't under these circumstances. (And to be clear, first and foremost, this chat has been presented to me as a one-time event.)

What a time we are living in. I would have never imagined it just a few weeks ago when we last met. Life has changed at a surreal, mind-blowing pace, and it almost feels like a dream. (Is anyone else having this sensation at times?)

There are so many angles to this, I have no doubt we could talk to each other-- and listen to one another-- for hours. (I am glad that we have two rather than one!) The health concerns themselves, and the very real fears for the lives of the most vulnerable among us, and fear and awe of the heroic folks on the front lines who are readying themselves without nearly enough protection and support, to tend to them. The people who are looking at an absolute crisis-level potential loss of their livelihoods. The people who were already suffering from depression or trauma or substance abuse and are now having their support systems shattered, or who are now cooped up with an abusive family member. The people who are wondering how they are possibly going to keep it all together now that they are supposed to keep working and watching their kids simultaneously for the foreseeable future. The people who feel an abject sense of terror about the uncertainty of it all. The people whose dreams and plans and lives and milestones are now on hold (or have disappeared.) 

The absolute anxiety of it all.

I want to strike a balance here between finding the light-- and there is still a lot-- versus validating how dark this all is. Like yes, it's lovely that I have been baking bread with my kids, but to put that out there without acknowledging that there are desperate mothers at this very moment wondering how they will realistically feed their children for the foreseeable future seems cruel and clueless.

So let's see how we can use this time to best support each other.

Some tips from the outset: I've been doing a lot of media on this and I think there are some main areas to focus on, every day that you are able.

1) Creating a sense of predictability and routine, no matter how small

2) Protecting your sleep

3) Moving your body when you can

4) Getting fresh air and daylight when you can

5) Making sure that social distancing doesn't mean emotional isolation

6) Nourishing your brain when you can

7) Observing your thoughts gently and recognizing when you are looking through a distorted lens

8) Noticing where and how your body is taking on the anxiety, and counteracting that when you can

9) Finding small moments of comfort or beauty, and slowing down to absorb them

10) Helping others, to feel like you are making a difference.

Now. Let's use this time to support each other, as so many of us have missed!

Hi Dr. Andrea. I'm glad your chat is back when we need it most. I have read a lot of articles about coping with social distancing, but they all seem to be about dealing with the people you are now locked in with. What I haven't seen are articles for people like me. Single and alone. I do a lot of virtual visits with family and friends who live far away and nearby (social distancing). I go for walks or runs or take an online exercise class. But I'm alone most of the time, especially the weekends when there isn't even a flurry of work calls to distract me. I'm alone with my thoughts and fears. Any advice on how do you cope when you're all by yourself in this?

This is part of this crisis that I feel like is really unprecedented, and a particularly ugly double whammy. In previous national emergencies-- blackouts, earthquakes, floods, wars, terrorist attacks-- communities typically get CLOSER physically. People gather at each other's houses. They give each other supplies. They cry together and hug. They have potlucks. It is very surreal-- and so, so terrible-- that all those usual ways of coming together aren't available to us right now. So, know that your feelings are understandable. This is unimaginably hard, and a truly unique time. It's something fundamentally different than anything that most of us have ever gone through.

That said, I think you need to up the virtual visits. Have larger groups, more activities together, more frequent meetings. Make goals together. Do activities together (like the whole "simultaneous Netflix watching" with group chat that I keep hearing about but haven't been able to try yet.)

And realize that part of what you're missing here is a sense of community, which of course involves other people, but also can involve just feeling like part of of the Earth, feeling part of something greater than yourself. even if it doesn't always directly involve other human beings. Take a virtual tour of a national park that interests you. Watch a history documentary. Listen to music that brings a sense of awe. Listen for birds outside.

This won't feel like normal life for a while. But anything you can do to remind yourself that you are not in this alone-- even though you are physically alone-- will provide a bright spot in the darkness.

I'm in a high risk group of seniors with severe asthma and CKD (eGFR 28). I also suffer from bipolar I disorder. I know that getting sleep is probably the single most important thing I can do to maintain stability. But I can't sleep because I am terrified. I have a sibling who lives in another state infected with the virus. How do I control my fear and get any kind of quality sleep?

I am sorry. You are right in that sleep is single-handedly the best thing you can do for yourself right now, and yet, by putting extra pressure on yourself to get it, that probably makes it even harder.

So, focus on rest. Even when you can't sleep, know that laying in your bed and doing some relaxation exercises is still valuable. Start with the most basic of sleep "hygiene" tips to keep your body as amenable to it as possible. Turn off devices an hour before sleep. Watch the temperature, noise, and light levels, along with caffeine intake. Don't eat a large meal too close to bedtime. Condition yourself to view your bed as a place of rest, so if you are cycling through anxious thoughts about being awake, get out of bed for a bit.

But I know, you can't sleep not because of the usual suspects but because of anxiety. And I am so sorry to hear about your sibling. Spend some time investigating some meditations and breathing exercises online (diagphragmatic or "belly" breathing is helpful) along with visualization techniques. Progressive muscle relaxation is helpful too, along with a hot bath before bed or warming your feet. I bet we get some good suggestions here.

On what may seem to be a screwball note, some friends of mine were recently discussing none other than Mr. Matthew McConaughey, and how his bedtime story for Calm.com is a gamechanger. I would feel silly bringing it up, except for the fact that one of those friends is a board-certified sleep doctor! And there's something to that voice, for sure. So give it a listen!

How do I not get paranoid about possibly contracting the coronavirus?

There's a slightly different answer here if the anxiety is about contracting it going forward, versus having already contracted it.

Going forward, you have a decent amount of power here. For the time being, following the social distancing guidelines as much as possible and staying home every moment you possibly can will go such a long way-- so focus on your autonomy within that situation. When life picks up again and your anxiety seems out of proportion to reality, then you can tackle it when the time comes. But for now, doing the things that under normal circumstances may be considered "paranoid" is actually part of the way to protect yourself here.

If you are worried that you have already contracted it, then you have to become an astute observer of your thoughts. It's okay to be afraid, and to sit with those feelings of fear. But try to notice-- gently-- when your thoughts become distorted. Ask yourself, is this thought realistic, or is it an unreliable narrator that comes from my heightened anxiety? Am I catastrophizing here? Am I falling prey to the classic bias of overvaluing the stakes of something, at the expense of being realistic about the odds? Am I cycling on the same thoughts over and over again and thereby giving them credence, instead of stepping outside of them "I'm having the anxious thought that I have the coronavirus" and evaluating them objectively?

It really does come down to observing your anxious thoughts as you have them. You can train yourself to draw the line between the thoughts that give you insight and help you make a plan (like the thoughts about going forward, above) versus the thoughts that are only depleting your strength and not giving you any reliable information.

Of course, paying attention to your body-- and engaging in some physical relaxation exercises-- is very important, too.

My daughter is a senior in high school and just found out that the schools in our county won’t reopen and extracurriculars won’t restart. She might still end up having online classes; we haven’t heard the decision on that yet. She’s upset at the loss of the fun parts of being a senior as the school year winds down. Any suggestions for how to help her deal with this? She’s aware that people are dealing with a lot worse, but she was really into several clubs and after-school activities and has a good group of friends that she misses seeing in person.

First, it's so important to let her have her feelings, and to appreciate her empathy but also not let her fall prey to the Yardstick of Suffering. Just because others have more serious concerns from this virus does not mean that it doesn't hurt to have your senior year in high school obliterated.

So, I would focus on two general areas. One is letting her grieve this. Talking about it, commemorating it, finding little rituals to mark this strange and scary and sad time. Expressing herself about it and letting her understand it and sit with it and feel it and eventually, grow from it.

The second area is to find a way to move forward (which sounds like the opposite of sitting with it, but really I view these processes as parallel-- even if the metaphors seem at odds.) How can she continue to have meaningful interactions with her friends even while physically apart? How can she still stay connected emotionally to her school community? How can she still pursue the interests that her extracurriculars represented? One bright spot has been seeing so many groups and organizations stepping up in amazing ways with free content-- from art classes to tours of zoos and live concerts. She can be sad about her extracurriculars ending while also finding ways to nurture those interests still (and perhaps bring her friends along for the ride.)

Ultimately, there is no easy soothing to be had here. But that is not necessarily the worst thing in the world. By letting her understand that her feelings have a place, that is a lesson in itself-- a lesson none of us chose, but one that is no doubt an education in its own right.

I am a senior and my friends and I usually play games together. Is there a safe way that we can still do that? I miss them very much.

There is no safe way to physically gather right now, unfortunately. I am sorry.

But please, please, please investigate ways to play games online with your friends. I know the learning curve seems tough and it seems like too much effort for something that could seem clunky or artificial or a poor substitute, but it just might click. And to be clear, I am not talking about video games per se. I am talking about finding ways to play your same games via Zoom or Skype or Google Hangouts or WhatsApp. Google around for workarounds for the specific games you enjoy. Yes, it might not work perfectly for every game. But you may be surprised. My husband and I just played CodeNames with dear friends-- one of our favorites-- and after painstakingly drafting a way to do it on our own and recreate the card arrangements in each of our houses simultaneously, we realized that someone had beat us to the punch and created a computer program that simulated the entire game online. It was wonderful. 

In absence of games, I'd still highly recommend having conversations with them somehow as a group, whether through a conference call or a video conference. It may seem intimidating, but hundreds of thousands of people are doing these things for the first time. If they can, so can you.

A significant source of stress for me over past 3+ years, and pointedly now during the covid-19 outbreak, is family members who believe the US is overreacting, this is a plot by China to destabilize our country, more people will die from economic losses caused by isolation measures than from the virus, or whatever they last heard on Fox News. Can you suggest approaches to responding to such naysayers? For the past 2 days, I have either said something like “I hope the US can avoid a situation like Italy” or simply not respond at all. I don’t mind not responding, but the barrage of group text messages can be upsetting, and I am loathe to block their texts in case anyone might actually need help.

Yes, talk about an extra layer of stress that nobody needs right now. Honestly, it sounds like tuning out these people is what's clearly best for your psyche. So, why not send an individual message to each person that says something like: "Hey, there. I am finding the group texts-- especially about political angles of this-- to be overwhelming and not good for me, mentally. But I don't want to totally ignore all my texts because I want us to be connected if we need each other. Can you text me individually if you want to have a conversation, or if you need help? I may not see it if it's in the group, since I'll be taking a break from those threads. Thanks."

Not only does this give them an avenue to make sure that they can still reach you and get a response, but it also gives you the opportunity to remind them that the politicizing part is taking a toll on people they love.

Not everybody's home situation is ideal. Some observers are predicting that, as couples and families are cooped up together at the same time they lose their jobs and face financial catastrophe, domestic violence is likely to spike -- and that's before anybody gets sick. Thoughts? Advice?

I am concerned about this, for sure. I can't (and won't) pretend that I'm not.

In my understanding, though, resources for those stuck in controlling and abusive relationships are still hanging on. Hotlines and chatlines are still running. Shelters are (for now) still housing people. Counselors are still able to have digital sessions (though I realize that this is perhaps the area that is most concerning-- people will not be able to talk in private about what is happening.)

This is where the micro-communities that we have built-- neighbors, coworkers, extended family, friends--become even more important, though. Let's keep eyes and ears open. Let's check in with people whom we worry about. Let's offer a shoulder and an ear and a mental break for people we know who need it. I wish I had a magic solution for you. But I can tell you that so many of us in the field are working hard to keep ourselves as available as possible. This road is going to be a long one.

How can I make my grandparents feel at ease during this time?

At some point, just being you-- their grandkid-- will go so far. We all want to help our loved ones who are feeling most vulnerable, but it's important not to lose sight of the fact that you need not turn into their therapist, or have some perfect script of the "right" things to say.

Think instead about your relationship. What do you think they love about it? What do they appreciate about you? What might they like talking to you about? How do you usually make them laugh? How can you express your love for them?

Definitely, you can share with them some of the anxiety-reducing tools that we've talked about here if you think that would be helpful. But I also think that just being a loving grandkid (no matter what your age!) is helpful in its own right. Maybe you can even choose a new endeavor together-- reading a certain book, watching a certain show or movie, or learning to knit or macrame or cook something or build something together. Flipping this into the "bright side" view, perhaps there is some new activity that you can bond over-- helping get their mind off their worries, and giving them a sense of hope and connection as well.

How can I distinguish destructive worry from constructive worry?

It's hard to do at first, but is absolutely something that practice helps with.

First, get in the habit of labeling your thoughts as thoughts. Instead of "The world is crashing down around me," label it as "I'm having the thought that the world is crashing down around me." The more you do this, the more you do what we call "cognitive de-fusion"-- you train yourself to understand that you are not your thoughts, and that no thought is automatically true just by being in your head.

Once you start labeling your thoughts, then you can also put them up on the witness stand and challenge them. In general, the line between "constructive" worry and worry that harms, can be drawn with a couple of questions:

--Is this thought adding insight?

--Is it helping me make a plan?

--Is it telling me something new that is useful?

--Is it making me stronger?

Learn to recognize the ones that don't meet any of those criteria. And for those, you can label them as unhelpful party crashers, unreliable narrators that have nothing to teach you. And then you can breathe through them and help them on their way.

Hi Doctor, I am a high school student currently at home from school. It's hard to focus with all the pandemonium with the virus, and I find it hard in general to focus in a space that isn't school on my schoolwork. How do I maintain and set a routine for myself when I am doing distance learning? do you have any tips or advice for distance learning? How do I set a daily routine for myself?

First, let me commend you on how much initiative it shows for you to be thinking about this and asking about it. That says quite a lot about you in a very positive way.

But I also hope that that level of motivation, and what are probably some high and impressive standards, doesn't lead to you being unduly harsh with yourself at this time. Understand that the usual rules are out the window, and that you may indeed not be as productive at home as you are at school. Your teachers get it. Colleges will get it. Your parents get it. So, recognize the difference between doing your best with the situation you find yourself in, versus holding yourself to an impossible standard when indeed the pandemonium is a real, tangible thing.

But, since you asked, trying to simulate the school environment as much as possible will be very helpful. See if you can create a little alcove in your house that is just used for schoolwork, no matter how small or how thrown together it is. The important thing is that it becomes a place where you are conditioned to tune other things out, and where it doesn't feel like the place where you also sleep or eat or watch TV.

Then, as far as the routine goes, be realistic. No, you can't (and shouldn't) be just doing straight schoolwork for six hours, even if that's how it might have been at school. Use this time to allow yourself to sleep later. Build in social time (if possible) with your friends and family, having a set lunchtime video conference with buddies, or eating with your parents (or both.) Set regular break times where you will hydrate and get a change of scenery. If you feel your mind start wandering and you know that you're not at your best, give yourself some compassion and step away for a little bit. Much better to put in twenty minutes of sustained attention than forty anxious minutes of not really anything sinking in.

Finally, think about a goal for yourself during this time that can help you grow in ways that you wouldn't have if you were still in your regular schedule. Taking on a project around the house. Exploring something that you wouldn't have thought you'd be "good at." Researching something that interests you but isn't considered "academic." Learning some skills of running the household and helping your parents in the process. (Maybe even learning a skill that has to do with their own workday, so that you can be something of an executive assistant to them when they need it.)

You can grow from this, and you will. But it's a matter of understanding that the path is going to look different for a while.... and that is okay.

I live with and take care of a 79 year old man and have done so for 6 years. I am also a Med-Surg nurse taking Covid cases with inadequate PPE.  He has said several times that I should quit. I can tell he is nervous and the people I work with are nervous. We feel that we have been thrown to the wolves with no support. I can understand management may not know what to do but I believe they should have been more prepared. I am starting to feel like I am disposable commodity in this crisis. What should the front line people do? I am afraid we are going to have a mental health crisis of healthcare professionals before or when this is done playing out.

I cannot tell you how much I hate this. I wish there were magic words for me to say. I wish I had the answers. I wish the masks I have played around with sewing with the machine I've had since sixth grade were realistically useful for folks like you and not just desperate stopgap measures if things get unimaginably bad.

This scenario is not right, and the people who could have made it more tolerable, sustainable, and safe fell down on the job.

You deserved better. And still do.

I am so, so sorry.

And I worry about the mental health crisis for you all as well.

But, right now, what you have is the ability to live one day at a time, one shift at a time, one hour at a time. To decide what measures you are willing to take to protect yourself and the person you live with. To decide what is enough and what is not. To value your own self-care-- from physical protection to emotional safety.

You got into this field for a reason, but no two health care providers are exactly alike in the personal calculus they have of what they need to do to take care of their own selves and families in this situation.

So, take it day by day. Be in frequent communication with your colleagues about protecting yourselves, helping each other, and planning for what's coming. Try to protect your sleep as much as possible. Stick to a protocol at home to protect the person you live with, and let him express his feelings while you listen.

You don't have to have all the answers here. But it's one foot in front of the other, one small decision at a time.

I know I join this entire audience of chatters today in saying-- as trite as it may sound-- that WE see you. We appreciate you. We are awed by you. And what you are doing will not be forgotten.

My husband is bipolar and on heavy duty sleep medication for the reasons you discuss. Can you check in with your doctor to talk about the situation and the added stress. My husband did a lot of CBT - can you tap into that as a way to reduce fear and worry, and if it doesn't seem to helping can you get in touch with your doc/therapist to discuss that. These are times where we need all the help we can - I teach yoga, and believe me, I'm call on my yoga to help keep myself centered.

Thanks for this. What a great reminder-- especially about checking in with OP's doctor.

Hello, Doctor. I have been having so many issues with panic attacks since this all started. It’s feeling like every time my front door opens is a death sentence. My husband and I both are high risk and I am finding that I have a tremendous amount of fear that we are already unknowingly infected and just waiting for symptoms to appear. The fear is looming so large! Do you have any suggestions for how to get that to a manageable place?

I am sorry. The stress is real, I know. Especially for folks who are realistically at higher risk here. I'm thinking a two-pronged approach. One, identify your triggers. If the front door is opening more than it should, tamp down on that. If there are specific things that are objectively raising your risk, tamp down on them. If there is a point at which you are cycling through social media or watching cable news and it is just making you feel worse, set limits on it and hold each other accountable. Identify the times of day when you feel worst, and try to connect the dots about what you need to cut out for now.

Next, you'll want to focus on the bodily anxiety itself. You used the phrase "panic attack" so I am going to assume that you are really feeling this, physically. So it's time to get serious about practicing some physical techniques that will help bring down your anxiety. Look for mindfulness meditations on Youtube (or through the Calm app, which I hear is offering free content.) Listen to a recording that walks you through progressive muscle relaxation. Or a visualization. Identify in your body where you feel the most stress, and try to counteract that-- neck rolls, leg stretches, yoga moves-- even lying down on your back and elevating your legs has a measurable effect on calming down your peripheral nervous system.

If the anxious thoughts themselves need tackling (and I bet they do!) then you will hopefully find some help with some of the other answers you'll find here. A very, very common theme that we could all use a little bit of support for.

I am so angry that our government knew about the risks and still did nothing to ramp up testing and supplies. To think that South Korea is handling this better than we are is mind boggling. How do I not let the anger eat me alive?

Yes, I think anger is an emotion that is not being talked about enough right now. Big anger, righteous anger, and small anger all the same. It's hard, and it's real. And anger and anxiety are BFFs physiologically-- they all serve to raise your arousal and agitation and make you less able to rest and see things clearly.

So, first, allow yourself to feel your anger. Don't stuff it. Turn it into physical energy. This piece feels like it was written a lifetime ago, but many of the same tips should still apply.

Next, think about a larger plan. How can you feel less powerless in this situation? From checking up on elderly neighbors, to reassuring a friend, to donating money (if possible) or making supplies if you are able, how can you feel like you are part of the solution in a meaningful way, no matter how small?

And finally, think about the old Mr. Rogers quote about looking for the helpers. Yes, seeing that the helpers are not getting the support they need is absolutely what is contributing to your anger, I'm sure. BUT, if you can take a moment to think about the goodness that they embody, and to appreciate that, it can help counteract some of the darkness. There is much to be angry at, yes. But there are also so many shining examples of things to be amazed by.

So glad to see you today, though I've enjoyed your Facebook posts and articles on The Lily. I've been unemployed since June, and started job-hunting "for real" in February (after spending a few months on my own health). I work in healthcare technology, so I know that jobs do exist right now... but I just want to stay home and cocoon. Still, I am proud that I TOOK SOME ACTION and talked with a recruiter/career coach this morning about how to shift my strategy for a work-from-home world. It was so helpful to have someone remind me that I have a lot to offer, and that smart companies are still focused on the future. We'll get through this eventually - stay well, everyone.

It is so good to "see" you all, as well-- really, I can't even express it.

And this is such a hopeful example. A scary roadblock thrown up, but you thought it through, and found a new path to try, to try to compensate for it. Thanks so much for sharing it.

I, like everyone else, have had a hard time dealing with the self-isolation, and fear surrounding COVID-19 follows a very tough 18 months, where 4 of my close family members passed away. And today, my sister in law died following a short battle with cancer. I hadn't seen her for more than two weeks because I had a cold first and stayed away out of an abundance of caution, then the hospital stopped all visitations because of the virus. The hospital only allowed my brother and nephew to say goodbye at the end. Due to current state limitations on gatherings (due to the virus), we can not have a funeral or church mass at this time. I guess my question is, how do I reconcile this? How do I deal with not saying goodbye before she passed or after since there can be no funeral for the foreseeable future? How do I come to terms with not being able to help my brother and nephew because we are not allowed to visit? I live alone, so I think this is compounding my feelings of helplessness and isolation. Thank you.

This breaks my heart. And I think these are the absolutely horrifying realities that are hitting home for folks right now. Who could have imagined a scenario like this? People unable to attend the birth of their children, or to memorialize those they love. It's awful, and I'm just so sorry.

But, I think that two things could be helpful here. One, is to remember that there can and WILL be a gathering someday. That a lack of memorial service now is not a lack forever, or an indication that your sister-in-law will be forgotten.

And second, it's about what you can do now. Although you missed the opportunity to say goodbye to her in person, and that is so unfair,  you can develop your own meaningful way of thinking about her now. You can still carry her with you; your relationship with her does not have to end even during this loss. Write something about her, or talk to others about her, or look at pictures of her, or even say something out loud now that you would have liked to have said to her. You can create your own ritual here, anytime that you would like.

And then, look to technology to help bridge this isolation gap. You can still help your brother and nephew by listening over the phone, by sending them loving words through email or text, and-- if you are all up for it-- going a step further and video-talking through Skype or Facetime or Zoom or WhatsApp. And you can try to reach out to friends of your own, as well, who can in turn help you by listening to your own feelings of grief.

It is an awful thing that you all can't mourn and support each other the way you want to. But it doesn't have to be all-or-none. Take small moments here to let yourself feel, and let yourself remember. If grief is the underside of love, then let yourself feel both, and fully-- whether there is formal structure to it or not.

Hang in there.

I am 7 months pregnant--due end of May 2020--and I have a lot of anxiety about coping with this new normal. Prior to the Covid-19 Pandemic in the USA, I felt very in tune with my baby, my body and my health. The past two weeks have been chaotic with work(I am an attorney, so already a very stressful profession) and life and I just feel like I have not been in tune or present with my baby, husband, or life. I can't even get the healthy foods I was eating before because everything is gone or difficult to locate. I am so worried about delivering in a hospital for safety/ health reasons, and worried the hospital may run out of essential supplies like masks, gloves etc. I am saddened about my decision to have a baby at this time and bring this poor child into a world like this. I guess I need advise about coping and adjusting to this is new terrible normal, from the perspective of a panicked first-time-mom to be. Thank you.

I would love to hear from other mothers-to-be (and fathers-to-be) in this same boat. I bet you'd have a lot of support there.

First, let's tackle the "bring this poor child into a world like this." Can I get you to zoom out a bit and recognize that as a catastrophizing thought? The world that you create for your child will have love, and light, and hope. It will have laughter and music and games. It will have a warm blanket and laps and pairs of arms. It will have smiles and new wonders to learn. All because you are still just as capable of creating every bit of that in the home that you bring your child back to. In fact, if I may allow myself to be the optimist here, it is quite likely that your child will never understand the nature of what was going on in the very beginning of his or her life, and will instead think about it as something in past history.

But I do get it, the way that this latter part of your pregnancy has been thrown into chaos that you would have never expected. The concerns about hospital deliveries are real and understandable and I can only imagine how frightening that uncertainty feels. You can help control that anxiety, though, by being in meaningful contact with your health care providers, making specific plans (and knowing when to change them, and bringing up your concerns directly.

It may be rather soothing to think of all of the thousands of years of mothers (and fathers) before you who have brought life into a world that felt uncertain or dark. But those babies came, and those babies were capable of hope. So we can be as well. The sun really will continue to rise.

Hang in there.

It sure helps me to work in the garden right now....I have 2 4x20 foot raised beds as I luckily live out in the country that will fill most of my vege needs for May thru September. I heartily recommend container plants for those who don't have the space. Gardening is great for my ;mood and provides physical activity that takes my mind of my isolation. Thanks

Yes. So very true. Thank you for this reminder. While others hit the grocery store my kids and I hit the plant stores too. Just watching those little seedlings come up has given us a project, and a sense of life moving forward, and a reminder that the natural world persists in all its beauty-- so invaluable.

(Speaking of which, how much do I want to bow down to the saucer magnolias in the DC area right now? The cherry blossoms get all the love, but the magnolias around my neighborhood are such a mood boost, it's indescribable.)

I am an older musician, but I have had to cancel every job i have and that i depend on to make money, laugh with friends and make live music. It feels awful to sit around, and wonder how long brfore the money runs out, and the possibilityof dying from this disease is omnipresent, even though I cant go anywhere. I know its terrible for a lot of people, but you cant zoom music making. Im not the only one like this... but what can we do?

I am so sorry.

But I do think keeping making music-- for an audience-- is something to still pursue right now. Yes, the pay is uncertain. But you CAN zoom music-making. You can Facetime-live it, or Instagram-story it, or whatever social media flavor you are willing to experiment with. Because as many drawbacks as social media has, it can provide something here for artists like you-- a way to still create and share. A way to keep in contact with your audience. Might you consider it?

My husband and I have an 11 month old and a three year old. One of my worries is that if either my husband or I gets Covid-19 or if both of us do, how will we be able to take of the kids? We are already both stressed and tired trying to take care of them and work (luckily from home), and I am scared of not being able to take care of them if we get sick, or alternatively not being able to rest and recover because we are having to care for them. His parents live near by but they are older so vulnerable and so we wouldn’t want to ask them help. This worry is on my mind a lot, and I’d be grateful for your advice.

I can really understand this concern. But let's zoom out a moment and look at the big picture here.

At what point is pressing the fast-forward button and worrying about the ins and outs of what exactly might happen in this scenario helpful to you? Versus it adding to your stress, actually making it harder to do what you need to do in the moment right now, reducing your coping? How much energy and preparation should you be expending on a scenario that doesn't exist yet and won't necessarily, ever? How much of your own current strength and energy and peace of mind are you willing to squander on that scenario?

Again, I am not saying this concern isn't rational. Since your child care responsibilities are fierce (11 month-olds and 3 year-olds can't just be plopped somewhere with a remote control; I get it) then you DO need to have a basic contingency plan in these circumstances. Where the sick parent would sleep to try to hole up away from the others. How the house could have a temporary, rigged-up extra layer of childproofing or an area where the kids could safely exist with less supervision than normal. What videos could be played for long periods of time if the two of you were laid up. Where supplies like diapers and clothing could be moved, to minimize having to traipse from one floor to another. What kind of medical consultation or calls you would make if you or your husband or your kid did get sick. What friends or family could be called on to digitally entertain the kids through video-conferencing for ten-minute chunks at a time.

But once you have that plan, then you need to recognize that if you keep returning to the "What ifs," you aren't gaining any strength. You aren't adding insight. Those extra thoughts are redundant-- they are superfluous. They're not helping you. And they shouldn't be invited to settle in.

I know that right now is anything in normal life, but in normal life, would you allow yourself to ruminate on the possibility of what would happen if you and your husband were suddenly debilitated and unable to care for the kids? I get it-- your usual backup plan of his parents is not possible right now, which makes the possibility of sickness even scarier, not to mention this entire experience is way more stressful than typical-- but even in normal life there are all kinds of scenarios that you can choose to cycle around and around about, or choose to make a reasonable plan for and then move forward. And yet at some point, your brain has allowed itself to draw the line and move on from the thoughts that don't deserve space. The aim is the same here too.

So, be gentle with yourself but when your thoughts move toward rumination, label them as unhelpful and create a basic nudge that helps you reset. "I'm having the anxious thought about one of us getting sick again. We have a plan, and that plan doesn't need to change right now. We will do the best we can, the odds are immensely in our favor of getting through it. I can help myself be stronger right now by breathing through this thought and letting it pass. I'm going to do some stretches/breathing/get some fresh air and reset my thoughts a bit."

So, do what you have to do to get through each day but stay in the present moment. Take things one at a time. Realize that these anxious thoughts will come, but if they don't have anything to teach you, then they're obnoxious blabbermouths that shouldn't be invited to sit down for a full-on conversation.

I still have a job but I am living paycheck to paycheck. I cannot stop worrying about the unknown of the future, what do you recommend are some coping strategies for people with depression and anxiety?

The unknown is one of the most difficult parts of this, no doubt. I am so sorry that the financial uncertainty in particular is so prevalent for you, because that affects the most basic levels of feeling secure and safe.

There are a couple of things to keep in mind. One is that our stress levels tend to lower when we increase our sense of predictability and controllability. So, of course that means that the uncertainty of everything raises our stress, but it does allow for us to find small areas of our lives to carve out some autonomy and help us feel better. Keeping a daily routine. Having some structure in your day. Limiting your exposure to news past a certain point. Protecting your sleep. Making your mealtimes regular. Having set breaks.

But the other part is understanding that right now your job is to get through each day. Do everything that you can to manage what is right ahead of you-- keeping up with your responsibilities at work and at home (which may have been blended at this point)-- and when your thoughts go too far ahead, ask yourself if those thoughts are actually helping you make a plan (admittedly some worry is good in this way), or if these thoughts are redundant or unhelpful or unduly catastrophic-- they're being hecklers in your mental audience. Catch yourself when you hit the fast-forward button too much about the future. Ask yourself, what can I do right now that I need to do, to help today be as good as possible, and position me for a better tomorrow?

The more you practice this, the more natural it becomes.

What are some ways to avoid family flare-ups when working and schooling at home? My wife and I have worked from home on occasion but the addition of our 13 year old daughter has increased the overlap (and stress) exponentially. Help us keep the peace!

Space, space, space. Physical and metaphorical.

Carve out certain quiet times where you are each not to be disturbed (and stick to them.) Designate areas of the house that are each "yours" and to not be intruded upon. Come up with rules-- together, with input from everyone-- that will help people get their individual needs met.

Make sure that your daughter is getting some sort of social interaction if possible. No doubt being a 13 year-old girl is not necessarily known as being the height of easy emotional sailing anyway, so you can imagine how her world feels like it was thrown into a blender right now. Let her express her feelings. Ask her what's important to her during this time, and how you can help honor that.

Then, lessen the standards. It's so much more important to keep some breathing room and some semblance of patience with each other than it is for you all to be going full-steam ahead with work and school. Try to set some ground rules about taking breaths before you say something harsh, and speaking to each other with kindness, and taking breaks when you feel yourself getting irritable. If those things can happen as a baseline, then that is as good as anyone can expect right now!

What advice do you have for someone who is very sensory and affectionate who is in solitary self-quarantine? I am self-employed, single, living alone and strictly self-quarantining. I have not hugged anyone in days. I video chat a lot for work and to stay in touch with friends but the physical isolation and lack of physical personal contact is very hard for me. To help I take warm showers, wear textures that feel good against my skin, I put on body lotion after every shower, I hug myself when I feel sad, I snuggle with stuffed animals, I absentmindedly massage my scalp....but it’s NOT the same as a hug from a friend. I may need to go another month or more in physical isolation, so any ideas for staying sane without touch from others is very appreciated. I don’t have a pet now but am hoping to adopt a cat ASAP.

I do think that the cat will help quite a bit. I hear that lots of shelters are needing help with fostering right now, if permanent adoption is not in the cards. It could go a long way for someone in your situation.

You are doing all the right things physically to try to mimic that sense of "warm touch." But of course, it's not the same. I understand. So you may need to go heavier on the other-person piece. What are ways that you can "touch" someone else across distance? (I am not even meaning sexually here-- though no doubt that is a separate but meaningful question in its own right.) How can you show affection even without physical touch? How can you express gratitude? How can you perform acts of kindness for someone else-- or even a stranger?

The physical piece has been taken from you right now, no doubt. And again, I think you are doing so much to try to compensate for that. But the emotional piece is an important component as well. And sometimes emotional connection can at least approximate that same warm sensation. Good luck!

I heard an acquaintance has coronavirus. I may be within the window of contact but need more info about the timeline. They are dealing with their own health issues of course but how to find out? It seems important to know. Yikes.

Well, I think it depends on where you heard this information. If it came from someone else-- a person in between you and them, perhaps-- then you can have a followup with that person. ("Hey, I don't want to intrude, but I need more specifics about Barry's illness. I may have had contact with him while he was contagious so I wondered if you had any details.")

If you heard from them directly but are now just hesitant to follow up, remind yourself that following up is what you need and deserve to do for your own well-being. And clearly if they told you the news, then they fully expect to have to answer more questions about whom they may have exposed. Do it sooner rather than later, in a compassionate and gentle way, but do it.

Good luck.

I have self-isolated with my husband and our two 20 something children in a second home we own, in a state where they have roots. Our main residence is in an epicenter and I don't want to return to it. They are understanding of my request they remain here but want to know when they can go back. They have boyfriends and relationships they are concerned will fracture. How do I manage their expectations. Differing family members either are angry we are here or encouraging us to stay.

Well, I have to be honest here. Part of this is a question about whether or not they have the right to do what they want as adults, right? In other words, how firm is your "request"-- and how much will you respect when they decide on their own that they want to be with their partners?

In an ideal world, they would continue to isolate with you as long as possible. But at some point, if their partners are considered their family in their own right, then some difficult but meaningful questions need to be worked through. And then, depending on your view, it becomes a matter of finding the sweet spot between advising them of your own opinions and respecting their autonomy, right?

Please get outside as much as possible -for all of us. Nature makes such a difference. Andrea mentioned the magnolias, which I love, and this area is alive with blossoms. Breathe in nature and exhale your anxiety. (Side note, please stay in your garden /local - don't travel for your nature fix.)

Yes. Thank you!

One thing that has not been taken away is our ability to get fresh air. That and the sunlight have measurable effects on our mood. We need to take Spring for all it is worth!

How do you suggest carving out space for everyone in the family? We’re all getting annoyed with each other, with no end in sight. :-(

It is so hard. Trust me, I get it.

I think we can look at this as having two important variables here: space and time. Both can be divvied up accordingly.

Space-wise, think about shifting things around. Can new little nooks be established with tables moved around? If there are younger children, can big cardboard boxes be repurposed for little enclaves or clubhouses, or can the classic cushion fort be called into service? If you have everyone trying to work or do school at once, maybe try to give everyone their own designated area-- even if it's just a part of the kitchen counter with a stool. If you have more than one floor, use that separation mindfully. And think about sound barriers too-- earplugs if you have them, closed doors so that sound isn't echoing as much, wearing headphones when you have to work or just need a break.

As for time, I do think a schedule can help. No matter whether you are a spreadsheet family or a fly-by-the-seat-of-our-pants family, some basic scheduling can literally keep people away from each other at different times. Carve out time for yourself where you go into a backyard or even a bathtub but are absolutely not disturbed. And build this into the routine.

You could also bring this question to your family members and let them have at it in coming up with solutions. One thing that is often surprising is just how different everyone's needs are, and if people can spell that out specifically ("I need to Facetime a friend without little sister interruptions" or "I just want to get a snack in peace sometimes" or "I want to play my instrument to calm down for 20 minutes without other people telling me to stop") then it can go a long way to reduce the annoyance.

Hi Doctor, thanks so much for being here. A few people I interact with regularly are going off the deep end with anxiety to the point of irrationality. What is a helpful way to respond to them without handling them with kid gloves or being condescending? Thank you again.

I think you have to validate the emotion without validating their catastrophizing. So, start with empathy, but make the distinction between that versus saying that what they are saying is rational.

"It sounds like you are really struggling here. I am sorry. I know how hard this all is, and how anxiety-provoking it is. But I also don't agree that X is bound to happen. A  lot is uncertain, but that sounds more like worst-case-scenario given the information I've seen. I hate that you are thinking in these terms. How can I help you feel better?"

During "normal" times, this does not bother me as much, but now - in the midst of a pandemic - the following situation IS bothering me: I could die in my apartment, and it would take several days before anyone thought to investigate. I'm single and live by myself, and now due to the pandemic am working from home. None of my family (two sisters, mother) lives anywhere near me, and although we are in touch pretty frequently now, 98% of that is on MY initiative. I don't have a BFF, and although I have many friends and acquaintances, certainly not any that I am in touch with every single day. And, yeah, if I'm dead -- who cares whether I'm found a couple of hours or a couple of days later. But I'm getting at is, no one truly cares enough about me AND follows through with the caring by checking to see how I am doing. I email & text family members regularly, I call mom regularly, I am sending snail mail and packages. BUT NO ONE ELSE THINKS TO DO THESE THINGS.

I am sorry. As much as this may make me sound like some sort of goofy self-help guru trying to sell you my own brand of essential oils, I do think that something that can grow from this is a recognition of what we want to reset in our lives. In your case, you are realizing that the connections you have feel insufficient in certain ways-- in terms of level of initiative. So, as awful as it is to be reckoning with that (and I realize you were noticing it before the pandemic as well), it can actually arm you with some motivation to change some of these relationships in the future, or seek out additional ones where the reciprocity feels more balanced.

But nothing should be stopping you right now from being more direct about what you need. What about choosing a friend that you particularly trust, or a family member who is on the more compassionate end, to air your concerns? To spell them out clearly? "This is a particularly difficult time for me because of living alone. I find myself wondering-- would someone even know if I needed help? I now it may sound strange to ask, but I think what I need right now is someone taking more initiative to check in on me, just like I check in on you. Would you be willing to do that? I really need that now."

How can I best deal with an eating disorder (binge eating) and the food scarcity caused by panic buying? It seems to be aggravated by the craziness at grocery stores.

Yes, yes, yes. No one is talking about this-- or substance abuse-- and yet it is something that I know is just another major layer of struggle in all of this.

Think about what you have learned in the past about your binge-eating. What are your triggers for it, emotionally? And what other coping mechanisms do you have for those feelings? Are there times of day, or circumstances, that make you more prone to do it? Are there other physical experiences that can guide you away from going into a binge (a hot bath, stretching exercises, aromatherapy, breathing exercises, doing something with your hands, having a cup of tea, chewing gum?)

The combination of being trapped at home, with normal food supplies being shaky, and no end in sight, can make this really tough. But the same psychological rules apply to help you be less likely to fall into the cycle.

I would also add: please, please, please watch your sleep. Sleep deficits cause a vicious cycle in terms of lack of energy and hunger cues, along with lack of impulse control.

And, don't be harsh on yourself. If you binge, you binge. Avoid all-or-none thinking and go heavier instead on self-compassion.

Finally, some of my past clients have had luck in "postponing the binge." It's a technique that's related to "urge-surfing"-- which is used in substance abuse, and I go into it in detail in Detox Your Thoughts. But basically what postponing the binge does is this: it's easier to do (much easier to say "Okay, I will wait 20 minutes before bingeing," than to just tell yourself not to binge at all), and then, by the time that 20 minutes passed, you forced yourself to tolerate the discomfort and the urges. You likely won't want to binge at all by that point because the hot emotions have flowed through you and you've still survived and managed them, and they've cooled down, and you've perhaps found other things to do. And even if you do end up bingeing, at least you've still notched twenty extra minutes of practice of sitting with difficult feelings.

No question: just— we are so glad you are here! Everything is good at our house. 2/3 of us are introverts who enjoy chess, watching movies and playing instruments. 1/3 of us is an extrovert who is making actual phone calls to friends, sewing masks for medical workers, and having yard-to-yard conversations with neighbors. Be well, everyone!

And I am so glad you are here-- especially with such a ray of hope. So glad to hear that your family is getting by so well. Thanks for writing!

This is so sad - but I think Andrea is right. People are most likely being clueless. I bet you have people who do care for you. Ask them to check in with you. Before I married, I worked from home / did research and I was like you: no-one would worry for a few days if they couldn't get hold of me. Yet I have friends and family who care deeply for me and would have really felt the loss. If you clue people in, like Andrea says, I bet you'll be surprised.

Yes. Thank you for this. Sometimes it really does help to simply ask specifically for what we need.

Yeah, thanks for imposing your privilege on me. I live in a big apartment building, not a house. No garden. No yard. I can't even get to the front door without sharing an elevator or walking down 13 flights of stairs. The way people love to superimpose their situation on others is just mind boggling.

I'm not following. OP said stay local. Clearly that includes just walking around your neighborhood, no?

There was a slash there between garden and local, for goodness' sake! Let's not use this excuse to create further dividing lines among us at a time like this.

Unless you heard directly from the person who is ill, DO NOT reach out directly to them. I am currently waiting on my COVID test results and there are people contacting me whom I didn't tell directly to ask for updates (solely because they want to know my test results due to their own risk of exposure) - and this is starting to piss me off. Find a go-between.

Yes. Thank you. The person who originally spread the news should be the one expected to update if possible.

Best of luck to you and your health. Hang in there.

Really, the kids should not be moving anywhere. They should not be taking any lurgey they have to another place, to spread there. It's tough and it's a sacrifice but from a purely public health point of view, no-one should be travelling.

I certainly think this perspective makes a lot of sense on a basic level. But I think there are some wide ranges of circumstances here. For instance, let's imagine a 25 year-old who lives with a partner in their own apartment, who has temporarily decamped to their parents house with their own car. After isolating there for enough time to be sure that they don't have symptoms on their own right, is it truly a bad thing for them to drive back to their own apartment and be with a partner who has done the same, especially if that would go a long way toward their mental health? I'm not saying that this is for sure OP's situation-- but rather that if we are indeed talking about legal adults, at some point their own priorities need to be taken into account.

As elementary and middle schools are closed for the foreseeable future, I feel like districts just shoved technology and assignments on kids. As a household with 2 working parents, and a lengthy list of "appointments" and homework that requires supervision, I am trying to find a way to push back on the school? We are all trying to be patient, but having mandatory things seems excessive. Plus, the toll on my emotional health is terrible. I am having to juggle work, have started yelling at the kids to get their work done (while I do mine) and so much of the homework involves parents. I am jealous of all the stay at home parents who post images of baking and collages. How can working parents better manage with school age kids at home?

I am sorry. I am not sure what your kids' school is requiring-- my kids' school district has been something in the general area of a big nothingburger, which is appreciated and not, depending on who you talk to-- but absolutely, no institution has any right to expect that you will be full-time homeschooling your kids on their terms in this environment. So, push back if it makes you feel better, but also feel free to just ignore it all at this point if that helps your mental health.

Set the schedule that YOU want, that helps YOU cope. That could be chores and movies. That could be video games and bike rides. Heck, that could be Ultimate Fighting Champions (we are having many rounds of that in our house, mostly unplanned.)

You are doing okay here. Whatever you decide needs to happen (or not) in order to keep your home as mentally stable as possible, that is the right thing. Promise.

Those of us in the chronic illness and disabled community have been dealing with the negative effects of isolation and being homebound for a long time. It's frustrating now to see people continue to minimize our experiences while lamenting their own experiences with isolation. The same people that told me, "it must be nice to lay in bed all day," when I was severely ill are now complaining about being stuck in their houses. How can I talk about this constructively with my friends and family that are now experiencing the struggles I have been going through with my illness for more than a year?

Ugh, I am so sorry.

Am I allowed to say, though, that anyone who says "It must be nice to lay in bed all day" to someone who is struggling with being disability and a chronic illness, is a wretched jackanape of the highest order? 

So I seriously hope that it wasn't actually your friends and family who ever said that in particular. But I understand the larger issue of how invalidating people in general have been, and how annoying it must be to see them using a totally different standard when it's applied to them.

I think you start by being honest, in a respectful and patient way. You use an "I" statement with a gentle nudge when there is obvious hypocrisy ("I've got to be honest here, it's strange for me to hear you complain about this when in the past it felt like you thought I should count my blessings about being stuck at home. It's kind of hard for me to hear this from you now that the tables are turned.")

They may get it, or they absolutely may not. But it can be a continued conversation. Those who are more willing to engage with their own mistakes and listen, you can go further with: "Here is what I have always found most difficult about it. I feel like maybe you understand me a little bit better. But here is also what I found can be helpful."

If you want to still be connected to these people, then you could view it as a chance to become more connected with them-- for them to really get you in a way that they had failed to before. And teach them something important in the process.

I feel like I need something for anxiety, but my doctor won't prescribe without an office visit and he isn't allowing office visits for anything but "emergencies." I'm not suicidal, just crying a lot and very anxious. Should I pursue it? I'm also reluctant to expose myself to his potentially dangerous office. (I'm 71.)

I would not tell you to go into the office for this, no. It does not seem worth the risk. But I am so sorry you are suffering so much.

I can't say I disagree with your doctor's policy, but I also hate that you are in this bind. I would suggest two things. One is to pursue the possibility of a different doctor who offers more formal telehealth consultations, where he or she can see you and indeed potentially prescribe something despite the distance.

The second would be to put every non-medication anti-anxiety measure there is, which is a good idea whether you receive medication or not. Diaphragmatic breathing, visualization techniques, progressive muscle relaxation....I am not sure if you tried any of these yet, but they all have good empirical support.

 

Since chest tightness and shortness of breath are symptoms of anxiety, how to tell the difference/cope?

Yes, you know you bring up yet another double whammy here (how many are we at now? Do the whammys grow exponentially at some point?)

That because this is a respiratory virus whose chief symptomology involves shortness of breath, then this means that psychosomatic symptoms are even more likely than in a typical situation, since breathing symptoms are one of the chief markers of anxiety as well. It is unfortunate, for sure. And is making a lot of people miserable.

That said, you can look for other symptoms of anxiety as well-- increased muscle tension, increased heart rate, sleeplessness, irratibility-- that are more indicative of anxiety and add to the likelihood that that's what's going on. (Or, on the other hand, if you have other symptoms of COVID-19 that don't correspond to anxiety.) But most important is to actually try to intervene in the moment to decrease that anxiety, which will not only help you assess if that's what's going on, but will also help target the problem and get you to feel better. So, diaphragmatic breathing. Visualization exercises. Mindfulness meditations. Progressive muscle relaxation. (Sorry if I'm becoming a bit of a broken record here on that score.)

I understand hard, ethical choices are coming our way, but I can't stop feeling lately like I'm disposable -- and that we older folks should just grin and bear it. I work crisis response and anxiety through the roof. very healthy except for asthma on occasion, which isn't good for this disease. my children and grands are staying away and contacting me via social media, so I'm lucky. but I feel rather hopeless

I am sorry. It is abominable, the messaging that makes people more vulnerable to this illness feel like they aren't cared about, or are "disposable" (my stomach lurches even reading that word.)

There will always be people without compassion, unfortunately. There will always be people who value certain groups above others. There will always be people without empathy, or without the ability to see the perspective of others, or the value of them.

Let's not let those voices-- which are being heightened in these times-- indicate anything about our society right now. They are the dark parts, but we don't need to elevate them.

Hopelessness and helplessness tend to go together and egg each other on, so I would focus on your daily plan to help you feel less helpless-- which will reduce the sense of hopelessness and despair, at least a little. What can you do each day to feel more in control, and to keep yourself safe? How can you still feel connected to those you love, and to remain feeling valued by them? How can you reach out to other people that are in your shoes-- crisis responders and older folks alike-- and be each other's support?

You are not alone. And you are anything but disposable. Thank you for everything you are doing.

If you're working from home, consider having a quick daily email check-in with your co-workers. My supervisor started that when we were all ordered to telework, and although I'm here with my husband, others on my team are single and probably like knowing someone is keeping a (remote) eye on them.

Yes, good idea. Thank you.

My wife takes music lessons -guitar. they have switched to zoom. she says it is about 80% as effective. she is happy with it. Make do. it isn't perfect. It is admirable the she is working within the limitations and persevering through it. it brings a form of acceptance and gratitude of the things we still do have. and once you try, it can be fun.

Yes, thank you!

I know the prior musician OP wasn't necessarily a music teacher, but now may be a time to test those waters.

This is a tough one at my house too. Have multiple late teen to early 20 kids back home all of whom are bored and stressing about missing boyfriends/girlfriends and are at different levels of "getting it" regarding how serious this is. Youngest in particular doesn't see why can't go visit boyfriend if their family is being careful and ours is too and keeps expressing that she is an adult and can do what she wants even though we have people in our house who are more at risk to complications. None of which is helping with my overwhelming anxiety about the whole situation.

Ah, these early 20-somethings. Technically adults, and yet not listening to reason!

As can be explained to your youngest, the problem is that there are different levels of "being careful" and the moment someone makes a single exception, they create a new chain. Your son goes to a girlfriend's house whose mother just happened to pop in on a neighbor for coffee and the neighbor is still having to go in to work. All of a sudden, your entire family is exposed to the workplace of your son's girlfriend's mother's neighbor.

Keep a hard line on this if you can. It may make it easier than equivocating. If boredom gets to be too much, I am sure there are things they could do around the house to be helpful.

I know it is hard!

Thanks for having this session for us all. It makes me feel happy there is support out there. Do take care.

And thank you for being here. It means more than you know-- I am so grateful for it as well.

Presumed positive COVID *and* clinically anxious here! For me, physical activity always helped my anxiety symptoms, even something simple like walking the dog or an easy bike ride would ease the tension in my chest. I realized I was sick - not anxious - when the usual physical activities made my shortness of breath worse. Purely anecdotal, but that's all I have to offer :)

Yes, that makes a lot of sense.

Hang in there and take care of yourself. Sending all good vibes!

How do I stay motivated to do essays I don't want to do? How do I avoid taking naps throughout the day to maintain a healthy sleep schedule?

First, you've got to be an observer of your patterns here. What are your Achilles heels of sleep? (Scrolling through news? Staying up late because you don't have a commute in the morning?) Then target those things that are getting in the way, one thing at a time, with reasonable goals.

As for the essay motivation, pay attention there as well. What times of day do you have the most energy? What times of day does your mind wander more and you need more of a mental break?

I would break the essay work into smaller chunks-- enact that aforementioned 5-minute-rule if necessary. And I would try to up the physical activity, which can both improve your sleep and also give you more energy during the day. The rare win-win in this situation!

My husband is 16 years sober. They are holding AA meetings by phone. Check out some support - is there are group you used to go to? If not, seek some out. I really believe that fellowship with people who know what it's like really helps.

Ah, this is so good to hear. Thank you.

Yeah, I have been very concerned about those in the recovery community, especially those who are newly sober. I am so glad to hear examples of meetings that are still able to go on in some form.

I suggest OP contact their kids' teachers directly and get some expectations. I had a virtual neighborhood get-together last night that included teachers from three different districts. Schools are figuring this out as they go, and they won't know that what they're trying isn't working unless someone tells them. All of these teachers said the same thing though: No one expects you to be able to educate your kids full-time. What we're doing now isn't even "home schooling" in the traditional sense since that would normally involve field trips, community programs and collaboration with other families.

Yes, exactly. Thank you for this. Very helpful.

The same is true of college classes right now. For instance, I have moved my in-person class online, yes. But quite frankly, that is different than "I am teaching an online class." We are all making do and learning as we go. But things are different than if I had been planning to be online from the get-go.

I really like this column for how to approach schoolwork / home schooling. 

I don't have time to vet this link but thank you for it!

Hi, Dr. Bonior! Great to have you back, even for a day. I have an issue with my thirty-something daughter, who just asked me for about the fourth time within a week to drive across the state to watch her two-year-old son full-time for a few weeks during this pandemic. I said no; I'm staying home for the foreseeable future because I'm in a higher-risk group due to my age (over 60) and a few health issues. She's always been pushy to get what she wants, and she pushed back by reminding me that our governor's new order to stay home allows people to travel to help family members. But there's no way I'd hang out with a germy toddler who's been in daycare. Plus my daughter's husband is notorious for his lack of handwashing even before this crisis. PLUS the three of them flew home Friday night after five days in a busy vacation area with a major outbreak and a governor who was slow to shut down public spaces. My daughter apparently doesn't see the need for the three of them to self-quarantine for two weeks before asking anyone to visit. What should I do with my hurt that she's ignoring my health and safety? I pride myself on being generous with watching my grandson, but this is a firm no, and I won't budge. So that's not the problem. It's how to handle my hurt and anger toward my daughter. There are other reasons not to say yes (not that I need other reasons) such as wanting to be home with my husband and near my other adult daughter and elderly mother in case they need help. My older daughter seems blind to it all.

I forgot to mention that finances are not an issue for her and her husband. They could hire help or take a leave from work without taking a big financial hit.

Good for you not budging. That is the most important part.

As for the hurt and disappointment, time will help. And communication. Understand that she is looking through a distorted lens here that is keeping her from seeing the reality of the situation. It could be a lens made of ignorance (not enough of a reality check about what we're really doing with here, exposure to news sources that are feeding her inaccurate information) or yes, it could be a lens made of selfishness. I can't tell you for sure, of course. But I would urge you not to let this one time be the ultimate referendum on who she is as a person. Yes, she is disappointing you now. But if this is out of line with her typical character-- if she is usually not this clueless, and not this selfish-- then I would try, in time, to give her the benefit of the doubt. You can express, eventually, how much this affected you and how hurt you felt, and how concerned you were that she seemed to devalue your safety in this. But for now, rest assured that you are doing what you need to do to withstand her poor judgment and keep yourself safe.

I’m a physician and live alone. I’m ok with it most of the time. My parents were killed in a home invasion a few years ago, which intensifies loneliness at times. I now have COVID-19. I’ve been surprised by how grief and severe PTSD symptoms have returned. My COVID 19 has nothing to do with what happened to them. Is this normal?

Oh, my goodness. This is one of those times where I wish I could reach across this crazy Internet and speak with you directly.

First, this is absolutely normal for PTSD. A trauma is a trauma is a trauma. Anxiety is anxiety is anxiety. As the famous book said, "The body keeps the score." I am so incredibly sorry for the unimaginable loss you suffered. That stays with you in certain ways, forever. And though no doubt you have grown bigger around it, and found new layers of resilience after it, there are ways that it sensitized you further to anxiety... which you are at the forefront of now, compounded by loneliness.

It's really important that you have access to more substantial support here. Did you ever have therapy after the traumatic loss? A grief group? A trauma support group? If you don't have an existing relationship with a mental health community or provider, please do find one. I know that this feels like yet another task to put on your plate when you are probably swamped with your professional duties. But in those duties, you are helping everyone ELSE. It's vitally important that you take care of yourSELF here as well. There are therapists offering video sessions, there are online groups that are meeting.

Please do reach out. You are not alone in this, and I don't want you to feel like it. My heart goes out to you!

Love that phrase. Thank you for being here. I find reading your Q&As soothing. We are doing fine considering. Biggest concerns are what will happen to family pets if we both die, and concerns about estate going to inappropriate family members by default. Note to self: estate planning and wills are a good investment in peace of mind. Thanks again and well wishes to you & yours.

Thanks so much for your kind words. Best wishes to you as well.

It's true that when we think about controllability of the situation, having estates in order can help add some peace of mind. I've spoken with more than one person who has been doing that at this point in time. It can feel morbid no matter when you do it, but right now is as good time as ever to check it off a list and feel like at least one thing has been accomplished and sorted out.

While the pandemic has put most of us into a precarious financial situation I have been more than happy to donate to musicians who are holding virtual concerts. Many are doing so with a "suggested donation amount" and it's been an awesome way to support the people who's art I love, and to bring some joy into my home! If you're able to I bet people would appreciate the opportunity for something other than the news to fill the silence, and so many people really seem to want to find ways to help.

Yes, yes, yes. Thank you. For doing this and for writing!

Musician OP, are you listening?

I'm the OP: This is my situation too. I live in a condo. I go for a walk in DC once every couple of days - there are next to no people on the street and I find it easy to keep far away from people. Please find a way to go outside and feel the sun on your face, it's super important.

Thanks for this, and especially for your kind tone. I hope the responder was listening.

I do think it's important that we don't make assumptions!

I am a very social person. I went from working full time and having social plans (concerts, dinners with friends, festivals, travel) nearly every day to nothing due to social distancing/quarantine. How do I stay sane with nothing to look forward to? Just talking to friends on the phone/video chat isn't helping.

I know. It's hard. (Fellow extrovert here feels your pain!) It sounds like you could go heavier on the "out and about" simulations, rather than just the talking-with-others-who are cooped up.

Can you seek out videos that "take" you to new places? Live concerts streamed online (or recorded?) Dive into learning something new? Get dressed up and use good china for your rice and beans?

There is no perfect substitute here, no doubt about it. But if the video socialization isn't helping, it may mean more that your mind needs more stimulation even in non-social forms as well.

I'm having a hard time staying motivated and engaged at work. Given everything that's going on, the projects I'm working on don't seem particularly important. There are times when it feels downright pointless. My entire office is now teleworking, so I feel even more isolated from work: I no longer have a real workspace and my only interactions are digital and limited to my immediate team. How can I cope with these feelings and stay motivated and engaged?

It's true that something as scary and big as this can make other things pale in comparison and lead to big questions about "Why am I even doing this?" But it's okay right now for that answer to be "To bring in a paycheck" or "To keep my health insurance." That goal is good enough for now.

I'd think about bringing in some rewards. Work for an hour, get to take a break with your favorite music. Get through the week, and get on a virtual happy hour with friends. Check three things off your list, and get to take a brief walk.

Sometimes, when things feel "pointless," it's important to remember that the "point" doesn't have to be the answer to Life's Big Question. Right now the point can be to get through the day and to keep your life and finances stable. This time does NOT have to be a self-improvement project where you come out bigger and better than before. This time can just involve putting one foot in front of the other (as you walk the same 500 square feet over and over again!) and getting through that day.

You're allowed to have that be enough!

So excited to see you back, (even if for only one session)! So, I'm one of those people that find decision making a little overwhelming. The funny thing is that I'm great at my job because it relies on data and evidence. But in real life, with either a lack of that or an overwhelming amount of choices, I get paralyzed. (trivial example... I'll flip though Netflix for 30 minutes before I decide on something to watch and usually just end up with a rerun of something I know I love... too many choices!!). So this leads me to this crisis. I'm in a decent situation. Yes, I have to telework with a kid at home but it's going ok. I don't have a ton of time (aforementioned full time job and kid) but I have money and resources to share. How do I even start to figure out how to help??? A little donation to a lot of places, or one big donation to one place? Help local or global? Where can I do the most good? Does ordering takeout to support local restaurants even matter?? How do you advise clients to approach complex decision making?

Maybe we will get some last-minute advice from other chatters here, but I say-- all of the above are potential avenues, and you are to be commended for thinking of them. There is no single "right" way to help.

I'd advise doing the things that resonate most deeply for you, and bringing your kid into it as well. Is there a particular restaurant you love whose staff you want to support? Is there an organization that you've always believed in? Can you choose a particular hospital or medical team's fundraiser to donate to? Do you have at-risk neighbors or relatives that you can provide some cheer (or some dropped-off groceries) for?

The helping is the point. Don't get bogged down in the decision-making. Do what resonates. Helping others is good right now. Period. Because unfortunately, there is no limit to the people who could use it right now.

My 66 year old mom who has lots of health problems just had a massive retirement party with dozens of her closest friends, all over age 60. Many of them are health care workers at high risk of getting infected in this epidemic. She lied to me and said that the party was canceled but one of her friends sent me pictures. This took place in a county that is currently under a shelter in place order. I recognize that I can’t control other people’s behavior, just my own, but this is causing me serious anxiety. How do I cope with what looks like my senior citizen mom’s death wish?

I am sorry. I can imagine the anxiety (and I would think some anger too), but what's done is done. Now, you can do your part to encourage her to take steps RIGHT NOW to keep herself safe, but past that, use the same tools to remind yourself that past a certain point, anxious thoughts are not strengthening you. They need to be stepped out of, and identified and labeled as unhelpful. It's a matter of breathing through them and not engaging with them as you watch them pass. Hang in there.

OP here. Many, many thanks! You said just the right things to calm me down. Wishing you and everyone all the best as we deal with this challenge.

I am so very glad it was helpful. Thank you!

Hi, fellow preggo here due in 5 weeks. I have a lot of moments of terror about what the hospitals will be like when I go into labor. There is a very real possibility that I will have to labor utterly alone, deliver without my husband, and receive suboptimal care from severely overtaxed caregivers. This is extremely frightening, and I expect puts me and my baby in some danger. I've had one video session with my therapist, who worked with me on practicing a mindfulness meditation for when this terror arises. It does actually help, and the truth is that I am imagining worst case scenarios when I do not know what will actually happen. She also has recommended that I spend some time visualizing laboring alone, delivering sans husband, and visualizing the best case version of this scenario. I find this hard, but I also find myself imagining myself using this same meditation practice while in labor, and that helps me feel like it's something I would be able to get through, even if it would be its own occasion for grief. Hang in there. We are going to get through this. We are going to make it.

I have no doubt this will be helpful to others. Thank you so much for sharing.

You hang in there as well!

Wow. So it turns out that two hours go more quickly, even, than one.

I thank you all so much for being here, whether you were a familiar voice from our old community or someone who had no idea what a live Post chat even was before today.

If I'm heartened by one thing in this, it's that the spirit of helping each other is alive and well, stronger than ever. 

As I mentioned, this was a one-time chat, unfortunately. (And on that note, thank you all so much for the outpouring of love and kindness about my being back. I didn't publish any of those posts because I wanted to respect the decision-making of the powers-that-be and not make this about me. But know that it was read and very much appreciated.)

You made today better than I could have imagined. I would love for you to stay in touch. I have additional tips about ways to calm yourself in your home here, and I'm writing an every-other-week column for The Lily. And of course, I am on social media. And in the midst of all of this, I am preparing for a book launch that may look weirder (and perhaps more disappointing) than I could have ever guessed. But do check out Detox Your Thoughts and the freebies available now if you can. So many of the anti-anxiety techniques we talked about here today, I go more into depth in the book.

So, please do stay in touch. None of us are alone in this-- even as we are forced to stay physically apart.

May you all be safe and healthy! Take good care.

In This Chat
Dr. Andrea Bonior
Dr. Andrea Bonior is a licensed clinical psychologist and writer of the Baggage Check advice column since its start in 2005. She serves on the faculty of Georgetown University, and is the author of two books in addition to the upcoming "Detox Your Thoughts: Quit Negative Self-Talk for Good and Discover The Life You've Always Wanted."
Kanyakrit Vongkiatkajorn
Kanyakrit is the community editor at The Washington Post, with a focus on comments, live chats and reader submissions.
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