Anxious and Depressed? Experts Share Tips for Coping in Pandemic

Take deep breaths, exercise among tips offered during media briefing

Part of the From Health Care to Child Care, the Impact of COVID-19 Series
Anxious and Depressed? Experts Share Tips for Surviving the Pandemic
Professors Timothy Strauman, Anna Gassman-Pines, Kyle Bourassa and Robin Gurwitch

DURHAM, N.C. -- COVID-19 has stripped control and predictability from us. We can’t do the things we want, and we aren’t sure when this mess is going to end.

So we’re anxious and depressed and overwhelmed. Many of us are trying to work and parent and keep households running. Many of us are “essential,” which means we have to work in public, putting our health at risk.

It’s a lot to deal with, but there are ways to cope, help others, and shepherd our kids to the other side of all of this.

Speaking to reporters Wednesday during a virtual media briefing, four Duke experts offered advice on getting back some control.

Watch the briefing on YouTube.

Here are highlights:

ON AVOIDING UNHEALTHY ROUTINES

Kyle Bourassa, clinical psychology researcher

“Mindfulness, exercise and mental health treatment have been shown to reduce stress over time. That can be very helpful for some people, but we do know from decades of research, and intuitively I think, that changing how we feel is hard. Wouldn’t we all just get rid of our anxiety and stress if we could do that?”

“Another useful option is focusing on our health behaviors and making sure we’re taking care of ourselves. For some people that might mean cooking healthier meals. For others, it might be exercise or making sure we get enough sleep.”

“It can be very easy to slip into unhealthy routines.”

 

ON PARENTING

Robin Gurwitch, child psychiatrist

“Parents are doing the best they can. Now you’re balancing the safety concerns with the educational and social/emotional concerns, so parents are truly put in a difficult position sometimes.”

It’s almost like trying to juggle a bunch of balls and then all of a sudden someone throws in a chainsaw as well.”

“One of the best predictors of how well your children are going to do is how well their parents are doing.”

“Do you have a routine that can help children? Having a regular routine truly helps reduce anxiety. Taking time to take a walk or do something fun or quiet as well as homework time or Zoom time.”

“Helping children feel they can control some things. Tell them, ‘You’re doing a lot of great things. You’re wearing a mask; you’re washing your hands.’ ”

“When parents are thinking about how they’re coping, think about that -- your child is watching every little thing. Even if you may not totally agree with what the school is doing … children need to see you’re supporting however they have to learn right now.”

 

ON TAKING CONTROL IN YOUR PERSONAL LIFE

Timothy Strauman, psychology and neuroscience professor

“There’s a difference between saying, ‘I personally myself am responsible for fixing the problem,’ versus, ‘I’m one small part of a solution, but I can still be part of a solution.’ Each of us can look into our daily circumstances, acknowledge the things that are truly uncontrollable .. but make choices that in some small way make us feel a small part of the solution.”

“We’re wearing masks. We’re protecting ourselves and other people. We’re choosing wisely among a set of options which, may not be a great set of options.”

 

ON SIMPLE TRICKS TO KEEP PEOPLE ON TRACK

Kyle Bourassa

“Create daily routines and daily lists. Something as simple as, ‘Every time I’m going to brush my teeth, I’m going to do something else at the same time.’ When we pair activities or things we do every single day with things that can help us in our health, it becomes easier to follow through on them.”

“It’s also important not to think about what ideally I’d be doing if the pandemic wasn’t going on. Instead, think about what realistically I can do.”

“Can I do 20 pushups or can I walk around the neighborhood? Maybe you can’t go to the gym or lift weights … but what are the small things you can do that are going to move you in the direction you want to go?”

 

ON THE STRUGGLES OF ESSENTIAL WORKERS

Anna Gassman-Pines, public policy professor

“For hourly service workers, a lot of them being essential workers, they were in a situation even before the pandemic where a key part of their adult life was often very unpredictable and out of their own control. Back in 2019, before this pandemic started, we were already seeing there were regular changes to people’s work schedules that happened at the last minute and were completely unanticipated.”

“Those work schedule changes have nearly doubled (in the pandemic.)”

“When you don’t know when you’re going to be working or for how long, that’s creating a tremendous amount of additional stress for these families. For hourly workers, if they don’t work, they don’t have earnings. So it has serious implications for families’ financial wellbeing.”

“For a lot of the essential workers we’ve been hearing a lot about during this pandemic, things were already very unpredictable and unstable and this pandemic has worsened that.”

“The policy supports that were in place during the really acute phase of the crisis have gone away now. This includes, for example, the pandemic unemployment compensation. That support, along with the one-time payment to families, have gone away.”

“That’s also increased families’ financial strain in ways connected to their mental health.”

 

ON CHILDREN AND ISOLATION

Robin Gurwitch

“Parents can’t turn their parenting manual to ‘Chapter 5: How to Help my Children During a Pandemic.’ It just doesn’t exist.”

“Social relationships are incredibly important.”

“Helping think through some new ways to make (virtual) connections. It may be, when we take a walk, can we socially distance and each put sidewalk art out.”

“With teens, it may be thinking about being socially distant but be together in a small group. For teachers too, helping to recognize that on top of all the academics they need to do, part of what they need to do is think about how to create small group activities, how to promote exchanges between students to increase those social opportunities.”

“This is where we get creative. This is where we also include children. For children, the drive-by birthday parties have really been wonderful. Children can think about what signs they want to make to hold out when they drive by a friend’s house and honk and wish happy birthday.”

“Include your children and your teens in discussing how you may want to be together, and recognize and validate that they are feeling disappointed and frustrated.”

 

ON PARENTS BALANCING WORK AND KIDS

Timothy Strauman

“Stop and breathe. Just let a few seconds go by. It’s just hard to work from home. It’s really hard for those of us who aren’t trained as educators, to educate. It’s hard to do child care. And it’s impossible to do all those things at the same time.”

“It’s very frustrating. It gets people down.”

“Literally just stop and take a breath. Sometimes it’s the most effective thing we can do. It gives our conscious mind a chance to say, ‘OK, what’s happening here?’ ”

“It’s not easy when your boss is in one ear and your family is in the other ear and you’re trying to pay attention to something on Zoom.”

Robin Gurwitch

“When your children see that you’re practicing your breathing and you can include them in that, that’s good all the way around.”

“We can only do what we can do. There are going to be some great days, and some ‘we could have done better’ days. But those eight-hour workdays or those 10-hour workdays just aren’t going to happen anymore on Zoom when you have children.”

Kyle Bourassa

“For me, exercise is one way I cope with stress. At the end of my workday, I go for a run. So for me, that’s something that’s going to happen every day. For other people, that may be something like waking up in the morning and working out.”

“For others maybe it’s setting a little reminder when they go to the grocery store and it pops up and tells them to focus on buying more vegetables or buying more fruits and healthy foods.”

 

ON RESOURCES FOR PEOPLE WHO RELY ON ADDICTION SUPPORT GROUPS

Timothy Strauman

“Long before the pandemic, we as a society weren’t providing sufficient support. And it’s clearly gotten worse.”

“When a meeting can’t occur, people are still finding ways to make smaller connections. Even if you can’t get together with a group of people that you trust, that you know … maybe you can connect with one of those people.”

“We don’t have to lose those connections. There are real constraints on what we can do. There also are an extraordinary range of professionals who are essentially making themselves available what is essentially crisis duty.”

“The pandemic has really highlighted ways in which we are not taking care of ourselves as a society. But it has also highlighted that there are things we can do.”

Anna Gassman-Pines

“For low-income folks in the United States in particular, but for all of us, mental health treatment was already difficult to access before the pandemic. This pandemic has increased need across income levels and also challenged service delivery in a lot of ways.”

“Can we be thinking about transforming our mental health system? Thinking long term about really investing in supporting the mental health of the people in our communities?”

 

On the importance of good sleep, and how to get it

Kyle Bourassa

“Make sure the environment you’re going to sleep in is as conducive to sleep as possible. Make sure your bedroom is dark and quiet. Make sure you aren’t being disturbed by light. Try to avoid caffeine later at night.”

“A lot of people are using phones in bed or maybe watching TV. The idea is you’re pairing the idea of bed with being awake and engaged in something. So only using your phone outside the bedroom could be effective.”

 

ON NOT BEING ON YOUR PHONE BEFORE BED

Robin Gurwitch

“One of the things we see in children of all ages – when they’re stressed, sleep takes a hit. Whether it is going to sleep or staying asleep, sleep takes a hit. And if children aren’t sleeping, their caregivers aren’t sleeping either.”

“Do you have a set time when you go to sleep and when you get up? That’s important for children as well. Do you do something calming before sleep? For young children, are they getting a story and then you turn off the lights?”

“With teens, help them recognize the impact that checking their phones constantly has on their sleep. There’s a lot of data about teens and anxiety and worries and increasing mental health problems because of the, ‘I can’t be away from my phone for five minutes.’”

 

ON SLEEP AND CHILDREN

Timothy Strauman

“What can we realistically control? No matter how much uncertainty is around us, we have values as individuals. We have values as families. Those are the things that guide us when we make decisions. Those values can really be a touchstone at a time when so much is unpredictable and out of our control.”

Robin Gurwitch

“This is an opportunity for families to think about the beliefs they want to share and instill in their children. Think about this as a seminal moment for that. I’m hopeful we come out of COVID a kinder nation. That we do model saying ‘thank you’ to our essential workers. This is an incredibly important time for families to step back and think, what are the values and beliefs we want to model for our children?”

Anna Gassman-Pines

“I do think the pandemic has helped people crystalize their thinking about their values and their families’ values.”

“We have as a society through our elected representatives, who are meant to reflect our collective values, in many cases made it quite difficult for vulnerable workers and vulnerable individuals to access social services and public supports. We have done that by choice with the value that only the absolute neediest should gain access to these publicly provided services and supports.”

“Individuals with more resources who can navigate a complex system with barriers built in are the ones who can access those services, and the neediest are left out.”

“I am hopeful that this might cause us to collectively step back and think about these systemic values. To set up structures that are less burdensome so that more members of our community, when they’re in crisis or time of need, are able to access services they’re entitled to.”

 

ON LETTING OUR VALUES GUIDE US

Timothy Strauman

“Self-care is where everything else begins. I’ve got to be somewhere near my best, so that really is where it starts. That’s where we live up to our values. I want to encourage people who are health care providers and essential workers to use what’s there. Don’t be afraid to use what’s there. It’s a sign of strength, it’s a sign of maturity, it’s a sign of wisdom.”

Faculty Participants

Kyle Bourassa
Kyle Bourassa is a clinical psychologist and a postdoctoral scholar at the Center for the Study of Aging and Human Development at Duke University Medical Center. His research focuses on understanding the impact of stressful life events on health across the lifespan.

Robin Gurwitch
Robin Gurwitch is a professor in psychiatry and behavioral sciences at the Duke University School of Medicine and director of parent-child interaction therapy at the Center for Child and Family Health. She studies the impact of trauma on children and families.

Anna Gassman-Pines
Anna Gassman-Pines is an associate professor of public policy, psychology and neuroscience, and faculty affiliate of the Center for Child and Family Policy. She studies low-wage work, family life and the effects of welfare and employment policy on child and maternal well-being, and the effects of job loss on children’s test scores.

Timothy Strauman
Timothy Strauman is a professor of psychology and neuroscience. He researches the psychological and neurobiological processes that enable self-regulation, including the role of self-regulatory cognitive processes in vulnerability to depression and other disorders. He also studies the impact of treatments for depression.
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Duke experts on a variety of topics related the coronavirus pandemic can be found here.