Traci Cipriano/courtesy photo.

Our world turned upside down here in Connecticut in mid-March. One day we were working, socializing and living our lives as usual, with perhaps an awareness of the coronavirus and its potential spread. The next, schools were closed unexpectedly and immediately, and workers were being told to telecommute. Within days, the state began to shut down and the economy began to tank.

Suddenly you are stuck at home, and unless you live alone, you have been forced to at once navigate the same shared space with others for days and potentially weeks on end. If you do live alone, the sudden pervasive silence can be deafening and the isolation demoralizing, distressing. Either way, you are very likely experiencing stress, and perhaps worried about the health of loved ones or yourself, in addition to the plummeting economy and potentially your income.

During a crisis situation, such as circumstances arising out of the current global pandemic, our sympathetic nervous system activates, engaging the "fight or flight" response and releasing cortisol and adrenaline. As a result, heart rate increases and breathing becomes shallow. In the short term, this leads to increased energy and clearer thinking. Over time, however, if not disengaged, our bodies become drained of energy, we may feel foggy brained, have difficulty making decisions, and may, in fact, make poor decisions.

The reaction is handy and appropriate when you can spring to action; however, with this crisis, inaction, hunkering down and immobilization are the prescribed remedies. The result: Dissonance between our internal drive to act to fix the problem and the reality that we can only wait and see. This dissonance can lead to frustration, impatience, helplessness, and anxiety. We are doers and problem solvers by profession; doing nothing is not an option. Chronic stress also leads to decreased immune functioning, inflammation and susceptibility to illness. In order to reduce stress and improve functioning, this cycle needs to be stopped. Paradoxically, at a time when the mandate is to stay home, we need to take action: actions toward self-care.

Stress often leads to self-care being placed at the bottom of one's "to do" list, and then it quickly falls off the list entirely. Energy is instead put toward meeting responsibilities to others. And since self-care is the one thing in life over which we have complete control, it is easy to tell ourselves we will get to it eventually (which for many means limited self-care behaviors, if any).

Right now, more than ever, it is vital to take care of your physical and mental health. Remaining physically healthy is paramount not only because being sick is—at a minimum—an inconvenience (not to mention potentially costly), but also because you really do not want to visit a doctor's office or hospital at this time, places where germs are rampant, staff is stretched thin and resources scarce. You also need to remain mentally sharp. COVID-19 represents uncharted territory, with guidance and rules of daily living changing on a moment's notice. During times like this, it is essential to process efficiently and adeptly the sometimes overwhelming and conflicting flood of information coming your way, to best protect yourself, your family and your clients.

Managing Stress With Deep Breathing and Meditation

Tools such as deep breathing, relaxation training, meditation and mindfulness-based stress reduction (MBSR), which incorporates a combination of meditation and yoga, are all evidence-based interventions for managing stress. Unfortunately, with life coming to a near standstill, in-person options are quite limited as well as risky in terms of both your health and that of the public at large. Consider exploring some of the many meditation apps available. Headspace is offering free meditations during the COVID-19 pandemic, and Calm has also added some free options. You can also find other resources online, such as free videos, workshops, or 1:1 secure video coaching. Online eight-week MBSR courses are another excellent option. Jon Kabat-Zinn developed the MBSR training at the University  of Massachusetts Medical School, but you can find other options as well.

In addition, several other strategies contribute to maintaining your mental and physical health. These include:

Adequate Sleep

Most people benefit from seven to eight hours of sleep. You may be able to get by on less, but your mind and body will likely function best with sleep in this range. Think of it as similar to charging your mobile devices at night; sleep serves as your mental and physical "recharge," benefits your immune system and reduces stress.

Exercise

While you are home all day, every day, strive for daily exercise, ideally outside. If you prefer to use equipment at your home, or one of the many yoga, pilates or zoomba videos available on YouTube, make an effort to also get outdoors each day. Being out in nature has been shown to improve mood and decrease stress. Connecticut has a great deal of open space for you to walk and hike. Take note of the weather, the temperature, the sounds, the colors. Immerse yourself and let go of the thoughts in your head. Exercise not only decreases stress and improves mood, but it also strengthens your immune system.

Eating Healthy, Nutritious Foods

This is more complicated, with quarantines and concerns about germs in grocery stores. At the same time, it is best not to try to get by on protein and grain bars, noodles and cereal. Your body needs healthy, nutritious foods for energy, brain power, and immune function. If you or a family member are in a high-risk group, consider ordering fresh foods from one of the online grocery delivery services, such as Instacart, Peapod, or Amazon Prime.

Stay Connected to Family, Friends and Colleagues

Strong recommendations to stay home and away from anyone outside of your household, or social isolation, can lead to feelings of sadness, depression, hopelessness and irritability. Step back in time and reach out to family and friends with a phone call, or enter the modern age and video chat using platforms such as FaceTime, Skype or Zoom. Just hearing someone's voice over the phone is much more soothing than reading words on a screen when in-person contacts have become severely limited. Consider watching a movie with a friend via FaceTime, or plan a Zoom or Skype dinner party or cocktail hour. It is also important to stay connected with your team while everyone is working remotely. Plan morning Zoom meetings at least once a week.

Altruism

Helping others has been shown to decrease stress and improve mood, providing a sense of purpose and satisfaction, and decreasing feelings of isolation. Helping others during this difficult time can also provide a much-needed distraction. Consider helping in a way that maintains social distancing, such as online donating of food, fuel, other supplies, or providing financial assistance to charitable organizations. Be sure to reach out by phone to elderly family members or neighbors who may be feeling especially isolated.

What Is Your Escape?

Engage in healthy, safe activities that "get you out of your head." It may be watching a movie, running, reading, cooking, organizing digital photos, solving puzzles, playing board games, or a creative pursuit. If you are having difficulty with this, think back to a time when you were less busy, or even back to childhood when you were too young to drive and had to pass time at home. What was your escape?

Daily Routine

We are ultimately creatures of habit and daily routines provide comfort. Now that most of your daily routines have been upended, be sure to establish new routines, involving work, exercise, socializing, entertainment and sleep. Routines give our days structure and a sense of purpose.

News-Viewing

If reading the news is increasing your stress levels, take a break and then limit yourself to checking once or twice a day.

Psychotherapy

Finally, if you find yourself overwhelmed, depressed, anxious, or unable to concentrate or do the things you need to do, contact a mental health provider. It is easier than ever to get an appointment and see someone via telehealth (such as through Zoom). Now may be the time to finally take the leap and address that issue that has been on your mind, but you did not have the time to drive to and from an appointment.

Making the Most Out of the Situation

Now may be the perfect time to engage in self-reflection and take stock of life, relationships and work. Journaling your reflections on a daily basis can be very helpful for getting started, and later exploring your inner thoughts and feelings. If you are struggling with this, a virtual coach can help here too. You might spend this time at home identifying life priorities and actively planning for the future. Are you where you want to be or on track for achieving your goals? Have your goals or priorities changed over time? Often, we are faced with choices in work and life; consider those choices and really think about how you can lead a healthy and fulfilling life going forward.

Dr. Traci Cipriano, J.D., Ph.D., is a licensed psychologist and formerly a practicing attorney who has been providing training, consultation, coaching, writing about and/or conducting research on stress, its broad effects, and how to address it, since 2002. She is a member of the Connecticut Bar Association task force on lawyer well-being, and the Legal Profession Subcommittee of the CBA COVID-19 Task Force. [email protected]