Emotional Well-Being and Coping During Crises

During difficult times, we need to work extra hard to manage our emotions well. Expect to have a lot of mixed feelings. Naturally we feel anxiety, and maybe waves of panic, particularly when seeing new or distressing headlines. For example in 2020, an article by stress scientist and Vice Chair of Adult Psychology Elissa Epel, PhD, outlines the psychology behind the COVID-19 panic response and how we can try to make the best of this situation.

Our anxiety can help us cope, bond together, create shared community. Even when our anxiety is uncomfortable - it can be a good thing, especially if we manage it well. At the same time, we must effortfully prevent panic contagion and create periods when we can be screen-free and calm, engaging our attention in normal daily activities. Seize opportunities to share lightness and humor. Laughter right now is a relief for all of us!

You can also find moments of hope and resilience all around us despite uncertainty. For example, a project created by UCSF postdoctoral scholar Nouf Al-Rashid shares stories of resilience and hope in response to the pandemic from individuals all over the world.

If you feel in crisis or overwhelmed, it may be helpful for you to make a list of what you can and cannot control right now. In this guide, we suggest radical acceptance of the situations we cannot control, and focus on what we can do. 

Limit media to reduce anxiety

When there are stressful social events, we hear about them through the news and social media. By now you have heard this recommendation many times and there is research behind it: Watching or scrolling through the media makes us even more anxious. An excess of news and visual images about a traumatic event can create symptoms of post-traumatic stress disorder and poor health years later, according to research by UC Irvine's Roxy Silver, PhD, and others. 

Try to limit media exposure during stressful times to no more than twice a day (e.g., checking for updates in the morning and before dinner) and try to avoid it before bedtime. Take a vow to not forward (and thus propagate) alarming headlines to friends and family.

Get and provide warm, comforting, social support by video, phone or text 

Being connected to other people and feeling supported is one of the strongest forms of stress relief! The science behind social connection is described by Centers for Disease Control (CDC).

Maintaining social connections is critical! Taking time to share your feelings and to listen and support others will go a long way. Talking with others who have our best interests at heart makes us feel safe. Use phone, video, text, or email. Fortunately these new highways of social contact are unlimited resources. More than just providing social support about the current crisis, it is a good idea to use these connections to talk about the things you normally would - host your book club online, for example - which can create feelings of connectedness. Host a dinner using FaceTime or Zoom so you can talk while you eat (and talk about some positive things, not just this crisis). Loving and caring for our pets can be phenomenal stress reduction for us too!

Find ways of expressing kindness, patience and compassion

Be extra kind to yourself. This is a hard time for everyone. Humans across the world are sharing this experience with you. We are all in this together and we may all emerge with a renewed appreciation for our interconnectedness. Helping others in need is both critical to get through this well, and also creates more purpose to our days and well-being. 

If you are having critical thoughts, treat yourself as you would a close friend. Dr. Christiane Wolf leads us through a five-minute self-compassion meditation that can bring relief. You might also try taking a compassion break, another well researched technique for reducing pain

If you are physically well, there is an important way you can help: The American Red Cross often faces a severe blood shortage. They continue to face shortages in 2024. Eligible and healthy donors are strongly urged to make an appointment to donate and help ensure that lifesaving blood products are available for patients.

Notice for find ways of experiencing joy in your day

We can experience joy or content, even during stressful times, and they create balance, equanimity, and relief. UC Berkeley’s Greater Good Science Center has an online library of many practices based on experimental research that can quickly create positive emotion. This includes experiencing awe from being in nature, purpose in life, and gratitude for what you have. When you wake up you may feel grumpy, but focusing on one or two things you are grateful for can shift your mood for the day. After experiencing any type of crisis, it is especially hard but important to notice moments of joy, content, or playfulness, as described in our webinar by Esther Perel and Jack Saul.

Create new routines and keep practicing health behaviors

Routine and ritual are restorative to us. Our brain wants predictable activity so we can relax our vigilant nervous system. Go to bed early and go outside each day to be active. (More information about sleep and activity is available below.) Remember that our activities, thoughts, and mood are closely linked. If you want to change your mood, change your activities and/or your thoughts.

Eat well

Good nutrition helps our mood. Stress makes us seek comfort foods, and in turn high carbs and sugars impact our mood. Many population-based studies show that a Mediterranean diet has been linked to better mental health and stress resilience, whereas a junk food western diet is linked to depression and anxiety. Try to fill your home with fresh produce, frozen vegetables, and whole foods when possible. Several new books written by nutrition scientists describe how diets can be used to improve depression, anxiety, and PTSD, such as The Better Brain or Brain Changer.

Working at home can lead to more snacking and mindless overeating. UCSF’s Dr. Ashley Mason provides tips for resisting compulsive overeating in our mini video series. Mindful eating, meditations, and intuitive eating may also help with compulsive eating. 

If you or a family member is struggling with an eating disorder, please see the toolkit of resources provided by the UCSF Eating Disorders Program.

Work well enough from home

Working from home can have its own challenges, especially in a small home with children. Don't expect to have the same type of productivity as usual. We are all distracted and needing to cope with a different daily life now, while helping others. Reduce your goals for typical work that is not urgent, if possible. Here are some recommendations on how to stay focused and productive during work hours: 

• Confine your workspace to a specific clear area in your home so your job doesn’t intrude on your personal needs. Use this same space regularly to work. This will focus your mind and increase your productivity. 
• Control sound. Use noise cancelling headphones or earbuds, or use music or fans to create white noise. 
• End the workday with clear boundaries. Put away electronic devices and work tools at the end of your workday and set clear hours in the day for work. 
• Have a morning or evening check-in with a colleague or supervisor to reduce social isolation and provide structure to your day. Use video communications when you can. Seeing faces provides more social connection and information than just talking. 
• More tips on being productive while working at home from Indeed 
• "Working From Home: 5 Environmental Factors Affecting Your Well-Being" from Purdue University 
• Resources and tips for UCSF employees 

Dealing with isolation and quarantine

Because COVID-19 is still around, the psychological stress of living alone or being in quarantine once infected can be severe. Here are some resources: 

• Psychological effects of social distancing 
• Psychological effect of quarantine and tips 

Our thoughts shape our physiological stress responses

Acute, short-term stress is not necessarily bad, and, in fact, can be good. We can approach stressors with a positive mental view that we can cope well, that we have the resources. We can also view the physical stress response as one that helps us perform better, such as increasing oxygen to the brain. These are both types of “cognitive reappraisal.” UCSF professor Wendy Mendes, PhD, has shown that teaching students a positive way to view acute stress led to better performance on tests.

Be realistic and fact-based. It’s easy to think about the worst outcomes, which are catastrophic, but that creates unnecessary stress arousal and suffering. It can be helpful to think of worst case, and then best case scenarios, and settle on something in between, according to clinical Psychologist Lisa Firestone, PhD.

Creating short-term stress in the body, that we recover quickly from, can even be good. It creates a calming effect afterward, stimulating the counter-regulatory stress response. Exercise is one example, especially high intensity interval training like the popular "7-minute workout". A protocol of physical acute stress developed by Dutch extreme athlete Wim Hof has become very popular in many countries. Preliminary studies suggest it is helpful for improving our immune response, and Elissa Epel, PhD, and Wendy Mendes, PhD, are currently studying how it improves autonomic and emotional stress responses and mental health at UCSF. It consists of a carefully guided protocol of hyperventilation and breath retention and cold exposure. Wim Hof is offering the online course free now. If you want to try it, it is important to read his safety tips. One can download the Wim Hof Method app to guide you through the breathing.

The acute effects of deep breathing and cognitive reappraisal are important to use throughout the day. See the breathing techniques described below.

The UCSF Department of Psychiatry and Behavioral Sciences has created videos of strategies you can use immediately to reduce acute stress in the middle of your day. These are often considered trauma-informed strategies. Here are four different strategies for you to try:

• Calming extreme emotions (using DBT)

This expertise is provided by Aric A. Prather, PhD.

Sleep is a pillar of health. Getting enough sleep keeps your immune system strong. It is also crucial for helping you mentally cope during this uncertain time. That said, it is completely natural to experience more disturbed sleep while experiencing a crisis - including difficulties falling asleep, staying asleep, or waking earlier than you are used to in the morning. You may also find yourself feeling more fatigued than usual. Below are some tips to help your sleep in this challenging time.

Create a “news-free” wind down