Emotional Well-Being and Coping During Crises

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 exercises.

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
• Cognitive restructuring to reduce anxiety
• Brief positive meditation
• Physical and mental grounding (engaging sense of touch)

Reducing stress arousal through breath practices

Practices that manage stress reactions in the moment are critical, particularly for front line providers. Taking time out during the day, frequently, to self-regulate, can be very helpful. Find a breathing technique that works for calming you.

The most basic thing to know is that taking a longer exhale than inhale can help calm your body. Easy techniques include slow diaphragmatic belly breathing (vs. chest breathing), a 2:1 ratio for the exhale (i.e., inhale to the count of 4, exhale to the count of 8); 4-7-8 count breathing, and a common yogic alternate nostril breathing (pranayama). UCSF clinical professor Daphne Miller, MD, has used these techniques to help her and her patients in the hospital or even through Zoom. Elissa Epel, PhD, demonstrates these types of breaking in our mini video series.

Before going to bed, it is important to unplug and ready yourself for a restful night. The first thing to do is to say goodbye to all distressing news. We suggest: 

• 1-2 hours prior to bed, unplug from email, news, and anything else that creates a busy mind and begin focusing on creating a calm, relaxing environment. Say goodbye to the news; trust that it will be there in the morning. 

• Turn down the lights and do things that are relaxing. Relaxing activities vary by person, but often include reading, listening to music, or a meditation audio (UCLA Health). 

• Avoid alcohol close to bedtime and discontinue caffeine after noon.

Keep a regular sleep schedule

Maintain a regular wake up time. If possible, also try to get some direct sunlight in the morning. Together, these will help regulate your circadian rhythm.

It can be helpful to find ways to exercise. More than ever before we know that our physical health affects our mental health, and exercise can reduce stress reactivity and even ameliorate moderate depression. Research shows that getting fresh air and seeing greenery reduces somatic stress in our body and clears our mind. 

Although it may be tough to exercise indoors, engaging in regular physical activity will help reduce your anxiety and stress. The online applications below have guided exercise routines. Each day, more teachers put their classes online. We will highlight good ones here each week. 

Consider that live classes for exercise and meditation give us a group experience which may make us more likely to show up for them. 

Consider that live classes for exercise and meditation give us a group experience which may make us more likely to show up for them. 

• UCSF Fitness Center offers a wide variety of live and on-demand workout videos, fitness clinics, and webinars with a virtual membership. 
• Planet Fitness has a series of free guided workout videos on Youtube. 
• UC Berkeley Recreational Sports has a free 30 minute workout video designed to fit your schedule.  
• Wakeout comes with hundreds of exercises you can do right at your desk, such as yoga, chair exercises, and hand health exercises to stay productive, energized, and healthy. 
• YogaWorks offers around 30 high-quality free classes each day via live streaming and 1300+ on-demand classes that can be viewed any time. 
• Do Yoga With Me and Yoga with Adrienne offer free yoga videos for everyone. 
• Down Dog Yoga has a wide selection of online classes include prenatal yoga, barre, HIIT, meditation, and yoga. 
• Core Power Yoga offers classes online. 
• Zumba offers great workout video packages. 
• A vigorous 30-minute Vinyasa yoga class with master teacher Janet Stone 
• Peloton is offering a 30-day free trial of their digital membership, which offers streams of live/recorded group classes from a closed set. (It doesn’t require their bike to access classes on cycling, strength training, yoga, and meditation.) 
• Gaia Yoga offers online yoga videos, as well as nutrition coaching like recipes, and can be accessed via a free trial. 
• Obe Fitness memberships offer free trials and include 22 live workouts daily as well as 6000 on-demand classes, including prenatal and postnatal routines and 30-day programs. 

Different people like different types of stress reduction practices. On this website, we have pointed you to social support, exercise, and sleeping well - all of which build your stress resilience. It also helps tremendously to adopt a daily mind-body practice, like yoga, qi gong, or meditation. Even if it’s only for five or 10 minutes a day, that practice makes a difference. Set a time of day you block out for this on your calendar; if possible, right after waking is a great time for practice. We have highlighted free apps, but there is an abundance of longer practices on the web to do at home for deeper restoration. 

Here are a variety of practices to reduce mental and somatic stress that can be done online. Explore these and see what you love! This is a great time to join a live group online. We will update this section regularly, including live events.