How can we manage our anxiety and look out for family members during the COVID-19 pandemic?

This blog was written by Dr Johnna Swarz, Assistant Professor in the Department of Human Ecology, UC DAVIS and an MQ researcher. 

As an Assistant Professor of Human Development, I study how stress affects the brain during the teenage years and young adulthood, and things we can do that help to protect against the effects of stress. And I’m sure I’m not alone when I say stress levels are higher for me than they have been in a long time (possibly ever).

The COVID-19 pandemic and social distancing measures now in place may be particularly stressful for teenagers since this is an age when interactions with friends are especially important. So what does research tell us about how stress affects the brain and what we can do to protect against these effects? 

How does stress affect the brain?

Research suggests that prolonged exposure to stress can affect the way our brains work. Although we don’t know how the global pandemic and lockdowns will affect our brains (since it’s so new we haven’t had time to research it yet), we can look at research on other forms of stress for some ideas about what may occur. Prior research suggests that when we are exposed to prolonged stress, it can lead to increased activity in a brain region known as the amygdala. This region plays a major role in detecting signs of threat or danger in our environments and can activate the “fight-or-flight” stress response. Increased activity in this region could mean that your brain is on higher alert for signs of danger or things going wrong. This could, in turn, lead to increased anxiety, difficulty concentrating on work, and getting upset or anxious about things that you normally would not find upsetting.

While prolonged stress has been shown to increase activity levels in the amygdala, other research has shown that it may also shrink regions of the brain that are important for regulating our emotions and managing our stress response.

So stress can increase activity in parts of the brain that contribute to anxiety while also decreasing activity in the parts that help us keep our emotions and stress levels in check.

What signs of prolonged stress should I look out for?

• Getting more upset than usual over small things

• Difficulty concentrating at work

• Having more difficulty controlling your emotions than usual, and

• Experiencing higher levels of anxiety

What can we do to protect against these effects of stress?

1. Get a good night’s sleep. 

This one is easier said than done. When we’re feeling anxious, it may be particularly difficult to feel relaxed enough to go to sleep. But, when we don’t get enough sleep, research has shown that this can lead to increased activity in the amygdala, which could further increase our anxiety.

If you’re having difficulty getting to sleep, you could try a relaxation approach before going to bed, such as mindfulness meditation or yoga. There are many apps available that offer guided relaxation meditations that you could try. For me personally, I use an audiobook app on my phone to listen to an audiobook before going to bed. This allows me to turn off the lights and close my eyes (unlike reading a paperback book) and listening to the story helps prevent me from thinking of things that might make me anxious right before going to bed.

2. Get some exercise.

Research has shown that exercise can be very effective for managing anxiety and depression. Some research even suggests that regular exercise may increase the size of the hippocampus, a region in our brain that helps to regulate our stress response. Since prolonged stress may shrink the hippocampus, regular exercise may be a great way to protect against this effect. But I know this suggestion is also easier said than done. Sometimes when we are anxious, tired, or upset, exercise is the last thing we want to do.

 Some tips for getting into the groove:

• Make sure you are doing a form of exercise you enjoy.
• If you are not in the mood for exercising and need motivation, try telling yourself that you will only exercise for 5 minutes. You may find that after you get into a few minutes of exercising, you now have motivation to do more. Often getting started is the most difficult part. Bonus result from exercise: it can often help with tip #1, get a good night’s sleep!

3. Distract yourself

If your brain is on higher alert for potential signs of threat or danger, it may find things to be anxious about unless you give your brain something else to do. Doing activities that require deep concentration and focus can help to distract you from things making you anxious.

Some things you could try might be learning to play a musical instrument, playing a board game that requires strategy (think chess), or cooking something by following a complicated recipe.

The key here is that the activity should be engaging and require deep focus or concentration, so activities like watching TV would not be as effective.

For me personally, I find that playing difficult board games works well for distracting me if I’m feeling anxious. If you don’t have anyone in your household that wants to play a board game with you, try searching for “solo board games”—these are games that you can play on your own!

4. Mindfulness meditation or yoga

Anxiety involves fears about what could potentially happen in the future. Mindfulness meditation (and some forms of yoga) help to combat this by focusing your attention on the present.

There are plenty of apps available that lead guided mindfulness meditations. As a bonus, many forms of mindfulness meditation incorporate deep breathing exercises, which have been shown to help with relaxation.

5. Extra tips for teenagers and parents of teens.

Teenagers can benefit from all of the recommendations above, but there are additional things to consider for them.

• Young people tend to have a body clock or circadian rhythm that favours going to sleep and waking up later. One potential benefit of online schooling is that it may be possible to adopt a later school schedule that fits better with teens’ circadian rhythms. If it’s possible for teens to start online classes later in the morning, this could help with addressing tip #1—get a good night’s sleep, by allowing them to sleep in later.
• Adolescents may be particularly impacted by reduced time with friends. If it’s possible to set up video conference online face-to-face social interactions with their friends, this could help them to feel less isolated.
• For parents of teens, ask your teen how they are doing and be ready to have open conversations about mental health. This can be difficult since we may not be used to having conversations around mental health but letting your teen know you are open to discussing can help to start these conversations.

6. Seek treatment. If you or your teen are experiencing levels of anxiety that make it difficult to perform everyday activities like school or work, you may consider seeking out a treatment such as cognitive behavioural therapy (CBT), with many remote options still available that allow you to see a provider from home. And if you’re not ready to see a provider yet, there are phone apps available that use cognitive behavioural therapy techniques to help with managing anxiety (the Anxiety and Depression Association of America has put together and reviewed a list of these apps here).

   CBT often involves exercises that teach stress management techniques and develop emotion regulation skills. Some research suggests that completing treatment with CBT may help make it easier to manage our emotions and protect against the effects of stress on the brain described above. More information on treating anxiety can also be found at the Young Minds website.

If you or someone in your household is experiencing thoughts of suicide or are currently in crisis, there are helplines you can call to speak to someone right away.  

• In the UK, helplines can be found at this NHS resource page.
• In the US, the National Suicide Prevention Lifeline provides 24/7 free and confidential support.
• Young people under 19 in the UK can contact Childline to talk about any issue they’re going through, including feeling anxious. They can call 0800 1111 to get through to a counsellor, or can have a 1-2-1 counsellor chat online. More information is available on their website.

Hopefully, you’ve found some tips to help with coping with anxiety for you or your family members. Everybody’s different and some of these may or may not work for you, so perhaps give it a go and try a few different things out to see what might work for you.