There are risk factors to being chronically ill in a high-stress environment and being isolated during the pandemic life. COVID19 brings with it unique external stressors we may have a difficult time adjusting to like we do other stressors.
Even before COVID-19 hit its shores, the U.S. was a clinically anxious place. According to the National Institute of Mental Health, just over 19% of all American adults will experience at least one anxiety disorder over any 12-month period. The fifth edition of the Diagnostic and Statistical Manual, the mental-health professionals’ bible, lists a dozen different anxiety and related conditions. Not all are likely to be especially affected by the COVID-19 pandemic, but a number are, especially obsessive-compulsive disorder (OCD), generalized anxiety disorder, social anxiety disorder, agoraphobia, acute stress disorder and separation anxiety disorder. Given that many around the world are being told by public health and political officials not to come within six feet of one another, this last one hits especially hard. Time
Add in factors of worries about income, one’s job stability, job loss, the future, loved one’s health, your health and any number of other concerns and anxiety is increased. It is then amplified by constant news coverage and constant social media coverage. You cannot escape it anywhere, and certainly not internally. Especially when we all have so much more time to think and overthink and ruminate on these concerns. So anxiety issues are definitely affected by COVID19.
I recently had a conversation with my doctor. I have well-treated Major Depressive Disorder but no medication is perfect. I am also on a Seasonal Affective Disorder medication. (SAD). I called to ask if I should still be on the SAD medication that gave me a nice good mood boost in the depths of our Canadian winter. Now at an end.
She asked about my mood. I said, ‘You know, depression doesn’t like self-isolation. Well, it does because self-isolation is what it does best. But my brain doesn’t like it and it lowers my mood. Removing the few socialization I had that meant a massive amount to my mental and emotional well-being isn’t a great idea. I am going to have to sit outside more or take more walks. Get more sun’. And so it was she left me on my SAD medication to keep the Boost on.
Because with depression eliminating social situations entirely and completely isolating is where it flourishes. Too much time to stress and overthink and ruminate. I am aware of it though so I can do something about it. Doesn’t mean I didn’t slowly feel like mood slump come on and hit me. It did. And it will more so for those not expecting it or for those with depression that is not as well managed or in the early stages of treatment… it could get bad, fast.
Chronic Pain and Stress
Chronic pain and stress go had in hand. More stress, more pain, less sleep, more pain, more stress…. and on and on feeding itself in a pain loop that often causes anxiety and depression.
Check out: Chronic stress and the body
External life stresses out of our control can influence our chronic pain levels in many ways. We already feel a great deal of stress and physical stress that we try to cope with. External factors often tip that scale. It can be a negative work environment to a death in the family. Certainly, with this pandemic of COVID19 we are stressed about money, we are stressed about our health, the health of loved ones, the financial health of loved ones, the future for us and others… and a lot more. Some of us are losing friends and family to this virus. All this impacts us emotionally and then affects us physically.
It is difficult to then manage all this stress when our pain then gets significantly worse. We feel like we must deal with it but then we are far less functional.
- Stress affects pain, doesn’t cause it
- Can be affected by external factors
- Increases intensity of pain
- Contributes to depression and anxiety
- We are less likely to use our effective coping strategies
Just like pain, stress aggravates various symptoms of chronic illness. It can cause flares. It can make us more tired, listless, less motivated, more fatigued. And less likely to do the things we know will help because we feel overwhelmed.
We have to focus on pacing and self-care. We have to focus on mood and routines. Routines can be our best friend. Doing the things we know help us feel better… even when energy is low and motivation sucks. But sometimes we have to pace more and do less, so it is fine if we slow that down. Do one good self-care thing a day, instead of all the things we do to maintain our well-being usually. Every bit counts.
I have learned this with my extreme dizziness and vertigo… I have had extreme low functionality. So small little things each day to help give me a boost mentally, physically, or emotionally go a Long way when I am not capable of much at all. And No guilt that I cannot function much. Sometimes that is just the way it is.
Sometimes we need a good recovery day. Say the fatigue is immense and you cannot do anything. It is fine to lay on the couch and just be all day doing whatever can be done from the couch (Netflix or a movie or whatnot). Sometimes the body signals us that it needs that recovery time and we need to listen to that.
What we can do:
- Acknowledge the stress factors
- Utilize relaxation techniques that work for you (meditation, deep breathing, relaxation breathing, visualization, guided meditation)
- Try to eliminate negative thoughts like catastophizing. Maybe write thoughts down in a journal and work through them that way instead of overthinking about them- this works well for me.
- Focus on your pacing. More pain more pacing.
- Try gentle exercise- stretches- short walks outside
- Focus on hobbies that give you pleasure
- Try to connect with people in different ways
We deal well with isolation, in general. We cope well with it because we often have to deal with it for extended periods of time when our health takes a downward turn and often we cannot socialize much at all, if at all sometimes.
However, isolation and increased stress comes with risk factors with chronic illness if we have mental illness and chronic pain. And with every symptom we have. Severity increases, coping decreases. The best thing we can do for ourselves is focus more on pacing and self-care, even if that means just a little bit of self-care for mood, physical, or mental well-being a day. A little bit can do a whole lot. And we definitely need to work on management of stress, which are the points I mentioned above, when we can, as we can. And some days we just need recovery days. Take it easy on ourselves and have some self-compassion for ourselves when we cannot function.
The problems we have during this pandemic are threefold
- Isolation and its effects on us mentally and emotionally
- Stress and its effects on us mentally, emotionally, and physically
- Social isolation which can magnify all these issues
And each of these needs to be addressed in the ways we best know how to handle them. Isolation aggravates my depression so I am focusing on my mood. External stresses of the pandemic makes me anxious so I have to focus on relaxation and decreasing exposure to news. The stress also amplifies my pain and increases my fatigue making it difficult to do anything. Motivation is suffering and I feel sluggish. But I set up small goals and stick to small routines and this helps with self-care and minimizing some of my own stress. I do meditation and relaxation breathing and journal writing. I rest a lot due to the level of my health at this time… and so the self care I do is vital for my well-being. I try to keep in contact with people I know because it feels good to know how they are doing and to reassure myself they are fine.
I would think about how these factors are influencing you, if at all, and how they affect your health or coping, if at all. And what you can do to adjust to it. In the personal ways that work best for you. You know your body best and what works for you and what does not. And you know whether you are having negative effects from this time of pandemic life… or coping perfectly fine. And if you are not coping well, there is nothing wrong about that. It just means we have to adjust our coping to these stressful times. And remember that external stressors do tend to impact our health often. And in ways we often cannot predict.