NEWS | April 16, 2020

Stress Management and COVID-19


Army Team,

PS Magazine cares about readiness, preventive maintenance and the people who do it. How are you doing today? However you answer, here’s some guidance that will help you do and feel better. 

Part of Army readiness is taking care of ourselves physically, mentally, emotionally and spiritually, and being attentive to our fellow teammates to ensure they’re okay, too. As you might suspect (or have even experienced first-hand), the COVID-19 pandemic is causing a lot of stress and distress.

What follows is information and tips designed to help you and your battle buddies better cope with the pandemic and its impact. It’s provided in coordination with the Army Materiel Command (AMC) Surgeon’s Office and the AMC Substance Abuse Prevention and Suicide Prevention Program Office.
 
Understanding social distancing, quarantine and isolation

Many people are confusing social distancing with social isolation. Social distancing, quarantine and isolation are temporary measures designed to reduce the spread of the virus. Social isolation is not meant to be long-term. Long-term social isolation can itself be damaging to one’s health.

Social distancing is physical distancing designed to reduce the chances of contact between a person carrying an infection and others who are not infected and slow viral spread. According to the CDC, individuals who believe they’ve been exposed to COVID-19 are instructed to self-quarantine to reduce the risk of possibly exposing others to the virus. Individuals who test positive for the virus are instructed to self-isolate from others until they are cleared by their health provider to return to socializing with others.
To learn more about social distancing, quarantine and isolation, visit:
 
 
Important note: Social distancing requirements do NOT diminish the need to be on the lookout for others who might be greatly impacted by stress or depression. In fact, it’s all the more important during this pandemic because the stressors aren’t just health-related but also magnified by relationship issues, financial hardships, food shortages, etc. Remember to apply ACE: Ask, Care, Escort. (link to ACE slide deck provided below).
 
Ace for Soldiers PowerPoint presentation
Click on the image to download ACE for Soldiers slides
(courtesy U.S. Army Ready and Resilient website)

 
Coping with stress: Some tools
 
Part of what makes COVID-19 particularly stressful is that individuals who show no signs of sickness may, in fact, have the virus. This uncertainty means we’re playing it extra-safe, which has resulted in all the stay-at-home orders across the country. The normal routines of our life have been turned upside down in some unique ways. But the fact is, no one’s life is stress-free. We’re just dealing with new forms of stress. Luckily, the tools available to deal with stress still apply.

Here’s a partial list of these tools, all of them free and low-tech:
 
  • Gratitude: Write down three things for which you’re grateful every day. Don’t worry if they seem simple or mundane—just get something down on paper. Writing “gratitudes” will help you identify positive aspects of even the worst days.
     
  • Acts of kindness: Make a conscious effort to do something nice for no reason other than to help. You might be surprised how a simple act of kindness can turn around the day for both you and the kindness recipient. Obviously, these acts will have to be more creative and inventive to avoid close contact with others, but they’re definitely still possible.
     
  • Exercise: The positive effects of exercise are astounding. Physically-active people have increased energy, superior immune systems and a recurring sense of accomplishment. Exercise can reduce insomnia, stimulate brain growth and even act as an anti-depressant. If jogging or lifting weights seems like too much, don’t be afraid to start with a 30-minute walk or a slow bike ride.  (More to follow later in Wellness Tip #5 below.)
     
  • Meditation: Research has linked meditation with reduced anxiety and more positive emotions. Those who meditate regularly may even permanently restructure their brains to create sustained happiness.
     
  • Positive journaling: Take some time to write about positive events in your life. Write about a fun day spent with friends, a good movie or an activity you enjoyed. Positive journaling will get you into the habit of focusing on the positive.
     
  • Connectedness: Strong social connections are thought to be one of the most powerful influences on our mood. Those who are dedicated to spending time with friends and family show the highest levels of happiness. In a socially-distanced world, fostering relationships is still possible, using a mix of low and high tech. Now might be a perfect time to return to hand-written letters delivered by snail mail. In addition to email and phone calls, we can connect with others using applications such as Zoom, Skype, and FaceTime, among many others. The key is to make it deliberate and habitual.
Here’s one high-tech (and also free) tool that’s DoD-endorsed.
 
  • T2 Mood Tracker: This tracker allows people with anxiety, brain injury, depression, post-traumatic stress or stress to monitor their moods and their general well-being. It’s available in your Android and Apples stores. For more information, visit:       
Investing in wellness

COVID-19 doesn’t discriminate in terms of infection but it does affect those with preexisting conditions more than others. We can’t control all risk factors but we can do our part of improve overall wellness. Here are some wellness tips that are effective at reducing stress and building resiliency:
Wellness Tip #1: Simplify and organize your life.

Avoiding stress altogether is nearly impossible, especially if situations make it hard for you to stay on top of all your responsibilities. If you can’t get rid of stress, you can at least reduce it. Try these steps:
 
  • Learn how to say no. Decide what tasks you must do and which ones you do not, and stop agreeing to do everything asked of you. Try saying: "I’m sorry but I can’t. Can I help another time?"
  • Call for backup. Take a look at your obligations and see if you can get help, as necessary, to tackle some of them and even the load. This is why having designated “battle buddies” pays dividends. Plan in advance for who you can turn to and be ready to serve as someone else’s backup. At the same time, be on the lookout for anyone in your unit, organization or social group who is exhibiting signs of distress and ask if you can become their backup.
  • Relax your standards. Sometimes people get stressed out because they hold themselves to impossibly high standards. If you feel overwhelmed, it’s ok to revise standards downward, especially for tasks that are routine, less essential or low priority.
  • Consider your long-term goals. Ask yourself where you want to be in one (1) year, five (5) years, or 10 years down the road. How might the pandemic have affected your goals and what you believe is truly important? Do you need to reframe your long-term goals? Then ask yourself whether a specific responsibility will further these goals. Free yourself from dead-end obligations and focus on the ones that will help you reach your long-term goals.
  • Go high-tech. Use your computer or smart phone to set up reminders for daily, weekly, monthly or even yearly chores.
  • Go low-tech. Hang up a bulletin board or whiteboard in a handy location and use it to post all your reminders.

Wellness Tip #2: Avoid or limit your alcohol and drug consumption.

One of the most frequently tried self-care approaches to dealing with stress, anxiety or depression is to increase use of alcohol and illicit drugs, or the use of prescription drugs in a way that is not prescribed.  While these approaches seem to help in the very short term, over the longer term, they tend to cause problems of their own. Distress, anxiety and depression can lead to substance abuse in people who never struggled with drugs or alcohol before, or worsen problems for those already dealing with dependency.  

If you’ve used alcohol or drugs more frequently prior to symptoms of distress, try cutting back.  If cutting back increases your symptoms of distress, see your doctor for more effective medications to help with your symptoms or for referral to a mental health professional for counseling.

Oh, and if you smoke tobacco, consider using a cessation program. There’s a chance COVID-19 will reoccur. Smoking negatively affects the lungs, which are particularly susceptible to COVID-19.

For more information on the Army Substance Abuse Program visit:
 
Wellness Tip #3: Help others through volunteering.

Stress and uncertainty, coupled with isolation, cause many to turn inward, which is an understandable protective reaction. Over time, however, it only deepens isolation, which can be harmful to one’s health. One of the best ways to ensure overall wellness is to consciously choose to rejoin the wider community through volunteerism. Reaching out to people in need benefits you as well as them, in several ways:
 
  • It puts your problems in perspective. No matter how bad your problems are, you’re bound to find other people with even bigger problems, and that awareness can help you value the positive aspects of your life.
  • It helps you transform a negative event into a positive force. Many people are helped by helping others who experienced the same trauma or by working to prevent others from suffering that trauma.
  • It’s a form of positive distraction. You’re less likely to focus on personal issues or problems when helping others deal with theirs in ways that produce positive outcomes.
During the COVID-19 pandemic, social distancing and stay-at-home orders make volunteering a bit more challenging but still possible. Call your favorite charity or conduct online research to find one that aligns with your values and priorities to learn their unique needs and how you might fulfill them.
Wellness Tip #4: Join a support group.

Sometimes, the people closest to you have difficulty understanding what you’re going through. Support groups, which bring together people with similar problems, can be powerful methods for healing. In a support group, you meet other people in the same situation and can see that you’re not alone.  It also provides a safe environment in which to share your feelings. Finally, sharing with others can help you keep from turning inward, which is good because talking with other people about your problems or fears can put them in perspective.

As with some of the other recommendations we’ve discussed, this one’s definitely affected by social distancing requirements, at least in the near term. As you investigate possible support groups, their points of contact or coordinators will tell you how they’re adjusting to the COVID-19 pandemic.

Here are some resources for finding a support group:
 
  • Your family doctor or counselor (if you have one).
  • Your local hospital or the VA.  Some hospitals and many VA centers run their own support groups. Talk to someone in the social services department.
  • Nonprofit groups focused on mental health.  They serve as clearinghouses for information designed to help those seeking help. For example, www.mentalhealth.org provides a listing of resources, phone numbers, insurance facts, and more.
  • Your local newspaper. Many newspapers publish calendars of support group meetings in your area.
  • A pastoral counselor or chaplain.
  • Community clinics in your area.

Wellness Tip #5: Get regular exercise and eat a healthy diet.

Exercise

Exercise has many helpful benefits for people with symptoms of stress. Here are the recommended exercise guidelines:
 
  • Aim to exercise about 20 to 30 minutes at least three (3) times a week. It’s best to establish a regular routine to make it more likely that you’ll stick with it.
  • For cardio respiratory benefits, the exercise should involve moving large muscle groups continually for at least 20 minutes, such as brisk walking, bicycling or swimming.
  • If depression is a symptom you have along with stress, exercise is known to be effective in reducing depression.
One caution: if exercise triggers hyperventilation and panic, talk to your doctor or counselor about breathing exercises and other methods for preventing or managing these attacks.
 

Diet

What you eat affects the chemicals in your brain, which in turn influence your moods, energy level, food cravings, stress levels and even your sleep habits.
Here are some suggestions for making sure you’re eating a healthy diet:
 
  • Make sure every meal contains some foods rich in whole grains.
  • Cut back on foods containing sugar including desserts, sugared cereals, candy and sugar-sweetened beverages. Instead, snack on fresh fruits and whole-grain foods.
  • Try to cut back on coffee and other caffeinated beverages including tea, chocolate, cocoa and colas.
  • Try to eat more fish and low-fat dairy products, and aim for a diet high in fresh vegetables and fruits.
  • Don’t skip breakfast but aim for three meals a day, plus healthy snacks.
  • It’s a good idea to set the table and decide on regular mealtimes and then stick with them.
  • Snack on nutrient-dense foods, such as peanut butter and small amounts of nuts.
  • Keep in mind that if alcohol and/or drugs are a problem for you, you might be depriving yourself of adequate nutrition, so these tips are particularly important to follow.
  • Don’t try to make too many changes to your diet all at once. Just start with some small changes in the right direction.
  • Talk with your doctor, dietician or other healthcare expert about tailoring your diet to address any specific problems you may have, like food allergies or hypoglycemia, that may be related to your stress.
Additional Resources and Who to Contact

We’re one Army team, which means we look out for each other, as well as ourselves. Readiness depends on it. Be ready to serve as a resource to others and don’t be shy about seeking help if you need it for yourself. These resources are places to turn for help:
 
  • Your chain of command. We’re all part of a chain of command. If you feel anxious, stressed or depressed, seek out your supervisor and let them know what you’re going through.
     
  • Your healthcare provider. Whether it’s your primary care doctor or a specialist, they tend to know what makes you “tick” and can offer strategies for dealing with health issues.
     
  • Your battle buddy or designated helpmate. They’re not health experts but they can help provide an objective perspective on what you’re dealing with and ideas on where to go for help.
     
  • Your chaplain, pastor or religious leader. Not only do they have a list of resources to deal with stress, anxiety and depression, they’re invested in you as a whole person and stand ready to provide guidance and comfort.
These websites and support lines offer a wealth of helpful information:
   

National Suicide Prevention Hotline: 1-800-273-8255

Military Crisis Line (U.S.) : 1-800-273-8255

(for OCONUS numbers, click HERE)

Substance Abuse and Mental Heath Services Administration (SAMHSA) National Helpline:
1-800-662-4357

 

Disaster Distress Helpline: 1-800-985-5990

 


Special thanks to Mr. Roderick Skip Johnson, CADAC, AMC Substance Abuse Prevention and Suicide Prevention Program Manager, for pulling these tips and helpful hints together and advising on this article.