Structure is key to maintaining mental health amid pandemic, experts say

If mental health wasn't top-of-mind before the COVID-19 pandemic began, chances are it is now.

The number of confirmed cases of the virus is rising, causing ripple effects on jobs, routines and lives.

"In this time of uncertainty and when we don't feel safe, it is normal to be stressed. Conflicting information and emotions can cause our mental health to suffer," said Janice Hurtado Aeppli, senior director for the central division of the American Foundation for Suicide Prevention. "With jobs in jeopardy, health scares and isolation, mental health will be more important than ever."

Several factors are straining mental health during the coronavirus pandemic and the public response to help contain it, suburban psychiatrists and psychologists say.

The spread of the virus can cause worries about physical health for ourselves and others. It can take us away from our jobs and daily routines. It can contribute to a feeling of losing control and to a human tendency to catastrophize.

Then there's the fact the mandated social distancing and stay-at-home precautions are unusual and drastic - and necessary, said Dr. Aaron Weiner, director of addiction services for Linden Oaks Behavioral Health in Naperville.

That's hard to square with another fact, he said: Roughly 80% of cases of the new coronavirus are mild to moderate and each one of us, individually, is statistically likely to be OK.

"This is truly a problem that's a population-health issue, where we have to be able to look past our own individual challenges and issues," Weiner said. "If we don't work together as a society, there are a tremendous amount of people who will be hurt, even if any one of us isn't likely to be that person."

So there's a lot on our collective minds these days as we stay at home, order takeout and struggle to occupy our kids while working, or slog through the hunt for jobs in a market constrained by shutdowns of nonessential businesses.

But there are just as many positive steps people can take to preserve a sense of purpose, stay connected, filter out unreasonable worries and see the positive in all these changes, mental health experts say.

It starts with structure.

Keeping our identity

Going to school or work gives a pattern to daily life. So does heading to the gym or attending a weekly worship service, said Dr. Pavan Prasad, owner, founder and CEO of Clarity Clinic, which has mental health practices in Arlington Heights and Chicago.

"Those activities form our identity. It's important to reframe that and try to create structure for yourself within your home," Prasad said. "Whether you're working from home or not working, it's important to find different ways to fill the day with planned activities."

Activities should include reaching out through the phone or internet to maintain social connections, said Dr. Edgar Ramos, a bilingual psychologist at Ramos and Associates Behavioral Health Clinic in Mount Prospect and an assistant professor at Concordia University. Too much alone time can be a negative for the mind - even if it's a positive for virus containment.

"There's a lot of concern about just being lonely, and it's exasperating those who already have mental health issues," Ramos said. "Those who normally know how to manage stress are having more trouble now."

Even people who normally keep their stress in check with healthy habits such as adequate sleep, nutritious food and regular exercise can harbor "sub-threshold anxiety," Prasad said. That's what comes into to play when uncertainty strikes and typical coping mechanisms aren't available.

It's also what can come to the forefront when people cross the line between staying informed on the progression of the COVID-19 pandemic and spiraling into a fog of news-induced worry.

"Our anxiety takes us to a heightened sense of concern, more than is even rational, and then we consume more (coverage of the pandemic), which provides a cycle," Prasad said. "It perpetuates our anxiety further."

News of increasing COVID-19 cases and details of how the virus spreads also can heighten fears people with anxiety or obsessive-compulsive disorder may hold related to germs and cleanliness, Weiner said.

It's a common technique of anxiety treatment to help patients understand which worries are focused on the slimmest of possibilities and which are about results that are more probable. But that becomes more complicated when what's usually a far-out fear - a global pandemic - actually is happening.

"Now the percentage at which that idea is true has just gone up," Weiner said.

That's why experts, again, emphasize setting up a new daily routine to keep the mind active and well.

"When we're at home, one of the things that we can do is maintain some level of control with structure," Ramos said.

Setting short-term goals can help contribute to a new structured lifestyle, Weiner said. Goals also can help counteract a uniquely human ability to perceive the results of things that have not truly happened. Typically, Weiner said, the mind does this trick with bad things, not with good.

"We have the ability to imagine these awful outcomes and then react to them emotionally and then physically," Weiner said. "We have to check ourselves."

Staying busy is another trick mental health experts employ in their own lives as they adjust their treatment plans to help established patients and new ones, all trying to stay sane through uncertain circumstances.

"Sometimes I can't even think about myself," Ramos said. "It's just trying to manage everything and make sure everybody's all right - not just patients, but loved ones. It's constant movement."

Self-care through mind, body, scenery, soulPracticing self-care can help maintain or strengthen mental wellness. Here are several suggestions from the American Foundation for Suicide Prevention.

Mind

• Start a gratitude journal

• Set an intention for the day

• Take a break

• Start a project

• Get creative (draw, paint, make music)

• Try something new

• Acknowledge something you've done well lately

• Read a book

• Express your feelings

Scenery

• Get out in nature

• Make an area of your home tidy and comfortable

• Watch a sunrise or sunset

• Go to the dog park

• Frame a favorite photo in a place you can see it

• Play your favorite song

• Watch your favorite movie

• Go for a drive with the windows down

• Watch a (replay of a) sporting event

Body

• Go for a walk, run or bike ride

• Do some push-ups

• Breathe slowly three times

• Drink a cup of tea

• Do yoga

• Prepare your favorite meal

• Get a massage

• Take a bath

Soul

• Ask for help

• Tell someone you love them

• Volunteer for a cause

• Follow social media that makes you feel good; filter out the rest

• Set boundaries for yourself

• Stop working on time

• Rest and restore

• Write a poem

• Call a friend