Many of us are feeling increased anxiety due to the recent outbreak of the coronavirus (COVID-19). This may be especially true for people with a rheumatic illness. Your immune system may be suppressed, and you may be more concerned about the chances that you will be directly affected by the illness. Each person reacts differently to uncertainty. Below are a few tips that may help you cope during this time.
- Stay in touch with your rheumatologist. Talking with your doctor about your concerns, physical symptoms and psychological and emotional well-being can be especially helpful. Many physicians offer virtual or telehealth services, but you can also connect through your patient portal (for non-urgent medical questions). It is important to talk directly with your doctor if you are considering making any changes to your medication plan.
- Give yourself some credit. Anxiety can sometimes make us feel out of control and uncertain of how to take care of ourselves. Many people with rheumatic diseases already practice infection prevention behaviors that are also recommended to prevent the spread of COVID-19: frequent handwashing, using sanitizer, and staying away from crowds. Continuing to use these tools can boost your confidence that you are doing what you can to prevent the virus.
- Practice social distancing. You are the expert on yourself and your condition and can set your own boundaries. All people are encouraged to practice “social distancing” to prevent the spread of COVID-19, which means a minimum amount of space between you and others of at least six feet. Preparing some language in advance to use when speaking with family and loved ones may be helpful. You do not have to feel afraid or bad about setting firmer boundaries with others who may not be mindful or fully understand the importance of these precautions . It is also important to recognize that your family members and loved ones may have emotional reactions, as they adjust to social distancing at home, deal with long periods of inactivity or changes in their social interactions with you. It may also be helpful to discuss your thoughts and emotions about this with your family so that you can explore ways to stay connected.
- Take care of your mental health. Most people are currently experiencing some level of uncertainty or anxiety as we seek to continue to find a “new normal” with COVID-19 . A mental health professional can work with you to understand your thoughts, feelings and behaviors and help you cope with the stress of COVID-19. Connect with your mental health professional about their availability to provide virtual or phone mental health sessions. Your healthcare providers, such as social workers, can help you decide if therapy is right for you, as well as provide supportive counseling and connect you with resources.
- Turn your focus inward. Studies show that mindfulness-based practices improve our ability to cope with anxiety. Just 10 minutes of quiet reflection, deep breathing or guided imagery may bring relief from stress and can increase your tolerance for it. Listen to music, relax and try to think of places and feelings that bring you joy. Here is a good free resource for guided meditation: https://www.hss.edu/health-video-library.asp.
- Keep active. Studies have also demonstrated that exercise can combat depression and help relieve feelings of anxiety. Physical activity such as walking or yoga can help ease tension, promote relaxation and enhance your mood. Although you may not be able to go to your local gym or workout class right now, an in-home exercise routine that you enjoy and gradually build into your week can help you to remain active. Just spending a few minutes outdoors taking in some fresh air or going for a short walk can also help. Remember, of course to practice social distancing recommendations.
- Prioritize sleep. Excess worry and fear can prevent you from falling asleep or cause interruptions in your sleep pattern. However, many studies show that sleep is important in helping our bodies fight off infections and our minds rest and reset. Try to practice good sleep hygiene such as a relaxation routine like meditation or a warm bath before bed; a consistent sleep schedule; a cool, dark bedroom free of distraction; and try to avoid heavy meals or alcohol before bed.
- Limit your news intake. It is important to be informed. But too much news and media consumption can be harmful to our mental and emotional health. Schedule 15-30 mins each day to connect with your trusted media and news outlets and then disconnect. Use social media to stay connected with friends, family and your support community instead of as a source for news updates.
- Line up the right resources. Even as COVID-19 precautions call for us to stay at home, there are existing and new resources available to support you during this time. Below are a few resources to consider:
- New York State Coronavirus Hotline: 1-888-364-3065
- National Alliance on Mental Illness (NAMI):1-800-950-NAMI (6264)
- Alcoholics Anonymous (for virtual support and phone meetings): https://www.aa.org/
- CDC coronavirus page: https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html
- Hunger Free America: https://www.hungerfreeamerica.org/
- LupusLine® Program: https://www.hss.edu/lupusline.asp
- Hospital for Special Surgery Department of Social Work Programs: https://www.hss.edu/social-work-programs.asp
Remember to be kind to yourself. Some days may be harder than others, as we have never experienced a situation like COVID-19 before. There may be times when you feel more anxious. Incorporating self-care techniques and engaging in other virtual activities, such as online church services or support groups, may help bring a sense of normalcy to these trying days.
Jillian A. Rose, PhD, MPH, LCSW, is the Director for Community Engagement, Diversity and Research at Hospital for Special Surgery. Dr. Rose leads the implementation of innovative community programs to enhance health, access to care and self-efficacy of traditionally underserved communities, in collaboration with other health care organizations and government agencies. She participates in research and quality initiatives to identify and address health disparities to ensure the highest quality care for all patients. Dr. Rose provides ongoing leadership and support for the Hospital’s collection of gender identity, sexual orientation, race, ethnicity and preferred language data. In addition, Dr. Rose plays an integral role in the HSS Community Health Needs Assessment and Community Service Plan. Since August 2005, Dr. Rose has occupied a leadership position in managing Rheumatology programs at the hospital, with a focus on two national peer support and education programs for people with systemic lupus and their families.
Priscilla Toral, LCSW, is the Senior Manager for LupusLine® and Charla de Lupus (Lupus Chat) ® programs, national peer based support and education programs for people with lupus and their loved ones. She is responsible for the planning and operational oversight for program initiatives, training and supervision of program staff and volunteers, psychosocial assessment and social work intervention with patients and their families.