Covid-19: How to live with uncertainty?

Stressors are especially dangerous when they are uncertain

Everyone recognizes that this period is very stressful. According to Dr. Pressman, who teaches Psychology at the University of California, Irvine, one of the most salient features of stressors – things that cause a state of strain or tension – is that “they are especially dangerous to us if they are uncertain. Right now, we don’t know if we will get sick, if we will have minor symptoms, or if we will be in the hospital struggling for our lives. We don’t know if we will lose our jobs, or if our basic needs will be met.”

In addition to uncertainty, the current situation is an “uncontrollable stressor.” As Dr. Pressman explains, “whether or not we are stuck at home is not up to us. We cannot do anything personally to remove that stressor. That’s why you see people behaving in odd ways, like buying up all the toilet paper in stores. They are trying to get control over something.”

Another exacerbating factor is duration. Stress is not particularly harmful in the short term, since our bodies are built to handle short-term flight-or-fight situations. But, as Dr. Pressman emphasizes, “when the stress keeps going on for an extended period, like what we are going through right now, our bodies start dysregulating.” They don’t go into homeostasis – stable equilibrium between physiological processes – and, in the words of Dr. Pressman, “that’s when you start to see psychological, behavioral and physiological damage happening.”

The damage is caused by unhealthy coping behaviors: “We overeat, we smoke, we drink heavily. Then, to make matters worse, we cannot engage in our good coping habits.” Good coping habits include going to the gym and socializing with friends. Convincing people that smoking and drinking can be harmful is not difficult but, as Dr. Pressman notes, “few people know the harms of not taking a vacation, for instance, which can literally kill you.” Combined with bad health habits, lack of access to our usual good coping strategies can lead us down the path to clinical depression. Many mental health professionals worry that suicidal behaviors could increase.

The pandemic is also eroding our social relationships, and not just outside the home: “because we are stuck together all the time, our homes can become a source of stress as well. We know that, in some cases, these situations can result in violence.”

Focusing on what is positive

Dr. Pressman advises to focus on elements that are within our control. The best intervention, she says, “is to try and release the energy our bodies are saving up, to release the adrenaline flowing through our bodies,” as a way of adapting to the anxiety the situation is creating, which she describes as “the constant feeling that a lion is about to attack us.” She recommends exercise: “Find a high-intensity workout online or go for a run if it is possible.”

Being unable to go for walks or let children outside creates another mental health challenge. “Nature and exercise are huge well-being predictors. Just being around trees can reduce your blood pressure.” Fortunately, there are solutions for this deficit: “Simple breathing exercises help. Paced breathing can activate the relaxation component of our nervous system and physically lower heart rate and blood pressure.”

To compensate for the lack of socializing with friends, “capitalizing on the relationships we have, like reaching out to people online, can help.” Dr. Pressman recommends concentrating on positive things that are available now and on things we can plan for. She also recommends using web-based psychological well-being resources. From a public health perspective, she recommends that we start imagining slightly larger “bubbles of isolation,” where people can quarantine together, in two-or three- family groups, and share childcare duties.

Anything we feel or think has the potential to alter our physiology. Decades of research have shown that mood, stress, and relationships can affect our stress hormones, our immune and cardiovascular systems and whether or not we recover from illness. “We also know that protective factors, like social relationships and positive emotions, can undo those stress processes and protect us so we don’t get sick. We really understand those mechanisms quite clearly.”

This mind-body relationship has implications for Covid-19 outcomes as well, which might be predicted by looking at psychosocial and behavioral factors. “The huge variability we are seeing in how sick people are getting, beyond preexisting conditions or age, could be partly explained by psychosocial predictors.” The behaviors we exhibit at home – how we are acting in our relationships, our thoughts, our stress level – undoubtedly influence whether we catch the virus and how sick we get. “If we can figure this out, we can tailor psychosocial interventions accordingly.”

Learn more about Dr. Pressman.