Coronavirus and Mental Wellness: Perspective for Families
Lets face it, it is a confusing and unsettling time right now. The unexpected and abrupt arrival of COVID-19 on our global door step has required modern-day
families to adapt to mandated changes in their social, economic and professional lifestyles almost overnight and with little choice.
The introduction of social distancing, closures of our favourite venues and activities combined with the once lucrative option of working and learning from home is not the type of ‘hiatus’ many of us were looking for from our already chaotic lifestyles.
But then again, it is not like Aussies are unaccustomed to adversity. Our nation recently watched in horror while 18.6 million hectares of land were burnt during our 2019-2020 ‘black summer’ of bushfires. Economic data suggests that Australia has amongst the highest levels of household debt to net disposable income in the world, one of the most expensive property markets in the world (rendering it almost impossible for many young families to own their own home) and not to mention being one of the leading fossil fuel exporters (adding to higher levels of global CO2 emissions).
For many Australians, these factors have contributed to significant amounts of stress in our daily lives. It is no surprise that our national mental health data reveals that 1 in 5 (20%) Australians aged 16-85 years experience mental illness in any one year. Of this group, approximately 11.5% have one disorder and 8.5% have two or more disorders. Almost half (45%) of Australians will experience a mental illness in their lifetime.
The most common mental illnesses in Australia include anxiety disorders (14%), depressive disorders (6%) and substance use disorders (5%). Generalised anxiety disorder (GAD) is the most common anxiety disorder in both adults and young people. GAD is characterised by excessive and uncontrollable worry about several aspects of everyday life including work, health, family and/or financial issues. Given the current circumstances however, it is no surprise that more Australians may be adopting ‘catastrophic thinking styles’ where irrational “what if?’” questions are starting to occupy our internal dialogues. How do we best manage these unhelpful thoughts to remain emotionally and physically available to ourselves, families and friends but most importantly our children?
Corona Anxiety: Control vs Acceptance
As parents, we are innately geared to protect our children at even the slightest indicator of threat or uncertainty. Perhaps part of the reason why there has been so much discussion about how to best respond to our children during the COVID-19 emergency, is simply because we are in unfamiliar territory.
The uncertainty surrounding best practice for our children’s social, emotional and academic development as well as uncertainty about when schools will return, for many parents is highly anxiety provoking.
Psychological theory underpinning anxiety recognises the importance of the body’s fight vs flight response. This is a key contributor to the nature and treatment of anxiety. When a person is in danger or believe they are in danger, a number of physiological changes occur in the body (e.g, increased adrenaline, heart rate and depth of breathing etc) to prepare us to either ‘fight’ or ‘flee’ from threat.
Anxiety disorders occur when the flight or fight response becomes triggered too easily and too frequently, and in the presence of ‘perceived’ threat vs imminent, real-life threat.To manage anxiety, people often engage in a range of coping behaviours (e.g, checking and reassurance seeking) in an attempt to eliminate distress. Whilst many of these strategies may be beneficial in the short term, they do not often lead to a long-term benefit.
As parents it is difficult not to get carried away with the sudden surge of online information about how to best assist our children during this unprecedented time. We find ourselves frantically reading, sharing and ‘liking’ articles not to mention downloading learning schedules and online educational apps just to name a few! Whilst many of these resources may be beneficial when used sensibly, we also need to ask, when is it too much?
To what extent are our behaviours an automatic attempt to cope with fear, that is, our fight vs flight response? Put simply, are we trying to create a false sense of security in a situation which is so largely out of our control? Analogous to panic buying, perhaps?
Maybe a better way to manage our fear is not so much looking for external solutions to cope, but instead, to turn inwards and be guided by what feels right for ourselves and our families. Asking core-self questions (e.g., “Who do I want to be during this time”?, “What experience/opportunities do I wish to create for my family now”? etc) can help guide what information we choose to read and what current decisions we make for the wellbeing of our families (e.g., schooling approach? working from home vs office? etc) with the aim of creating a more purposeful and present-focused perspective. Evidence-based treatments for anxiety such as mindfulness recognise the importance of conscious awareness in the present moment.
By focusing our attention on the present, mindfulness counteracts rumination about the past and worrying. Worrying about the future (e.g. “What if I contract coronavirus”?) and ruminating about the past (e.g., “They should have detected this earlier”) are generally maladaptive thinking processes which can lead to anxiety and depression, respectively. In mindfulness based-therapythere is a focus on acting with intention and being non-judgemental with the aim of relinquishing control to foster growth and fulfilment.
Interestingly, these core principles have recently been reflected in a diagrammatic representation released by Canada Youth Mental Health (online) in response to the COVID-19 pandemic.
This diagram suggests that our individual coping zones have important implications for the nature of our thoughts, feelings and behaviours during this uncertain time. Whilst the ‘fear zone’ is characterised by a strong need to control, better mental wellness is associated with mindfulness-based constructs. These include acceptance, being present focussed and using this time as an opportunity for self-growth.
Fostering Mental Wellness During COVID-19 Pandemic: Applications for Families
With the current health situation, many of our normal routines and daily activities are changing which can be unsettling. Identifying how to best maintain overall wellness can be confusing right now given the abundance of available information.
Below are some key strategies for families to maintain good psychological health whilst also using this time as an opportunity to mindfully cultivate growth.
Set a balanced daily routine
When being more home-bound, it is important to continue with a regular routine but also to be guided by what feels right for your family during this unpredictable time. It may be useful to visually represent these priorities in a graph which clearly illustrates areas of importance to your family unit. This may reduce the likelihood of us becoming overwhelmed by too much external information and advice, thereby creating a greater sense of control and cohesion within the family unit.
Establishing a regular routine is associated with several health benefits, particularly increased mood and sleep stability. Try to maintain a regular time for waking up and going to bed, eating meals as well as sleep and wake times. If working or studying from home it is useful to; allocate a dedicated work space, limit distractions and schedule regular breaks and rewards for good progress. Evidence repeatedly suggests that good mood management is associated with a combination of activities that provide a sense of achievement (e.g., meeting work or study goals), help you feel connectedwith others (e.g., Face Time, Skype and Zoom video chats) and that are pleasurable (e.g., listen to music, creativity, cook etc).
Stay mentally and physically active
When planning your routine, it is useful to include activities that keep both your mind and body active. For example, you could try learning something new with an online course, or challenge the kids with innovative DIY or STEM based-projects. It’s also important to allocate approximately 30mins a day to keeping physically active. This could include individual practice (e.g., yoga/pilates), group-based exercise
(e.g., family sporting game), fun/entertaining exercise for the kids (e.g., GoNoodle, KIDZ BOP etc), or simply going for a walk.
Communicate and unite while we isolate
Maintaining good social connections and communicating openly about how we feel with family and friends is critical to keeping a positive frame of mind. Do not be afraid to talk to children about coronavirus. It is likely they will pick up on the concerns and anxiety of other people whether this will be through observing or listening to them. Providing opportunities to answer children’s questions in an honest and age appropriate way can help to put a child at ease. It is useful to first ask a child what they already know about the coronavirus so you can clarify any misunderstandings. Normalising any anxiety your child may have and explaining ways they can keep safe (e.g., washing hands, staying away from people who are sick etc) can help provide children with a sense of control. Limiting media exposure to avoid any unnecessary fear or anxiety is also recommended.
In addition to communicating with your child, it is important to take this opportunity to spend quality time together by harnessing their interests and having fun at home (e.g., board games, dance to music etc). You could also teach your child a new skill or game, read with them or research a new topic together.
Research has shown that mindfulness helps us reduce anxiety and depression. Mindfulness teaches us how to respond to stress with awareness of what is happening in the present moment, rather than simply acting instinctively. By being aware of one's physical and mental state, mindfulness allows for more adaptive reactions to difficult and uncertain situations.
Practicing mindfulness can help us let go of worries and the urge to control by bringing ourselves back to the present moment. For example, activating bodily senses by focussing on the sounds around you or the gentle movement of your breath can provide us with ‘anchors’ to come back to the present moment and relinquish control. Neuroimaging studies have shown that mindfulness increases activation in the anterior cingulate cortex (ACC), a brain area that is involved in executive functioning skills such as attention. This suggests that if we are able to improve our attention, we can better focus on a present task rather than being distracted by worry.
Keep things in perspective and limit worry triggers
When we are stressed, it is easy to adopt catastrophic thinking styles where we expect ‘worst-case scenario’ and start worrying about it. Try to keep things in perspective by adopting rational self-talk and ask yourself; “Am I getting ahead of myself and assuming something bad will happen where I don’t actually have the evidence to support this”?, “Am I overestimating the probability of this happening”? and “Am I underestimating my ability to cope”?.
It is also useful to try and notice what triggers your worry and be specific. For example, is it watching/reading the news for more than 30 minutes? Checking social media every two hours? Try to limit your exposure to these triggers each day so that you may only watch the news for 10 minutes in the evening, or limit social media use to two times per day.
Practice gratitude and compassion
During times of uncertainty, practicing gratitude can help us to connect with moments of joy, liveliness and positivity. Research suggests that gratitude is strongly correlated with reduced levels of anxiety and depression, improved sleep quality and stress regulation.
At the end of each day, it can be useful to reflect on what you are thankful for. Try and be specific and notice something new each day, for example, “I am grateful for the warm, sunshine on my skin while on my walk today”. Similarly, demonstrating compassion towards others, getting in touch with nature and expressing our creativity have all been implicated in greater mental wellness. In fact, studies suggest that expressing positive emotions such as gratitude, is associated with the release of dopamine and serotonin in the brain, which are two neurotransmitters largely responsible for our emotions and making us feel good.
Know when to seek help
If you feel that your stress or anxiety levels or those of a family member are impacting on everyday life, it is important to seek support. Talking to a GP or a psychologist may be helpful. Psychologists are highly trained and qualified professionals, skilled in providing effective interventions for a range of mental health concerns. A psychologist can help you manage your stress and anxiety using evidence-based techniques informed by clinical research.
About the Author
Dr Cristina Cacciotti Saija (PhD, USYD) is a clinical psychologist specialising in child and youth mental health as well as adults and families. Her areas of expertise include anxiety and mood disorders as well as eating disorders and family-based interventions. She offers private consultations at Uspace (St Vincent’s Private Hospital, Darlinghurst) and at The Wellness Centre (Five Dock, Inner West). She is also a busy mum of four girls!
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