Ask Dr. Paul: Managing sustained stress during the pandemic

Published 1:30 am Sunday, April 26, 2020

Adjusting to the “new normal” caused by this pandemic can seem like an eternity. Our bodies and minds have been under sustained stress that can impact our health and relationships.

We need to recognize and address sustained stress to prevent it from consuming our daily lives.

Q: As time wears on, I find myself feeling physically drained, even though I’m less active than usual. I thought I should be adjusted to this new normal by now. What’s wrong with me?

A: I woke up the other day and the muscles in my neck were all knotted. I felt tired and dizzy. How come? It wasn’t from anything I’d done.

It’s the impact of sustained stress.

Our bodies are wired for threat detection and instant action. Our “fight, flight or freeze” system quickly responds to an immediate hazard — a car racing toward us, an accident about to happen or some other potential danger. After we escape the peril, our body returns to its normal resting state.

But what happens when we can’t escape or erase the threat? What happens when there is an ongoing threat, like COVID-19, that doesn’t go away? We experience the physical and mental effects of chronically heightened nervous system arousal.

While we talk a lot about the fight-or-flight response, we often forget about the “freeze” response by our central nervous system. When we’re threatened by something that we can’t escape or overcome, our bodies can start to shut down, our breathing slows and we are immobilized. We may feel depressed or numb. It can be a scary sensation.

Sustained stress plays havoc with our endocrine system — flushing our bodies with cortisol from our adrenal glands, which impacts our entire body. Some people will start to have muscle aches and pains, headache, stomach or gastrointestinal distress, or a general feeling of malaise. It builds slowly, like my stiff neck.

In the 1950s, Hans Selye observed that sustained stress resulted in a three-stage process of alarm, resistance and, finally, exhaustion. The alarm stage refers to the fight-or-flight response, the resistance stage is when the body tries to turn off the alarm by adapting to the environmental stress, and the final stage is when mind and body are depleted by our physiological response to the stressor. We experience fatigue.

So, how can we help our body and mind cope better with sustained stress?

Understand why. What I experienced the other day is normal — it was just my response to the sustained stress of the coronavirus. I have to recognize the symptoms: For me it is usually muscle tension and sometimes irritability. It’s helpful to normalize abnormal sensations.

Lower your expectations of yourself. During this sustained stress, we aren’t going to be as productive as we might otherwise be. Recognize that you may need more time to do nothing, nap or simply watch a movie.

Walk. I try to get out in the early morning and walk in my neighborhood when fewer neighbors are out and about. Physical distancing is jarring — we’re not wired to avoid others. Too much self-isolation goes against our grain, even if we are introverts.

Find outlets. I am taking an online writing class, participating in a morning tai chi Zoom group, and studying neuroscience. Stay busy, find alternatives to your usual activities and keep yourself occupied.

Keep fear in check. Easier said than done. This invisible threat, the coronavirus, has a way of igniting fear in all of us. It’s easy to go down the rabbit hole of catastrophic thinking. Focus on what is in your control.

This too shall pass. Life will eventually return to some semblance of normality. And when it does, we will all celebrate.

Paul Schoenfeld is a clinical psychologist at The Everett Clinic. His Family Talk blog can be found at www.everettclinic.com/family-talk-blog. Do you have a behavioral-health question related to COVID-19? Sending your questions to askdrpaul@everettclinic.com.