How to cope…

This is from Facebook by Imogen Wall

Okay. So I’ve (largely) kept my peace so far on this whole pandemic thing, even though I’m working on it, because I’m not an epidemiologist/virologist/immunologist – and I’ve seen enough over the years (this is my sixth epidemic response) to know just how seriously dorky all of that is. When it comes to all that, UK Chief Med Officer Chris Whitty is Da Man and I got nothing. But now a lot of people are talking about going into self isolation, lockdown etc – and that IS something I know a bit about. Like most aid workers, I’ve been stuck because of hurricanes, home bound due to political crises and once got stranded in a hotel suite in Haiti with a BBC Radio 4 team for four days with only one pair of knickers. I’m also a mental health first aider, and qualified therapist. So let’s just say I have a few lessons I’ve learned the hard way, which mostly boil down to how to take care of yourself and others. And now I’m at home alone with a glass of wine and nothing better to do, so here goes:

DON’T PANIC – easier said than done but it doesn’t help. Deep breath everyone. We’re in this for the long haul and it’s going to get worse before it get better so start with that assumption.

REACTIONS: everyone reacts differently to emergencies. Some people information-seek like mad, some get angry, some pick fights (in real life or on social media), some panic, some make a LOT of jokes, some deny the problem, some become terribly terribly active and efficient and want to help, some withdraw and fall off the radar. These are, fundamentally, all coping mechanisms for the same thing, which is at its root a deep sense of fear and loss of control. They’re all valid. Bottom line: we’ll need to be kind to each other, and that includes if someone is being aggressive or argumentative or overbearing. Experience suggest that we’ll all have a bit of a meltdown, and probably a cry, at some point. It’s just the way it goes.

RIGHT NOW IS ONE OF THE WORST BITS: the worst bit of crises is that moment when everyone collectively realises the severity of what we are facing and goes, oh shit. The moment at the top of the rollercoaster when we all look down. It’s horrible. But it doesn’t last. In a little while everything will normalise and find a new rhythm. It’ll be a different life, and a (much) harder one for some, but it’ll have structure and routine. I’ve been in camps of disaster survivors a week after an earthquake – and there are always, already, communities reforming, hairdressers opening up, coffee shops. Humans are incredibly adaptable. Also, you are about to find out just how many amazing people you have around you.This is one of the best bits.

THERE WILL BE GOOD BITS. I always struggle to explain why I loved working in crises, but it basically boils down to the fact that when the chips are down, people are just incredible at looking after each other. You’ll never see community cohesion, support offered to strangers and kindness like that which emerges in crisis situations. Unimportant things melt away, at least for a while, and stark choices ask of us all: who ARE you? Love your friends and family and take care of them – they are what will get you through this, and you them. You’ll see people do amazing things, things you’ll never forget. And you’ll do amazing things too.

EXERCISE: yoga is great when you’re stuck indoors and so are online classes, but if you’ve got an outdoor area or a bit of space indoors you really can’t beat skipping for getting your heart rate up in seconds (and making you feel better). If you don’t have a rope, washing line (esp the pastic kind) is an excellent substitute. Even a few minutes and you’ll feel loads better (if quite out of breath). Or put on some music and dance dance dance (you won’t even have to pretend no one can see you). That will lift your soul as well as your heart rate (hat tip Tania Bernath for that one).

BOOZE: Hurray for a crisis in which wine stockpiling is an option (makes a change from lockdown in dry countries I can tell you). Obviously this is for those of us who don’t have issues with drinking – and even then we need to be careful as too much alcohol will make the anxiety worse and it’s also a depressant. But if you opt for spirits, go for vodka. I know, I know – I’m a gin girl myself, but it does tend to need tonic/ice/lemon which can be harder to source than liquor. Vodka can be sloshed into anything, drunk neat and at a, pinch warm. Plus in extremis, it’s better than nothing as a disinfectant (let’s hope you don’t need to go there). Having said that, if you insist on gin, Morrisons is doing a litre of bombay sapphire for £18 which is a stone cold steal. Just don’t forget the tonic.

STOCKING UP: If you’re really going to isolate you do need to do this, but don’t go nuts – we’re not on a remote pacific island. Include some treats among the basic – trust me, you have NO IDEA how obsessed it is possible to become about nice eats. There have been times in my life when cheese was seriously the most exciting thing in the entire world. A diet of baked beans/pasta will keep you going, but it will get VERY dull and won’t help your mental health. Also, loo paper really doesn’t taste great. Easter eggs are half price, people! Chocolate, sweets, your comfort food of choice should all in there if that’s your bag, but my top tip is things that keep like cured meats, waxed cheese, tasty things in tins and smoked salmon. If you can afford it, do a bit of your stocking up at delis – they also need your business more than the big supermarkets. Delish, better than plain sugar and if it really gets bad, excellent in a middle class barter economy (wait till you see what your mates will do for a packet of prosciutto when scarcity really bites). Also don’t forget things like lightbulbs and washing power.

TRANSPORT: If you haven’t got a bike, think about getting one. If you have, get it serviced (did mine today). Definitely going to be the most reliable, safest and healthiest way of getting around in cities at least and when you do go out, and might be only even remotely safe way of socialising for a while. Plus panniers make shopping v convenient. If you have a car and you think you might need it in an emergency, brim it – fuel shortages aren’t on the cards right now but better safe than sorry (you taught me that YG).

ACTIVITIES: Cook. Garden. Knit, Draw. Do things with your hands (stop sniggering at the back) that don’t involve a screen. It’s basically meditation and and will relieve stress better than anything involving a screen.

MAKE USEFUL FRIENDS – with people like your local cornershop owner. Even if they are forced to close, they will have the connections to get you stuff. In Indonesia we agreed to turn a blind eye to a local trader plugging into our electrical supply as long as he stocked my housemate’s favorite ciggies (Tim Kassapian Olly Hall remember)? They’re the ones who’ll keep you in prosciutto.

MEDICINES: If you get Covid you’re almost certainly going to have to home treat. Other people will be better placed to advise on this than me (ie take advice from actual medical professionals), but you’ll need stuff like painkillers, things like lemsip and detergent to keep your bedding and clothes as disease free as possible. The advice is loads of fluids so things to make water taste nice (my choice is Ribena). I also swear by ORS but that’s probably just me.

HELP: Ask for it if you need it – there are no prizes for suffering in silence. The Mutual Aid people are amazing. But there are also, sadly, going to be scammers taking advantage of this situation (already reported in Haringey). Ask for ID and an organiser contact, don’t give them money without a receipt and definitely not your bank card. And don’t put up with any nonsense: if anyone harasses you, report them.

LIMIT SOCIAL MEDIA, and realise your own susceptibility to rumours. The mill goes mad at times like this. From hot water treatments to believing that the military are about to take over, the myths fly around and we’ll ALL fall for at least some of them at some point. It’s not stupidity, it’s human nature: scared people are really bad at evaluating data and especially risk. Clever people if anything are even more susceptible because they believe they are too smart to fall for misleading info. They are wrong. And don’t gloat if you catch them out – it’ll be you next.

LIMIT NEWS EXPOSURE: In addition to feeding the rumour mill, spending too much time watching the news will just create stress. Likewise, spend too much time online and sure as COVID is COVID you’ll find infinite rabbit holes and do very bad things to your mental health. Staying up all night reading is not going to make you an instant epidemiologist, just sleep deprived which makes everything worse. Ration it, trust reliable sources (like the NHS) and make like the BBC: double source everything you hear, ESPECIALLY if you really want to believe it is true. Turn it off, go outside and feel the spring sunshine.

EXPECT MORE CHANGE: we don’t know very much about this bug yet, and the scientists are learning more every day. The advice will alter on that basis. It’s not because our evil government is trying to kill us, it’s because they’re finding out new things all the time about how it affects different groups and what works. This happens in every epidemic with a new bug: it’s weird to us but it’s normal-outbreakness (and completely bloody fascinating if you’re a nerd, which all outbreak professionals are at heart) (Emma Dreyer you know what I mean).

SMALL GESTURES mean a HUGE amount. Flowers left on someone’s doorstep. A card saying I’m thinking of you. A phone call, a direct message. The last slice of aforementioned prosciutto. They take on a real disproportionate impact. I will never forget one particular person arriving in a particularly tight spot with a can of cold diet coke for me. Even tho we’re no longer friends that remains. Do the little things, they HUGELY count.

HUMOUR is also uber important. So important that sometimes I see aid worker job descriptions that actually ask for this as a qualification (don’t ask me how they test that at interview): never forget the healing power of a good giggle. Especially good with children. Make yourself and the people around you laugh and you’ll all feel better (there’s actual science around this). Everything from watching comedy shows to sharing memes (the meme game on COVID-19 is impressively on point). If you lose your sense of humour, take that as a warning sign that you’re not doing OK.

UNDERLYING PROBLEMS don’t go away. One of the things about crises is that they seem like the only show in town. But people’s day to day problems don’t stop, they only get compounded. If you’re in an unhappy relationship, mentally ill, dealing with addiction or infertility, coping with a family death, or your identity has been stolen or you’re in a custody battle then these things don’t stop – they just get compounded, but everyone else tends to forget. So if this is one of your mates, keep taking care of them on that level too.

ONE DAY IT WILL BE OVER. The day will come when we meet up for drinks, and gather for dinners, and laugh and raise glasses and chat and hug and relax together again. Taste the sweetness of friendship and casual conversation and trivia and a life without this care. Every day we go through this is a day closer to that day. Maybe we’ll even be better people in a better world – and one in which we can get a jab for COVID-19 and forget about it, and maybe even one in which the antivaxxers have finally shut the hell up. But if we’re not this will still have ended.

And the rest of our lives – blessed as they are, in this country and continent where we do not face these kind of restrictions (and far, FAR worse) every day of our lives, as so many do, and because we live in the age of modern medicine – will be epidemic free. We’ll back to the humdrum existence of first world problems, of complaining about nothing – but maybe perhaps with new knowledge of our neighbourhoods and new friends, because that’s who the strangers on our streets turned out to be. I’m raising a glass tonight, to that today. One day soon, I know we’ll raise one together.

And in the meantime, keeping spare knickers in my handbag. Just in case.

So… my goodness. A couple of days ago, I threw out an off-the-cuff post on aid worker tips for surviving lockdown and quarantine. Today I’ve woken up to find it’s been reshared thousands of times. I’m getting comments from strangers around the world, messages of thanks, even requests to translate it. If you’ll forgive the expression, it appears to have… gone viral. The overwhelming reason it seems to have a struck a chord is that it talked about how we’re all feeling a bit wobbly. It sounds like there are an awful lot of people having reactions they don’t really understand. So today I thought I’d write a short follow up with my mental health first aider/therapist hat on. Ladies and Gents, this is Pandemic Anxiety 101. (NB for those asked for more lockdown tales, I’ll get to those in coming days).

IN CRISES, WE START DOING WEIRD STUFF: Over the last week I have struggled to sleep, stayed up late into the night reading endless news articles, bought pasta I don’t even like very much, got angry with my mum for not staying home. My spelling is a disaster and I’m definitely drinking more. I’ve been a bit teary, and all I really want to eat is cake, cake and more cake. From what I got back from my post yesterday, I’m not alone.

If you’re having a wobble, you may also have noticed all sorts of weird stuff going on. Are you arguing more, talking faster, struggling to sleep, restless, desperate for information? Or are you teary and overwhelmed, perhaps feeling a bit sick? Struggling to make decisions? Just want to stay in bed? Tummy upsets? Having palpitations, butterflies, headaches? Ranting, picking fights or getting into arguments? Laughing unexpectedly or saying random, inappropriate things? Developing Very Strong Opinions on epidemiology overnight? Or have you just completely gone to ground?

If you are feeling any of these things: good news! You are not going mad. And you are 100% not alone. You are, in fact completely normal: a fully emotionally functional human being. Congratulations! Why? I’ll explain: take a seat and put the kettle on.

WE ARE LIVING IN TURBO-ANXIOUS TIMES. Well, no kidding. We’re in the middle of an unprecedented crisis that has showed up unexpectedly (they do that) and which presents a mortal threat to ourselves, our loved ones and our way of life. It’s terrifying and it’s getting worse and it makes us feel totally out of control. And this is on top of anything else we have going on.

HERE’S THE SCIENCE BIT. When we are exposed to threats and need to deal with them, our brain springs into action. Specifically a tiny, innocent-looking thing buried behind your ear called the amygdala (fun fact: it’s the size and shape of an almond). It’s the bit in charge when we are frightened and right now, it’s in full tin-hat klaxon mode. Unfortunately, it’s also very ancient bit of kit. It came into being when threats basically consisted of being eaten by large scary animals like bears. You know that thing about when you have a hammer, everything looks like a nail? Well, to the amygdala, everything looks like a bear. It’s also pretty basic, so it really only has two settings. They are no bear 🙂 and BEAR!!!.

SETTING: BEAR!!!. Because all threats look like a bear to the amygdala, it preps you accordingly. There are really only two reactions to a bear about to eat you: fight it, or run away really fast. So this is what the body gets you ready to do. It’s called the Fight or Flight response (there’s also freeze, meaning you just get paralysed). It does this by flooding your body with chemicals like cortisol, and adrenaline. Your heart rate goes up, you feel super alert, your breathing goes shallow, your muscles are ready for action. These chemicals are also largely responsible for the huge range of other cognitive/physical/emotional reactions in my intro. In group fear situation like a pandemic, this tends to happen whether you think you’re scared or not – anxiety is even more infectious than COVID. Your body reacts even if your conscious mind doesn’t.

BEAR V VIRUS: Obviously this is all great if you really are running away from a bear. But we’re now in a situation where we’re being asked to do the EXACT OPPOSITE of running away. We are being told to sit tight. Literally stay still. Process large amounts of information, make complicated and life changing decisions, and stay calm. All while a bit of your brain is running around yelling BEAR!!! BEAR!!! BEAR!!! This isn’t easy. The result is an awful lot of stress and anxiety. And if you’re anything like me, you end up feeling really overwhelmed and having all sorts of reactions.

SIGNS AND SYMPTOMS: Anxiety isn’t just mental – it’s also physical, cognitive and behavioural. You will notice all kinds of things: stomach upsets, headaches, insomnia, changes to eating, changes to the way you talk. It’s also cognitive: it’s very difficult to think straight when you’ve got the BEAR!!! BEAR!!! BEAR!!! thing going on – so we also become very bad at making decisions, absorbing information and generally thinking rationally. Which is EXACTLY what we need to do.

SO WHAT TO DO: well, the good news is it is possible to calm down. We can turn the amygdala from BEAR!!! to NO BEAR 😊, and not just by distracting it with cake and tea. Her are some solid, scientifically proven things you can do.

BREATHE. It’s so basic, but breathing exercises are basically magic. They work in minutes and you can do them anywhere. They work because of all the physical reactions the amygdala triggers, rapid breathing is the only one over which we have conscious control. Control your breathing and you are basically telling your body: it’s OK. There is no bear. Your body will then start to dial down the adrenaline and cortisol and all the other reactions will slow to a halt. How to control your breathing? It’s easy – and if you want help just put “two minute breathe bubble” in into Youtube. The golden rules are these:

• In through the nose, out through the mouth. SLOWLY
• Make the outbreath longer than the inbreath – imagine there’s a candle in front of you and it mustn’t go out
• Breathe from the tummy not chest – really make your tummy go out when breathing in.
• Do it for two minutes – time yourself – and see how you feel

Seriously, try it – this technique is used by everyone from top athletes to the US military to help stay in control while under stress. There are all sorts of versions – from yogic breathing to box breathing to 4-7-8. Google them, mess around, figure out what works for you.

CALL A FRIEND: Don’t suffer alone. Call a mate – someone who’ll listen while you have a bit of a rant, or a cry, or a general wobble. Someone you can trust not to judge you and who’ll just sympathise. And if you get one of those calls, just be nice to them. You only need to be kind. You can’t fix what’s going on so just give them a bit of space to rant and tell them they’re normal and doing great. And if you’re OK, call your friends and check in on them. Especially if they’ve gone silent.

LAUGH: it doesn’t matter what is funny – laughter is a huge releaser of endorphins. Silly memes, silly jokes, stand-up, rolling around with your kids – videos on youtube. The sillier the better. Also v good for bonding with friends, which will also help you feel less alone.

DO SOMETHING WITH YOUR HANDS. Yes you can meditate if this is your bag, it’s amazing. But if it’s not, and personally I’m rubbish, then trying to start when you’re already anxious is really hard. So do something instead with your hands, that you have to focus on to get right. Cook. Tidy. Knit. Draw. Bake. Garden. Mend things. This is what nice middle class therapists like me call Mindfulness.

TREAT YOUR BODY: We hold stress in our bodies at least as much as our minds. Take a bath or a shower. Put on things that feel good on your skin. Use nice smelling body creams. Stretch. Skip. Do yoga. Dance. Eat healthy but delicious things – fresh if you can get it. All of these will help calm you down.

SUNSHINE. It’s SPRINGTIME amid this horror – enjoy it. If you can’t go outside, open the windows and feel it on your face and breath it in. If it’s safe for you to go outside (maybe you live in the country) do it, while of course observing social distance. Go for a walk. Being outdoors, connecting to nature, is hugely calming.

STEP AWAY FROM SOCIAL MEDIA/THE NEWS: All it will do will scare you more and make things worse. Turn off the telly and for gods sake avoid the psychopathic digital wild west that is Twitter. Stick to sensible sources like the BBC and the NHS, and limit yourself to short need-to-know bits a day. You’ll feel better immediately. Talk to friends instead – this is physical, not social distancing

STEP AWAY FROM TERRIBLE COPING MECHANISMS: They will all translate as BEAR!! to your poor brain. Especially don’t get drunk, especially if you’re alone (BEAR!!!), take drugs (BEAR!!!), stay up all night reading (BEAR!!!), get sucked into conspiracy theories (BEAR!!!), pay attention to ANYTHING Donald Trump says (BEAR!!!). See? Stress levels going up already. Breathe.

BE KIND: to yourself and others. Now is not the time to go on a diet. Nor is this the time to start on Proust or makeover your life. You’ll probably struggle to concentrate, fail and make yourself feel worse (hat tip Laura Gordon for this bit). Don’t make this more stressful than it already is. Think comfort books, comfort telly, comfort everything. Personally I re-read children’s books. Everyone is wobbly, everyone is going to have a meltdown at some point. Understand that if someone is angry or aggressive, then they are also just scared. And eat more cake. Cake makes everything better.

So, there we go. Hopefully a bit less BEAR!!. Now, that kettle should have boiled by now. Go make a nice cup of tea, sit by a window and drink it in this lovely morning sunshine. We are British after all. And save me some cake <3.

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