Psychological Impacts of COVID-19 on the Elderly

The government announced on 10 March 2020 that it was suspending activities for seniors for 14 days, affecting some 290,000 participants. Current projections suggest that our fight against COVID-19 will be a long one, and suspensions like these form part of the measures necessary to slow and contain the spread of COVID-19.

Although necessary, suspending communal activities presents our seniors with unique challenges, especially to their mental health. While a 14-day suspension may not result in the mental health issues brought about by isolation or loneliness, without knowing when our fight against the virus ends, we must be able to talk frankly about the impacts of our measures on our seniors.

The immediate impact of a suspension of activities on seniors is the fear of isolation or loneliness. Isolation or loneliness is a subjective concept and immensely personal in nature; seniors may view the temporary suspension of communal activities or the occasional loneliness as a form of isolation, even though they may in fact continue to have access to their family and friends. No matter the reality, their subjective reality is enough to trigger the detrimental effects of isolation.

There is a strong link between isolation and morbidity.

Morbidity is a term used by mental and other health professionals to describe illness or disease. In fact, isolation is used as one of the risk factors in predicting the development of morbidity. The detrimental effects of isolation are even more pronounced in seniors, where the protective factors of employment, access to technology, and strong social support networks, do not generally exist. By contrast, seniors are often associated with risk factors such as frailty and neurodegenerative disorders, or the lack of strong social support networks.

Sustained isolation brings about increased levels of stress and emotional distress, which in turn puts physical and mental strains on the body. Specific examples of illnesses and diseases that are associated with isolation include depression, Alzheimer’s disease, heart disease, including high blood pressure, and a general decline in cognitive functioning. One longitudinal study in Singapore found that isolation was associated with a greater risk of death in Singapore and was more predictive of mortality than even living arrangements or social networks. With more than 41,000 seniors above the age of 65 living alone in Singapore in 2015, we must take care that we do not mitigate an immediate crisis by substituting it for a longer term one. The number of seniors above the age of 65 living alone is projected to increase to 83,000 by 2030.

However, our seniors do not merely face the feelings of isolation or loneliness. As much remains unknown about COVID-19, there is also a general anxiety among the population, including seniors, about its prognosis and mortality rates. In the face of escalating case numbers and fatalities amidst the widespread media coverage on COVID-19 especially among the vulnerable and the elderly, given that much remains unknown about the novel coronavirus, it is inevitable that fears of dying and death are stoked. And when combined with the effects of isolation or loneliness and being unable to externalise their anxieties, the anxieties and isolation become more pronounced.

To cope with their anxiety and low mood, our seniors may develop unhealthy coping behaviours such as excessive smoking or drinking, maintain a poor diet, or experience a decline in exercise or physical activity.

These behaviours are unhelpful and contribute to other long-term health issues, and they tend to persist even after the period of isolation is over. We must therefore continue to keep an eye out for our seniors, given especially that no one can accurately predict how COVID-19 will continue to impact us.

However, it is not easy to design alternative activities to allow our seniors to continue to feel engaged outside of their usual social settings. Seniors hold on very dearly to their sense of independence and freedom, to the extent that some seniors may choose to live by themselves or away from their families. These seniors tend to form strong external social networks, and the communities that they participate in become an integral part of their identity and serves as a powerful protective factor against the detrimental effects of isolation.

It is important to remember that many seniors take part in community activities as a way to cope with their unique set of circumstances in the first place. In recognition of the role that strong social networks play in combating depression and isolation, many of these activities were specifically designed to promote “gotong royong” or a sense of community.

It is commendable that extensive efforts have been made to extend these activities to all our seniors, given that strong social networks have been found to be effective in reducing symptoms of depression. Seniors who were engaged in social activities were associated with positive health outcomes were more likely to be happier, live longer, and experience fulfilment. Furthermore, social activity also slows cognitive and physical decline. Like muscles in our body, our cognitive functions gradually weaken if it is not put to regular use. Retirees who had more social interaction and engagement through some form of work involvement or volunteering reported better cognitive performance, fewer depressive symptoms and overall better mental health and life satisfaction compared to those who did not.Other studies have also found that socialisation was associated with a delay in memory loss, cognitive impairment and reduced the risk of dementia.

Returning to the impact of the suspension of activities for seniors, the potential loneliness or isolation experienced from the suspension of a single routine activity cannot be considered “in isolation”. A change in a single key activity is a significant deviation that might impact on all their other activities for the day. For example, seniors typically structure their entire day around these activities that take place at the same place or activity centre, involving the usual suspects (i.e. their friends). While some seniors might be able to adapt or find substitutes for their routine activities, there will be many who find it difficult to give up routines that were honed through years of practice. Without a routine activity to “anchor” their day, seniors may not be able to plan or follow through on activities for the rest of their day,even if those activities have nothing to do with the routine activity.

One strategy is to give our seniors a sense of purpose;

that they are very much an important tool in Singapore’s fight against COVID-19. Providing seniors with accessible and regular updates on our fight against COVID-19 and empowering each senior with an individual action plan are useful measures that can help mitigate their sense of loss from the suspension of activities. For example, seniors could be appointed as COVID-19 ambassadors responsible for disseminating information on COVID-19 to their social networks, and to check-in regularly with other seniors to address or escalate any health or other concerns to the authorities. These informal social network models tap on existing social media and chat platforms and are already effectively employed in our armed forces to boost camaraderie and reduce AWOL numbers. Seniors can continue to engage one another in small coffeeshop groups,alleviating some of the impact from the suspensions. This approach is preferable to the usual prescriptive approaches of encouraging seniors to “look on the bright side”, as emotional regulation is a finite resource that is scarce in the battle against COVID-19 without an end date in sight.

Seniors should also be encouraged to maintain the non-affected portions of their daily routine. The gap created by the suspension of activities should be positively reframed as an opportunity to try new activities or crafts such as baking, gardening, mah-jong, reading or other individual activities that the person has always wanted to try. There are plenty of options available if seniors can be persuaded to perceive the gap as a welcomed development.

There is also a role for family and friends to play. Seniors who were previously very independent and mobile may develop feelings of isolation or loneliness now that they are unable to engage in their usual social activities. They must recognise the enhanced impact that COVID-19 has on seniors, and wherever possible increase the number of engagements with their senior family members or friend. Engagement may take the form of phone or video calls, visits, or small-group activities to keep our seniors socially active. This form of social interaction will go a long way in assuring our seniors that they are still cared for, and they can reach out for emotional or other support during their time of need. This will help to prevent and reduce negative feelings and thoughts that might arise from loneliness or isolation.If the feelings of isolation or loneliness persist, it is advisable to seek help from a mental health professional.

Lastly, we should remind our seniors that it is normal to feel distressed or isolated during this period. We should also ostensibly acknowledge that our seniors are making an important sacrifice and contribution to Singapore’s fight against COVID-19. Their sacrifice, together with our front-line workers and healthcare professionals, will keep us and our loved ones safe.

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Religion and Therapy

Religion and Therapy

(and should they ever mix?)

There exists a long-standing debate on the compatibility of religion and psychotherapy.

Much like how religion and science are often viewed as antagonistic in their attempts to explain the human condition, religion and psychotherapy are often perceived to be at odds with each other in the mending of the psyche.

Given that over 80% of Singaporeans consider themselves religious, many patients are interested in discussing their religious concerns with their psychologist. Indeed, an extensive body of research has consistently demonstrated the benefits of religion on one’s mental health. When used in an appropriate context, it can enhance one’s stress resilience, impart meaning to life, and serves as a source of social support. People who are more religious have also been found to be less susceptible to depression and are better able to cope if they do become depressed.

However, we must respect the diametrically opposed starting points of psychology and religion, keeping in mind that the two disciplines have fundamentally disparate presuppositions, methodology, and social roles.

Thus, their conflation can lead to tension, misunderstanding, and unnecessary strive that diminishes the effectiveness of psychotherapy.

The introduction of spiritual and religious content into psychotherapy runs the risk of replacing, diluting or deviating from the evidence-based intervention models that undergird psychology as a scientific discipline. There is also the possibility that psychotherapists may unintentionally alter their clients’ religious values or beliefs. All of this could potentially undermine the therapeutic alliance.

Psychotherapy should not draw from any authority in any faith tradition but must instead be scientifically grounded and validated

Here are some do’s and don’t’s that every clinician should abide by:

Ψ A clinician must respect a patient’s religious faith and spiritual beliefs and commit to establishing a religion-agnostic and spiritually sensitive therapeutic relationship with patients.

Ψ Clinicians should and must strive to deliver psychological services taking into account the full circumstances of each patient, including any religious and spiritual beliefs and commitments.

Ψ A clinician must be deliberate in their attempts to learn about how their patients’ religion shapes their worldview, and how it affects their experience of and management of mental illness.

Ψ The importance of religion as a social institution and the central role that it plays in the lives of our clients must also be acknowledged by the clinician.

Ψ However, clinicians must be aware of the potential risks associated with integrating religious or spiritual interventions into clinical interventions. This means that religious and spiritual issues should not be the central focus of psychotherapy. A range of problems and ethical dilemmas usually accompany the unification of religion and psychotherapy and could seriously impede the attainment of efficacious and ethical intervention.

In the ultimate analysis, clinicians must provide psychotherapy in a religiously agnostic manner that does not promote any one religion or belief.

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Alcohol and Sleep

Alcohol and (the lack of) Sleep

Alcoholic beverages are well-known for their sleep-inducing properties - thanks to the anti-anxiety properties of alcohol which help suppress arousal and stimulation - and are commonly used as an over-the-counter somnogen (which is just a fancy word for sleep aid).

Indeed, low doses of alcohol at around 1 to 2 standard drinks (one standard drink equates to one can of beer, half a glass of wine, or one nip of hard liquor) may help us to fall asleep faster, reduce the incidents of awakening shortly after we fall asleep, and increase the amount of time we spend in rapid eye movement (REM) sleep – the stage of sleep when our eyes dart around under our eyelids in a rapid movement, as its name suggests; it is also the stage when our memory is consolidated, and which helps with concentration and learning.

However, there is more to the story.

At moderate doses (2 to 4 standard drinks), alcohol reduces the amount of brain-boosting REM sleep. Doesn’t sound like a good recipe for a good night’s sleep, does it?

At high doses (more than 4 standard drinks), it can have a rebound effect on the later stages of sleep, leading to longer periods of awakening while also decreasing the amount of REM sleep. Now that is really bad.

Furthermore, since alcohol is a diuretic, which means that it acts as a signal to your kidneys to expel more water from your body, the consumption of alcohol prior to sleep is usually associated with frequent late-night toilet trips and sleep disturbances. Losing the extra fluid would also leave you feeling dehydrated.

Consuming moderate to high amounts of alcohol before bed can also constrict the air passage, leading to episodes of apnea, whereby a person's breathing is interrupted during sleep. The risk is heightened in those who have a tendency to snore in their sleep.

So, while small volumes of alcohol can help you to wind down after a busy day, too much of it can equal a fitful night's sleep.

At the end of the day, folks, you don’t have to drink to have a beery (… ok sorry) good sleep.

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Coping with Sexual Assault

Credit: Millennials of Singapore

AWARE Sexual Assault Care Centre
6779 0282 (10AM to midnight, Mon-Fri)

KK Women's Hospital
6225 5554 (24 hours)

Singapore General Hospital
6222 3322

Tan Tock Seng Hospital
1800 7372 7500

Sexual assault is any unwanted sexual behaviour that makes a person feel uncomfortable, threatened or scared. Consent is key - if you did not consent to such behaviour, or withdrew your consent, and the other party continues to make unwelcome advances, that is sexual assault.

AWARE Singapore has also published a helpful resource on what sexual assault is.

If you are a victim of sexual assault, please don’t blame yourself for whatever that has happened to you.

No one has the right to violate you no matter how you dressed, or whether you are unconscious or not.

First Steps

Try and remember as much as you can about your surroundings when the assault occurred; the smallest details can make a huge difference. At the earliest opportunity, try and picture the offender’s face, features or clothing (distinct colours, features or brands for example).

If you were unconscious during the assault, try to remember what you can of what occurred before and after you became unconscious or assaulted, including your surroundings. Find out if there was anyone around whom you can ask for more information of what happened.

Lodge a police report and seek medical attention as soon as possible in case of STIs and pregnancy.

In order to gather and preserve evidence, a sexual assault forensic examination (commonly referred to as “rape kit exam”) can be done at either KK Women’s Hospital, Singapore General Hospital or Tan Tock Seng Hospital within 72 hours of the incident – these hospitals are best equipped to deal with sexual assault.

You are required to make a police report before doing the rape kit exam. If you are under the age of 21, your parent or legal guardian is required for the rape kit exam.

Although it is strongly advisable to make a police report and undergo the rape kit exam, do not feel that you must do so against your will (or at the insistence of your family or friends) if doing so causes you great distress. This may only end up worsening your mental health. Instead, persuade your loved ones to respect your decision.

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Management

It is normal to feel strong emotions such as disgust or shame. Don’t avoid experiencing them.

Accepting that these feelings are unavoidable is the first step to managing what you are going through. When you are ready, open up about what happened to people you trust. In fact, keeping the fact of the assault all to yourself can be extremely suffocating.

There are countless testimonies published online (#MeToo movement) and support groups where survivors share their experiences – AWARE has one for female survivors (16 years of age and above) of sexual assault. You could hear from others on how they coped with their experiences. If you're not comfortable speaking to a group of people, you could share your story online anonymously with AimForZero or speak to a trusted friend. We all need an outlet somehow.

Sharing your experience and seeking comfort in the support of others can help you to cope with the debilitating incident. Here are some benefits of doing so:

Ψ Release pent up emotions
Ψ Receiving support from a support network (family, volunteers, welfare organisations)
Ψ Make sense of your thoughts and emotions
Ψ Greater clarity of what happened during the incident
Ψ One step closer to management
Ψ Spread awareness of this issue in society (without these small contributions, many others may continue to be oblivious)

Even if you really do not feel like confiding in someone, try and seek out at least one or two trusted confidants.

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Acceptance (Not Avoidance!)

While it may be painful, recalling and accepting the incident is important. Avoidance only makes whatever you were avoiding more salient.

The harder you try to avoid it, the more likely that you will be reminded of it, or make it more salient in your head. Acceptance is not the same as blaming yourself for what happened. Rather, it includes being able to accept that what happened was out of your control.

Coping with Flashbacks

It is common to experience traumatic flashbacks. Prepare yourself by developing some awareness of possible triggers (e.g. certain smells). Once you are more aware of your triggers, it will help you make sense of what is happening and why.

During flashbacks, pay attention to physical sensations and what emotions you are feeling during these episodes. After, take steps to calm down, such as breathing exercises. Ground yourself in the present (e.g. tapping your arms, naming the current day) as this will help you realise that it is a flashback and not reality.

Don’t Isolate Yourself!

Stay connected with loved ones and join social activities. You don’t have to constantly talk about sexual assault or things related to it. You can do things that have nothing to do with the trauma itself.

If these activities bring you joy, they can be equally helpful. Participating in joyful activities isn’t avoidance. You can choose to accept that you are feeling low or down, and yet try to do something to lift your spirits.

Seek Professional Help

Sexual assault and trauma is linked to a bunch of mental disorders, depression, PTSD, anxiety disorders etc… If you feel unable to carry on with your everyday life due to the repercussions of the incident, seek help from a mental health professional.

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For friends, family, loved ones of victims

Don’t blame them for whatever that has happened, pass judgments or express doubt on their story.

  1. Be a listening ear. Listen to their narration of events, bearing in mind that effect of trauma may have had an adverse impact on their ability to accurately remember the relevant sequence of events.

  2. Don’t downplay or trivialise the incident. This will (definitely) come across as doubting or invalidating their feelings. Let them feel whatever they must feel as part of their own process.

  3. At an appropriate time, encourage them to seek help whenever they can (e.g. psychologists, counsellors), but let them do so on their own terms. Do not insist for them to seek help. Only encourage them to do so if it seems as though their distress is causing them to be unable to function daily or normally.

  4. Provide emotional support whenever you can. A sexual assault experience can be extremely traumatic and effects can last for a long time. Think along the lines of “How can I be there for him/her?” rather than “What concrete steps do I need to take to help?”.

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For others

Tips/Precautions

  • Be mindful of your surroundings and the environment you are in. If necessary, take additional precautions if you have to walk in an unsafe area.

  • Do not assume that someone else will look out for your safety. In bars or at parties, keep your drink with you. Leaving your drink unattended makes it possible for someone to spike them with date rape drugs or intoxicating alcohol. Know your limits and keep within them, especially when it comes to drinking in unfamiliar places. Being surrounded by familiar people does not make a place “familiar”.

  • Sexual assault occurs even if you least expect it. Do not keep quiet if an assault is imminent. The shock may overwhelm and you may be too frightened, but always seek help immediately. Scream or shout for help if you have to.

How to contribute to the cause

  • Stay current on sexual assault laws. By educating ourselves on the many forms and types of sexual assault, when they can happen and what safety nets we have in place in society, we become more knowledgeable on the issue and can either help spread awareness, or strive for change in the community.

  • Become an advocate for sexual assault victims. You can start small – from sharing with your friends and family about your experiences (if any) and how you survived. You can volunteer for AWARE, join a movement or speak up about the issue whenever you can.

  • Know how to respond to sexual assault cases. For example, if a stranger approaches you for help or if you witness something happening, don’t be an apathetic bystander. Help the person. With people being more alert and informed, offenders will be more afraid to act out. Deterrence may not completely stop sexual assault, but it can at least reduce the number of cases and victims.

A Brief Note on Grief

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Grief is a natural response to loss

Grieving is a completely normal reaction to loss. The passing of a loved one, the loss of a treasured relationship, or loss of use of a physical ability, or perhaps something more intangible like an opportunity or aspiration.

Everyone’s processing of grief is different, and it takes time. Sometimes, lots of time. There are different theories on the various stages or trajectories of grief a person may go through. Regardless of which, some common emotions during grieving are:

Shock, numbness, disbelief. Guilt. Fear and anxiety. Or sadness; extreme sadness.

Questions such as “What could I have otherwise done?” or “What if this happens to someone else I love?” may fan the flames of the ever-present anxiety usually accompanying grief.

All these are intense emotions that are overwhelming. How to cope?:

Ψ Allow yourself to feel the full spectrum of emotions that awash you. Don’t let anyone tell you that it’s not okay to feel what you are feeling, be it sadness, fear, shock or any other emotion.
Ψ Take care of yourself – remember to eat well and exercise. If you have a routine, stick to it.
Ψ Be gentle with yourself. Forgive yourself for things you may have said or done (or did not say or do). We are, after all, only human.
Ψ Talk to peers. Remember your Tribe, and that you are not alone in this world.

When should you seek professional help?

It may be a good idea to seek therapy from a mental health professional if you feel:

Ψ The intense emotions aren’t subsiding.
Ψ You don’t feel capable of coping with the overwhelming emotions on a day-to-day basis.
Ψ You have trouble sleeping.
Ψ Your relationships are affected by your grief.
Ψ You feel continually sad, depressed or anxious over a period of time.

Therapy centred around coping with grief involves helping you come to terms with what has happened; to process, accept and allow yourself to feel the emotions you are feeling. Your clinical psychologists may also work towards helping you forgive yourself if you are feel immense guilt. Stress management and relaxation techniques can help to cope with feelings of anxiety. You may be asked to think about how your basic emotional needs, such as love and belonging, were met before the loss, how your needs have been compromised by your loss, and how new steps can be taken to meet your needs.

There are, of course, differences in the way each human processes grief; the therapeutic techniques used will vary between persons. However, as with all psychotherapy, processing grief and loss is very much a collaborative effort between you and your psychologist.

After a (suicide) Attempt

After an Attempt

Surviving a Suicide Attempt

A suicide attempt is extremely traumatic.

Survivors feel disorientated, lost, not knowing where and how to go from here on. Others may feel intense waves of fear, sadness or anger. Some, after experiencing these waves, become seemingly emotionless. Numb. It is natural to have such feelings and thoughts.

Here is a list of steps to follow after a suicide attempt:

Inform

Call a loved one or trusted friend right away.

Our ability to actively care for ourselves are greatly affected by the circumstances that give rise to the attempt in the first place. Having survived the attempt, this ability is further compromised. Which means that you are going to need support. Reach out immediately.

After informing, go to the nearest hospital or medical clinic to seek medical attention. Even if the attempt does not result in you suffering from any physical injury however minor, you should still seek medical attention.

What to do at the Hospital or Clinic

Knowing what to expect greatly reduces the anxiety that comes with waiting in a busy medical facility.

Firstly, emergency staff are trained to assess and manage any injuries requiring immediate medical attention. This is known as triage. After treating these injuries, they will then arrange for a mental health professional to meet and have a chat with you about your mental health status. This may include questions on your mood, the presence of recent major stressors, and any concerns with your daily functioning. This is really just to assess your mental state and look for any further risks that you may be facing.

Occasionally, the hospital may require a detailed review by doctors with different specialisations. Depending whether such doctor(s) are on hand, you may be warded for further observation or admitted into a ward.

Reaching out to your Tribe (my what?)

We often do not realise how many members of our tribe (your family, friends, colleagues, peers - anyone who is a part of your larger network) actually do care about our safety and well-being. Even if you don’t ordinarily consider them to be part of your support network.

It’s common for people to worry over what to say to others after the attempt. You may want to start a conversation only after you feel comfortable enough to share about your experience, and even then, you can control how much you want to share. Confiding in a support group that you trust and feel connected to helps you process the experience and suicidal thoughts, or make these thoughts easier to manage if they return.

Going forward

You may find it helpful to write down thoughts and helpful tips to make your transition period easier (“journalling”, for example). These include things like knowing what you can do to make it easier to cope with things in the days following your discharge from the hospital, knowing who in your social support network you can reach out to, and most importantly, having a plan for dealing with suicidal thoughts should they come up again.

Things can change for the better if you allow it to.

Most importantly, seek support from a mental health or counselling professional if you feel suicidal. They will work together with you to create a safety plan or finding ways to cope. Things can change for the better if you allow it to.

Managing Anxiety, Stressors and Worries

We all experience anxiety, stressors and worries of one form or another.

Here are some helpful psychological strategies that have been tested and found to be effective for many.

A. Mindfulness – Observing non-judgmentally

When confronted with environmental stressors, our emotional reactions arise naturally. And we usually occlude the facts as they are. But that is rarely helpful.  

First, observe nonjudgmentally and take stock of what is actually happening around you. 

What are you thinking about?
Is it about the future, past or present?
Do you think it is affecting how you are feeling? 
What is going through our minds when we feel anxious, low or stressed? 

When we start to notice and be aware of our thoughts, we’ll be able to start identifying what might be contributing to our distress.

Doing this non-judgmentally means not reacting to our observations or thoughts (and/or the emotions attached to it) but rather simply letting the observations and resulting thoughts and emotions arise and being aware of its presence in our mind.

B. Mindfulness – Mindful Breathing. 

While mindfulness is a practice that helps us to not get swept away on a wave of our unhelpful or negative thoughts, people may find it difficult to observe their thoughts and emotions without reacting to them. 

Let’s try this simple exercise:  

  1. Breathe in and out.

  2. Maintain your usual breathing rhythms without being overly conscious about the preciseness of each breath. 

  3. Let your lungs expand and fill as you inhale, and contract as you exhale. 

  4. Bring your attention to each inhalation and exhalation through your nose.

  5. As you continue to watch your breath, remind yourself that each breath grounds you in the present moment. 

You are fully present in this moment of being. 

Now ask yourself, what is happening, and how are you feeling or thinking about that situation. 

C. Schedule “Worry” Time

First, identify all the tasks or items that are within your “sphere of influence”; essentially, matters that you can do something about. You may not always be able to control or determine the outcome, but you can take steps to influence or alter the outcome. 

Identify what needs to be done and complete those tasks. You’ll start to feel a whole lot better once you make a checklist and tick them off. Then tell yourself this: “there are always going to be things that are not within my influence (your “sphere of concern”)”. 

Here is how both spheres look like:   

 
 

I am going to allow myself to worry about it, for no more than 10 minutes. But after these 10 minutes, I shall leave my worries for my tomorrow self to grapple with” (or similar words… but you get the idea).

This tool has been found to be clinically effective in managing worries by freeing up your “head space” for important, relaxing or fun activities.

D. Challenge unhelpful thoughts. 

If you still feel a lingering worry after your scheduled worry time, you may want to directly address or challenge these persistent thoughts. Persistent thoughts might include: 

Catastrophising: “The world is going to end”, “I’ll definitely get the virus if I go out”, “My boss hates my presentation and I am going to get sacked” 

Filtering: Only focusing on the negative parts of the situation but not the positive aspects. During a pandemic for example, “being at home is like prison”, rather than “being at home is keeping me and everyone else safe”. 

Some ways to challenge such thoughts are to ask yourself: is that the only, and the whole truth? Are there other perspectives that I should consider? Am I constantly making reference to a state of perfection that does not exist? Am I worrying too much about how things should be instead of embracing and dealing with things as they are? This leads us to our next tip… 

E. Acceptance

Remember your sphere of concern? 

There will be many concerns that we cannot change or challenge successfully. These thoughts will usually keep us in a bubble of constant worry and anxiety instead of helping us deal with the situation. Issues within our sphere of concern that we might not be able to successful challenge include the social distancing and circuit breaker measures that will be with us for a period of time to limit the spread of the virus. But fretting about this situation will only result in more distress, anxiety or stress. Acceptance does not mean that you approve of or like the situation you find yourself in. What it means is that you have decided to embrace and acknowledge what is happening.

You have come to terms with the situation being what it is – no more, and no less – and you are no longer actively struggling or resisting the fact of its occurrence. 

 

F. Look after your Body

Yes, this means regular exercise, eating balanced meals, avoiding alcohol and drugs, and sleeping well.

 
 

There is a ton of research about the mind-body connection, it is not a myth!

How you feel emotionally and mentally can affect your physical health, and vice versa. The best demonstration of how your mental health and physical health are closely related is seen with burnout. When you’re pushed beyond your limits and putting too much stress on yourself, you experience burnout in forms of headaches, migraines, bowel issues and so on. 

At the same time, this also has implications on your motivation levels, your cognitive functioning, and may even make you easily irritated or emotional.