Managing worries and anxieties through coronavirus

Neill Boddington – Mental Health Advisor, Disability Support Team

Neill.Boddington@open.ac.uk

www.open.ac.uk/

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Introductions

Format for todays session

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01Understand what worries are, and consider your own.

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Learn some in the moment strategies and consider longer term coping strategies.

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05Plan some defined actions to help manage your worries and stressors.

07 Be aware of further guidance and support available.

Session outcomes

Appreciate, based on psychological models, why you could be feeling as you have.

Be aware of the stress response and how that affects our body and mind.

Learn and practice some simple ‘check in’ exercises.

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GROUNDING CHECK IN ACTIVITY

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Where are you right now?

0 10

As bad as it could

possibly be

As good as it

could possibly be

Consider everything that is going on right now. Where

would you rank (out of 10) your quality of life right now?

Again, consider everything and think of what number

you would need your quality of life to be so it is ‘good

enough’.

What has contributed to your quality of life being higher or lower than

your ‘good enough’ level?

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How are you doing right now?

0 10

As bad as it could

possibly be

As good as it

could possibly be

If your quality of life score is lower than your ‘good enough’ level:

• Why? What is contributing to this score? What actions need to be taken? What

easy wins are there? What bigger issues can you identify? What positives in

your life could be enhanced to raise your score?

If your quality of life score is the same or higher than your ‘good enough’

level.

• Do you sometimes focus on the negatives and that drags down your mood?

How can you remember the positives to not let one negative take over? Are

any negatives growing and need to be kept in check?

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What are you worrying about?

Reflect and write down some of you worries (they don’t need to be coronavirus related)

CHANGE, STRESS AND ANXIETIES PLUS COPING MODELS

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Time of uncertainty = change = stress

• Sudden changes to our ‘normal’ lives - Little or no warning and preparation time.

• New situations we have little to no experience of to help guide us

• Direct challenges to ours and others health and wellbeing.

• Increase in stressful situations – i.e. children fighting.

• Decrease in calming behaviours – i.e. going to yoga, clubs, social time.

“It ain’t about how hard you hit, it’s about how hard you can get hit and keep

moving forward.”

“It’s not whether you get knocked down, it’s whether you get back up.”

“It is not the strongest of the species that survives, nor the most intelligent, but the

ones most responsive to change.”

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How change affects people

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What is stress?

‘you perceive’ – How you view the situation, are you thinking rationally, previous bad experiences?

‘cannot cope’ – Self-efficacy and confidence. Learning from past experiences and learning new skills to cope.

‘the demands’ – What is being asked of you? What can you control, time management, support structures, etc.

Pressure becomes stress when you

perceive that you cannot cope with the

demands placed upon you.

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What is stress?

PRESSURE

STRESS

RELAX

Deadlines

Blinkers on

Focus

Workload

I am anxious

It’s all too much

I feel Ill

Demands

I’m so angry

Hobbies

SleepSocialising

Family Watching TV

Exercising

ReadingMusic

LE

VE

L O

F…

TIME – minutes / hours / days / weeks

I don’t have any control

I’m overwhelmed

I cannot cope

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Amygdala Hijack

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A-B-C Coping Model

Aware – Am I stressed, pressured, relaxed?

Buy time – Be still / Be calm / Be present

Choose – What to say, do, feel

STRESSED – PRESSURED - RELAXED

ABC Model

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Anxiety Based - Irrational Thinking

Thinking style Description Example;

Catastrophising Seeing only the worst possible

outcome in everything often

when other options or solutions

are offered.

• You cough = I have coronavirus =

I could die.

• Problems getting some food =

we will not be able to get any

food.

Threat

scanning

Searching the environment for

what you fear.

• Checking yourself and loved

ones for symptoms.

• Frequently reading & watching

corona related news stories.

Emotional

reasoning

Deciding that your emotions are

reality.

• I’m scared so there must be

danger present.

• I feel guilty so I must have done

something wrong.

Fortune telling /

Leaps in logic

Taking some facts and then

deciding on the outcome even

though there are missing steps

and then often acting as if the

perceived situation has already

happened.

• The Government has not said

when schools will go back, so

that means it will not be until next

year.

Stress levels with demands exceeding our ability to cope, can alter our perceptions,

especially when our brain is being hijacked!

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THINK Coping Model

True? – Is this worry factual? What evidence is

there?

Helpful? – Is it helping me or others right now?

Inspiring? – Does it inspire me or creates

negative emotions?

Kind? – Is it offering kindness to me or others?

Do I need to be kind to myself right now?

Necessary? – Is this what I need right now? Is it

necessary (or appropriate) to engage it right

now?

Anoth

er w

ay to

‘Check in

’

TYPES OF WORRIES AND HOW TO MANAGE THEM

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What are you worrying about?

Is your worry realistic and likely to happen?

Can you directly do something about it?

YESNO

Practical worries Specific, defined and often

rational

Hypothetical worries‘What if’ in their nature. Often

un-specific, not based in (much)

evidence and often irrational.

Establish positive actions to help

manage your thoughts about

these worries…

Can you do something

about it right now?

YESNO

When can you?

Plan for when you

can act.Emotions focused copingRoot cause

solving

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Breathe - Breathe in for a count of 7, out for 11.

Imagine your worries in a bubble – They float away on the wind, while others can be popped.

Tighten, then relax - Tighten all your muscles for a count of three, then let go. Repeat.

Do a 5/5/5 mindfulness exercise - Pause and notice 5 things you can see. Acknowledge 5 things you can hear. Take note of 5 things in contact with your body.

Movement - A quick walk, going up and down stairs, stretching – it doesn’t have to be strenuous. Any sort of movement will help you de-stress.

Step out of the stressful situation - Literally walk away and give your attention to something else, even if only for a moment. It gives you a chance to calm down and regain control of thoughts and emotions.

Break the cycle - When you find yourself caught up in a cycle of negative thoughts, deliberately turn your attention to something positive (e.g. a good memory, something nice you’re going to do).

Talk to someone about it - Talking about thoughts and feelings can help to release tension. Putting things into words to another person gives you distance. It can also offer a different perspective.

Imagine it’s your friend - Pretend is a friend or loved one bringing you this problem, what advice and support would you offer them?

Be picky with your social media - Consider who is in your social media news feeds and whether their post encourage anxious feeling or help you to cope with your worries. Use THINK to help here.

Rank your worry – On a scale of 1-10, how bad really is it? Consider in relation to your ‘good enough’ score.

Worries before bed? – Write it down on a paper to get it out of your head and reflect on it using THINK. If your worry can be ignored, thrown the paper away. If you need to action it, keep it to remind you tomorrow.

Strategies to manage ‘in the moment’ anxiety & stress

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Schedule in news time - Timetable in when you will watch/read the news regarding coronavirus.

Get reliable info – Use trusted sources of information such as national news channels rather than what appears in a google search or on social media.

Look for positives within the negatives – Don’t focus on the negative aspects, we often zone in on the stories and people that align to our beliefs and thoughts. Explore different perspectives and search out good new stories.

Can do’s not cannot’s – Think about what you can do and not what lockdown means you cannot.

Have routines – along with other routines you can create, make sure you have an ‘end of work day’ routine to clearly separate work time from home time. What repeatable action will help to say to your brain; ‘works over’?

Creating a calming zone - Stability zones can have a calming and stabilising place that helps you to relieve stressful feelings just by being there. In your house this could be somewhere like the bedroom or the garden. These zones could also be just outside, a local park or familiar place you walk. A stability zone must

have positive and happy associations attached to it.

De-clutter - If you find yourself with added pressures now, try the 3D’s approach. Drop – Delay - Delegate

Have some goals – It can be very easy for days to have less meaning when we a lockdown limits work, social, personal time. Create some weekly goals to help with motivation and a sense of achievement.

Be healthy – Never a better time than when a virus is around to consider our health. Eat well, move more, sleep plenty, limit alcohol, quit smoking, moderate screen time, reduce time spent sitting.

Re-focus on priorities – Now is a great time to re-establish what is important to us. What have we had to go without that we can actually live without? What do we miss the most? What is truly important to us?

Corona and lockdown longer term coping:

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Gratitude Journal

Spend 10 minutes considering what you are thankful for currently, recently and coming up.

I am currently thankful for……

I will be thankful for….

I was thankful for…..

Circle of influence

Practice these 2 strategies;

Within my control

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Root cause solving

Top tip:

Rather than thinking; “I’m worried about….”. Re-phrase as; “If I care about….”

This can help with motivation and decisions to make a positive change

7 Step approach:

1 Write down what you’re worried about (just the practical worries)

2 Decide on what one you will action firsti. Urgent-Important principle

3 Think about what success looks and feels like

4 Write a list of possible solutions and consider each ones

advantages and disadvantages.

5 Choose an action or actions.

6 Plan how you will carry out your action/s – the how, where and

when’s.

7 Do it!

“… grant me the serenity to accept the things I cannot

change, courage to change the things I can, and wisdom

to know the difference.”

Worries are mental events that will pass, just as other

events in our life do.

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• Consider everything we have covered.

• What changes would you like to make?

List down 2-3 things you could do to make a positive change

Re-framing exercise

Reframe one of

these as;

“I want….

I will…..”

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NHS ‘Every Mind Matters’. Coronavirus advice.

Public Health England. Guidance on the mental health and wellbeing aspects of coronavirus.

Mental Health Foundation. Coronavirus advice.

Mental Health Foundation. Talking to children about Coronavirus.

Rethink Mental Illness. Specific advice for anyone with a MH condition, or their carers,

Mind. Various advice and further links to wellbeing through coronavirus.

Action for Happiness. Covid-19 coping calendar.

Shout. Free text service for anyone after immediate support for their mental health.

Anxiety UK. Increased helpline coverage, online support groups and webinars.

Sport England – Staying active while you’re at home.

Citizens Advice. Coronavirus and benefits.

ACAS – Coronavirus advice for employers.

The OU’s free learning platform, OpenLearn also offers short courses in related mental health and wellbeing topics.

Free mental health tips and resources from the OU.

www.open.ac.uk/

Resources – Web sites

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Resources – Apps (from trusted sources)

Calm – Mindfulness, meditation and breathing programmes to help lower stress, anxiety and promote more restful sleep.

Catch It – Learn to look at problems differently, turn negative thoughts into positive ones and improve your mental wellbeing,

Feeling Good – Improve your thought, feelings, self-esteem and self-confidence using the principles of cognitive therapy.

My Possible Self - Pick from 10 modules to learn how to manage fear, anxieties and stress, and take control of your thoughts, feelings

and behaviour.

Stress and Anxiety Companion – Guided breathing exercises, relaxing music and games made to help calm the mind, and handle stress

and anxiety on the go.

Reflectly – Simple personal journaling ap, mood tracker and daily gratitude journal for self-care.

Action for Happiness – Daily companion for a happier life. Receive simple, daily actions designed to boost your wellbeing and

happiness.

Cove – Create music to reflect emotions like joy, sadness and anger to help express how you feel.

SilverCloud – An eight week course to help manage stress, anxiety and depression at your own pace.

Thrive – Use games to track your mood and teach yourself methods to take control of stress and anxiety.

Ten Percent Happier – Get better at feeling good with guided meditations, videos, talks and sleep content.

UCLA Mindful – With this easy-to-use app, you can practice mindfulness anywhere, anytime with the guidance of the UCLA (University

of California, Los Angeles) Mindful Awareness Research Centre.

THANK YOU

Additional Resources

Not covered fully in the workshop but may be of use to you.

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Social support

Emotional

Support

Expressions of empathy,

love, trust, concern and

caring.

Listening and

empathising, being a

shoulder to cry on and

helping to manage their

emotional response.

e.g. Partner hugs and

listens to them as they

get emotional talking

about their car

accident.

Esteem This type of social

support is shown in

expressions of

confidence or

encouragement.

Pointing out a persons

strengths and abilities,

drawing on past

successes and offering

encouraging words and

guidance.

e.g. Work colleagues

points out how

tenacious they are in

work and they can use

this to deal with the

insurance company.

Informational Gathering and sharing

information or offering

advice, guidance and

suggestions.

Providing information and

advice that often has the

potential to help the

person problem-solve,

supporting them with the

next steps.

e.g. Friend sends a link

to a web site that

explains your legal

rights when involved in

a car accident.

Tangible This form of support

includes the concrete,

practical and direct ways

people assist others.

Taking on specific

responsibilities, direct

help or other applied ways

to help someone manage

a problem they’re

experiencing.

e.g. Mum drives them

to and from work while

their car is being

repaired.

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Ways of Coping – Folkman & Lazarus

Negative Approach

Detachment - Psychologically remove oneself from the possible solutions.

- “I don’t want to know.”

Keep to Self - Internalise and avoid people.

- “It’s my problem to sort.”

Wishful Thinking - Wishing and dreaming about changing the situation or self.

- “It will all be okay in the end I’m sure.”

Self Blame - Critical of self.

- “This is all my fault.”

Positive Approach

Problem Focused Coping - Dealing directly with the problem.

- “Let’s get to the route of this issue.”

Seeking Social Support - Sharing thoughts, feelings and seeking help.

- “What do you think I should do?”

Focusing on the Positive - Look for positive outcomes and focusing on true personal values.

- “I have my family and they still make me happy in tough times.”

Tension Reduction - Using methods to help distract mind and manage emotions.

- “I have a great book to read to take my mind off it all.”