Managing stress reactions of health-care workers during COVID-19

This pandemic is not the only new crisis that has swept the globe. We are also experiencing a mental health crisis because of the uncertainty of COVID-19 and the necessary restrictions that have been put in place to flatten the curve.

“Even if you have never had issues with mental health previously, you are likely to experience heightened stress, anxiety, irritability and low mood,” explained Justine McNulty, social worker, MSW, Arnprior and District Family Health Team.

Below are tips and tricks for health-care workers that Justine McNulty adapted from trauma expert Dr. Bessel van der Kolk who frames it as a time of “pre-traumatic stress:”

6 strategies to manage your stress caused by COVID-19

1. Sense of unpredictability: At work, at home, in our community and globally, things are unpredictable. New legislation, policies and procedures, distancing regulations, timelines for physical distancing and finding vaccines and treatment options are uncertain and variable – this instability results in increased stress, anxiety, and fear.

Ways to manage: Create routines that include self-care, physical exercise, pleasure, emotional connection, and getting outside. Plan something to do each day you can look forward to. When at work, make sure you structure your day and set boundaries around work time and home time. Take your breaks at scheduled times and make a daily to do list that you keep track of as you work.

2. Your fight, flight, or freeze response is activated: since we are under increased threat our primal fight flight or freeze response has been activated, leaving us on high alert, on edge and utterly exhausted at the end of the day. The world feels unsafe and this can be heightened for health-care workers.

Ways to manage: Activate the calming response to soothe the brainstem’s fear response. Engage in activities that allow you to feel a sense of agency and such as taking a minute to ground yourself by noticing things around you with your five senses. You can create a sensory kit to have on hand to help with this. Include in this kit something you can look at, touch, smell, listen to and taste. Some examples include scented hand lotion, a stress ball, sour candy, a picture of a loved one and an inspirational quote that you can read to yourself out loud.

3. You may feel disconnected: We have lost our ability to be close to others. Not just our family, but at work we are doing our best to stand 6 feet apart. We are social creatures and crave physical contact. As a result, our mood can drop and make us feel lonely and sad.

Ways to manage: Be creative in ways to feel as connected as possible to those who matter to you. Make physical contact with those in your home when you can, and if you are unable to do this, get a weighted blanket or wrap your arms around yourself to encourage the production and release of oxytocin which helps relieve stress and feel connected even when apart.

4. Numbing out: You are under immense stress and/or are experience something traumatic. As a result, you may feel disconnected from yourself, like you are in a fog and may have trouble concentrating or feeling.

Ways to manage: Engage in mindfulness. That is, paying attention, on purpose to the present moment without judgement. You may also want to engage in activities that are stimulating, such as going for a run or eating something with a lot of flavour. The Family Health Team posted a 14-day mindfulness challenge to their Facebook page you can try as well.

5. Loss of a sense of time: This is a protective response that causes us to shut down and dissociate. If you have not experienced trauma before, you may notice time loss in less extreme ways such as days feeling longer or shorter and everyday feeling the same.

Ways to manage: Keep track of time: set alarms to take mindful pauses. Remember to S.T.O.P.: Stop; Take a deep breath; Observe what is going on around you; and Proceed with intention. Keep track of the days of the week and at the end of each day write down one thing that happened that was helpful, positive, or provided you with hope or inspiration.

6. Lack of safety: Words used such as “emergency” “pandemic” “war” and “battle” are used to describe your work and can be very triggering. These phrases in combination of the realities you face everyday can increase the feeling of being unsafe. Realities such as the anxiety around the effectiveness and availability of PPE available to you at work.

Ways to manage: In an effort to soothe your nervous system’s natural response to feeling unsafe, take a few deep belly breaths allowing your exhale to last longer than your inhale. Have a visual that you can conjure in your mind of a place (real or imagined) that elicits a feeling of safety. Exercise control over measures to keep yourself physically safe and remember to speak up to management if you are feeling unsafe so you can work together to find a solution.

“Remember, it is normal to be feeling these things at this time,” said McNulty. “What is not normal is this pandemic. Even though you are being referred to as heroes, you are still human and susceptible to human reactions to a pandemic.”

Available resources for self-management and therapeutic support:

Free Apps:
PTSDcoach – uses CBT to help manage symptoms of PSTD
FEARtools– uses CBT to help with the management of anxiety and fear

Free Supportive counselling and psychotherapy services for front line workers:

Ontario COVID 19 Mental Health Network:

Arnprior and District Family Health Team offers 30-minute supportive counselling and psychotherapy sessions. Contact your family doctor to be put on our wait list. Also check out The ADFHT Facebook page for regular mental health tips and tricks to help you manage.

Social media:

#MindVine is the social media home of Ontario Shores. It is a hangout which encourages conversations on the topics of mental health, mental illness and stigma. Recent posts have been related to supporting mental health and well-being during the COVID-19 pandemic, such as:

COVID-19: Lessons from CBT on How We Look at the Pandemic
COVID-19: Why Building a Fort Can Improve Your Mental Health

More information for self-management:

Dr. Bessel van der Kolk: Steering Ourselves and our Clients through New and Developing Traumas


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