These are unprecedented times and everyone is experiencing an upsurge in fear, anxiety and uncertainty about the day ahead, let alone the longer-term future. I wanted to share with you as many practical tools and skills that I can to help you manage any symptoms of anxiety, panic or low mood that you might be experiencing during this time.

Our main job right now is to try and regulate our limbic systems – otherwise known as our fear brains. These are wired to lock onto threat and stay hypervigilant in order to help us to fight or flee as needed. A global crisis, flooding in 24/7 through the media and our ability to be connected online at all times is not helpful in regulating this panic response, especially as this is not a short-burst threat that we can actually fight or flee but rather an endurance one.

Practical strategies for coping with self isolation

Strategy 1: Limiting threat-based stimuli

  • We need to regulate our exposure to threat-based stimuli to give the limbic system a chance to cool down. Limit checking the news to 2-3 times a day and don’t check in the evening as you’re winding down
  • Limit panic-based conversations with others if you can and if need be mute Whatsapp and other conversations that are fuelling the limbic fire
  • Try to shift your focus of attention regularly to a here-and-now activity or distract yourself with something completely different e.g. music, nature documentaries, walks, exercise, playing a musical instrument, cooking – anything at all

Strategy 2: Turning off threat-brain and turning on self-soothing brain

Any form of physical exercise or meditative activity will help to turn off threat centres in the brain and activate self-soothing centres. The two are mutually exclusive systems and cannot be activated at the same time. 

  • Consider using any meditation apps like Headspace, Buddhify or Calm. Otherwise there are a host of resources on You Tube. My top picks are Jon Kabat-Zinn’s Mindfulness of Breathscape and Bodyscape https://www.youtube.com/watch?v=NbXUAg5tA0s and Vicki Panagotacos’ 15 minute Mindfulness Meditation for Stress Relief https://www.youtube.com/watch?v=8v45WSuAeYI
  • You don’t actually need to meditate to meditate! Any repetitive activity will help – washing dishes with focus, walking rhythmically, singing, grooming your pets, baking will all do the trick. Use all the senses you can to engage and just keep bringing your mind back to the task at hand everytime it drifts off (as it will). 
  • Physical exercise will help to get you back into your body and ground the panic brain. It will also help to burn off the adrenalin generated by the limbic system response (needed for actual fighting or fleeing but not used in hiding out in our homes). Get out for a walk, run or cycle or use any home exercise videos that you can. 

Strategy 3: Regulating more severe panic

For more severe panic symptoms, the following grounding skills are very useful in tipping body chemistry to calm:

  • Lower your body temperature: use ice on pulse points (wrapped in a tea towel)
  • Slow your breathing down. Focus on the exhale, not the inhale. A useful count is in for 4, hold breath for 5, out as slow as you can for about 7
  • Move – burn up the adrenalin with any physical activity. This will also help to ground you.
  • Keep repeating either a single skill or combination until you feel little more settled and able to think again 

Strategy 4: Gentle grounding

The skills above are useful when panic has overridden our cognitive functioning and we can’t think. When we have calmed enough to think again or if we’re not so panicked in the first place that we have some access to thinking, gentle grounding helps immensely. 

  • Focus on your immediate environment: name 5 things you can see, hear, smell, taste and touch
  • Move your gaze around the room naming everything you can see in order: “blue chair, book shelf, pot plant…”
  • Wiggle your feet into the floor and feel the pull of gravity. Slowly stand up as if you were extending yourself upwards from the base of the spine to the top of your head making your body as spacious and open as possible. Open your shoulders and chest. Feel yourself open, grounded and empowered from your feet up. 
  • Use soothing touch: place a soothing hand over your heart (like where you might put a baby to soothe it) and feel your chest rise and fall with your breath as you offer comfort to yourself.
  • Use your five senses in any way possible. Grounding smells are sharp and strong (vinegar, citrus, menthol) and soothing ones are more mellow. 
  • Make a coping card with supportive statements: “My name is ___. I am safe right now. I will get through this.” Or whatever helps. 

Strategy 5: Gentle structure

Another strategy of immense help for anxiety is to set yourself a gentle structure for the day with a range of activities from working on something with purpose, eating, exercise and getting outside or connecting with other people, even via phone. Gentle structure will help things feel more contained and less like they’re falling apart. 

  • Plan your day loosely
  • Have a regular time to get up, eat and go to bed if you’re able
  • Get outside at least once a day
  • Put boundaries on time spent working 
  • Keep things up at home: get dressed, make your bed etc
  • Plan social contact – virtual coffees or chats are immensely helpful in reducing social isolation, panic and low mood 

Strategy 6: Help out

Helping out in times of crisis is an excellent way to cope with the sense of powerlessness and lack of coherence that comes when our world is in disarray. We know that during times of war and crisis, those people who felt like they were doing their bit had significantly better psychological outcomes.

It doesn’t matter what you do, as long it gives you a sense of purpose and contribution. Whether it is simply following government guidelines assiduously in your home or taking it further and helping out in the local community or using your skills to make art, entertainment or provide relief to people in some way, it will all help you to feel more empowered, connected and in control.

Dr Natalie Raiher is currently offering video consultations for anybody who is struggling at this difficult time. Please email contact@thepracticeat322.co.uk for further details or to make an appointment.