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5 Strategies for Managing Uncertainty During COVID-19​  We're all unsure what comes next. Here are some ways to approach the unknown.

5/17/2020

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From Psychology Today
By Austin Perlmutter M.D.
https://www.psychologytoday.com/us/blog/the-modern-brain/202004/5-strategies-managing-uncertainty-during-covid-19
​

In the space of just a few months, the 2019 coronavirus disease (COVID-19) altered the global landscape. Billions of people are confined to their homes. As the infection flouts state and national borders, the world is unified in battle against an unseen but deadly foe.

The direct consequences of the virus grow by the day. These are measured in infections and later by deaths. At the moment, our best solution is some combination of flattening the curve, herd immunity, and scientific innovation. But while it’s likely that millions will suffer from the virus itself, billions are currently dealing with its indirect costs. One of the most significant of these is the collective strain on our mental health.

A March 2020 survey revealed that 36% of American adults are already experiencing a serious impact on their mental health due to the virus. When 1,210 Chinese respondents were polled on their mental health in early 2020, over half reported the psychological impact of COVID-19 as moderate-to-severe. Given the degree to which lives have been changed to date, it’s likely we’ll experience psychological aftershocks of COVID-19 for decades to come.

When addressing this problem, we must acknowledge that as a planet, we are anxious, overwhelmed and scared. And each of these descriptors relates to a fundamental challenge of the moment: we are painfully uncertain about what comes next.

Uncertainty isn’t always problematic. It’s part of what motivates people to play the lottery, watch a sports game or yell at someone when they give away a movie ending. But when we can’t handle uncertainty, the possibility of negative outcomes looms large in our mind. This intolerance of ambiguity is linked to higher levels of anxiety and depressive symptoms.

If uncertainty makes us uncomfortable and even damages our mental health, what should we do at a time when the future seems especially fuzzy? There are a few ways to approach this puzzle. We can reframe uncertainty, accept it, change the way we experience it or move our focus elsewhere. 

1. Reframe
Reframing (also known as cognitive reframing) is a psychological tool that helps us to see our problems from another angle. It can get us to stop perceiving the world, the future, and ourselves in an unnecessarily negative light. As it relates to the moment, we could perseverate on bad things that could happen to us or our loved ones. But if we reframe, we could instead see this period of uncertainty as an opportunity to connect with those we care about and as a powerful reminder that we’re all in it together. 

2. Accept
We can also lean into not knowing. Mindful acceptance is the idea of paying attention to the present moment—even if it’s unpleasant—without judging or reacting to the situation. Studies have shown that using mindfulness and acceptance strategies can help with depression, anxiety, loneliness and may even lower the expression of pro-inflammatory genes.
article continues after advertisementIn a 2019 trial, a group of participants was given brief instruction on how to accept unpleasant events. They were then shown photos of negative images and told to either react as usual or to accept the negativity. When the volunteers applied acceptance strategies while viewing the photographs, they reported significantly less negative feelings. Applying this to COVID-19, it means that while we continue to participate in the global fight against the virus, we might pause before allowing our mind to become weighed down by all the things we cannot change.

3. Rewire
Each of us experiences uncertainty in a different way. It’s not just facts; it’s how we interpret the data that determines our mental health. To this end, we know that we can change our brains so they are better able to manage stress and anxiety. In the last several years, research in a variety of fields has revealed strategies that can help us with this goal. 
Exercise, for example, has long been seen as therapy for the mind. Both aerobic and anaerobic exercise programs decrease symptoms of anxiety. But it’s also been connected to changes in brain function. A 2019 study showed that 12 minutes of running were sufficient to alter connectivity patterns in the amygdala, a part of the brain implicated in anxiety.
Nature exposure is associated with general health benefits, better mental health, and alterations in brain function. One study found people who walked through a natural environment for 90 minutes had decreased activity in a part of the brain linked to mental illness compared to those walking in an urban area.
article continues after advertisementSleep is related to a variety of health outcomes. More recently, sleep issues have been tied to poor mental health, with sleep loss connected to depressed mood, anxiety, and distress. Researchers believe sleep helps reset our brain’s circuits overnight, allowing us to approach the next day with less emotional reactivity.
Finally, meditation appears to decrease multiple markers of stress, including cortisol and blood pressure. It’s also been associated with improvements in anxiety. Studies have consistently shown that these meditative practices are linked to structural changes in the brain.
​
4. Refocus
While it’s helpful to consider methods of reframing, accepting, or recalibrating your response to uncertainty, it’s sometimes necessary to engage in quick refocus. To this end, you can switch your attention from the daunting lack of clarity in long-term planning to predictable, short-term outcomes. Instead of worrying about the fate of the stock market, plan and execute a quick exercise circuit. In place of fretting over potential travel restrictions next month, strategize a movie night with the family or schedule a phone call with a friend. This is all about small, guaranteed victories. When these are added up, they can offset the larger uncertainty. 

5. Reset
At this moment, many things are outside our control. Typical routines, interactions, and financial stabilities have become distorted or even dissolved. Our health and the well-being of the people we care about can seem tenuous. Mental wellness is battered when uncertainty shakes our psychological foundations.
article continues after advertisementHere, then, is a time to look deeply at our internal philosophy and drill down to the bedrock. Regardless of the changes happening around us, we retain the ability to choose how we respond. In this trying time, we benefit from the words of Eleanor Roosevelt, “life is what you make it.”
Yes, we are unsure, scared, and anxious. At the moment, there aren’t many easy answers to the virus or to its expanding ripple effects on mental health. But we should remember that despite this, there are a number of tools we can use to support psychological health, and benefiting from this information is as simple as finding even one strategy that works for you.
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    Michelle Stewart-Sandusky

    I write articles based on my experience as a therapist or a training or conference attendee.  Many of these articles are written by others who are experts in their field and I share their information as resources for others.

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