Psychologist and mental health expert Dr. Rehman Abdulrehman joined us on Friday, March 20 to answer your questions about how to cope during the coronavirus pandemic.

Dr. Abdulrehman is a consulting and clinical psychologist with specialist experience in cognitive psychology and behavioural change and an additional focus on diversity and inclusion. He is the Director of Clinic Psychology Manitoba and Lead With Diversity.

You can follow Dr. Abdulrehman at his website and on Twitter.

All answers below are from Dr. Abdulrehman.

From Khan: I’ve had 3 anxiety attacks this week. I think for my own mental health I need to stay off social media and stop watching the news. It’s just too much. How should I balance my worries with my need to stay up to date on information?

A: Hi Khan. This is a very, very good question. Background information first; anxiety or panic attacks have two components; psychological worry, and physical symptoms. Some people have both of these symptoms, some just worry, some just have the physical symptoms (shortness of breath, dizziness, narrow vision, heart palpitations, etc.). Panic is a normal response to danger, and is like your brains alarm system. It prepares you to fight or flight when you perceive danger (psychological worry) by changing your breathing style to rapid breaths, usually breathing from your mouth. This takes in more oxygen and increases the physical symptoms of panic.

It makes sense you’ve had 3 such attacks this week, because with all the news, the perception of danger is high, and so your alarm system is on, preparing you to fight or flight. We need to do two things: 1. turn off the psychological trigger, and 2. turn off the physical trigger to this alarm.

Turning Off The Psychological Trigger

We have to do the first by managing our perception of danger. Know that the panic symptoms are normal and a response to fear or danger. This will allow you to help put the worry about what’s happening to you aside. LIMIT the intake of the news you have coming in. If your brain is consistently watching the news or media about this pandemic, the perception of fear and danger is higher. Set a time to catch up on what you need to and then carry about other things that you need to do, including things tied to self-care. Yes, that could even mean a good netflix binge. Remind yourself this coverage, and these measures being taken are meant to be helpful and develop a sense of control. This too will help limit concerns of imminent danger.

Turning Off The Physical Trigger

The trigger happens by taking in too much oxygen, so you want to slow down the intake of oxygen. Breathing in and out through your nose (two small holes) will regulate how much oxygen comes into you at any given time better than your mouth (one large hole). Also to get a deeper breath, breath from your diaphram, instead of your chest. You can gauge this by putting on hand below your rib cage, and one on your chest. With every breath in, push your tummy out and not your chest. Practice doing this for a period of 5 to 10 minutes to allow yourself to turn off the physical trigger.

From M: We are over 70 and our daughter with Aspergers lives with us. We are trying to practise self isolation. She works in a grocery store. She is having great anxiety about bringing something home and infecting us. She wants to ask for time off but is afraid she will lose her job, which would also cause her great anxiety. Is there any way I can help her manage her anxiety.

A: You’re kind and wonderful and thoughtful parents. Know that to begin with. Your daughter is lucky to have you. So many people are in your boat. And I would hope that your daughters employer would understand the situation. Many people are not going to work for the same reason. What I might suggest first is the practicality of having you or your daughter speak with her employer to see if she were to take time off, would that cause her to loose her job. If the answer is no, this might help with anxiety all around. Given that she is on spectrum too, I would hope the employer might also be mindful of the challenges she faces. The practical nature of this will allow her some comfort. I would say start there.

From Sarah: Thanks for taking time to answer our questions. I am a stay-at-home mom with a toddler and we are used to getting outside and interacting with groups of kids every day. There are a lot of shamers out there about not letting your toddler watch TV, but it’s hard to avoid sometimes now that we’re stuck inside. How can I get over the guilt and fear I feel behind having her mostly stuck inside for the foreseeable future while this time in her early life is so critical for development?

A: Sarah, my fellow parent, I get this. All parents do. Despite how much someone may shame you know that parenting 24/7 is not the easiest thing. And in this unique situation, know that what you normally may not do (more screen time) is not what you will always do. And my guess is you’re not leaving the tv on hours at a time. That said, screen time can be semi-interactional when you engage in a conversation about the show with your child. Ask them questions about characters. Pause the show, and act out scenes with them. Turn it into a game. Using the show as a structure, will allow you both a semi-break.

From Phil: How can we deal with job loss in the middle of the pandemic? I was told my contract at work was ending due to the pandemic. I will apply for EI like everyone else but applying for a new job now will be very difficult with so many people being laid off or about to be laid off.

A: Ugh. The economy. The impact of all this on the economy will be difficult! What can be helpful in all this though is to know you are not alone. And that is a protective factor here. As so many will be in this situation, there is a good chance there will be programs and measures taken from higher level government and organizations to get back on track. As much as you will be impacted the employer will be too, and everyone is going to want to get back to work as soon as possible. The worry you’ve noted is a “what if?” thought. And that can leave us stuck with just a question and no answer. And that uncertainly will only make us anxious and worried.

Start to answer that “what if?” with a “now what?” Ask others in your situation what they are doing. You may not have the best answer, but the process of thinking of a solution will be more helpful to your mental health than just ruminating on the question. The answer, or the process of thinking about, and talking about an answer, will offer you a little more control and as a result some increased hope. I am wishing you, and all those in your shoes, all the very best.

From Stone: I am feeling guilty and worried for my 9 year old daughter. I am fortunate enough to work from home but my wife has to go into work as an RN. I can hear my daughter watching more TV than she has in her entire life, I sneak extra long lunches to take her outside for a bike ride, and we go out for more in the evening, and she is being awesome ..... BUT .... it feels like it is not nearly enough given how long this situation will last. How do I beat the worry and guilt?

A: Hi Stone. See my responses earlier on managing guilt and worry about this. We are in a time when we need to be flexible with house rules. That said, this is also a time for creativity, in finding ways to connect with each other. Might also be a time where we are forced to talk to each other and get to know one other more than we did previously. Managing the worry and the guilt will be all about knowing this is a unique and difficult situation, that you’re not alone, and being creative in ways to connect and engage with each other. Aaaand, knowing some alone time is healthy.

From Jonathan: As someone who has has health-related OCD/anxiety, I find myself constantly checking myself for symptoms (energy levels, temperature, shortness of breath, cough etc. etc.) of the virus to the point where it’s not helpful. The vagueness of the symptoms doesn’t help either. I check so often sometimes to the point I’m convinced that I have it already and I’m just a ticking timebomb.

What practices do you recommend one take to make sure they’re not constantly reassurance checking? How do you cope when you’re stuck in your home? (I work in an industry where I can’t just “check out” from the news)

A: Jonathon, believe it or not, there are thousands of other people who have breathed a sigh of relief because you asked this question. So let’s get to it. Both with health anxiety and OCD, although the checking behaviours or reassurance seeking might help provide relief for a short immediate moment, it actually reduces our confidence in ourselves, increases anxiety and the likelihood that we will need to seek reassurance or check again very soon. Many people who struggle with OCD and sometimes health anxiety, do appreciate rules and guidelines. And as you’ve said, the vagueness of symptoms doesn’t help with creating a clear rule. So create a rule yourself and stick to it. For example, I will look at the list of symptoms noted on the website. If I do not have them, I will not check again for a period of time. Gradually try to space out the checking, so that you rely on it less and less. If you’ve already been to a physician, or a health check centre and they’ve confirmed you are not symptomatic, then create the rule in your mind that you’ve checked once and that is all you need. These are your new rules, stick to them. Use what normally might work against you (the need for rules) to help you.

If you’re in an industry that doesn’t allow you to “check out” from the news, change the purpose of reviewing the information in the news you’re stuck with looking at. Before setting your new rule, you may have been trying to review the news in relation to yourself. Set your new rule to say your role is use the information to help others. Say for example you work for the news. Remind yourself your job is to just act as a conduit. If the urge to read or check is strong, revert to the original rule that you have to wait that period of time before checking again.

Also, take breaks. Where you get to step away periodically and allow your brain to focus on another task other than the news. If you are able to have others take over, do so. Your mental health deserves it.

From Tara: I have a high functioning autistic (HFA) teenager at home and we are struggling. I created a routine to follow, which helped, but the behaviours are big and with nowhere to go for a “break” the whole family is reaching the breaking point. As parents, how do we help all our children to survive this?

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A: Taking on the responsibility of creating a structure and routine when you previously did not, is a challenging issue. Some thoughts that might help. (1) Allow yourself to use some pre-organized tools for structure. For example, board games! You don’t need to create the rules, you just pull out the game. Recipes, and cooking, another idea. The recipe creates the structure. (2) Ask others in your family to come up with ideas of what they would like to do. This way they will be more engaged and you don’t have to shoulder the mental burden of coming up with everything. (3) Alone time is ok! Let the kids have some time to themselves. It might mean they are on social media, but this is a situation where it will be helpful. They’ll get to connect with their friends. (4) This is a situation where we need to be flexible with some of our house rules. Where we didn’t previously allow as much social media use, now, it will be a help.

Also from Phil: What are the best tips to help seniors cope with the pandemic? I have a 73 year old mother and she is following instructions to self isolate. She is healthy but worries a lot. I am concerned about the impact on her emotional health.

A: You’re a great son, Phil! There are many ways to check in on her, including by phone and video chats. Keep doing so. Worry is normal. Knowing she has a son who is concerned and checking in on her, I promise you, will have a great positive impact on her emotional health than the worry might. Social support is found by research to be one of the single most important factors to promoting psychological resiliency. So tell her you’re worried, and that she can talk to you about any of her concerns anytime. You don’t need to have answers, but listening alone will make a world of difference for her and for you.

From Jessica: How can I talk to my kids about what’s going on in the world without sparking fear? And should I be worried about how their routines have been completely upended? Thanks

A: Hi Jessica. In short, tone is everything. EVERYTHING. They will look to you to see how you are coping and reacting to all the news. Think of what happens when a child hurts themselves on a the playground. Though you may be worried, you’re calm and point out the pathway to feeling better for them. You offer them compassion and love, and lots of hugs and kisses. This will be very much the same. You’ll explain the situation in an age appropriate way, and remind them that you’re going to be there, and that the steps you’re all taking are what everyone is doing and that it is to help us all stay healthy and positive. You’ll be calm. They’ll be calm. The routine is important, but this is a temporary change. Use your wonderfully creative parent mind (if you’re a parent, your creativity has been growing since you were not, you know it) to come up with a new routine. It does not have to be the same it was before you were engaging in social distancing, but a routine will still help your kids and you stay on track with a positive state of mind.

From Lynelle: What advice would you give to support workers caring for older adults who are already somewhat isolated?

A: Be your usual wonderful selves. Know that in many ways you’ve become like family to many of these older adults. Talk to them. Use your sense of humor. Connect. Talk to them about what is happening in the world and their feelings about it. Social support is a critical factor in psychological resilience.

From Donna: Living in a small condo with my partner, and both working from home, what’s the best way to give ourselves boundaries without driving each other insane?

A: Very appropriate and important question. You want to make sure your partner remains a significant support. Though we believe we rely on our partners heavily in our day to day lives, what we don’t account for is the fact that we also rely on many other people for support, and a healthy dose of alone time (the need of which varies from person to person). Have a discussion up front, and cite this answer to help avoid any misconceptions that you are tired of them or don’t love them. The discussion should be around allowing each of you some alone time, some time to call friends and coworkers, and then some time with each other. Do your best not to take offence to the fact that your partner needs some alone time. It’s not that they don’t love you. It’s just that they’ll love you more with a little space. It’s human, it’s a common need, and it’s important to have.

From Dan: Hi, my son live downtown and wants to come home, I’m worried as social distancing where he has not really been down. I know if I say no he will start to feel more anxiety, I’m lost on what to do.

A: Good question. You’re going to have to make a judgement call. But I think you need to talk to him about being concerned about his health as opposed to you not wanting him to come home. That said, if you feel he is symptom free and will be better at social distancing while he is with you the social support for both of you might be a really wonderful thing.

Question: Is there anything I can do to cope with the anxiety?

A: Oh, so many things! But first, we should clarify what we mean by anxiety. Anxiety can refer to both physical symptoms (in which case see my response above on how to manage that) but also thought symptoms like worry.

First, limit the intake of news. You don’t need your brain consistently having it’s alarm system go off. Set a time to know what you need and how people are responding, and then turn it off until the next time you’ve set that check in time with the news.

Second, challenge worries you might have. Answer “What If?” questions with “Now What?” Ask yourself if the worry you have is realistic ? If not, what is? We often catastrophise, with the realistic answer may be problematic, but not insurmountable. Speaking of that, consider solution focused answers to “What Ifs?” The process of looking for answers will give you more hope and control.

Third: Talk. To. People. You might not be around others, but please please pick up the phone and call people. Even those you haven’t spoken to in a while. They will appreciate the check in and you’ll feel more connected.

Fourth: Exercises. Google ideas on ways to exercise in your home. Or go for a quick bike ride while practicing appropriate social distancing. This will allow you to sleep better which will also manage anxiety.

Fifth: Have fun. This is an opportunity to get to things you’ve always wanted to that you never allowed yourself time to indulge in before. Me, I’ve been baking. A lot. Hope this is some help in the general right direction.