People around the world have been weighed down by the burden of stress arising from COVID-19. This is normal and to be expected, and many people seem to be struggling well—at least, for now.

But some are not. The intensity and duration of the pandemic have inevitably taken a toll on mental health—and, as the pandemic trudges on, it will take a much greater toll. Fear of infection has left some people cleaning their residences constantly. Loneliness, already widespread in Western societies, has increased. Domestic violence is up significantly. Liquor sales in, for example, British Columbia are up 40 percent. The closure of schools and daycares has left hospital staff and other essential-service workers scrambling. Some desperate people disregard social-distancing because they can’t handle being by themselves or cooped up with small children.

Lots of people are stressed when they learn about those who flaunt self-distancing guidelines, justifying their behavior with arguments, such as, “If I get COVID-19, then I get COVID-19,” “I’m healthy so I don’t have anything to worry about,” or “You can’t live by fear.” Newscasters have asked their audiences, “Should we shame those who are not social-distancing?” After all, anyone who does this is just a “narcissistic, self-centred idiot,” to quote British Columbia’s solicitor general, Mike Farnworth. Farnworth’s anger is common in the public. We’re hearing more and more about “stress” and “anxiety” in the media and around dinner tables.

Mainstream Psychology Focuses on Stress Management

To deal with these stressors, the typical psychologist recommends stress management techniques. The Canadian Psychological Association and the American Psychological Association send out links to members on helping clients manage stress. Establishing new routines, practicing mindfulness, exercising, eating well, using the internet to connect with friends and family, watching movies (but not those about global virus infections), taking up a hobby, having a positive attitude, living one day at a time, avoiding alcohol and drugs, and, if necessary, finding an online counsellor are heralded as the solution to pandemic stress.

A Brief Meaning-Centered Strategy to Reduce Stress

Former Canadian astronaut Chris Hadfield, who spend many months at the International Space Station, gave us advice on how to cope with isolation during the pandemic.

His four steps—realistic assessment of the situation, focus on purpose, understanding constraints to achieve the purpose/mission, and action—will be familiar to INPM members.

Step 1: Understand the risks—Although there is plenty of trustworthy information on the internet offering solid facts and sound recommendations on helping us through the pandemic, too many people are relying on social media as their guide. The problem is that those who get information from social media are far more anxious than those who don’t. Based on research into the psychological consequences of collective distress, such as the reaction to the 2014 Ebola crisis and the 2014 Boston Marathon bombing, American Psychological Association recommends avoiding social media as an information source. Even friends and family can warp perceptions if conversations dwell on risks, complaining, anger, and other troublesome issues.

There’s a curious phenomenon known as group polarization: A group of like-minded thinkers who dwell on a topic will move to an extreme position. If a person’s perception of risk is out of proportion to the actual threat, and that person talks to others who feel the same, then both of them will unconsciously begin magnifying the problem out of all proportion.

Step 2: Figure out what your purpose/mission and obligations are—This step is, of course, personal to the individual and circumstance. At our healthcare facility, many staff members have chosen to stay at home. Those who have kept working have had to come to terms with why we remain open. What is our purpose/mission and what are our obligations in pursuing that purpose? Like other healthcare facilities, we remain open because we are helping others. We help clients (whose addiction is a far greater threat to their health than the pandemic), and we help the community by keeping clients out of the local hospital, which is why the health department and the Mayor want us open. We are obligated to provide PPE and practice good hygiene, to ensure the safety of clients and staff. And, of course, this step also means coming to terms with any other purpose/mission and obligations, such as taking care of kids.

Step 3: Be aware of the constraints facing you to achieve the purpose/mission—Accepting the various limitations imposed by the pandemic makes sure we ground our efforts in a realistic assessment of the situation. And there are lots of constraints, such as the lack of personal protective equipment, limitations on travel, closed parks, curfews, long lines at grocery stores, and no haircuts.

In the small town where I work, a few locals have been vocal that our mental health and addictions healthcare facility should be closed. One fellow on Facebook accused us of having “two confirmed cases of COVID-19,” which we’ve been “hiding.” He said he knew this was a fact because a nurse had told him so. These vocal residents have even been rude to staff members who are grocery shopping. The accusation was nonsense, but expected, and there’s nothing we can do about it. These people are the authors of their lives. But recognizing that gossip and rumors are part of the pandemic reinforces the importance of this step.

Step 4: Take action—This is essentially getting on with the work.

These steps are how astronauts take responsible action, rather than allow anxiety to dictate their thoughts, emotions, and behaviors.

Working Through “Existential” Anxiety

Hadfield’s advice is very good, but it was designed for astronauts, those who had good mental health before the pandemic. Advice from mainstream psychologists is also good; however, it tends to work best only in the short-term.

But the anxiety that many people feel is an “existential” anxiety, and no amount of positive thinking or exercise or routine will do more than offer short-term benefit.  When we tack the word existential onto a feeling, it means that we believe something is a threat to our very existence. Loneliness can be that feeling of having no one to go out with on a Friday night. But existential loneliness is the feeling that each of us is fundamentally separate from all other human beings. Anxiety can arise from a fear of spiders, nervousness over giving a speech in public, or some other clear and limited condition. But existential anxiety arises from a threat to our very existence, such as the anxiety of death. This existential anxiety drives much of the stress some people feel during the pandemic.

There are no quick fixes for these existential anxieties; however, handling existential anxieties are one of the best protections we have against adversity.

Learn to live comfortably in the grey area of life—The greatest anxiety many people have in the pandemic is not so much the fear of infection, but their distress living in grey area of life, where there are no clear answers. It’s obvious that the doctors still do not understand this coronavirus, which they’ve never seen before. Governments are in the same position. Recall Mayor Bill de Blasio of New York City, who declared with conviction that there was insufficient evidence that closing public schools would slow the spread of the virus, and then he listed a litany of problems that closure would create. A few days later, with equal conviction, he completely reversed his position. Living comfortably when there are no clear answers is difficult for those who truly believe they need to know “the answer” to be in control. Research has shown that people with good mental health have learned to struggle well, even when answers are unclear.

Accept that there are no guarantees in life—It is impossible to protect yourself 100 percent. Some who live healthy lives (exercise, eat right, practice relaxation exercises, go to the doctor, and so on) are diagnosed with cancer. Some are victims of a motor vehicle accident or crime. Some return from holidays to a flooded basement.

Adopt an attitude of “death acceptance”—Fear of death is driving many anxieties during the pandemic. We feel dread when we worry about losing ourselves or families to infection, and this fear is so powerful that it drives our perceptions, choices, and actions. Psychologists who study meaning and purpose, however, tell us that those who are most afraid of death have not really felt alive during their lifetime. On the other hand, those who live full and productive lives typically do not fear death. This lack of fear doesn’t mean that they want to die or that they don’t care whether they live or die. Accepting death simply recognizes that death is a natural and expected part of existence. Those who accept death have much better mental health than those who are afraid of it.

Gain perspective on your life—You can choose to use this time to look at what we’ve been doing with your life. Does it need some tinkering or a complete overhaul? One writer in the New York Times said that the things he worried about two months ago now seemed “ludicrous” in the face of the pandemic. Here are some questions to ask yourself, based on research into living a meaningful life:

• If you watch a lot of television, is this a productive activity, or is it simply a way to distract yourself?
• Do you deal with stress in a responsible, constructive way or do you turn self-centred?
• Has the risk of illness and social isolation given you insight that life is fragile, so you should live as fully as you can?
• What can you do to take control of your life, even though you can’t control the pandemic, the rules the government imposes on you, or the way others behave?

These exercises are far more complicated than Hadfield’s recommendations or those of the mainstream psychologists. But exploring them and other personal issues likely offers the best protection you’ll have in the face of any adversity.

Viktor Frankl told us that even in situations where we have lost control of our environment (his example was a Nazi death camp), we are still free to choose how we respond to our situation. Frankl noticed in the death camp that those prisoners who were motivated by fear turned self-centred and lost their humanity. But those prisoners who gave up their meager rations to the sick and did other acts of kindness were the ones who survived. There is a lesson here for all of us.