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Coronavirus Stress & Anxiety Cognitive Behavioral Tools & Life Hacks
Host: Dr. Dawn-Elise Snipes

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• Objectives
• Identify why controlling stress and anxiety is important
• Describe cognitive behavioral tools and “life hacks” to address stress and anxiety during viral outbreaks
• Identify reliable resources to acquire accurate information about the virus
• Identify practical steps clinicians can encourage mainstream media to take to reduce the negative impact of the situation on the mental health of the general public.

Why is Controlling Stress and Anxiety important?
• Stress and anxiety cause the body’s threat response system (HPA-Axis) to be activated
• In the short term like when you get cut off in traffic, this system might be helpful
• When it stays activated for days or even weeks it causes
• Impaired sleep
• Difficulty concentrating
• Weight changes
• Fatigue
• Reduced immunity
• Irritability (behavioral issues in children)
• Reduced libido
• Increased risk of anxiety and depression
Why is Controlling Stress and Anxiety important?
• Interpersonally stress and anxiety increases distrust, suspicion and social isolation/distancing which negatively impacts interpersonal support and personal self esteem and safety.
Cognitive Behavioral Tools
• Use fact-based reasoning
• Who does this impact? (elderly, those with compromised immune systems or cardiovascular issues)
• How much will it really impact me?
• Payroll tax cuts with “very substantial relief,” as well as ways to help hourly wage workers who cannot get paid when they stay home sick “so they don’t get penalized for something that’s not their fault.” Washington Post
• How many people have it who have not been tested and recovered?
• What practical steps can you take to protect yourself?
• If the government declares a state of emergency—what does that actually mean?

Cognitive Behavioral Tools
• Don’t confuse possibility with probability
• What is the probability it will happen to you AND be the worst cast scenario
• In 2019-2020 there have been 34 MILLION cases of the flu, 350,000 hospitalizations and 20,000 deaths (CDC)
• The mortality rate of people who have been tested for the flu is .1% but for coronavirus ranges from .2% (10-39 year olds) to 3.6% (elderly) (China CDC Weekly study)

Cognitive Behavioral Tools
• Practice Mindful Acceptance
• Notice how you feel without judgement
• Identify the options for dealing with the situation (including tolerating uncertainty)
• Choose an option to help you improve your next moment (instead of continuing to feed the anxiety)
• Engage in meaningful activities instead of channel surfing to find more of the same information that is causing your distress
• Get reliable facts and use fact based vs. emotional reasoning
• Stop trying to control things that are out of your control
• Figure out a way to make this an opportunity
• Live in the AND (This virus can exist AND I can have a rich and meaningful life / go to work)

Cognitive Behavioral Tools
• Be aware of all or nothing thinking or catastrophizing
• There is nothing I can do to protect myself
• If I get the virus I will die
• No public places are safe
• If my daughter gets the virus, she will die and I won’t be able to go on.
• Make an effort to find the positives in your life
• Currently I do not have it
• There are steps I can take to protect myself
• Thanks to online shopping I will be able to get my basic needs met
• Thanks to the internet I will be able to stay in touch with loved ones and possibly work from home
• This is encouraging me to clean more
• There will likely be disaster assistance to help with bills in the event of community shut down

• See challenges as opportunities for growth
• Being in quarantine or community shut down allows me to…
• Spend more time with my family
• Get caught up on yard work
• Reduce my carbon footprint by not driving as much
• Accept that it is what it is and currently there are a lot of unknowns
• Anxiety and anger are normal reactions to abnormal situations
• You can choose to feed your distress or use your energy to do things to help you feel more empowered
• Unhook from your thoughts
• This situation is going to be catastrophic vs. I am having the thought that this situation is going to be catastrophic. (What facts do you have to support or dispute your thought? How often are your thoughts wrong?)
Life Hacks
• Get your information from a reliable source like WHO or CDC
• Get your daily dose of news then TURN IT OFF if they insist on fear mongering
• Remember that the more anxious people are, the more they seek answers which equates to increased ratings. MSM benefits from your panic.
• Encourage your local stations to run stories on
• Avoid spending too much time on the internet with fear mongering clickbait
• Maintain your routine as much as possible
• Get sufficient quality sleep (even if you don’t have to go to work)
• Do something positive each day
• Focus on the positives for 10 minutes each day

Life Hacks
• Belly breathing
• Practice 5-4-3-2-1 mindfulness
• Make a list of 5 activities you can do to get your mind off the situation (balloon toss, painting, cooking, exercising, working, gardening)
• Identify 5 sensations that can help get your mind off the situation
• Be aware of other’s impact on you and your impact on others (including children)

What MSM Can Do
• Quickly communicate the risk or lack of risk from associations with products, people, and places.
• Raise awareness about COVID-19 without increasing fear by sharing accurate information about how the virus spreads.
• Provide people tools to deal with not only the physical aspects, but also the emotional aspects of the situation
• Speak out against negative behaviors, including negative statements on social media about groups of people, or exclusion of people who pose no risk from regular activities.
• Be cautious about the images that are shared and headlines that are used.
• Share the need for social support for people who have been exposed or are worried about friends or relatives.
• There are many unknowns with the current coronavirus situation
• The flu is widespread and catastrophic for tens of thousands of people in the US each year and we do not panic.
• High levels of stress and anxiety however will reduce immunity and make people more susceptible to all types of illnesses
• Steps to reduce anxiety
• Get accurate information
• Limit your exposure to negative media
• Practice mindful acceptance of your reactions
• Use belly breathing to help de-escalate the physical anxiety reactions
• Identify proactive, positive ways to cope with the situation
• Regularly evaluate your beliefs against the FACTS at that time