How to get by without panicking

Our social-distancing mental health guide suggests authentic strategies to stay grounded amid the chaos

We’re all dealing with anxiety lately. What do we do if things start to spiral? How do we manage our thoughts when the future is so unpredictable? What if it all starts to seem a little too much? Medcan director of mental health Dr. Gina Di Giulio, a clinical psychologist, has a frank, authentic and grounded discussion with Eat Move Think executive producer Christopher Shulgan that walks through real situations and how to manage them. “We can all cope better than we think,” says Dr. Di Giulio.

 

Podcast transcript edited and synthesized for readability.

Chris Shulgan
You’ve been seeing a lot of clients who have a lot of anxiety about how things are going—which is natural. It’s an anxious time. So what sort of concerns are you hearing? Is it about the coronavirus, specifically the sickness, or how long this thing is going to last, or financial concerns?

Dr. Gina Di Giulio
It’s all of the above. As the situation develops and the government places these extra measures in place, anxieties are going to be created and they’re going to morph alongside what’s happening. So whereas at the beginning, a couple of weeks ago, I was hearing more anxiety around the general uncertainty of this virus, now I’m hearing more, “What is going to be the impact of this virus on my living, my financial situation, my well being?” I mean, these are all real concerns that people are having.

We can all cope better than we think we can cope.

Chris
You wrote that piece, Seven steps to de-stress, about how to manage anxiety through the early stages of what was happening. And I think we’re in a very different situation now, which is why I asked to speak with you again. But one thing that I keep thinking about in that, from your previous article, is this idea that routine is important. And, you know, it’s stuff like, make your bed. Make meals the same way that you always would have made meals. Do these things, adhere to this routine that makes you feel like yourself. Do you still feel like that’s important?

Dr. Di Giulio
One hundred percent. More so now than ever. Because when you stick to a routine, when you add structure to your day—these things help to introduce predictability into your day. And during this time of great unpredictability, that can be very calming. Introducing as much predictability into your day decreases anxiety over time, because it gives you an enhanced sense of control over your environment. What I’ve been suggesting to people is, as much as possible, carry on with as much of the structure in your day as is currently possible. Wake up at the same time every day as if you were going to work. Go to bed the same time, try and take your lunch at around the same time, your breaks. If you can, set up a separate area in your home from which to work. Don’t stay in your pyjamas all day. The routine pieces are really important.

Chris
I feel like every new day, or even sometimes every new hour, brings with it a new announcement that throws the situation further into disarray. And I think it’s tricky to manage anxiety when it’s this anxious time.

Dr. Di Giulio
This is no longer even a case of, Let’s take it one day at a time. This is something that we really are managing now an hour at a time. Because the situation can and has changed so quickly. So my suggestion is, try not to actually think too far ahead. Like, trying to get ahead of this is just an anxiety behaviour that isn’t going to work because we don’t really know where this is going or how the situation is going to unfold. Instead, respond to the information as it unfolds, as it comes in. Try to be in the moment. Trust yourself, that you will be able to cope with this.

Chris
This too shall pass. This is temporary. Focus on what’s happening in the present. 

Dr. Di Giulio
Right. This is unprecedented, but we’ve gone through similar-ish experiences in the past with certain viruses or illnesses that have prevailed, and they have passed and this too shall pass. And so it’s a reminder that this is temporary. It’s not an if this is going to end but rather, when and how. Because it will end. But trying to predict when at this point—it’s just an impossible task. So definitely stay as present-focused as you can, because that will help to instill and maintain calmness.

Chris
I think we probably both have friends who work at gyms or restaurants, or in any of the sectors that have completely shut down. What do you say to them? It’’s fine to say, okay, just be in the present moment, but if you’re not working and you don’t have a line of sight to money coming in, how do you manage that anxiety?

Dr. Di Giulio
Right. So I’m not saying, avoid making any contingency plans whatsoever. But you’d want to do what you would normally do if this situation was happening outside of this crisis that we’re having now. So outside or independent of this virus altogether, how would you respond? And you want to respond in that way, rather than taking extreme measures because those will do nothing but continue to exacerbate your panic.

Chris
Oh, that’s interesting. So what do you say to somebody who is in an immediate situation and experiencing spiralling anxiety? How do you help them move away from that situation?

Dr. Di Giulio
The recommendation is the same. As much as possible, stay in the moment. Remind yourself that, okay, I don’t know what this virus is going to bring tomorrow. But you have to trust yourself that you’ll be able to cope with the situation as it unfolds. And it might be helpful to think back to previous times when you’ve had to deal with adversity or a challenge and think about what you did to cope. That often can be a helpful reminder that despite what is happening, despite the difficult challenges of life that are presented to us, most of us will be able to cope much better than we think we will.

This is because anxiety does two things. Anxiety overestimates the risk that something “bad” or untoward is going to happen. And anxiety also has this tendency to underestimate or undercut our perceived coping resources. It tells us this bad thing is going to happen, and it’s going to be horrible, it’s going to be apocalyptic, and I’m not going to be able to handle it. None of that is true, though. It is helpful to think back to how you’ve coped with adversity in the past, and as a reminder: that you can cope much better than you think you can.

But in order to be able to do that, you do have to stay as present-focused in the moment as possible, because that’s where our focus, concentration, decision-making is at its sharpest. When we’re in the now. It’s not sharp when we’re ruminating, you know, thinking about the past, and it’s certainly not at its sharpest when we are forecasting and making negative predictions about the future, because anxiety just gets in the way of making effective decisions. So stay present-focused, and remind yourself that you can cope and deal with the situation as it unfolds.

Chris
We were talking about anxiety spirals. And I was just talking to a nurse friend of mine who was coming home from work after a 12-hour shift, and she was freaking out because she was heading into two more 12-hour day shifts and hadn’t yet figured out childcare. We started working through the problem and at some point she said, “Oh, I didn’t eat breakfast. I was too busy to eat today.” What I’m wondering — if you haven’t done the kind of baseline stuff like eating or, you know, if you’re sleeping poorly or if you haven’t exercised that day, is this stuff more likely to make you go into an anxiety spiral?

Dr. Di Giulio
Yeah. 100 percent. These things—they are the fundamentals of both good physical health and mental health. It’s often during times of crisis or chaos that people put self-care aside. Just like your friend. Because they feel like, well, there’s just not enough time and there’s all these other things they have to attend to. Who has time for self-care? It feels indulgent. But not attending to those things will leave you more vulnerable to illness of any kind, and it’s especially during these uncertain times that we need to ensure that we take extra good care of ourselves, because that’ll better enable us to manage the situation at hand.

Chris
Can you sum up for me? We’ve had this wide-ranging conversation about anxiety in the time of crisis and how to manage it. If we were to sum it up in three points, what would you say?

Dr. Di Giulio
Okay, so three things. I would say:

First, take the precautions that one needs to take under the circumstances. Things like practising good hygiene—but don’t go overboard. Taking extreme measures is only going to exacerbate anxiety.

Second, ensure that you are taking good care of yourself and actually carving out time for self-care and healthy activities such as making sure that you’re still getting enough sleep, eating healthily, exercising. Taking care of you is paramount.

And then, thirdly, try and stay as much in the moment as possible, and respond to the situation as it unfolds knowing that you will be able to cope.

Chris
That’s fantastic. You’re taking clients virtually throughout this for the foreseeable future?

Dr. Di Giulio
For the foreseeable future, yes. I, too, am working from home. And I don’t anticipate that changing anytime soon.

 

Arrange a virtual Mind Health Session. Please subscribe and rate Eat Move Think on your favourite podcast platform. Follow Dr. Gina Di Giulio on Twitter @DrGinaPsych.  Eat Move Think host Shaun Francis is Medcan’s CEO and chair. Follow him on Twitter @shauncfrancis. Connect with him on LinkedIn. And follow him on Instagram @shauncfrancis. Eat Move Think is produced in conjunction with Ghost Bureau.

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