Coping through the COVID pandemic.

I think we can all agree that coping through the COVID pandemic has not been easy for most.

The other members of the AYOSC team have blogged about what life has been like for them over the past few weeks.

This week, I’ve pulled together some thoughts on how I have been coping over this tumultuous period.

How have I been coping through the COVID pandemic?

Most importantly, I think it’s really important to start by saying how privileged I feel to have ongoing, structured ways to access meaning and value in my week.

As a Consultant Clinical Psychologist I have the ability (and need) to keep working through these difficult times.

Automatically that makes these unprecedented times just that little bit more normal for me. As a result getting through the days should therefore be that bit more manageable.

As my wife also works in the NHS, she has been able to keep up a level of routine too.

Another plus of our jobs is that our son has been fortunate enough to have a place at a Hub school.

We all feel incredibly lucky in this respect.

So many others have been forced out of routines and face threats to fundamental elements of life that many of us took for granted before this crisis.

So in that sense, I’m not going to be offering advice based on personal experience on how to cope in these strange times.

Instead I’ll summarise some evidence-based advice on how best to cope with the psychological impact of this crisis in the immediate term.

I’ll also give you a bit of insight into the adjustments that I HAVE had to make, even with the bit of on-going routine I have.

Work

Our services, just like all others in the NHS across the UK, are no longer recognisable.

In order to protect ourselves, our patients and the wider NHS we have had to cancel all routine clinical duties. Sadly, this is true of many NHS services at this time.

Like Izzy and Laura, this was a really hard transition to make.

A fundamental purpose of our role is to provide empathy and evidence-based interventions for those struggling with mental health problems.

So the thought of withdrawing that opportunity for many of our patients at this time felt counter-intuitive.

However, we have quickly found other ways to provide at least some ongoing intervention and care.

What have we changed?

We have made use of the various on-line platforms available to us.

Of course not all therapies can be delivered in this manner. In addition, not all conditions can be treated effectively on a remote basis.

I know form discussion with colleagues that the lack of a ‘face to face’ service concerns us all.

We miss the personal connection.

We all look forward to being able to connect with our patients again face-to-face.

I don’t think a single day has gone by without us seeing another change in our service.

In a good way, we have rapidly evolved and staff have shown a great willingness to change and adapt to these new circumstances.

This has been no insignificant challenge. The pace of change has been rapid. We have had to get up to speed with loads of new IT processes as we transition to remote working.

As someone who was already only just clinging on to the wave of IT developments in all areas of life, this has actually been a really positive experience overall for me.

I’ve been forced to take a leap into the relative unknown both at work and home so that I can remain productive and connected. So sad that it had to happen in these circumstances, but it was certainly a push I needed.

Where are we heading?

Currently, we are looking to the future and considering which services we might be able to re-instate. Clearly, these will have to be on a remote basis for now.

This brings us great hope as we are keen to get back to providing a more comprehensive and responsive mental health service for out patients.

We know the Mental health burden of the COVID pandemic will be both huge and wide ranging.

The changes we are planning will hopefully begin to address at least some of the mental health difficulties that will be cultivating in our communities during these times of social restriction.

Alongside interventions for our communities, important developments around NHS staff-support have been implemented by colleagues in specialist trauma services and acute psychology.

Support services will soon also be available for our in-patient psychiatry staff who face similar stressors to those working in other hospital settings.

All of these services are based on the current best practice for the immediate psychological management of emotional reactions in times of major crisis (i.e. Psychological First Aid). More on this later.

Home and family

At home we’ve been trying to enjoy our time together and appreciate what we have. With no clubs to run our son to and no social commitments, we have adapted to living life at a slower pace.

I have actually really appreciated this as the stress levels at work have been very high.

I’ve managed to cook more and spend much more time with my son than I would normally.

There are definitely some breaks in the clouds if you look for them.

A quick note on home-schooling though. While I always knew I would make a terrible teacher and already had the upmost respect for teachers, I quickly found I wasn’t even going to pretend I could take the place of our son’s favourite teacher.

Instead, I’ve been taking the time to share life skills and experiences I’ve picked up along the way. Just simple things like how to wire a plug, put up paintings, fix a puncture on his bike. The school of Dad!

How I am coping?

Initially I would readily admit to failing completely to maintain a reasonable boundary between work and home.

Without doubt, this took a toll early on in the crisis.

However, at that time I acknowledged to myself and spoke to my wife about the fact this was a short-term necessity.

It wasn’t sustainable, but it helped to weather the initial storm and those additional hours have proved worthwhile now we’re clearer on how best to run our services in these strange times.

Now that things have settled into a more regular pattern I certainly feel a lot more grounded.

Thankfully, I have been able to get back into more helpful coping strategies around exercise, cooking, family time and connecting with friends.

Tips on coping through the COVID crisis.

I’ll finish up with a few words on coping.

I think it’s important to distinguish between the kind of coping that we need to use in the current crisis and the strategies we’ll need to think about further down the line. The things we will need to consider when the pandemic and the related restrictions begin to resolve.

Psychological First Aid (PFA) is an evidence-based intervention which was originally developed for people living through a major disaster.

While this is a specialist intervention, the core principles of PFA can help promote adaptive coping for us all in these challenging times.

I’ll run through a basic summary of the core principles:

1. Care and Protect

This is about focusing on our most basic, immediate needs (food, accommodation etc.).

Take steps to ensure safety (e.g. social distancing) and acknowledge any specific vulnerabilities.

2. Comfort and support

Seek sources of comfort and empathy.

Use helplines as required.

Ask for practical help where possible (e.g. help with getting food delivered).

3. Adaptive coping

Focus on what you can control and try to pay less attention to the factors you can’t control.

Worrying about things that are outside your control needlessly uses up energy you could direct to other areas of self-care.

Think about what strategies worked well for you in the past in difficult times and try to use these again.

Make future-based plans and stick to them, e.g. phone a friend for a chat.

Prioritise self-care – you can’t look after anyone else in the family if you are not looking after yourself.

It’s like putting on your own lifebelt before anyone else’s!

4. Connect

Make sure you reach out to friends and family regularly so you can stay connected and feel part of a wider community.

5. Normalise emotional responses

It is normal and expected to feel anxious and/or sad about the current circumstances.

There is no right or wrong way to think or feel about this crisis.

Feelings of loss, confusion and irritability are examples of other common emotional experiences that might pop up at this time.

Feelings come and go and sometimes it’s a bit like riding a wave – whatever the strong emotion you are feeling – it will pass in time.

While PFA is a stand-alone, clinical intervention, which is delivered to those in greatest need by trained practitioners, there’s nothing wrong with being away of these core principles and applying them to your own life at the moment in order to improve your coping.

These are appropriate, helpful strategies for an immediate crisis such as this.

However, it’s important to acknowledge that as this situation begins to change and we start to re-build our lives, different strategies will come into play.

For some, working and/or employment circumstances will have changed.

Others will have lost loved ones.

Isolation will have taken a toll on others and some may find moving around their local community more freely quite an anxiety provoking experience.

We won’t fully understand the impact of these times on ourselves and our communities until we have more freedoms again and start to try and pick up.

At that time coping strategies will be about processing what we have experienced, coming to terms with change and looking to the future again.

For now though, we need to focus on our needs today and on supporting those most vulnerable around us that we can help to get by in these difficult times.

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Matt.