Coronavirus: Coping with Stress, Anxiety and Depression

The Coronavirus spread from China to various parts of the world and has proved to be a global disaster. It has rapidly killed thousands and affected millions of people worldwide, not just the poor and weak, but also the rich and powerful. This shows how lethal and penetrative this virus is.

The recent predictions are ominous suggesting that as many as 240,000 Americans could die. Because the United States did not impose restrictions early on, the coronavirus spread here rapidly, especially in Seattle and New York. While Asian countries like China and South Korea have controlled the spread of the disease, the world’s richest countries with the best scientists and infectious disease specialists in USA and European countries did not. Dr. Anthony S. Fauci, head of Institute of Allergy and Infectious Disease, told members of US Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic. Now 229 million people in at least 26 states, 66 counties, 14 cities are urged to stay home.

Everybody is advised to stay indoors, all schools and colleges are closed, all places of worship are closed, and all large social gatherings are banned. Many doctor’s offices are closed, elective surgeries are cancelled, and physicians are seeing patients through telemedicine as most hospitals are treating only emergencies. Flights are canceled, malls and shops are closed, and all restaurants are closed except for take-outs. All sports and outdoor events are canceled.

People have lost jobs and their income. There are long lines at unemployment offices throughout the country. New York is almost shut down and Manhattan has become a ghost town. Everybody is uncertain about what might happen in the coming weeks. People who have a physical illness or mental illness are more vulnerable especially the elderly, individuals with chronic diseases, history of anxiety and depression, and people with financial stresses. Feelings of anxiety and uncertainty are completely normal occurring under these circumstances.

We are grateful to medical professionals, grocery store employees, delivery drivers, pharmacy workers, mail carriers, firefighters, police, nursing home employees, and everyone else who is working to save lives. These are the front line worker who experience extreme stress  due to concerns about  their own and their family members safety.

Health care professionals and front-line workers directly engaged in caring for COVID-19 patients experience symptoms of depression, anxiety, insomnia, and distress. They are at high risk of getting infected and some of them have died. The ever-increasing number of confirmed and suspected cases, overwhelming workload, depletion of personal protection equipment, lack of specific treatment, feelings of being inadequately supported, and seeing unimaginable scenes of suffering and death may all contribute to the stress of health care personnel, especially those responsible for triage and making decisions about who will or will not receive ventilators. An article published on March 23 in The New England Journal of Medicine estimates that the number of American patients who will require a ventilator for the coronavirus could be as high as 31 per machine. Imagine having to explain to a family that they have to take a ventilator off to give it another who has a better chance of survival. There are clear guidelines and doctors follow them. But these guidelines do not protect physicians from psychological stress. Many physicians may suffer from post-traumatic stress and moral injury (trauma of violating your own conscience) for a long period after the pandemic has gone.

Under these situations when we experience things that feel threatening to us, we don’t generally feel safe and we start to feel anxious. When we feel helpless about what will happen, it causes anxiety. Prolonged anxiety may lead to depression. People feel more on edge than usual. They feel angry, helpless, or sad.

Here are some suggestions to help cope with the stress caused by this epidemic. In some situations, people in great distress must seek professional counseling. One wife complained that “I feel like a pressure cooker in this house. It’s definitely way too much togetherness.” A pregnant lady complained about “What if we get the virus? What if you get it and can’t be there when he’s born? What if I get it and they isolate the baby”? Another obsessive-compulsive lady nags her family to constantly wash their hands and use hand sanitizer. A husband may be watching TV to divert his attention and his wife shouts about the latest infection rates or death toll. One wife realized that her husband lost half of his money in the stock market which ruined him financially and was now also losing income from his business. She was concerned that he might harm himself. Unfortunately, we are also seeing an increase in incidents of domestic violence and child abuse. However, despite the rise, little is being done to stop this and women and children are at risk by staying with an abusive partner at home.

What can we do to relive anxiety, fear and depression?

Take the necessary precautions

Wash your hands for 20 seconds at a time, try not to touch your face, keep a distance of 6 feet from one another, don’t shake hands, open doors with your closed fist or hip, use disinfectant wipes or sanitizer when available, wipe the handles at grocery stores and at gas stations. Cough or sneeze into a disposable tissue and immediately discard. Use mask if you are going outside.

Do not use unproven remedies

Social media is flooded with false claims of cures of coronavirus. These untested and unproven treatments may be toxic. Some of these false remedies include use of snake oil, drinking household bleach, gargling vinegar, or using a hairdryer to blow hot air into your nose. If you read or see something that purports to prevent or cure Covid-19, go to a reputable source such as the Center for Disease Control and Prevention or the World Health Organization to confirm.

Things you can do to support yourself

Take breaks from watching the news or social media. Hearing about the pandemic constantly can be upsetting. Try to eat healthy and do your daily exercises at home. This is one way to help stay grounded when things feel beyond your control.

Stay connected and reach out if you need more support

Talk to trusted friends about what you are feeling. By sharing accurate information about COVID-19 you can help make people feel less stressed. Social distancing does not have to mean social isolation especially with modern technologies available to many of us. Video calls with friends and family can help. Take the time to calmly and confidently talk with your child about the pandemic. Reassure your child that they are safe. When schools are closed, create a schedule for learning activities and relaxing or fun activities - take time to relax and focus on the present.

Life and death are in the hand of God. At the minimum you should take care of the following items if you have not done so.

Make sure you have an updated will including, a clear statement of your assets and liabilities, bank accounts,  investments and businesses.

Identify guardians and executor of your will.

End of life decisions. Who should decide to remove the life support systems?

It is normal to feel stressed!

Fear, worry, and uncertainty about your own health status, as well as that of your loved ones, are common. Each one of us experiences anxiety and sadness at some point in our life and most of us are experiencing these now. It is especially important to be aware of the signs of stress so that you can act or consult a healthcare provider. Talking to those you trust is a helpful way to reduce feelings of isolation, anxiety, fear, boredom, or vulnerability during social distancing, quarantine, or other safety measures.

This pandemic reminds us that we are all equal, regardless of our culture, religion, occupation, financial, or social status. By being “locked in,” we have developed a sense of supernatural control and oppression. This should make us aware that millions of people in the world have spent their whole life under oppression and misery. This experience should make us realize our powerlessness and I hope we can give up our big egos and become humble. A single virus can make this world “stand still.

Our reaction to COVID-19 is a sign of humankind’s smallness and vulnerability. I hope in addition to making us feel afraid and unsure, it is also making us more pragmatic and more open-minded, more sensible, more compassionate, and more understanding. We should maintain a sense of hope and improve our sense of control and endurance.

What does the Quran say about such a grave human crisis? If we go through the chronicles of the previous nations in the holy book, we find that many communities and nations were destroyed as a punishment to transgressions, sins, disobeying God, violating natural order and corruption, ingratitude to God and oppression of people. The community of Prophet Shoaib a.s., community of Prophet Lot a.s., the community of Prophet Saleh a.s., the community of Prophet Noah a.s, the community of Pharaoh and the community of Saba are some of the nations who were destroyed for their transgressions and sins.

I believe that there is a divine purpose behind everything that happens. It reminds us of the shortness of life and of what is most important for us to do, which is to help each other, especially those who are old or sick. We should realize that all we need to survive is water, food, and clothes; not all the luxuries we are so used to. We can be calm, or we can panic and see it as the end of the world and, consequently, cause ourselves more harm than good.

Many see the Covid-19 virus as a great disaster. Actually, it is giving us an opportunity to change and adopt a right path. God has given us free will to learn from this experience and to choose our path. We should revisit our priorities in life and re-evaluate our paths to serving humanity as the supreme goal of life.

Dr. Basheer Ahmed MD is a former professor of Psychiatry South Western Medical school Dallas, TX and chairman emeritus MCC for Human services North Texas. 


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