Quarantine and social isolation: Coping in the age of COVID-19
You may be one of the several million people who have been forced to
stay at home in isolation or quarantine due to the outbreak of the
coronavirus (COVID-19). Social distancing and interruption to our
everyday routines is a challenge for everyone, but if you live with
obesity, you may experience the challenging times of living under a
world-level threat especially difficult regarding weight management.
In order to make life just a little bit easier and help you cope
with the situation, we asked Dr. Michael Vallis (MV
hereafter), a health psychologist and Associate Professor of Family
Medicine at Dalhousie University, Canada to explain some of the
emotional reactions that people are having to the coronavirus pandemic
and what the healthy ways to cope with the situation are.
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"If you are feeling nervous or fearful, that makes you normal."
-Dr. Michael Vallis, health psychologist, Associate Professor of Family
Medicine, Dalhousie University, CanadaShare ThisShare This
This is general disease awareness information and should not be
understood as medical advice. If you experience symptoms of COVID-19
or have questions, doubts or concerns, you should contact your doctor
and always follow the advice of local authorities.
Q: A lot of people find it hard to cope with having to stay home all
day. Many are nervous or afraid. Why exactly do we react the way we do?
MV: It is generally the case that fear grows in the dark. What
do I mean by this? The natural reaction to the perception of threat,
uncertainty and “what if…” thinking is a host of feelings: anxiety,
worry, fear and panic. COVID-19 brings with it extreme threat and
uncertainty. So, if you are feeling nervous or fearful, that makes you
normal. But it also puts you in the position of needing to manage your
feelings. Low to moderate levels
of anxiety can kick you into gear, but very high levels can
overwhelm or paralyse you.
The most natural response to fear is escape – to get away from the
fear. This worked well for us in primitive times when we could escape
a predator. How do we get away from a stress that we cannot escape,
like COVID-19? Isolation can help you avoid the virus itself but not
the fear of the virus. We go into survival mode and we do what works.
It turns out that for most of us, food
is calming and positive or distracting and numbing. Ask
yourself: Are you likely to turn to food when stressed? If so, would
you be interested in coping strategies that can help you manage stress
and manage the stress-eating connection?
"It turns out that for most of us, food is calming and positive
or distracting and numbing."
-Dr. Michael Vallis, a health psychologist, Associate Professor of Family
Medicine, Dalhousie University, CanadaShare ThisShare This
Because food is experienced as pleasure, stress
eating (and eating when bored) is really a way of coping. Although
not healthy, it makes sense from a coping perspective. I encourage you
to see food as serving a function in this situation. My invitation to
you is to ask yourself: How
can I replace the function of food as a stress manager?
Q: Now that we understand how the COVID-19 situation may affect people,
the central question seems to be: How can people with obesity cope with
the extra stress?
MV: Understanding is an important first step in coping, yes,
but it is only a first step. So now let’s talk about the next steps of
coping. Coping involves several steps:
Step 1: Emotional expression and social support
Fear is normal when there is a threat. Humans are emotional beings
and we will feel both positive and negative emotions, based on our
experience. Threat results in fear, the perception of loss results in
sadness (or depression) and the experience of intrusion results in
anger.
Coping
with these normal feelings is generally associated with
emotional expression and social support. That is, when we are feeling
worried and anxious, we do not have to suppress these feelings.
Finding ways of expressing our feelings (such as talking, writing,
singing or dancing) can help us discharge our feelings. Emotions are
like waves; they come on and if we allow them, they pass. Trying to
ignore or suppress our normal
feelings can make things worse.
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"Ask yourself: How can I replace the function of food as a
stress manager?"
-Dr. Michael Vallis, a health psychologist, Associate Professor of Family
Medicine, Dalhousie University, CanadaShare ThisShare This
Step 2: Engage in coping strategies
Here is where the concept of replacing food as a stress manager comes
into play. If you find yourself eating in reaction to fear, anxiety or
boredom, would you consider practicing coping strategies other than
eating? The good news here is that there are many alternative
strategies that could be helpful. The bad news is that any coping
strategy needs to be learned and will not work right away. We
recommend that people practice any coping strategy many times, say 20
or 25 times, before deciding if that strategy is helpful. I can
summarise general coping strategies into five categories :
Physical calming activities. The stress response prepares the
body for action; stress hormones increase, our muscles tense and our
breathing speeds up – all in an effort to get us ready for action.
Learning to calm can go a long way toward managing stress. Calming
strategies including deep breathing, muscle relaxation and
mental calming. Organised activities such as yoga, tai chi,
meditation, prayer, listening to music, painting, patting a cat or
dog or tending to plants work for many people. I encourage you to be
creative and try things till you find what works for you. These of
course need to be practiced in accordance with your local government
guidance for quarantine.
Physical discharge activities. It has also been shown that activity
can be a good way of managing stress. Walking, running, jumping,
cycling or dancing can be helpful to many if you are able to do it
indoors. You might need to get creative to find a way to discharge
physical energy in a small space. The nice thing about coping
strategies is that every little bit helps. There are many online and
virtual exercises taking place during this time.
Emotional
expression. As mentioned above, humans are emotional beings and
finding ways to experience, express and accept our emotions is very
healthy.
Social support. Connecting to others is an excellent way to
manage stress. Within COVID-19, we are seeing how random acts of
kindness towards others can inspire us all. Even if you are
physically isolated, you can stay socially
connected either online or by calling friends and
family.
Acceptance. I am sure you have heard that “today is all we
have”. Yesterday is over and all we can do is learn from it.
Tomorrow hasn’t happened yet; we are in this moment NOW. Being
mindful of our current state in an accepting and curious way can be
helpful. Mindfulness is enhanced when we think about the core values
that we are committed to. Those of us isolating ourselves are doing
this not just for ourselves; but for our community and the whole
world. Those values can guide us.
"Emotions are like waves; they come on and if we allow them,
they pass."
-Dr. Michael Vallis, a health psychologist, Associate Professor of Family
Medicine, Dalhousie University, CanadaShare ThisShare This
Step 3: Have a meal plan
COVID-19 has changed our physical world. For many of us things have
changed significantly and very quickly. We have more unstructured time
and we are closer to our kitchens than usual. We may benefit by
figuring out how to keep a distance
from our food, especially the foods that we might turn to for
reasons other than hunger.
If you have a daily
meal plan (say, 3 meals and 1 or 2 snacks) it will be healthy to
stay on the plan. Here are some ways to control your eating:
Eat at set times and try to avoid eating at other times.
Eat in one location only.
Sit down and do not engage in
any other activity when you eat.
After you serve yourself a
portion, put the remaining food away so it is not sitting on the
stove or cupboard.
Package food into small bags so you
don't access large amounts of food (especially tempting food) at any
one time.
Consider keeping really tempting food out of the
house.
If you have any further questions regarding COVID-19, please visit
the World
Health Organization and your local health authorities websites.
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Living with obesity – a training camp for the 2020 lockdown
I have been living with obesity for 35 years. Since I was a teenager,
actually. Believe it or not but that puts me in a unique position to
speak about social distancing and social isolation.