5 therapeutic tools to manage stress amid covid

declining mental health is a serious public health concern during the pandemic, with three- to five-fold increases in psychological distress across  canada , the  united kingdom ,  italy  and  around the world .

in canada, adverse mental health effects are even more elevated for  parents . our research shows how  mothers’ mental health has been affected , and a preprint manuscript reveals the possible  impact on fathers . clinical teams are dramatically understaffed to meet population-level needs, and the most common therapeutic ‘self-help’ strategies are inadequate given the challenges of social isolation.

as clinicians who research how to handle tough emotions, we have found that skills from  dialectical behaviour therapy  (dbt) are uniquely positioned to manage unpleasant emotions during lockdown stress. it is vital to consider new strategies to work through inevitable pandemic challenges and build mental health resilience.

1. solve the problem — get your partner to do the dishes.
2. feel better about the problem — don’t stress, because they’ll probably get done eventually.
3. tolerate the problem — accept that you feel frustrated, but say nothing and move on.
4. stay miserable (or make it worse!) — don’t change anything, yell at your partner for never cleaning up and continue feeling very grumpy.

5 dbt strategies

1. catch your mind when it is stuck in negative loops , so that you can come back to the present moment with grounding techniques. for example, identifying five objects you can see, or squeezing an ice cube and paying attention to the sensations it elicits, can redirect attention to the present moment and reduce focus on negative thoughts or intense emotions that you may be experiencing.

2. plan ahead for positive activities  that you can fully participate in during covid-19 restrictions. by scheduling  pleasant events  that demand your full attention and that are important to you (such playing with your children or having a virtual dance party with friends), you can build up positive emotions that soften the blow of more difficult feelings when they happen.

3. when your emotion does not match the problem , counter ineffective emotion-driven urges (that is, when the emotion is too intense, not appropriate for the situation or may be harmful) through opposite actions. try engaging in an activity that elicits an emotion that is opposite to the one you are feeling. for example, if you are really sad and want to hide under the covers instead of getting up to walk your dog or bake cookies for an friend, you could start by blasting  pharrell williams’ happy , or watching a favourite comedy show. although these activities probably won’t make the problem go away, they can help turn down the volume of unpleasant emotions so that you are in a position to problem solve and move on with your day.

4. communicate your needs  for space, time and support effectively while keeping important friend and family relationships intact. try using the win strategy, which stands for “when,” “i feel” and “i need.” in other words, describe the situation factually, express your feelings and opinions (avoid should-ing, and remember people can’t read your mind), and assert by asking for what you need and saying “no” clearly. for example: “when i take the lion’s share of child care during the work week while also trying to work from home / i feel burnt out, tired and irritable / i need you to help with bedtimes during the work week so that i can have a bit of a break and be less irritable during our time together.” and be willing to negotiate for common ground!

5. practise radical acceptance of the current circumstances  to choose a path forward with less suffering and more joy. acceptance does not mean you approve or agree, but instead it allows you to acknowledge your pain and decide to move on, instead of suffering more. start by noticing when you are fighting reality and figure out exactly what needs to be accepted (without judgemental language). practise radical acceptance by reminding yourself that reality cannot be changed and allow yourself to experience difficult emotions that arise. only by accepting current challenges (such as sadness that we can’t give our loved ones tight hugs), can we truly move onto problem solving (such as dropping off a favourite dessert and enjoying it together over a facetime catch-up). be sure to practice acceptance radically, meaning all the way!

leslie e. roos, assistant professor, department of psychology, university of manitoba; emily e. cameron, associate postdoctoral fellow, department of psychology, university of manitoba; natalie mota, assistant professor, department of clinical health psychology, university of manitoba.