Tips & Techniques for Managing Anxiety in a Pandemic

In a period of uncertainty, it’s normal for our body and brain to feel threatened and high states of anxiety are common. This is a normal response and something we can control over time, by taking action to help our body and brain to lower this state of high arousal.

Being in lockdown and having significant changes in rituals and routines in our lives, caused by a pandemic that has wide and scary media coverage is bound to cause a state of anxiety.

Here at Khulisa, as a group of therapists and trauma-informed professionals, we want to share tips and techniques that we personally find work for us and for our clients. This toolkit is an indication of what many of us do as ritual and routine on a daily basis, to keep our own survival response at calm and containable levels.

We hope you find this helpful. We’d love your feedback on what works!

 

30 Second Reset

When you feel a sense of panic, breathlessness, heart-racing, overwhelm:

  1. Stop and acknowledge your feelings, emotions, body sensations
  2. Say them out loud - be kind - remind your brain and body this is a normal response in a time of threat
  3. Steady yourself - feet on the ground, a hand on the stomach, a hand on the heart
  4. Take a deep breath in - breathe into your stomach - feel it balloon out
  5. Breathe out fully - allowing your out breath to be longer than your inbreath - feel your stomach contract
  6. Repeat 3 times or as long as you need until your heart beat starts to slow down
  7. Respecting social distancing - If you can do this with a member of your family safely at home, even better
  8. Now notice what sensation in your body feels good - is it the in-breath? Your slowing heart? Your shoulders releasing? Your jaw relaxing? Whatever it is, focus on increasing this positive sensation
  9. Look around you - what brightens this moment? Blue sky? Sun? Flowers in a vase? A tree outside the window? A picture of a loved one? A happy memory? A nice picture? A piece of music? Whatever it is, focus on this now
  10. Know that in this present moment, at home, you are safe and you can be calm

It may help to keep photos, pictures, memes or other positive anchors close, so you can refocus whenever you need to. Comfort and familiarity are important to ground us.

Restrict phone/social media time – have a social media/news ‘detox’ to reduce negative messaging that builds anxiety. Unfollow, mute or delete posts/contacts that feed into anxiety or a sense of ‘not being or doing enough…’

The following sections provide a range of tools. Try them – you never know what might just make a difference. These are extraordinary times and they call for us to adapt and try a new way of being!

Rituals & Routines

Set new rituals and routines for this new home-based existence. This helps provide a container for our emotions and keep us practically on track each day. These routines and tasks within them help us retain a sense of normality and control.. Create a simple timetable for yourself to keep you (and your family) on track. Things to consider include:

 

  1. Morning exercise (evidence suggests that we need to regulate our body before we attempt to do anything else, so exercising (walking, jogging, yoga or online fitness videos) will help to settle our nervous system, given that our hormones (eg cortisone) are running high at this time of day. It’s also important to regulate your circadian rhythm In the morning, as soon as you wake up as this will also improve your sleep routine and quality. Try to get outside and stand in the daylight for a few quiet minutes every day.)
  2. Morning meditation / appreciation or gratitude rituals (alone or as a family, create a sense of what is positive in the here and now to set up your day)
  3. Nutritious Breakfast (ensure you start the day with healthy fruit, cereals, yoghurt, toast, so that your sugar levels are evened out before the day starts.)
  4. Timed breaks (cut the day into activity chunks, so that you ensure you’re taking regular breaks to move around)
  5. Evening appreciation (spend time - ideally with the family or call/connect with friends virtually to appreciate what you did well during the day and what worked to keep you positive and focused)
  6. Healthy sleep hygiene (start your sleep routine early, ensuring you do soothing activities before bedtime - hot bath, milky drinks, herbal teas, an uplifting podcast, movie, using a meditation app, breathing exercises, journalling or gentle yin/restorative yoga can all help to settle the mind and body before sleep)

The following pages provide a selection of tools/techniques – from 30 seconds to ground you in the moment to longer more concentrated tasks, that will calm mind and body.

30-60 second pattern breaks - Have you tried....?

Breathing exercises

  • 1. Box breathing: Holding in the breath has been found to increase our tolerance of distress in anxious situations. Simply, breathe in for 4 counts, hold your breath for 4, exhale for 4 and then hold your breath for 4 and repeat.
  • Elongated Exhale: When we exhale we activate our parasympathetic nervous system, which is a calming process. If we exhale longer than we inhale, we become less anxious eg inhale for 4 counts, exhale for 8 (or similar).
  • Humming Bee breath: Putting your hands over your ears, so you can fully hear/feel the noise in your mind & body, deep in-breath and hum like a bee as you breathe out. This is a great way to reset your mind and body. Focusing on the sound and where you feel it in your body enables your brain to have a few seconds rest, whilst also oxygenating your whole body. Repeat 6-9 times ideally.
  • Chanting breath: Take a deep breath in and as you breathe out, chant the word ‘Om’. This is a yogic symbol (a Hindu word embodying creation, liberation and preservation). If you prefer to chant a different single-syllable word, that’s also enabling you to be present to your breath and the sound, this is also calming. Whilst it can help to put your hands together over your chest and drop your shoulders, to relax your neck whilst chanting, you could also put one hand on the chest and one on the stomach to notice the movement of the breath and your heartbeat, as this allows you to monitor your own physical movement.

Why breathing, humming and chanting?

Basic vocalizing activates your parasympathetic nervous system, calming you down. The vagus nerve is a long, critical nerve, stretching from your brain down your neck, chest, lung cavity and abdomen, connecting the brain stem to the body. It’s associated with many physical functions including swallowing, taste, digestion and heart rate. Activating this nerve basically tells your brain all is well, stimulating the parasympathetic nervous system to relax you. Your voice box (larynx) is connected to your vagus nerve. Subsequently, when you hum or sing, you naturally activate it. On top of this stimulation, humming requires you to control your inhalations and exhalations. Experts know that, even without humming, the vagus nerve links to respiration, and that slowing down exhalation has a positive effect for calm, activating the parasympathetic nervous system (read more here).

Want to be reminded to regulate your breathing and stay calm?

Try the  Mindbell app – It sets off a gong sound at intervals throughout the day which reminds me to pause what I’m doing and breathe.

 

  • Shoulder mobility exercise  Helps to release tension. Sometimes,  high levels of stress and anxiety restrict our breathing. These exercises not only release tension but  help to loosen up your diaphragm to enable deep breathing  (examples here).
  • Balance exercises Try balancing on one foot or place a tennis ball on a book, hold it with one hand and slowly move your body into different positions (rotating, moving up and down) while keeping the ball balanced on the book. This  gently releases tension in the body/diaphragm and also enables deep breathing, whilst calming the mind,
  • Grounding and Mindful  ‘5 Senses’ exercise  Being present (as opposed to speculating about the future or attaching to the past) can be hard if we’re overthinking. A quick & easy way to get present and calm in the here and now is to focus on:
    • 5 things you can see (textures, colours, details in pictures, plants, flowers etc)
    • 4 things you can hear (birds, traffic, footsteps, dogs, children, breathing, rain etc)
    • 3 things you can touch (feet on the ground, hands in your lap, clothes on skin etc)
    • 2 things you can smell (food cooking, perfume, flowers, cut grass, fresh air etc)
    • 1 thing you can taste (morning coffee, afternoon tea, toast, chocolate! etc)

     This is really useful for adults and young people who struggle to focus on non-tangible/ non sensory activities. 

  • Bouncing a ball Rhythmic, repetitive activities are good for reducing the fight/flight/freeze response in the body. Bouncing a ball, juggling, throwing/catching (safely within your own home) creates a rhythm which is good for steadying breath and heart rate.  Create a rhythm -play with options eg. catch with your left/right hand only, clap once before catching the ball, clap under a knee before you catch etc. Make it fun, keep the rhythm. 
  • Shaking and Wiggle exercise Shaking is the natural way to release tension and return the body to its normal homeostasis (an internal stable state). Shaking is a primal impulse to a stressful situation. This website offers some good guidance and practical tips on ‘shaking the stress away’. 
  • Eye yoga  involves focusing on objects  close at hand and far away. It also involves moving your eyes from the left, upward, to the right, and downward. These small, purposeful movements can help calm your body down. Find out more about eye yoga here. 
  • Tennis ball rolling Sit/lie in a comfortable position.  Scan your body, with your eyes closed,  to identify areas that feel tight and ‘stuck’. Now, roll the tennis ball on that spot – eg. putting the tennis ball under your shoulder blade, laying on your back. Move around with the ball to find the point where the pressure is most intense. Breathe into the pressure,  relax into it, allowing the tennis ball to do the work of breaking up the tension. More info here.
  • Drumming  Well known to reduce anxiety and soothe the nervous system. We respond with our bodies and our limbic system to rhythms, so taking part in anything rhythmic or with a regular beat activates our parasympathetic nervous system. No drum to hand? Improvise! Pots, pans, wooden spoons, tapping your fingers to beat out a rhythm still works. Try this website for more information. 
  • Pillow Beating  Frustration, anger and resentment can accompany feelings of anxiety. Sometimes we just need an outlet for these feelings, particularly when we’re stuck inside for long periods of time. Just pummelling pillows for a few seconds can be enough to release tension and provide an outlet for adrenaline/cortisone that would otherwise remain in the body.

 

3 - 10 minute pattern breaks - Have you tried....?

  • Guided meditations Try the  ‘Calm’ app, headspace or podcasts such as Tara Brach. These really help us ‘sit with’ and process anxiety and uncertainty, and tune into the breath.
  • Body Scans  Sit/ lie in a comfortable relaxed space with your head, neck and back supported. Close your eyes and scan your body from the tip of your toes to the top of your head. Imagine tensing and relaxing each set of muscles – toes, feet, ankles, shins, calves, thigh etc – up through the body and into the head, ending with your eyes relaxing in your sockets and your jaw releasing. You can also imagine a calming energy is soothing your body from the tip of your toes to the top of your head.  This type of body scan helps us recognise and relate to all muscles and become associated with the present moment.
  • Dance Put on your favourite songs and dance around your living room / kitchen / house. Dancing is a great form of exercise and the combination of movement and music release endorphins and relaxes tension.
  • Mindful BIF walking  BIF stands for Beautiful, Interesting and Funny. As we walk,  take time to be curious and pay attention – this helps us to be mindful of our surroundings.
  • Short exercise workouts Create your own 7-8 minute workout to get the body moving, stimulate lymphatic drainage and cardiovascular activity. Exercise is proven to be great for improving mood and brain function. If you need help, there are countless fitness apps available. Do it with someone to keep you motivated – even if it’s via WhatsApp, FaceTime, Zoom or another virtual platform.  (If you need inspiration – try 7-minutes workout, Gymondo, , Fiit)
  • Write a gratitude journal  Spend 5-10 minutes each day focusing on what you appreciate, what you’re grateful for.  It can help to think of 5 things each day, and always include at least one thing that relates directly to your own strengths (some days are harder than others!).  Over time, we start noticing things we’re grateful for as they occur, which helps us remain in the here-and-now. It’s ok and normal if you’re not always consistent with this (we aren’t either!)  – but writing a journal in general helps us manage our thoughts, get emotions out on paper and grounds us in the present moment with how we relate to our world. Writing things out can make space in the brain for new thinking and valuable reflection time.  (Apps available:  eg ‘Gratitude’, which provides daily reminders, positive affirmations, and ideas of what you could focus your gratitude on each day).
  • Forgive yourself  Be compassionate towards yourself and your process. Each day may bring different challenges and different opportunities.  Be kind to you.

15 - 30 minute pattern breaks - Have you tried....?

  • Connect with others over your anxiety Remember it’s a normal response in unsettling and uncertain times. Others will likely relate to how you’re feeling and expressing your experience. This can create relief and reassurance for you both.  It takes courage to own what is going on for you and may lift a huge weight for you and for them.  (Reach out on insta, facebook, twitter – you might be surprised who would love the chance to share with you.)
  • Share appreciation/gratitude  If you’ve worked with us, you’ll know the power of appreciation! Take time with others to share what you appreciate about them and what they appreciate about you. Even the smallest things have the biggest impact.  Make it a dinner table exercise – 1 thing we appreciate about each person, 1 strength we see in each person, describe the best of each person in 3 words. These are simple activities that create positive connection and help us to remain emotionally connected even if we are physically distant through social distancing. During national crises like this pandemic,  we will likely have decreased recognition from others, it can be really helpful to give each other positive reinforcement.
  • Online high or low intensity workouts Sometimes, we’re more motivated by a structured activity – online ‘coaches’ such as Yoga with Adriene, Tim Senesi Yoga or Joe Wicks for High Intensity Hiit workouts (20 mins or less) can provide structure and routine. Joe Wicks has a live daily P.E. workout session for young people at 9.00am each weekday morning.  Nutritious Movement have opened up their virtual studio for $9/month and have some great tips for incorporating more movement into your day. 
  • Emotional Freedom Tapping (EFT) A system that works with acupressure points known as meridian points in the body. It can be used on its own but works best when used, alongside targeting specific emotional states, and the reasons behind them. The points in the body are shown in the illustration below and listed here: 
- karate chop - eyebrow - side of the eye - under the eye - under the nose - chin - beginning of the collarbone - under the arm - top of head

Start by identifying your emotion - one at a time eg “I feel anxious about getting sick”. Rate the intensity of the emotion out of 10. Before you start the tapping, you then say “Even though I feel (anxious)…. About (getting sick)... I completely accept myself”. Repeat this as you tap the “karate chop” point 3 times. Work your way down the list of body points, tapping each one 7 times, ending with your head.

Then rate the intensity of emotion you are feeling after the experience and note by how much it has gone down. Repeat as many times as feels comfortable to you.

Projection work  You can use any object – rocks, pebbles, crystals, wood, glass  – this technique works with literally any object. Pick up the object and hold it in your hand. Concentrate on the feeling of the object:

  • How smooth/rough is it? How heavy is it? Does it feel comfortable in your hand? 
  • What’s the texture like to touch? 
  • Really examine the object and look at it for a couple of minutes. 
  • Now focus your anxiety onto the object. 
  • Say out loud – “Rock/Crystal/Object – I’m giving you my anxiety/stress/panic in a minute. I know you’ll take it from me and then it’s no longer inside me.” 
  • Imagine your anxiety/stress is transferred from you into the object. 
  • You might visualise your emotion as a colour transferring from you to the object, or do this through blowing out a breath – whatever feels right works. 
  • When you’re done,  take 3 breaths and place the object back. 

In summary

All of these activities are things  we’ve personally used and gained benefit from. 

We encourage you to try everything once  – Do one thing you’re drawn to for at least 3 weeks to embed this as a habit in your daily routine!  

Wishing you peace and calm! 

 

For a PDF version of our guide, please click here.

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