By Paul Hinckley, Occupational Health Advisor at Staywell Occupational Health – 30th March 2020

One thing that has set Coronavirus apart from other infectious diseases is that it comes with a huge fear-factor for most people. Even the word “pandemic” sounds scary.

The speed with which this virus has spread throughout the world has surprised many and the fact that anyone can be infected, young or old, has understandably created a lot of anxiety amongst people. The old adage of “keep calm and carry on” has now been superseded by a call for compliance and a rush to search for information and advice on how best we can protect ourselves.

To feel stressed and anxious at this uncertain time is a perfectly normal, human response. The existence of Coronavirus has meant that we have all had to make changes to our lifestyles, reorganise our routines and relinquish the autonomy we once had to make our own decisions about the way we live our lives. Unfortunately, accepting change and relinquishing control are two things that human beings tend not to be great at.

When we feel anxious, one of the first things to naturally happen is that our threat appraisal increases, sometimes to an irrational level. The threat posed to our health and wellbeing by Coronavirus is very real, and we are right to be concerned, but it is important to try to keep things in perspective as much as possible. The most effective ways to do this are by keeping up to date with official sources of information that tell us how to protect ourselves, and also by understanding the natural, biochemical processes that lead to stress and anxiety in ourselves at such times.

Stick to reliable, approved sources of information, such as www.gov.uk and www.nhs.uk. Avoid the unofficial sources of information found on social media, as these will only fuel uncertainty and create more confusion.

The Science behind stress

Remember that your stress response is entirely normal and will include a physical as well as a psychological response. Historically, the first understanding of the human stress response was published in the 1930s by Professor Hans Selye. He was a physician, with a speciality in endocrinology, and his work was based on monitoring the biochemical, hormonal responses to excessive pressure. His general adaptation syndrome model was based on three stages: alarm reaction, resistance and exhaustion.

The first “alarm reaction” embodies the well-known “fight or flight” response: stand and fight the threat, or run away and live to fight another day. Under normal circumstances, this response is usually sufficient to recognise the threat and deal with it effectively. The body will then enter the “resistance” stage, where it effectively restores the biochemical balance and repairs itself. If the exposure to stress is prolonged, the body will remain on high alert, and will fortify itself to cope with a higher level of stress than would normally be expected. Whist this sounds great, it’s not good news for our blood pressure which, if elevated for long periods of time, can increase our risk of cardiovascular disease, heart attack and stroke. The higher concentrations of the stress hormones cortisol and adrenaline can also lower concentration levels, and make us feel irritable, angry, emotional

There can be a number of other sources of stress in our lives: work, relationships, financial worries etc. and the build-up of these can cause a layering effect. If the resistance stage continues for too long, without pauses to offset the effects of stress, this can lead to the exhaustion stage, which can be overwhelming to the individual. 

Classic signs of the exhaustion stage include fatigue, burnout, depression, anxiety, and decreased stress tolerance. The physical effects of this stage can also weaken our immune system, and therefore increase the risk of other illnesses. As you can see, if the process is not addressed, it becomes a vicious circle.

Professor Selye himself said that one of his biggest regrets was coining the term “stress”, as it has subsequently become wrongly used, out of its original context, to nowadays refer to psychological disorders and mental health conditions. Selye said that, with hindsight, he would have instead probably chosen the word “strain”; he recognised that, being an Austrian-born Hungarian citizen, who emigrated to Canada to complete his research, something was very probably lost in the translation and in his understanding of the English language at the time.

What can we do to help ourselves during this present situation?

• Understand that it’s perfectly normal to be anxious and worried about the threat of Coronavirus.

• Appreciate that “stress” is a normal biological response that is a reflex action and beyond our own intervention.

• Try not to “overthink” everything. Look at things that are within our control (such as staying at home, social distancing, handwashing etc.) and follow the current recommended best practice. Try not to worry about those things at a strategic level over which we have no personal control.

• Think about the stages of “stress”, and understand the negative physical effects that it can have on our health if it is left unchecked.

• Be aware of the signs of “stress”, so that you can act on them and avoid the exhaustion stage.

• Talk to people. Stay in touch with work, family and friends through appropriate means of communication.

• Make time for some exercise and get some fresh air and daylight if you can go outside.

• Split up large, potentially overwhelming tasks in to small, achievable steps, and give yourself credit when you achieve each one.

• Set a “to do” list to help if your concentration is low. You will then have evidence of what you are capable of achieving.

• Try to establish a regular sleep pattern. Have a set time for going to bed and getting up.

• Try to eat well. Avoid junk food and binge eating, and keep your alcohol intake within sensible limits.

• Make some time for yourself. Watch a movie, listen to your favourite music, read a book, cook a meal, draw or paint a picture… the list is potentially endless.

• Don’t be afraid to ask for help. If you can’t confide in colleagues, family or friends, there are many great online resources, such as Living Life to the Full (www.llttf.com), NHS Every Mind Matters (www.nhs.uk/oneyou/every-mind-matters) and Mind (www.mind.org.uk).

• To talk to someone if you feel hopeless or suicidal then a great resource is the Samaritans. Call free, 24 hours a day, on 116123, or visit their website (www.samaritans.org). If you have a mental health condition and have problems with your medication, or feel that you are in crisis, then seek help from the nearest hospital Emergency Department.