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Mental Health Through A Winter Lockdown: A Guide

It has been almost a year since the first reports of cases of a novel coronavirus emerged. Since then COVID-19 has rampaged around the globe, flattening economies like dominoes and leaving in its wake a wave of psychological distress. The initial lockdown from March through to July required significant mental adjustment for all of us. If you were already struggling with your mental health, the likelihood is that the pandemic has worsened it, or has at least slowed your recovery. The full psychological impact of the spring/summer lockdown – both on the general population and on people who were already using mental health services – is not yet formally clear. However, you do not have to be a psychologist to predict that it will have been considerable.

Getting through the summer lockdown felt like a colossal task, and we were only just beginning to emerge from that process. Now here we are facing a long winter of further restrictions on our movements, activities and relationships. More poignant milestones will go unmarked in the usual ways. We do not know how far it will go. We do not know when it will end. Many people are losing their jobs and businesses and some their loved family members.

The truth is, for many people it is going to be incredibly hard. Even harder than it has been so far.

Here are 10 suggestions that might help. They are underpinned by evidence based psychological principles. Please note that this is a generic guide and it will not be suitable for everyone. You should seek personalised advice from your GP or a mental health professional if you have specific difficulties that require specialist input.

1. Make a Plan

Extensive research shows that if you make a plan in advance you are more likely to successfully carry out your intended behaviours.

Make a personalised plan of how you are going to get through this winter. It may sound obvious, but when life is busy and daily demands need to be met, actually spending time thinking about what is going to be helpful for YOU may easily pass you by. Identify a time in the next week when you will be able to focus on this task. Putting in the time to think about this now is likely to pay off in the longer term, even if you feel OK just now.

If you were going on holiday, (we’ll have to imagine) you might write a list of what you need to take with you. This helps you to ensure you have what you need to get there and back safely and comfortably (passport, holiday insurance etc). You are going to need a kind of a list for this next bit;  not a shopping/panic buying list, but  a selection of tools that are specific to you, that are going to help you to alleviate emotional distress when you need to.  Use this guide to think about what you might put in your plan.

2. Identify the emotional resilience you already have

We all have some form of emotional resilience within us. We have all survived difficult things, big or small, from embarrassing situations, to difficult jobs, to dealing with a difficult person in our lives. Try and identify these resources. We often forget or don’t realise we have them. Or we minimise them because we tend to be a bit mean to ourselves.

Reframe them to show the efforts YOU put in. For example if you are thinking of saying: “my friends and family helped me through”  say instead, “I was able to manage my emotions by talking to my friends and family about what was distressing me”.

Write a list of all the difficult things you have got through in your life to date. Beside each one, list all the things that got you through it, as many as you can. Think about what YOU did. Did you cry? Great, you were able to express emotions and not suppress them. Did you find distractions? What were they?

Think about whether you can use any of these resources in a lockdown. If you can use them, put them in your plan. They worked before, so there’s a good probability they will work again. Avoid adding anything that made you feel worse in the long run.

3. Identify your vulnerabilities

Prevention is better than cure. What strategies do you use to manage your emotions that aren’t particularly good for you? Be honest with yourself. We all have them at times. Too much alcohol? Over or under eating? Oversleeping? How would you know these issues are getting worse? What would that look like in YOU? What are your acceptable limits? List all the potential negative consequences that may happen if you used these coping strategies too much during a winter lockdown. Write down what the potential benefits would be if you managed to moderate these behaviours instead. Put both in your plan to remind you.

4. Work on something that evolves

The world keeps turning – even in a pandemic. The sun keeps rising, and the day always ends. You need to keep moving too. I don’t mean physically (though do that too), or by being busy. I mean you need to have something that reminds you that you are still moving forward. You don’t have to get an online degree, build an extension or learn to play an instrument. A small project that you can tend to every day is more realistic. An example might be getting a new seedling that will grow into a plant. Or a craft project you can gradually add bits to like a mosaic, or a collection. It doesn’t have to be any good. The point is, in a time when choice is significantly limited, it’s something you are CHOOSING to do. It’s a reminder that something that is evolving and changing and you are too.

Choose something/anything….don’t overthink it. Big or small, something that gradually changes over time. Put it in your plan. If your plant dies, that’s okay….get another one. It’s not about the plant it’s about the process.

5. Use your senses

Your senses are an effective tool in grounding you in your present. When we are anxious, distressed or sad, we often spend far too much time thinking. Often these thoughts are worries about the future, or memories of the past. Thoughts can feel like they are going round and round in your head. Psychologists call this ruminating. Too much of this makes you feel even worse and can be overwhelming. A good way to stay in your present is to use your senses. Your senses can also have powerful self-soothing qualities.

For each of your five senses – taste, touch, smell, sight, sound – list things that you think would be calming for you. Examples might be: a scent you like such as lemon or lavender, vanilla, or herbs and spices; a cosy blanket; fairy lights; the sound of a waterfall or the sea. Many apps now have recordings of sounds from nature. Put one on and close your eyes. Imagine you are at the beach. Take time to really notice how the clouds are moving, or how the water feels on your skin in the shower. Think about the different textures you can see in the room and try and notice things in your environment you haven’t noticed before. Pay close attention to the detail and describe it in your mind. Use your senses to interact with your environment. Cook something from scratch and take as long as you want over it. Notice all the different colours of the ingredients. Make jams or pickles and enjoy the smells that fill the house. Try and fill your environment with things that work for YOU and your sensory preferences.

6. Make a new friend (yourself)

Consider this scenario: You are teaching someone a new skill; let’s say it’s tennis. You decide the best way to get them to improve is to tell them how bad they are at it, that they should probably not even try because they’re not going to be good enough. In fact, they might as well just go home.

Of course, you don’t really decide to do this, because that would make the person feel terrible, and they certainly wouldn’t get any better at tennis. It is well known that people perform best when they receive encouragement, confidence boosting and empathically delivered constructive suggestions for improvement.

We are better at getting the best out of other people than we are out of ourselves. Self-criticism doesn’t drive us to function and perform better. It is not self-criticism that stops us failing or keeps us “on the right track”. That’s an illusion. You do what you do DESPITE your self-criticism and you can do and feel better when you let go of it.

Consider how often you have said critical things to yourself that you would never say to a friend. Fact: the person you will spend most time with in your life is yourself. You are your closest friend. Do you want to have a supportive friend or a nasty friend following you everywhere? When you notice yourself being self-critical, think about what you would say to a friend in a similar situation, and say that to yourself instead.

Self-compassion is the opposite of self-criticism. Learn about it, read about it, find out how it works and how to become good at it. It’s not about letting yourself off the hook, it’s about helping your brain and body to manage threat in better ways and function better. It’s based on evolutionary theory and it’s fascinating. There is a growing body of research that demonstrates the significant psychological benefits of practicing self-compassion.

Use this socially limited winter to make friends with yourself. Give yourself compliments, admire things about yourself, smile at yourself. Make a choice that you’re going to LIKE yourself. Sound strange? Ask yourself why is it so crazy to do that but it’s okay to emotionally beat yourself up?

7. Make time for humour

Don’t feel guilty for laughing. Laughing doesn’t make this situation any less serious. But it will probably make you feel better and it may shift your perspective enough to help get you through a tough day. Watch a movie or comedy show that makes you laugh. Think of a funny response in conversations (you don’t have to say it out loud). Remember instances where someone has made you laugh. It sounds simple, but do you make time for humour? Or do stress and worry take up more of your time? Make a conscious effort to schedule it into your day. Put it in your plan with examples of what you like and where and to access it, so you don’t have to think about it at the time, you can go straight to it.

8. Make a rescue box

We can use things that are meaningful to us to help manage difficult emotions. Think about how you feel when you look through old photographs from times you have enjoyed, or light candles, or have a bath using a special bath oils. Maybe you have some favourite books that transport you, or a feel-good DVD. Is there an object or a letter that reminds you of someone special to you? A music album you love? If there are things that distract you like crosswords, put in a few of those. Throw in some positive affirmations that you have pre-prepared.

This is also a good activity to do with kids. You’re teaching them how to self-soothe in healthy ways. They can decorate their boxes and choose where in the house to keep them.

9. Try to find balance

Psychologists think that well-being comes from living a life with a balance of activities that give you feelings of pleasure, achievement, and closeness. We are social beings – we need connections to thrive and feel good. We would recommend trying to do at least some activities that are social and involve other people. In times like these you might have to find some creative ways to do social things at a distance. For example, by keeping in touch online or by phone or taking a socially distanced walk.

Getting daylight is key to keeping on top of your mood in winter, so avoid sleeping through daylight hours. Moving your body is also essential. Walk, run, cycle, do some yoga, stretch, lift weights, play frisbee, spend time doing household chores that keep you on your feet. Anything that raises your heart rate will help. Your body will release endorphins which improve your feelings of wellbeing. If you’re having a really down day, exercise is often the last thing you want to do, but it is likely to be one of the most effective ways of lifting your mood. It is also a good way to release unpleasant emotions like frustration and anger. Physical activity can also increase your energy and motivation levels and improve your concentration. In psychology we call the process of increasing activities that lead to feelings of pleasure, achievement, and closeness “behavioural activation”, a first line intervention for depression.

It is also worth taking some time to think about what your values are. In other words, what do you stand for as a person? What is meaningful to you? It could be that it’s important to you to be a trustworthy and loyal friend, an attentive parent, a hard worker, an adventurer, a good team player, to be creative, or to support your local community. When we act in accordance with our values, we tend to see our life as purposeful and meaningful. Our values act as a reference point for who we are, how we respond in certain situations, and where we want to go in life. We are less likely to feel overwhelmed when we face challenging experiences if we manage to stay in touch with our values. When we are distressed it is easy to lose sight of them. Values are ideas, not behaviours. Once you have identified your most important values, see if you can identify an action or behaviour that will bring your life more in line with a particular value.

10. Stop breathing so fast

Most of us breathe too fast at the best of times. When we are anxious our breathing becomes more rapid. We take in more oxygen and breathe out more carbon dioxide (CO2) than usual. However, because the body is not working any harder than normal (as it might if we were exercising) it is not using up any extra oxygen. The CO2 concentration in the blood therefore goes down. This leads to a body state called respiratory alkalosis (temporary change of PH levels in the blood). In this body state we can feel light-headed, clammy, and sweaty. Sometimes it can lead to tingling sensations in fingers and toes or feeling faint. We may find it hard to focus. These feelings can be really unpleasant and focussing on them can make you breathe even faster.

When we slow our breathing oxygen and carbon dioxide levels in the blood return to normal, and the unpleasant feelings resolve. If we interrupt the panic by changing your pattern of breathing, we can initiate the process of feeling better. Slowed breathing gives the body the signal that it is safe and helps reverse the fight, flight or freeze response.

Breathing to reduce feelings of panic/anxiety

When we are anxious or panicking, breathing is fast and forceful, and high up in the chest – we try and get as much oxygen into the body as possible.

If you are anxious, slow, relaxed breathing can feel counter-intuitive. The key is to breath out for longer than you breathe in, for a period of 5-10 minutes. I suggest the pattern below.

Breathe in for a count of 4 (pause), then breathe out for a count of 6 (pause).

The pauses will help slow the whole process down. When you breathe out, imagine you are blowing on the flame of a candle. You want the flame to flicker but not go out. This will also help you slow down your breathing. You might feel a bit light-headed when you first do this, but that is OK. Gradually you will begin to feel relief from the anxiety.

Normal relaxed breathing

Practice your normal breathing as much as possible too. This should be slow and steady and you should feel your stomach rising and falling as you do it.

Breathe in for a count of 4 (pause), then breathe out for a count of 4 (pause). The more frequently you practice normal relaxed breathing, the more your body will realise that it is safe and will relax.

If it all gets too much….

If you’re really struggling, reach out to friends, family, or support services. Remember you are not alone, lots of people are be feeling overwhelmed, anxious, disappointed and lonely just now. Here are some important contact numbers to be aware of.

If someone’s life is in immediate danger, always call 999 straight away

NHS 24 can be accessed by calling 111 on any mobile or landline

Breathing Space:  0800 838 587

The Samaritans: 116 123

Shout

Shout is a 24/7 text service, free on all major mobile networks in the UK, for anyone in crisis. It’s a place to go if you’re struggling to cope and you need immediate help. At the heart of the service is a team of volunteers who take people from crisis to calm every single day.

Text: 85258

Rape Crisis Scotland

provides a national rape crisis helpline and email support for anyone affected by sexual violence, no matter when or how it happened.

0808 801 0302 (18:00 – 00:00)

National domestic abuse and forced marriage helpline

 This is a service for women experiencing domestic violence, their family, friends, colleagues and others calling on their behalf. Confidential and fully trained female helpline support workers.

0800 027 1234 (24 hr)

Fife Women’s Aid

Freephone helpline (24h)

0808 802 5555

Respect: Men’s advice line

Free helpline for male victims of domestic abuse

0808 801 0327

Monday – Friday 9am-8pm