Actions to Take to Mitigate Stress on the Front Lines
Photo by Paopano via iStock
“We'd like to thank those of you on the front lines of the COVID-19 crisis. To the medical workers, first responders, cashiers in our grocery stores, farmers, delivery drivers, and countless others, we appreciate you taking care of our society. The work you are doing is incredibly important and does not go unnoticed. We want to take a moment to show our appreciation and let you know we recognize that caretaking in times of stress, emergency, and other disasters has its own set of challenges. We are here for you and hope to help you combat negative mental health issues down the line.”
Sarah Adler, Chief Clinical Officer
How is this stress different from the stress of the public?
Sources of stress for the front line can take many different forms depending on the type of disaster. In the case of COVID-19, you are all faced with exposure to the virus, risk of personal harm, and risk of transmitting the virus to your loved ones. This loss of control leads to the kind of chronic stress that can have lasting effects.
At Octave, we want to ensure that you, who are taking care of the rest of us, can take action to protect yourself from the consequences of chronic stress. The stress itself may not be preventable, but you can arm yourself with both knowledge and tools to help you mitigate the risk. These actions can help you now during the acute phase of the event, and will serve you well after in preparation for what might come next.
What are the signs of stress?
Bodily sensations and physical effects: Rapid heart rate, palpitations, muscle tension, headaches, tremors, gastrointestinal distress, nausea, inability to relax when off duty, trouble falling asleep or staying asleep, nightmares or flashbacks
Strong negative feelings: Fear or terror in life-threatening situations or perceived danger, anger, frustration, argumentativeness, irritability, deep sadness, difficulty maintaining emotional balance
Difficulty thinking clearly: Disorientation or confusion, difficulty problem-solving and making decisions, difficulty remembering instructions, inability to see situations clearly, distortion and misinterpretation of comments and events
Problematic or risky behaviors: Unnecessary risk-taking, failure to use personal protective equipment, refusal to follow orders or leave the scene, endangerment of team members, increased use or misuse of prescription drugs or alcohol
Social conflicts: Irritability, anger and hostility, blaming, reduced ability to support teammates, conflicts with peers or family, withdrawal, isolation
What are actions a person can take if they’re showing signs of stress?
Make stress management your number one task.
Know your own personal signs of stress. Think back on other times of stress in your life and take a look at the list above. What can you learn from that time, looking back, what did you think and feel? What types of things worked to help you? What made the situation worse? Pay attention to when these signs show-up and have a plan ready to use the strategies that have worked in the past.
Lean on your community for support.
Now that you are aware of your triggers and your plan to cope, share with your co-workers and loved ones so that you can create a community plan. I know that those of you in the helping professions (I’m looking at you Physicians), can often have a hard time sharing your vulnerabilities. Your strength is what often carries you through tough times, but a critical piece of self-care is community care. When you share with your community, you can help each other when in need. This is what makes strong teams and strong systems.
Try to find some self-compassion.
Be aware that sometimes people reach a limit in their abilities to continually provide care and empathy to others. This is known as “compassion fatigue.” Accept when you need to take a break and get some support.
Find a buddy to practice stress relief when you are off duty.
This can be a co-worker, partner, friend, or other buddy. Plan a walk, run, hike, (six feet apart of course), Facetime/Skype for 15 minutes, even over the phone if that works best for you.
Start a mindfulness practice.
It is widely accepted that mindfulness reduces stress. Now that science has caught up with 3000 years of anecdotal evidence, now is the time to start your practice. Even 5 minutes a day to start can yield benefits. Check out Headspace.com for some free options.
If mediation isn’t your thing, there are plenty of other ways to practice mindfulness. You can listen to music that is timed to your breath, or just focus your attention on any object, and describe it as if you were from another planet and hadn’t ever seen it before.
Do a breathing exercise, taking ten deep breaths. Five counts inhale, hold at the top, and then exhale slowly for 7 counts. Repeat 10 times. Check out this article, where Octave Therapist and Clinic Director, Kristen Scarlett guides you through 3 different breathing exercises.
Prioritize sleep and daily routines.
Sleep is controlled by biological, social, and environmental time-keepers. These include the amount of light we are exposed to, time-of-the-day when we eat our meals, exercise, interaction with others, and many more. The key to maintaining good sleep patterns is to keep to a schedule so that the body recognizes the cues it needs to know when to sleep. This means, eating, exercising, even saying hello to a friend at the same time every day can help. See our blog post on sleep here.
Reduce your stress when you are on duty.
Even if you think you know, review your duties at the beginning of each shift. The more confident you are in your role, the less stressed you will feel. Also, we recommend trying to keep to routines. Eat at the same time if you can, pace yourself, and take breaks. Lastly, check in with your work buddy to assess if they are showing signs of stress, and if they notice that you are.
Take care of yourself when you are off duty.
First and foremost, fuel your body when you can, avoid excessive sugar, caffeine, tobacco etc., and prioritize rest and try to sleep. In addition, increase your social contact. Just because you are physically distant does not mean you have to distance yourself from contact. Pick up the phone, video, or shout from the rooftops. We also recommend reducing the physical tension you hold in your body with exercise or stretching. Take deep breaths, walk, skip, jump. Do arm circles or jumping jacks. If you notice you are holding tension in your body, move it. Lastly, talk to someone about your feelings. If you are feeling overwhelmed sharing with another person can help relieve the tension. If there is no one who can hold your emotions and be supportive, you can always journal.
References and Helpful Resources
Substance Abuse and Mental Health Services Administration Disaster Technical Assistance Center (SAMHSA DTAC)
Toll-Free: 1-800-308-3515
Website: https://www.samhsa.gov/dtac
Administration for Children and Families*
Website: http://www.acf.hhs.gov
Department of Veterans Affairs*
National Center for Post-traumatic Stress Disorder (PTSD)
PTSD Information Line: 1-802-296-6300
Website: http://www.ptsd.va.gov
Treatment Locators
Mental Health Treatment Facility Locator
Toll-Free: 1-800-789-2647 (English and español)
TDD: 1-866-889-2647
Website: http://findtreatment.gov/
MentalHealth.gov
MentalHealth.gov provides U.S. government information and resources on mental health.
Website: http://www.mentalhealth.gov
Substance Abuse Treatment Facility Locator
Toll-Free: 1-800-662-HELP (1-800-662-4357) (24/7 English and Español)
TDD: 1-800-487-4889
Website: http://www.findtreatment.samhsa.gov
Hotlines
Disaster Distress Helpline
Toll-Free: 1-800-985-5990
Text: “TalkWithUs” to 66746
Website: http://disasterdistress.samhsa.gov
National Suicide Prevention Lifeline
Toll-Free: 1-800-273-TALK (1-800-273-8255)
TTY: 1-800-799-4TTY (1-800-799-4889)
Website: http://www.samhsa.gov
This resource can be found by accessing the Suicide Prevention Lifeline box once on the SAMHSA website.
National Domestic Violence Hotline*
Toll-Free: 1-800-799-SAFE (1-800-799-7233)
TTY: 1-800-787-3224
*Note: Inclusion of a resource in this fact sheet does not imply endorsement by the Center for Mental Health Services, the Substance Abuse and Mental Health Services Administration, or the U.S. Department of Health and Human Services.
We at Octave are grateful for all of you on the front lines. Thank you for all you do.
by Sarah Adler
Chief Clinical Officer, Octave