stress management

Dr. Stephanie Knight, assistant professor of psychiatry at the School of Medicine, offers suggestions on managing stress and anxiety as we cope with the COVID-19 crisis.

Stephanie Knight, MD, FAPA, assistant professor of psychiatry at the University of Maryland School of Medicine and chief of psychiatry and vice president of the medical staff at the University of Maryland Medical Center-Midtown, offers some tips for stress management during the chaotic times brought on by the novel coronavirus (COVID-19) pandemic:

Take a break

Take a break from conversation about the coronavirus. It can be distressing to hear stories about the disease or read news coverage constantly. Set time limits and stick to them. Dr. Knight suggests making sure you have at least two conversations each day that aren’t about coronavirus. This is especially important if you work in health care.

Focus on Your Health

Don’t neglect your physical health. The Centers for Disease Control and Prevention recommends trying to eat healthy, exercise regularly, get plenty of sleep and avoid alcohol and drugs. Even if you are working from home, it is important to find time to stretch your legs. “Put your phone on speaker and walk around the room while you’re on a call,” Dr. Knight says.

Stay Connected

Practicing social distancing doesn't mean that you need to isolate yourself. Reach out to others. Call up a friend or family member and use them as a sounding board as you process your thoughts and feelings. There are many ways that you can stay connected.

Control Your Perspective

We have control over very few things in this pandemic, and the uncertainty of every situation adds to our individual and collective distress. However, you always have domain over your PERSPECTIVE. If you find yourself in one of those “moments” — head propped up on your hands, feeling like what you’re doing won’t be enough, overwhelmed by all of the to-dos racing through your brain, etc. — don’t try to muddle through it. Take a deep breath and focus: 

  • Remind yourself why you’re here.
  • Know the detailed ins and outs of your role, your program’s plan of action, and/or your part in the larger algorithm. Confusion seems inevitable in these situations, so when it comes time for a tough choice, you’ll know the key elements already and can make an efficient, impactful decision.
  • Have at least two non-work-related, non-COVID-19 casual conversations each day. You are a valuable human being and you deserve some relief!
  • Keep something on you or in your office that has a comforting smell that you associate with a positive memory. When you need to calm down and refocus, triggering your olfactory pathways with that scent will get the job done!
  • Don’t let teleconferencing/video meetings keep you in your chair for too long. Put your phone on speaker and walk around the room while you’re in the meeting. Get up and move!
  • Reach out to your support network! Call up your mentor from years back and use them as a sounding board. They’ll be glad to hear from you and grateful that you still revere them.
  • Remember that RIGHT NOW you are living the moments that you will reflect on in five, 10, 20, or 30-plus years when people ask you about how the Pandemic of 2020 affected you. Get in the moment. 

Make yourself do these things as routinely as you get up and go to work. Self-care is most effective when it’s part of your everyday life. 

Frozen Orange Technique 

Here’s another tip called the frozen orange technique. This can be helpful for anxiety, acute distress, or any kind of emotionally overwhelmed state of being. It’s a quick, straightforward method to bring you back to center and ground you in the moment. 

Put a ripe orange in the freezer and keep it in there until you need it. When you’re feeling especially anxious, overwhelmed, or frenetic, give yourself five minutes to do some “Minute Maid Mindfulness,” as I’m calling it. Focus on your experience using all five senses: 

  • Slow down your breathing and relax your shoulders. Cup the orange in both hands and focus on its coldness. The temperature of the orange will naturally slow down your heart rate and reduce your anxiety level. For an added calming effect, hold the orange to your face near your temple.
  • Look at the orange, noting its color and shape. If you’re having trouble focusing, then count the dots in the orange skin to improve your concentration.
  • Scrape the peel with your fingernail, taking note of any juice that sprays out. Smell the scratched area of the peel. If the aroma is associated with calm or happy memories, then allow those to come into your mind. If you don’t already have positive associations with an orange scent, then create it now! Experience your new sense of calm and couple it with the smell of the fruit.
  • Begin to peel the orange. Attend to the sound that’s produced as the rind pulls away from the fruit.
  • As you remove the outer rind, imagine depositing your stress and anxiety into the peel. When you’re finished, throw those “feeling peelings” into the trash as a cleansing conclusion to your Minute Maid Mindfulness. If you need a boost of energy, prepare the rest of the orange so you can enjoy it as a snack.
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