Isolation during COVID | City of Hope

COVID-19: Coping with isolation and anxiety

Jeanelle Folbrecht, PhD
Jeanelle Folbrecht, Ph.D.
A pandemic has frayed the fabric of American life as entire cities stay home trying to flatten the curve of the novel coronavirus’s spread. Ironically, some who have faced cancer already have experience with measures recently adopted across the U.S. — avoiding public places and engaging in social distancing out of worry about infection — as well as dealing with the accompanying feelings of isolation. Even so, this is a moment of heightened anxiety among many patients, survivors and caregivers.
With these people in mind, Jeanelle Folbrecht, Ph.D., head of the Division of Psychology in City of Hope’s Department of Supportive Care Medicine, shares a few ideas for how — and how not — to cope emotionally and psychologically with the outbreak of COVID-19.
DO: Stay connected to people.
Keeping people at a physical distance doesn’t have to mean distancing yourself from people. Your outlet might be regular phone calls, texts or video chats with those who are important to you. Among children and young adults, online gaming is also a popular way to stay connected with others — this is the good type of screen time.
“I hate to see someone withdraw and not get the support they need,” Folbrecht said. “Loneliness is going to be a big part of the stress we all feel, so reach out to others and tell them what you need.”
DO: Get up and move.
Exercise is an excellent stress reliever. In places where it’s allowed, you might get outside, even take a walk — as long as you practice social distancing. If not, look for ways to stay active indoors or in the yard.
“I’m afraid that people are not going to move enough,” Folbrecht said. “I’m encouraging my patients to figure out how they can move at home. You might climb onto that exercise bike you haven’t used for a while, or just stand and pull one knee up, then the other.”
DO: Practice self-care.
It’s difficult for many of us — especially parents and caregivers — to find the opportunity to care for ourselves. In the moment, this might be as simple as stopping, centering yourself and taking a deep breath. But it’s also a good idea to set aside a little time for yourself.
What to do with that time? Mindfulness meditation and yoga can help to bring down your overall stress level. For guided meditations, Folbrecht recommends the smartphone apps Calm and Headspace. She also notes that a number of yoga studios are offering free online classes.
Importantly, self-care will look different for different people.
“We have to recognize that everybody has individual needs and their own ways of coping,” she said. “It helps to find something in your day that in a small way acknowledges the things that are important to you in your life.”
DO: Seize opportunities for humor and fun.
Living in the shadow of a pandemic can draw our thoughts to a lot of doom and gloom. So seek out a little bit of levity, whether it’s a text thread sharing jokes with friends or a family game night. Doing so can help counteract anxiety.
“Coping can absolutely be about creating moments for laughter and fun,” Folbrecht said.
DO: When a loved one is worried, listen before you comfort.
Spending most of the day at home with loved ones can mean that their stress becomes your stress. How you respond to difficult emotions as a parent or caregiver makes a big difference. Folbrecht advises that instead of trying to immediately fix things, you first take the step of asking questions and listening intently.
“As parents, as care providers, we have certain concerns or fears, but our loved one might be worrying about something totally different,” she said. “Asking can always be helpful. It’s all about checking ourselves to make sure that we’re addressing the concerns that the person is actually having.”
DO: Maintain — or establish — structure.
The exceptional circumstances surrounding the COVID-19 outbreak tend to throw the rhythms of our daily life off beat. One good way to respond is by maintaining some sort of structure.
This could be a set wake-up time or dinnertime, a steady work-at-home schedule, or certain chunks of the day dedicated to teaching for parents pressed into service as educators. Structure helps us pass long days without the desolation of boredom, makes us feel more productive and imparts some sense of normalcy.
“Keeping normalcy is important for all of us,” Folbrecht said. “Consistency provides a huge comfort for both children and adults. It can be like a safety net.”
DO: Demonstrate gratitude. 
"Expressing, and receiving, gratitude makes us all feel happier and a little less stressed," Folbrecht said. "Gratitude helps us connect during difficult circumstances in a way that acknowledges our humanity and worth. We all need to know and feel that what we do is valuable and important. So find some way to share your gratitude with another, maybe through a card, email, a meal dropped on the porch, or other creative ways. You will make not just that person's day, but yours as well."
DO: If you need it, seek help from a professional.
With this unfamiliar and ubiquitous source of stress, it’s normal to feel anxious or depressed. So how do you tell if you or a loved one should seek help managing mental health?
"We will all feel irritable or might have troubles with sleep" during this stressful time, Folbrecht explained. But when worry and disappointment reach the point that all motivation is gone, we can’t get out of bed, or we withdrawal from friends or family members, that is the time to reach out for a bit more help. "If you don’t have a counselor, call your physician if you have these symptoms or feel hopeless," she said.
While many people are delaying certain aspects of health care — from an optician’s visit to elective surgery — now is not the time to put off coping. The help is out there. In fact, there’s a COVID-19-driven boom in mental health professionals who offer counseling via phone or video chat.
Folbrecht said: “It’s OK to reach out for help — it actually demonstrates strength. It’s much easier to find help, and at City of Hope, we are open for business if our patients need support through this crisis.”
City of Hope patients seeking assistance managing their emotions should contact their clinical social worker or the clinical social work office at (626) 218-2282, she said. The clinical social worker will evaluate their needs and work with their physician and members of the Department of Supportive Care Medicine to assure that those needs are addressed.
Additionally, patients ages 18 to 39 can check the City of Hope young adults Facebook page  for information on connecting with other young adults undergoing treatment and survivorship programs for additional support.
DON’T: Develop bad habits.
Some ways to feel better in the moment can have undesirable consequences over the longer term. So resist the urge to overeat or to abuse alcohol or other substances.
“I’m recommending that people keep an eye on what they’re consuming, not let it get out of control and avoid some of those less-than-helpful means of coping,” Folbrecht said.
DON’T: Binge on the news.
These days, nearly every headline or news segment concerns the coronavirus pandemic in one way or another. Many of us feel the compulsion to remain plugged in, but such wall-to-wall coverage tends to fuel anxiety.
Consider tuning out from time to time.
“This is going to be a long haul,” Folbrecht said. “Sometimes you kind of have to limit your media exposure.”