The Importance of Self-Care Amid COVID-19: Coping With Stress in the Time of COVID-19
Stress always exists, but at times like now, amid the coronavirus pandemic, it’s a global phenomenon. As you watch events unfold in your communities and around the world, you aren’t alone if you feel lonely, anxious, and worried.
In one way or another, everyone on the planet has been affected—directly or indirectly—by COVID-19, the disease caused by the novel coronavirus. Our lives have changed as we adapt to physical distancing and shelter-at-home guidelines.
Stress has a measurable effect on our physical and mental health, especially for people living with chronic conditions like Gaucher disease. The good news is that you can easily adopt self-care techniques to help manage and reduce the effects of stress on your body.
Dr. Robin Ely explains the importance of self-care, particularly at this time, for people with underlying conditions like Gaucher disease. Dr. Ely practices integrative medicine, a discipline that approaches health and wellness by considering the whole person, including mind, body, and spirit. A founding member of the National Gaucher Foundation (NGF), she is a Clinical Advisor of the NGF and a member of NGF’s Board of Directors.
What Is Stress?
In 1936, Dr. Hans Selye was the first to define stress as “the non-specific response of the body to any demand for change.” For humans, stressors are anything that puts pressure on our minds or bodies. These stressors can be positive or negative. We all deal with stress constantly.
The word “stress” can refer to:
- An uncomfortable situation, like asking someone out on a date, your boss calling you into their office, or—in our current situation—being isolated from others and worrying about the coronavirus pandemic
- A thing that causes discomfort, like an irritating noise, food poisoning, or a saber-toothed tiger chasing us (keep reading for more on this one)
- Our physical reactions to stress, such as chest pains, stomachache, pounding heart, or shaky hands
“Every organism has a homeostatic set point, or balance point, where everything is operating smoothly,” explains Dr. Ely. “The exact middle is an idealistic number, not an actual reality. That’s because life itself is constantly impinging on you with ‘stressors’ that throw you off that theoretical balance point.”
How Does Your Body Respond to Stress?
Stress can result from emotional causes like anxiety, situational causes like fear, or physical causes like illness.
“When these things occur, depending on the setpoint of the individual—the body will deal with these stressors in a more or less smooth fashion,” Dr. Ely says. “If the body gets exhausted from too many stressors, then it will go into fright/flight/fight mode.” Without thinking about it, you react by freezing (fright), running away (flight), or lashing out to protect yourself (fight).
What is the autonomic nervous system?
Your autonomic nervous system regulates the fright/flight/fight response. The autonomic system is part of your brain and nerve pathways. It controls body functions that you don’t need to think about, like your heartbeat, breathing, and digestion.
Your autonomic nervous system has two different pathways:
- Sympathetic nervous system: The sympathetic nervous system helps your body cope in an emergency. It speeds up your heart rate and breathing so you have more oxygen to help you run. Then it sends energy to your large muscles, such as your legs. It also slows down non-emergency functions, like digestion and urination.
- Parasympathetic nervous system: Your parasympathetic nervous system helps your body stay calm during everyday situations. It manages daily functions like rest, digestion, and healing.
Here’s where the saber-toothed tiger comes in. Imagine you are one of your evolutionary ancestors living in the jungle, when you realize there is a saber-toothed tiger behind you. Your autonomic system will drive your reaction through three phases:
- Freeze (fright): Stopping still is an instant response to fear. “It is a protective mechanism that diminishes a predator’s ability to see and hear you,” explains Dr. Ely. “It has an obvious function: To protect the organism (your body).” You instinctively hold your breath. Your circulation changes to redirect blood flow from your organs to your heart and legs.
- Fight or flight: If the tiger continues, and freezing didn’t change the situation, your body will automatically switch to the fight or flight response. Your pupils dilate so you can see where you’re going. They may contract again rapidly if you’re taking in too much information. Your blood vessels contract in the digestive tract to send oxygen to the legs. Adrenaline, a hormone that lets you run faster and longer before being exhausted, floods your body.
- Exhaustion: In the exhaustion stage, your body’s emergency response system essentially burns itself out.
These responses evolved in response to real dangers, Dr. Ely explains. “Now, we’re not being chased by a tiger. Instead, we’re chased by a multitude of things: Fear of climate change. Right now, fear of COVID-19—of getting sick. People have lost their jobs, which is massive, because the economics of this situation are going to last longer than this spike, and people know that. Today, the ‘saber-toothed tiger’ never goes away, so people are in constant survival mode.”
What is the parasympathetic nervous system?
Your parasympathetic nervous system manages the way you respond to and manage stress. The longest nerve in your body, the vagus nerve, sends messages for your parasympathetic system, running all the way down your torso and ending at the lower parts of the gut.
The parasympathetic nervous system is responsible for:
- Rest: At rest (sleep), your body increases blood flow to the digestive tract. Most of your body’s repair and healing occurs while you’re asleep. In children, most growth takes place while they sleep.
- Digest: When you take in food, your digestive system produces the right amount of acid in your stomach. It moves food through to your small intestine and manages the absorption of nutrients, the elements you need for energy and to maintain your body’s cells. Then waste matter moves to the colon to be ejected as feces.
- Repair: In children, repair includes growth; in adults, it’s wound healing.
- Relaxation: Relaxation is a little different from rest, Dr. Ely explains. “It’s the ability to ‘keep calm and carry on.’ It’s being calm in the eye of the storm.”
What Is Self-Care?
“Self-care is doing those things that help reestablish the balance of the parasympathetic nervous system,” explains Dr. Ely.
You can’t change your body’s response to fear—and you wouldn’t really want to. But you can practice self-care to ease the way your body responds to stress.
Dr. Ely uses the metaphor of a ship in stormy waters to describe the experience of an imbalance between the sympathetic and parasympathetic nervous systems. When your system is imbalanced, it’s like a rudderless ship that’s tossed and turned in the waves. Without anything keeping your system on course, it’s at risk of capsizing and sinking.
The parasympathetic nervous system is the captain of the ship. It helps steer the ship through the waves. Self-care practices that enhance your body’s ability to rest, relax, and heal can act as tools to support that “captain.”
“Taking care of ourselves in the different ways that we can discuss makes it much more likely that we’ll be able to get that ship back on course,” Dr. Ely says.
Why Is Self-Care So Important for People Living With Gaucher Disease?
Our bodies are amazingly resilient, meaning they bounce back from damage. Some people, however, are more resilient than others—and everyone’s body becomes less resilient with age. People living with Gaucher disease or any other health condition are coping with a constantly elevated level of physical stress.
Even with successful Gaucher disease treatment, your body has an underlying level of chronic (ongoing) inflammation (your body’s process of fighting against toxins). This inflammation puts stress on your body. Stress and inflammation can raise your risk of getting sicker with any illness.
The good news: When you acknowledge that reality, you can make the most of your current level of health and well-being and boost your immune system. Practicing good self-care can reduce stress. It can also strengthen your body’s reserves so you are more able to bounce back from physical or emotional challenges.
4 Self-Care Practices You Can Start Today
Dr. Ely divides self-care into four main areas. Anyone can incorporate these self-care practices into daily life.
“The breath is the single most important, most powerful element of self-care, bar none,” says Dr. Ely. While there are many breathing techniques you can use, Dr. Ely recommends a simple technique called “box breathing” or “4-4-4-4.” It’s called box breathing because the technique includes four steps, just as a box has four sides:
- Inhale for a count of 4. Inhale through your nose.
- Hold for a count of 4. While you are holding your breath, it should be a gentle pause. Try to relax your muscles.
- Exhale for a count of 4. Exhale gently through your mouth. Make a “shhh” sound through your teeth, or purse your lips like you’re blowing out through a straw.
- Hold again to a count of 4. Again, don’t clench your muscles while you hold.
You might breathe faster or slower depending on your current lung capacity. “Initially, people who are in a really stressed out state can’t do it slowly,” Dr. Ely notes. “But if a person wants to immediately activate the parasympathetic nervous system, box breathing is very effective.”
Dr. Ely recommends five minutes of box breathing about four times per day. “Some people will want to do it every couple hours. The more you do it, without being obsessive, the better off you are. You can constantly be putting your body back into balance over and over again.”
There are many forms of meditation, Dr. Ely notes, but ultimately all of them share the purpose of quieting what some traditions call “the 10,000 thoughts” or “monkey mind,” the busy, darting part of our thoughts. You can find many guides to meditation online, in books, or in apps like Insight Timer.
“For example, if I’m looking at a tree outside the window, I could think about what species it is, what stage of vegetation it’s in (analyzing). Or I could just look at the tree and perceive it and feel the beauty of it within me (receiving),” she says.
Meditation is really being in a receptive state, Dr. Ely says. For a simple meditation:
- Set a timer for 10 or 20 minutes.
- Sit up straight and still in a chair, on the floor, or on a cushion.
- Focus on your breath, noticing each inhale and exhale. Or you can repeat a word or phrase, like “one” or “I am here,” as you breathe in and out.
- If you notice yourself thinking or planning, visualize the thoughts as clouds that are passing by. Let them go and return to your breath or your word.
“Our culture talks a lot about aerobic exercise, like running—but those exercises are more about overdrive, about activating the sympathetic nervous system,” Dr. Ely says. “Doing exercise that doesn’t require big large muscle movements, and requires paying attention to the breath and being slower, is much more effective at buttressing the parasympathetic nervous system.”
Each of these exercises may be better for different people:
- Tai chi involves steady, repeated movements in the same order. It is a slowed-down version of a martial art.
- Qigong is a discipline of energy. Its movements are similar to those of Tai chi but don’t occur in the same order. Its emphasis is mental health, stability, and well-being.
- Yoga involves focus, stretching, and uniting the body and mind. It’s not necessary, Dr. Ely notes, to “get into the positions yogis pretzel themselves into.” As yogis say, showing up on the mat—just being present mentally and physically—is most important.
Food and nutritional supplements
“Diet is a very individualized thing,” cautions Dr. Ely. “In my practice, I never found one program that works for everybody. We’re all different. Your genetics are different from my genetics. But there are certain principles that apply to everyone.”
- Very low in sugar
- Very low in processed foods
- Rich in good vegetables and some fruits
- Including some grains, but not too much grain
- Including moderate amounts of fish, chicken, and meat, leaning more toward the fish
- With an occasional splurge
“If your blood sugar is unstable, your mood is unstable,” Dr. Ely adds. “When your blood sugar spikes, then drops, that is an internal stressor. Low blood sugar puts your system into sympathetic overdrive. So you’ll want to keep your blood sugar steady. How that takes place is going to be different for different people.”
Self-care can’t ensure that you’ll never get sick, and it can’t prevent you from sometimes feeling anxious or stressed. Stress, anxiety, and illness are part of the human condition. But these four self-care practices can help equip your body and mind to cope with whatever life brings.
- American Board of Physician Specialties – Integrative Medicine Defined: https://www.abpsus.org/integrative-medicine-defined
- The American Institute of Stress – What Is Stress? https://www.stress.org/what-is-stress
- Mayo Clinic – Mediterranean diet: A heart-healthy eating plan: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801
- Mayo Clinic – Paleo diet: What is it and why is it so popular? https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/paleo-diet/art-20111182
- Merck Manual – Overview of the Autonomic Nervous System: https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/autonomic-nervous-system-disorders/overview-of-the-autonomic-nervous-system
- Tindle J. and Tadi P. Neuroanatomy, Parasympathetic Nervous System. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK553141/