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What to Do If You're Struggling

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Seth J. Gillihan, PhD - Blogs
By Seth J. Gillihan, PhDClinical psychologistApril 09, 2020

Anxiety, fear, uncertainty, isolation – the coronavirus pandemic has been a “perfect storm” of emotional challenges. Now, as days of this have turned into weeks, many of us are struggling.

You might be feeling things you’ve never felt before that are hard to put into words—a confusing mix of painful emotions like fear, anger, loneliness, and bewilderment.

Or maybe what you’re feeling now is all too familiar—a return to mental health challenges you’ve faced in the past. Perhaps your depression or anxiety has returned, or you’ve had a resurgence of trauma-related symptoms, or insomnia is a nightly visitor once again. If you’re in recovery from addiction, you might have urges to pick up substances you’d left behind weeks, months, or years ago.

Or perhaps you were battling a serious bout of something like anxiety or depression even before the arrival of COVID-19 and social distancing, and now you feel like you’re barely keeping your head above water. You may even wonder at times if you should go on living, and who would miss you if you ended your life.

The following recommendations and resources can be helpful for whatever mental health struggles you’re dealing with right now. I’ve arranged them roughly in order from least to most intensive level of intervention. (Please note that while I have selected resources that appear to be of high quality, I have not tested all of these personally and cannot guarantee their effectiveness for every individual.)

Reach out to Loved Ones

No one should have to go through mental health struggles alone, but unfortunately, we often tend toward isolation when we’re having a hard time. Make a point to talk to someone you love and trust about what you’re going through. Be as honest as you can. Ask for what you need from them as directly as possible, like daily check-ins or practical assistance to tend to your self-care. Allow yourself to receive the love and concern they have for you, and if they have suggestions about what might be helpful, try to listen openly.

Self-Guided Cognitive Behavioral Therapy (CBT)

Research has shown that self-guided therapy can be an effective way to manage conditions like anxiety and depression. The fundamentals are very simple:

  • Cognitive: Train your thoughts to serve you well
  • Behavioral: Plan actions that move you toward your goals
  • Mindfulness: Practice bringing your focus to the present, with openness to what is

I simplify these components to Think Act Be in my mindfulness-centered CBT approach. The brief three-part exercise below is an easy way to begin applying CBT principles when you’re feeling stressed or anxious. I recommend starting with mindful presence to lay the groundwork for the cognitive and behavioral work. (Mindfulness-centered CBT is not the only effective psychotherapy approach, but its principles translate especially well to self-help applications.)

  • Get Grounded (Be): Sit comfortably and close your eyes. Take three calming breaths, breathing in for a count of four and out for a count of eight. Begin to sense your body: Your weight pressing into the chair, your back where it’s supported, the feelings in your hands where they’re resting. Open to a feeling of coming home to yourself.
  • Recognize the Story (Think): Notice what thoughts are going through your mind—disasters you expect? Fears of failure? Worries about becoming overwhelmed and “losing it”? Whatever you find, recognize it as a story the mind is telling. It may or may not come true, but it’s simply a story. Identify at least one alternative outcome; for example, an alternative to “I’m going to fall apart” is, “I will find the same strength that’s gotten me through crises in the past.” Don’t try to force yourself to believe the alternative; just recognizing your thought as a story will start to loosen its grip on your emotions.
  • Do What’s Important (Act): Finally, ask yourself what one thing you need to do next—tend to your self-care? Complete a chore? Serve those who depend on you? Break down the activity to make it as manageable as possible. For example, if your task is doing the laundry, resolve to collect the dirty clothes and put them in the hamper. It’s hard to overstate the value in simply getting started.

Self-Directed Books

For a deeper dive into mindfulness and CBT, consider a small investment in a book on the topic. The Association for Behavioral and Cognitive Therapies maintains a list of CBT self-help books that they’ve reviewed and awarded their “Seal of Merit” for being grounded in solid principles and research. You can search the books by condition (e.g., depression, anxiety), and most of the titles are available through Amazon.

Self-Help Apps

There are also digital apps that can lead you through CBT, some of which are available for free. Research has shown that these kinds of apps are helpful to many people. Examples include:

If you struggle with obsessive-compulsive disorder, an app like nOCD might be useful. There are also apps for posttraumatic stress disorder (PTSD) like PTSD Coach, and for insomnia such as SHUTi.

Online Courses

You can also consider an online course that’s relevant for the condition you’re dealing with. There are many options—here are a few examples:

Insomnia

Anxiety, Stress, & Worry

  • e-couch
  • Balance (disclaimer: this paid course is offered through my online Think Act Be school; need-based scholarships are available)

Depression

Support Groups

Give and receive support with others who are dealing with similar issues. The Anxiety and Depression Association of America (ADAA) provides links to support groups throughout the country, and offers their own online peer-to-peer support group. You can also find support through a group on Facebook that addresses your particular challenge like anxiety, panic, or bipolar disorder.

A word of caution—avoid joining a large number of groups that look like they could be relevant; most likely your attention will be divided and you won’t end up getting much out of any of them. Aim instead to invest your time and energy in one or two groups that fit your needs. 

Online Psychotherapy

Most therapists are not providing in-person sessions now because of social distancing, but many are offering online sessions (teletherapy). Consider reconnecting with a former therapist if they offer teletherapy, or search for one who has availability and expertise in treating your condition:

Crisis Text Line

The Crisis Text Line is available in the US 24 hours a day, 7 days a week. Text “HELLO” to 741741 to connect with a crisis counselor who can offer free support and information for any type of crisis, including for difficulty coping with the coronavirus pandemic.

National Suicide Prevention Lifeline

This free crisis hotline (800-273-TALK) is also available 24/7 to provide crisis counseling and referrals for mental health service. (Access the lifeline via TTY at 800-799-4889.)

Remember that you don’t have to face this alone—many forms of help are available. Start with one that feels right for you and see how it goes; give it time to work, but also be ready to try additional approaches if you need something more. For example, if a self-help book isn’t cutting it, it may be time to consider online therapy.

This time of stress and uncertainty might feel like it will last forever, and will outlast your ability to stand it. But as hard as it might be to imagine, there will come a time when all this is behind us. These difficulties and disruptions will not last forever. Eventually they’ll fade away, with brighter times to look forward to. Find what you need to sustain you through this storm, starting today—starting this very moment.

 

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About the Author
Seth J. Gillihan, PhD

Seth J. Gillihan, PhD, is a licensed psychologist and host of the weekly Think Act Be podcast. He is author of The CBT Deck, Retrain Your Brain, and Cognitive Behavioral Therapy Made Simple, and co-author with Dr. Aria Campbell-Danesh of A Mindful Year: 365 Ways to Find Connection and the Sacred in Everyday Life. Dr. Gillihan provides resources for managing stress, anxiety, and other conditions on the Think Act Be website.

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