The pandemic-induced uncertainty about the future has turned our current winter of discontent into one of smoldering anxiety.

And while the situation is unfortunate, we are lucky to be in a region with several academic and professional institutions where individuals have been sharing information to help both people and organizations fight back against stress and mental and emotional fatigue — aka burnout.

Ann Murphy

Ann Murphy at the Rutgers University of School of Health Professions writes that burnout symptoms “include feeling unfulfilled, overwhelmed, easily frustrated, exhausted, forgetful, easily distracted, fatigued, having difficulty sleeping, and experiencing changes in appetite with weight loss or gain. Over time, if not addressed, burnout can lead to more serious anxiety, depression, and physical health concerns.”

While she advises “checking in with yourself to assess your experience of these symptoms” to help identify the need for additional support, she has some practical advice: “The best strategy is to develop a routine for self-care. Identify self-care activities — like walking, yoga, or napping — that you enjoy and look forward to doing.”

Other advice includes balancing home life and work-at-home life by scheduling and “instead of replying to emails as they come in, set aside blocks of time and return all emails then. You can include an automatic email reply that tells people you will return emails during set hours so they aren’t expecting an immediate response. Also, set a cut-off time later in the afternoon or evening after which you won’t reply to emails so you can create a distinction between work and non-work time.”

Meanwhile, as a New Jersey Center for Nonprofits publication points out, there is another simmering anxiety for people working in both nonprofits and profit-making organizations. “For most, the COVID-19 quarantine experience has been very concerning, and some individuals will report significant anxiety, fear, and reticence about re-entering the workplace.”

The publication, “Going Forward: Reopening,” advises “Organizations should not be dismissive or judgmental about this anxiety. It is important that staff members have some avenue to express concerns — either with coworkers, leadership, an established employee, an employee assistance program (EAP), or other outlet.”

The report recommends that management and co-workers “should be ready to work with staff members and volunteers in an empathetic and trauma-informed behavior” and to remember that “trauma and anxiety can manifest in a number of ways.”

It also states that we are not dealing with “business as usual,” and that “keeping close attention to staff morale is more important than ever. Morale and mission are not mutually exclusive — in fact, in the most successful workplaces and organizations, they often go hand in hand. Encourage positivity and show genuine care and concern for employees’ physical and mental health and well-being.”

Other organizational advice includes “recalibrating expectations, balancing flexibility with the importance of work responsibilities, being clear about goals/expectations while being able to adjust as needed, and finding ways to connect the staff through regular check-in sessions or informal discussion groups.”

The paper ends with the key point: “Ensure active and quick communication to your staff, volunteers, clientele, and constituents. Have a plan at hand in case you need to move back a step or two.”

Cary Cherniss

Cary Cherniss, emeritus professor of applied psychology at Rutgers University and author of the books “Beyond Burnout” and “The Emotionally Intelligent Workplace,” offers the following in the co-authored article “Coronavirus Disease 2019 (COVID-19) and Beyond: Micropractices for Burnout and Emotional Wellness.”

While Cherniss’ intended audience is healthcare professionals, his advice can also be applied to other essential workers, including supermarket and restaurant workers.

“Micropractices only require a few seconds to a few minutes to implement. Those that connect with an already existing activity offer a special appeal and ease, such as a moment for mindfulness when using hand sanitizer. Hand hygiene — now a constant routine in and out of the hospital — is a continual opportunity for self-awareness and self-management. It can be an opportunity and invitation to focus on one’s breath, center one’s mind and body, and visualize the kind of presence, empathy, and calmness one would like to bring to the next patient and the next moment. It is also an opportunity to self-connect — Am I well hydrated? Hungry? Carrying an unreasonable emotional or mental vestige from the last patient or the last news update? Quick micropractices like these are potentially possible even for the busiest radiologist or other healthcare provider.”

The writers note that opportunities to engage in this type of mindfulness micropractice are available on a daily basis. “Examples include the wait time when logging into the PACS or electronic health records. Such opportunities present themselves continually outside our work lives as well — when hearing the concerns of family or friends, when waiting at a red light, before answering e-mails or texts, or when brushing one’s teeth. Any recurring event can serve as a cue for a wellness self-check. Over time, such built-in wellness moments have the potential to shift one’s energy level and the tone of one’s day.

They say another favorite micropractice is taking a moment to name one’s emotions, especially challenging emotions. “For example, when I notice that I am feeling upset, is it anger? Concern? Exhaustion? Such naming aids self-awareness and self-management. This ‘name it to tame it’ practice has supportive functional MRI research; it has been show to shift brain activity from the amygdala, the emotional center of the brain, to the higher-order thinking area of the brain, specifically the right ventrolateral prefrontal cortex.

“In so doing, it can help bring calm and ease. Helpful lists of the range of human feelings are readily available and can help facilitate this process.”

Another simple helpful act is to “write down three things one is grateful for several times a week.” Citing a study, the article notes that “a 15-day practice of recording three good things had significant positive benefits on self-reported happiness, burnout, work-life balance, and depression. Extending gratitude practices into groups, such as starting meetings by giving kudos for recent efforts, can also help stimulate positive emotions and positive relationships among team members. Clearly many good things are happening in the midst of all the stress and swirl — the dedication of so many, kindness and consideration for those most at risk, and emotional support. To help us survive, our minds are biased to notice risks and danger; consciously noticing the good can help bring balance and calm.”

The two researchers also advise learning to become more aware of tension triggers and delaying response as well as a simple technique known as diaphragmatic breathing to reduce stress and anxiety. It “involves inhaling deeply by expanding the lungs downward rather than inhaling using the abdomen or rib cage alone. Inhaling is done through the nose, with a pause before exhaling slowly and completely through the mouth. Some find silent counting during inhalation and exhalation helpful to establish a respiratory rate of six to eight breaths per minute (e.g. inhale for a count of five seconds, pause, and exhale for a count of five seconds for a respiratory rate of approximately six breaths per minute).

“In preliminary experimental studies, diaphragmatic breathing has demonstrated a statistically significant improvement in stress reduction as measured by both physiologic biomarkers (blood pressure and salivary cortisol) and self-reported stress levels via the widely used Depression Anxiety Stress Scales.”

Yet what about school teachers and students?

Rutgers’ Murphy says, “It is important for all people within a school system to feel that they are heard, respected, and are being taken into account. Administrators can do this by holding regular open forums to discuss teachers’ and staff members’ concerns, maintaining regular communication so that everyone feels they are being kept informed, being transparent about how and why decisions are being made, and including all stakeholders, to the greatest extent possible, in decision-making. Administrators can create nurturing environments that recognize and support the good work being done, promote team building, and inform teachers and staff about available physical and mental health supports.

A team of William Paterson University faculty members conducted a study that included Northern New Jersey students and found the pandemic had “a significant negative impact on mental health of college students” and that “proactive efforts to support the mental health and well-being of students are needed.”

One proactive effort came from students at Princeton University and the creation of an online publication, “Mind Matters: Navigating Mental Health Concerns With COVID-19 Through Student and Teacher Resources.”

The advice includes maintaining support systems and familiar connections; monitoring moods and health; adopting habits that promote health and avoiding drugs and alcohol; and reducing academic stress by finding support and time management methods.

Princeton University’s Health Services likewise provided advice applicable for all levels of education and community members.

In addition to what has already been mentioned above, PUHS advises setting long-term and short-term goals and rewarding yourself on the way to reaching these goals; releasing anxiety by exercising and journal writing; eliminating clutter, including listservs; stopping dwelling on past mistakes; focusing on things you can control; and learning “to say ‘no’ and set healthy limits and boundaries.”

Advice also includes using free self-care phone apps — including the Calm Harm support to manage and resist self-harm and “Stop, Breathe & Think” — and participating in mind-body activities like tai chi and meditation to prevent the negative effects of stress and improve health.

Yet perhaps one of the most important comments it makes goes to the crux of our current situation: “Self-compassion involves realizing and accepting our failings and our humanness through mindfulness.”

And through being mindful of ourselves and others, we will — to use Shakespeare’s quote — see “the winter of our discontent made glorious summer.”

 

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