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HOW TO MOVE TOWARDS A ‘NEW NORMAL’ WHEN WE STILL FEEL ANXIOUS?

As we now begin to expand our “bubbles” of human interaction in Phase 2 of the Province’s Restart Plan, each of us may be experiencing different emotional responses.  Some are ready and eager to jump in with both feet; others are preparing to move more slowly, to dip their toe to test the water first before making changes. To varying degrees, many may fear the downstream effects of reopening and remain anxious about a second wave of the virus.  

As healthcare providers, we have spent the past three months resolutely determined to keep our family, friends, and most importantly our patients and/or residents safe and well. We have been ‘vigilant’ in our preparations and actions, and in many ways such vigilance has served us well.

But the need to be constantly on guard to protect others and ourselves, combined with fear of an uncertain future, can be exhausting and even disabling. This constant scanning for a threat, real or perceived, is referred to as ‘hypervigilance,’ and can lead to a state of perpetual stress and debilitating anxiety.

It is important to be aware there may be long-term psychological effects on all our workers in healthcare at all levels if we continue in an unremitting state of hypervigilance.  Hypervigilance can lead to burnout, exhaustion, and compassion fatigue and it can also interfere with work, homelife and personal well being.

Common features of hypervigilance include:

  • Feeling the need to always be on guard against hidden dangers. Increased fear, anxiety, feelings of panic and worry, and constant concerns for others.

  • A heightened sensitivity to your environment. Jumping at sudden sounds, movement, or loud noises and over-analysing the environment in a ‘self-defence’ mode. Waking to even the smallest noise and having difficulty falling back asleep due to an adrenalin surge. Paranoia or the feeling as if you are in perpetual fight-or-flight mode.

Experiencing physical symptoms when you think about work, such as:  

  •  Pains in your chest, headaches, or nausea

  • Feeling depressed, hopeless, and overwhelmed

  • Feeling exhausted mentally and physically before your day even begins

  • Sweating, rapid heartbeat, hyperventilation, or exhaustion.

How to maintain your own wellness, prevent burnout and ease the effects of hypervigilance

As healthcare providers, we excel at providing empathy for others and can feel reluctant to ask for help or admit we are feeling anxious and fearful.  It may feel selfish, but for caregivers to look after others, caregivers need to look after themselves.  The good news is there are healthy habits and self-help skills you can develop to counter the stress and constant anxiety of hypervigilance.  

  1. You are not alone, and you are not the only one who may be experiencing this. Know that your reactions, thoughts, and feelings are normal and that you are not alone. Look to your peers for support; at work, consider “buddying up” with someone you trust for check-ins and informal chats. Call on your support network and share with them what brings meaning and purpose to your life and work.

  2. Start noticing what causes you anxiety. Note the triggers and write them down so you can see any patterns later. Acknowledge your own feelings and be aware of the signs, to seek help early.  If you feel your everyday functioning is impacted, then seek out help professionally.  You do not need to suffer alone and in silence.

  3. Meet your basic needs. Eat, drink, sleep, and exercise regularly to help you stay resilient.

  4. Take control of the pace of your life and be in the moment. Try “grounding exercises,” to try and stay in the present moment if feeling completely overwhelmed and not sure where to start.  Ground yourself in what you can see, hear, touch, or smell to force you into the moment and try to focus on things that are in your control. Celebrate the wins, big or small.

  5. Use the natural transitions within your day – e.g., your commute to and from work – to pause for mini self-reflection exercises.  Ask yourself, “Am I distracted or anxious? Do I need a mental break?”  Consider what is working for you and what keeps you motivated or recharged.  What keeps you coming back to work again each day?

As we transition into this ‘new normal,’ have empathy for yourself. Practice forgiveness and patience for yourself, your patients, your family, and your colleagues. Celebrate everyone’s courage, poise, dedication, and resilience during these extraordinary times. As Dr. Bonnie Henry reminds us, this is not forever, this is for now.  Our well-being and our future are still in our hands. This too shall pass.  If you feel you need more help; do not be afraid to reach out to the Wellness Team or refer to the Wellness team mental health resource page for support as we are all here for you.

http://covid19.providencehealthcare.org/staff-support/mental-health-wellness-support-all-staff

covidwellness&support@providencehealth.bc.ca or call 604 806-9925

Submitted by Staff Support & Wellness Group.

References:

Maintaining Wellness during a Pandemic (2020) Canadian Medical Association Retrieved from: https://www.cma.ca/maintaining-wellness-during-pandemic

Fessell, David P.& Goleman, Daniel (May 20,2020) How Health Workers Can Take Care of themselves. Retrieved from: https://hbr.org/2020/05/how-health-care-workers-can-take-care-of-themselves?utm_source=linkedin&utm_medium=social&utm_campaign=hbr

Chochinov, Alecs & Lim, Rodrick (2020) On the Brink of Burnout: COVID-19 and the ER Retrieved from: https://caep.ca/wp-content/uploads/2020/03/CAEP-Wellness-OpEd_Final_Clean.pdf

Clinical Neuropsychiatry (2020) 17, 2, 94-96 Citation: Conversano, C., Marchi, L., Miniati, M. (2020). Psychological distress among healthcare professionals involved in the Covid-19 emergency: vulnerability and resilience factors. Clinical Neuropsychiatry, 17 (2), 94-96.

Kimble, M., Boxwala, M., Bean, W., Maletsky, K., Halper, J., Spollen, K., & Fleming, K. (2014). The impact of hypervigilance: evidence for a forward feedback loop. Journal of anxiety disorders, 28(2), 241–245. https://doi.org/10.1016/j.janxdis.2013.12.006 Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211931/

This page last updated May 29, 2020 9:18am PDT