Consultant Occupational Health Physician and RMBF volunteer Professor Harj Kaul shares his advice for keeping anxiety at bay and staying mentally well, during and after the second wave of the Covid-19 pandemic.

As we head into 2021, you are likely to be wondering what the year is going to bring. The SARS-CoV2 virus has certainly made this a memorable year, and not necessarily for the right reasons. And while there seems to be an end in sight, there is also uncertainty around timescales for the vaccine, the impact of Brexit, and plenty of other unknowns.

How has this made you feel?

No doubt increasingly anxious, perhaps more emotionally and physically fatigued, and probably fed up. You will be sharing these emotions with many members of your family, friends and colleagues.

It is more likely that emotions will be both verbalised and kept internalised in the current ongoing uncertainty. You may have for the first time experienced subclinical or even clinical anxiety-related symptoms, causing you to now feel agitated, irritable, short tempered, tired, and worried. No surprise then that your emotions and those of others may be even more dialled up!

So, what do I do?

We all know that the only rational choice is to try to accept the current situation and move on beyond the “new normal”, accepting that this “here and now” may be with us for another 12 months. We have to deal with our fear while at the same time managing our tendencies towards anxiety, perfectionism and overthinking (perhaps medical practitioners, and some other traditional occupations, especially so). In order to move forward in any reasonable way, we need to remain focussed on what we can control, rather than what we can’t.

The fear and fatigue that is out there still needs to be dealt with by examining facts and creditable and trusted information, not media driven fiction or conspiracy theories. It’s reasonable to continue trusting the same good sources of information, and valued judgements from colleagues, as you have been doing for the last year.

When it comes to individuals who have suddenly found their “voice” on social media accounts or news sources as “epidemiological experts”, you may wish to take some of their views with a larger pinch of salt, and continue to take a guarded view considering the medical science as they are presenting it.

Recognise and accept that your personal anxiety levels – as well as those in the community, your teams and the general public – will eventually subside, more so if you take control and focus on what needs to be done today (the “here and now”).

Pressing concerns

This summer RMBF volunteers were asked their thoughts on the most pressing concerns the NHS would face in the coming year. Their top answers were

  • Burnout/staff exhaustion
  • Poor mental health of the medical workforce
  • Possible second wave of Covid-19 and other winter pressures

The second wave is now no longer merely a possibility and the winter pressures have set in. In addition, research and reports from charity organisations over recent months suggest that the pandemic is contributing to risk factors like increased comfort eating, intake of alcohol and family-related difficulties e.g. domestic crisis.

In recognition that many doctors are struggling with these issues, and more besides, the RMBF has made available an online wellbeing resource. Provided by Rightsteps, it includes a wide range of advice on looking after your mental and physical health. The online sessions are flexible, from bite-sized overviews to structured, self-guided support sessions for doctors and medical students. It’s really worth looking into.

Visit the Rightsteps online wellbeing resource

Other practical steps you can take

Consider how to remain connected with others: Maintaining well-established and even new relationships with people you trust is important for your mental wellbeing. Think about how you can stay in touch with friends and family via telephone, video calls or social media instead of meeting in person.

Help and support others: Think about how you could help those around you – it could make a big difference to them and can make you feel better too. Could you message a friend or family member nearby? Are there community groups that you could join to support others locally? Of course, remember to follow the current coronavirus guidance while doing so, i.e. facemasks, social distancing and hand-washing, to keep yourself and others safe. Try to be accepting of other people’s concerns, worries or behaviours, and be compassionate to yourself and to others.

Talk about your worries: It is quite common to feel worried, scared or helpless about the current situation. Remember that this is a difficult time for everyone, and sharing how you’re feeling – and the things you are doing to cope – with family and friends can help them too. There may well be peer mentors or other structures that have been established in your workplace or community. If you don’t feel able to do that, there are people you can speak to via NHS Employer support structures.

Look after your physical wellbeing: Your physical health has a big impact on how you are feeling emotionally and mentally. As this this has now gone on for such a long time, it can be easy to fall into unhealthy patterns of behaviour, which in turn can make you feel worse. Try to eat healthy, well-balanced meals, drink enough water, exercise inside where possible and outside, and try to avoid smoking, alcohol and drugs.

There is an initiative that offers free virtual fitness classes for life to NHS staff. Log in with your NHS email address to access a collection of exercise videos for you to do at home, made and presented by fitness experts.

Fit 4 The Fight – NHS members area

Look after your sleep: Feeling anxious or worried can make it harder to get a good night’s sleep. Good-quality sleep makes a big difference to how you feel mentally and physically, so it’s important to get enough. Maintain regular sleeping patterns and keep good sleep hygiene practices, like avoiding screens before bed, cutting back on caffeine, and creating a restful environment. The Every Mind Matters sleep page provides practical advice on how to improve your sleep.

Try to manage difficult feelings: Try to focus on the things you can control, including where you get information from and actions to make yourself feel better prepared. It’s okay to acknowledge some of the things that are outside of your control right now, but constant repetitive thoughts about the situation that lead you to feel anxious or overwhelmed are not helpful. The Every Mind Matters page on anxiety and NHS mental wellbeing audio guides provide further information on how to manage anxiety.

Other resources include:

Manage your media and information intake: 24-hour news and constant social media updates can make you more worried. If it is affecting you, try to limit the time you spend watching, reading, or listening to media coverage of the outbreak. It may help to limit the number of times you check the news, or only check it at certain times.

Get the facts: Gather high-quality information that will help you to accurately determine your own or other people’s risk of contracting coronavirus, so that you can take reasonable precautions. Find a credible source you can trust such as GOV.UK or the NHS website, and fact check information that you get from newsfeeds, social media or from other people.

More links

Health Education England has developed a helpful e-learning resource for healthcare professionals to understand the management of the key issues of long COVID; breathlessness, fatigue, exercise and cough.

There is a significant number of additional signposts and resources available to all health care staff on the NHS Employers website, as part of the national well-being offer from NHS. It’s definitely worth looking at.

Professor Harj Kaul is a Consultant Occupational Health Physician and Clinical Lead at Leicester University Medical School, Leicester Partnership NHS Trust and Glenfield Hospital.