A psychologist explains the 4 ways people cope with COVID-19

Most of us have been affected by the COVID-19 pandemic to some degree. This may be on mental, emotional, social, business-related and/or financial levels; it may be acknowledged or not. In many ways, the pandemic has shed light on what is not working too well in our world.

Depending on the coping strategies we have been using in response to this crisis, the pandemic is serving as a powerful catalyst both for societal transformation and new solutions to many pressing global challenges.

Both in my clinical work with patients, and in the general population, I have observed a variety of tendencies when it comes to the way people are coping during these uncertain times. These can be separated into four main categories:

1. Negative or destructive external expressions: This can involve constantly watching the news, reading about and disseminating information about negative developments, looking for hidden agendas and engaging in conspiracy theories. Furthermore, destructive outward tendencies can lead to people denying or ignoring the facts of the situation and consequentially taking risks, personal and collective, by not adhering to physical distancing or other preventative measures.

2. Positive or proactive external expressions: This can manifest itself in reaching out to provide help, comfort and support to family, friends, neighbours or strangers in different ways. Others have found more time to spend outdoors or in nature, to learn a language or read the books they always wanted, or have found pleasure in home activities like playing games, cooking, baking and engaging in creative hobbies.

3. Negative or destructive internal expressions: This style of response is characterized by negative thinking. People worry about themselves or someone close to them getting sick, and form negative expectations about the future regarding their work, life in general, or the state of the world after the pandemic. Some seem to think that they are better prepared if they expect or prepare for worst-case scenarios, but this strategy is likely to create a spiral of negative thinking, avoidance, apathy and self-isolation, which can lead to increased feelings of anxiety, depression, hopelessness and loneliness.

4. Positive or proactive internal expressions: People using this strategy have responded to the crisis by contemplating their personal lives and the state of the world, their true values and what changes they could make to live more in-line with them, and how they can contribute to the changes they would like to see in the world. Other examples involve practising mindfulness and meditation techniques; trying to be more present in their everyday life and to accept the present moment as it is, and becoming more appreciative of the things they take for granted in their lives. Such coping strategies can help create a greater sense of meaningfulness and faith in their own capabilities of managing the situation.

Some people express combinations of these coping styles, while others appear less affected by focusing on making their daily routines as normal as possible.

Fortunately, I’m not among those who have experienced unmanageable changes when it comes to my clinical practice during the pandemic. For some time prior to the outbreak in Scandinavia, I had been transitioning into using e-mental health solutions and video consultations to a larger degree within my clinical work.

However, my work with patients has changed to some extent. Instead of focusing only on their pre-existing issues, I have found it necessary to address and reflect upon the current situation and how it affects their mental health and life in general. Some of my patients have either lost a family member or a friend to COVID-19; others have been sick with symptoms that match the virus or know someone who has been taken ill. Others have lost or worry about losing their jobs. Several patients have experienced increased levels of negative emotions, like anxiety, and worry about getting affected in different ways, while others have experienced feelings of depression, hopelessness or helplessness about the situation. In these cases, the focus of the therapy has shifted immediately into working to process the grief, worry, unanswered questions, practical challenges and other issues related to their experiences.

In contrast, some patients feel that their own issues are diminishing and becoming less significant in comparison to the evolving global challenges. Stronger community bonding and feelings of togetherness have led many of them to seek ways to support and feel useful to others. This is helping them to create meaning and structure within the chaos and uncertainty.

Depending on their personal challenges and coping style, as well as other contextual factors, some patients have required either more frequent or longer therapy sessions – while others have been prone to pause or make slower progress in their therapy programmes. Overall, some additional efforts have been required in my clinical work during these months to help my patients process these challenges and ensure the continuation of care. So far, however, I have had very few cases of complete drop-out due to the pandemic, which indicates that people still are motivated to get help and work on both their pre-existing and new mental health issues during these times.

With regard to my network of colleagues in the healthcare sector, I know that many have experienced challenges in adjusting to new technologies and ways of working. However, they have tried their best to be adaptive and creative during these times. They have been scheduling and facilitating consultations and appointments via video or telephone, if possible. Some have even offered ‘walk and talk’ sessions while practising physical distancing.

Even though mental health professionals in Scandinavia have adapted quite well during the COVID-19 outbreak, this might not be the case in parts of the world where demand has been higher and where working conditions and resources are not as good. Moreover, we need to be prepared for a rise in demands for mental health services across countries in the coming months when the full mental health impact of the pandemic is getting clearer. It is therefore crucial to have an adequate support system in place, not only to protect the health and wellbeing of frontline workers, but also of the mental health workforce.

In sum, the more proactive or adaptive coping strategies we use when it comes to protecting and managing our mental health during times of crisis can be helpful in creating relief from our symptoms, a greater sense of inner balance and wellbeing, more structure and meaning in the world around us and more empathy and collaboration across nations, as well as fostering new solutions to existing global challenges.

The coping strategies that we use now and in the times to come will determine our resilience as a human species, and will strengthen our ability to adapt more smoothly to future crises.

Choosing the more proactive or adaptive coping strategies will help us develop and cultivate our empathic, imaginative and creative skills, and will thus make us evolve both as individuals and as a human family.

I believe the pandemic will contribute to speed up digitalization and other innovations within healthcare, and also change the ways we as professionals are working and engaging with our patients and clients in the times ahead.