Rhythm, routine, and rituals: How to protect your mental health while self-isolating

Rachel Moreno is making masks.

She has made more than 200 so far. Each one takes about five minutes to make on her home sewing machine, and they are often stitched together from old scraps of fabric that she’s held onto for years. She’s expecting a shipment of elastic to arrive at her home soon. She’s excited. Little things like that seem to matter more now, she said.

Moreno makes masks for the front line workers at Alaska Native Medical Center, some of whom were her students at Mt. Edgecumbe High School in Sitka during her tenure of nearly three decades. She makes masks for her students’ colleagues and masks for her coworkers in Juneau.

“It’s been really rewarding and meaningful,” Moreno said.

For Moreno, making masks has been a therapeutic exercise with tangible benefits. Her activities align with strategies psychologists recommend for protecting your mental health during stressful times.

Your brain during stressful times

Moreno hunkered down in her Sitka home for quarantine.

“By the first morning before noon, I had made biscuits and gravy, and cookies, and a big batch of fried rice,” she said.

The next few weeks she spent cleaning and reorganizing. Even so, she felt uneasy.

“I just felt this overwhelming sense of being displaced, even though I was able to come back home. I felt like the whole world is displaced right now. There’s not one person on Earth who’s not affected by this,” Moreno said.

Rebecca Robinson is a clinical psychologist with the Alaska Native Tribal Health Consortium. She has studied resilience -- the ability to bounce back from adversity -- throughout her career.

During times of stress, your brain defaults to flight-or-fight survival mode, Robinson said. Stress hormones flood your body. The thinking part of your brain that handles imagination, goal setting, and judgement goes offline.

For smaller stresses, this is a short-term experience, and once it ends your brain returns to normal functioning. But when stress becomes chronic, it can be harmful, with a variety of symptoms and reactions.

The symptoms are familiar: Fear and anxiety; feeling isolated and alone; sadness and grief; exhaustion, irritability and anger; feeling confused, forgetful and distracted.

These feelings are being experienced on a collective level right now, Robinson said, and they are completely normal.

“These are normal responses to abnormal circumstances,” she said.

Robinson recommends five ways to help build your resilience and buffer negative stress responses:

1. Establish rhythm, routine, and rituals.

By creating a schedule for yourself and your family, you help add structure and a sense of safety and security in your home.

“The human mind and body thrive on rhythm, routine, and ritual, three things that COVID-19 has dramatically disrupted,” Robinson said.

Robinson advises including times for work and for self-care in your schedule. Wake up and go to bed at regular times. Shower, get dressed, and maybe even wear bright clothing. Open the window and take some time to get outside. Create new rituals like attending a virtual meditation or church service.

Also, move your body. Research shows that repetitive movements -- especially those that go right to left -- help people to self-soothe, Robinson said. Activities like drumming and knitting both fit the bill.

For Moreno, movement is key.

“If you don’t find something to do, you have too much time to ponder, to fret, to work up anxiety,” she said.

After a few weeks at home, Moreno learned people were making masks for those who needed them. She got to work right away.

2. Name your fear.

When you name your fear, you help pull yourself out of survival mode by engaging your thinking brain with language, Robinson said. Research has shown that naming your fear helps to decrease biochemical markers of fear in the brain. She recommends sharing those fears with a trusted friend or counselor.

And don’t stop there. David Kessler, one of the world’s leading experts on grief, says it is important to acknowledge the grief you are feeling.

“Emotions need motion. It’s important we acknowledge what we go through,” Kessler told the Harvard Business Review.

3. Practice gratitude.

Write down three things every day for which you are grateful.

There is evidence that this simple exercise may make you feel more optimistic and have a better sense of well-being in your life -- and may even have a positive impact on your physical health, too.

“What we watch and what we think about builds neural pathways in our brain,” Robinson said. “There are lots of scary, negative and overwhelming things to think about during this pandemic. There are also lots of stories of people doing great things.”

4. Stay socially connected.

“It is critical,” Robinson said of staying connected socially with our family and friends. Text, call, email, send letters, or use video conferencing.

For Moreno, watching too much news sends her emotions on a rollercoaster.

“If you just continually watch the news, you continually get bombarded with how bad things could be,” she said. “Then the next news channel will talk about hope. Then you look at the (infection) numbers and it brings you back to a surreal reality.”

Setting limits on how much time you spend absorbing news about the pandemic is one way to bring yourself back to the present, according to the Substance Abuse and Mental Health Services Administration.

Social isolation isn’t just hard on your mental health; social isolation and loneliness has been shown to have the same impact on longevity as smoking 15 cigarettes a day. So reach out to your loved ones.

Also, Robinson added, stay involved.

“As a community, we are responsible for one another, too,” she said. She recommends you watch out for your neighbors, make a donation to a local nonprofit, and avoid hoarding items so everyone can get what they need.

Moreno’s mask-making is a great example of staying involved in the community.

“It made me feel good, like I was contributing in a really small way, not just for my former students, but for everybody who might have to go through that hospital,” she said.

5. Access support services.

“The hardest thing to do is ask for help, but the easiest thing you can do is to give help,” Moreno said. “Most people just want to be heard.”

Reach out to your health care provider, counselor, and other organizations in the community when you need help. (Look for information and resources at the bottom of this article.)

Remember to help those around you, too.

Compassion is key, according to grief expert Kessler.

“Everyone will have different levels of fear and grief and it manifests in different ways … So be patient,” he told the Harvard Business Review.

Find your ‘why’ & be gentle on yourself

Even if you use every strategy available to help protect your mental health, it’s likely that you’ll have days when they’re less effective. One way to bring yourself back to the present is to find your “why,” Robinson said.

Why should you create a schedule? Maybe because you want your children to be healthy. Why stay socially connected? Maybe to support your parents.

“We all have different whys,” Robinson said. And if you don’t know how to do something like create a schedule, seek out help. There are lots of resources online and in our communities.

Remember that you’ll have good days and bad days. Be gentle with yourself.

“Sometimes you have to radically accept where you’re at,” Robinson said. “Sometimes if you miss a day, OK. There’s no need to get caught up in how you ‘should be’ or ‘must be.’”

For Moreno, “I really do get the blues,” she said. “I get in this funky mood where no matter what I try to work on, I can’t focus. So I’ll go for a car ride, you know, just spend time with my son or my mom, try to do something that we would normally do without any restrictions.”

Know when to reach out for help

Even if you’re feeling fine now, all of these strategies are helpful to keep in your back pocket in case you start to feel down. Sometimes, though, professional help may be the most beneficial option.

In fact, seeking out a counselor or talking with your doctor can be helpful anytime, Robinson said, as it can help prevent any symptoms from hindering your life.

It may be time to seek professional help if you are unable to do things that are important in your life, or necessary -- like being unable to get out of bed in the morning, make family meals, or make it to an important meeting, Robinson said -- and especially if you are having thoughts of self-harm or suicide.

Remember, she added: You are not alone. Right now, almost everyone is feeling fearful, anxious-ridden, and confused.

“Those are normal responses to abnormal circumstances,” Robinson said. “But when those get in the way, that’s when it’s a good indicator that professional help could be helpful.”

How to reach out

Contact your healthcare provider, counselor, or Behavioral Health Aide.

Visit the Disaster Distress Helpline, call 1-800-985-5990, or text TalkWithUs to 66746

Visit the National Domestic Violence Hotline or call 1-800-799-7233 and TTY 1-800-787-3224

Access Alaska support organizations & resources by calling 2-1-1.

Call the National Suicide Prevention Hotline 1-800-273-8255

Behavioral Health Treatment Services Locator from the Substance Abuse and Mental Health Services Administration

For help finding mental health treatment 1-800-662-HELP (4357) or FindTreatment.gov.

This story was sponsored by Alaska Native Tribal Health Consortium, a statewide nonprofit Tribal health organization designed to meet the unique health needs of more than 175,000 Alaska Native and American Indian people living in Alaska.

This story was produced by the creative services department of the Anchorage Daily News in collaboration with Alaska Native Tribal Health Consortium. The ADN newsroom was not involved in its production.