Newswise — Coping with a public health emergency can be stressful as people try to manage the uncertainty about the future, health concerns, financial instability, access to resources and what to expect as we move forward.

Ann Murphy, director of the Northeast & Caribbean Mental Health Technology Transfer Center at Rutgers School of Health Professions, discusses how to recognize and manage extreme stress, and shares the services and support systems available for those who need a higher level of emotional care.

What are signs of distress during a time of public health emergencies?

There are four primary areas where signs of distress can manifest themselves. Cognitively, we may find ourselves forgetting things more often, feeling confused, having trouble concentrating or having difficulty making a decision. Emotionally, we can experience fear, worry and anxiousness, or even anger, guilt, sadness and irritability. Our bodies can respond to stress with stomachaches, tight muscles, headaches, worsening chronic health problems and changes in energy levels. We might also see changes in behavior, such as sleeplessness or sleeping too much, changes in eating habits, wanting to disconnect from others, heightened use of alcohol, tobacco or drugs and an inability to carry out routine daily activities.

How can people best take care of themselves?

It’s natural to feel stressed, worried, anxious and overwhelmed during a public health emergency, but there are steps you can take to build your wellness:

  • Take care of your body by being physically active, eating well, getting a good night’s rest and relaxing with breathing exercises and stretching.
  • Take care of your mind by engaging in activities or hobbies you enjoy. Try as much as possible to maintain a daily routine. Meditate or pray.
  • Take care of your emotions. Notice and accept how you feel; try not to judge your feelings. Treat yourself with compassion. Talk about your feelings with someone you trust and use calming self-talk (“I can handle this.” “One day at a time.”).
  • Connect. Reach out to others while maintaining recommended social distance or isolation (call, text, email, social media). Use FaceTime, Skype or other video tools to talk to people “face-to-face.” Talk about your feelings about the emergency, but also enjoy other conversation to remind yourself of the many important and positive things in your life.
  • Notice early warning signs of stress and understand how your past experiences affect the present; think of how you handled past challenges.
  • Ask for help when needed. Access drug and alcohol sobriety support groups or mental health groups remotely: Alcohol Anonymous; Al Anon and Depression and Bipolar Support Alliance. Many mental health counselors are also providing services remotely so you can still reach out to your local mental health agencies for support.

What are some calming activities people can do at home?

There are many apps that can help you with meditation, deep breathing, calming exercises and other activities. You can also try box breathing, where you sit upright in a comfortable chair with your feet flat on the floor and your hands relaxed in your lap. Inhale for a count of four, and hold for a count of four. Then exhale for a count of four, and hold for a count of four. Repeat until you feel calmer. You can use the app Box Breathing – Breath Air.

Try keeping a gratitude journal and write in it even a few times a week. Here are tips to get started:

1. Write down up to five things — big or small — for which you feel grateful. Think about something you enjoyed, someone with whom you interacted, an accomplishment or an obstacle you overcame.

2. Be specific and include details of an event, experience or accomplishment.

3. Try to focus on people more than things.

4. Think about being grateful for negative things that didn’t happen or an obstacle you turned into an opportunity.

5. Think of the good things you receive as gifts.

6. Write down things that you didn’t expect or that surprised you.

How can people stay informed without becoming anxious?

While it’s important to stay current about the public health emergency, avoid excessive exposure to media coverage and limit yourself to a single, credible source such as the Centers for Disease Control and Prevention. Check for information at a specific time, only once or twice a day. Gather information that helps you take practical steps to protect yourself and your loved ones.

Where can people get help if they are overwhelmingly sad, depressed, anxious or are experiencing feelings of self-harm or harm to others? There are hotlines and help that are open and accessible to everyone:

  • Substance Abuse and Mental Health Services Administration’s (SAMHSA) Disaster Distress Helpline: 800-985-5990 (TTY 800-846-8517) or text “TalkWithUs” to 66746.
  • SAMHSA’s National Helpline: 800-662-4357
  • National Suicide Prevention Lifeline: 800-273- 8255 (TTY 800-799-4889)