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Roadmap to Resilience: Managing Sustained Stress

Mental Health Expert Explains How People Can Turn Prolonged COVID-19 Stress Into Strength

After two and a half years of living through the COVID-19 pandemic, the upcoming long weekend can feel like a respite from the constantItai Danovitch, MD stress, says Itai Danovitch, MD, MBA, chair of Cedars-Sinai’s Department of Psychiatry and Behavioral Neurosciences.

But Danovitch, who has spent much of the pandemic studying the mental health impact of COVID-19, said it's not how long the pandemic stress has lasted, but how well an individual manages  pandemic stress that is the real determinant of mental health. 

Clearly, the impact has been significant. An October 2021 report by the American Psychological Association (APA), which tracks stress in the U.S., found that 63% of adults surveyed reported that uncertainty—whether about the next few months or their life paths—was a major stressor. Nearly half of those surveyed reported that the pandemic has made planning for the future feel impossible.

Defining Stress

“Stress” is a broad term, Danovitch said. It’s used to describe the body’s normal reactions to everything from everyday pressures and challenges to extreme danger.

“Stress occurs when we encounter perceived threats,” Danovitch said. “When this happens, our bodies produce hormones like adrenaline and cortisol, which do things like increasing our heart rate and slowing our digestive systems. This is often called the fight-or-flight response.”

Once a perceived threat passes, those hormone levels usually return to normal, allowing regular functioning to resume.

“This stress response system is an important function our bodies use to keep us from danger,” Danovitch said.

But prolonged exposure to stressors, like worrying about possible exposure to the coronavirus or having a sick family member, can cause longer-term disruptions, which can put people at risk for other health problems, like weight gain, anxiety, depression and even heart disease.

“I like to think of it as a supply and demand problem,” he said. “You feel stressed when, for example, you don't have the time to complete a task. The ability to deal with stressors varies from person to person, and even within each individual, it can vary from moment to moment, day to day.”

He said that learning to manage stress, especially in cases where there is prolonged exposure to potential stressors, is key to long-term health.

Managing Stress to Build Resilience

The APA defines resilience as “the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands.”

Danovitch said that social determinants of health, like race, gender, sexual orientation or socioeconomic status, which are often outside of an individual’s control, can play a role in determining the resources and tools that each individual has available to deal with stressors, and can therefore impact their ability to build resilience.

Unfortunately, that means for many, the results of that prolonged stress are beginning to show. The American Psychological Association report found that 74% of U.S. adults had experienced health impacts of the pandemic in the previous month, including headaches, fatigue and feeling overwhelmed.

“The foundation of building resilience is managing day-to-day stress,” Danovitch said. “The basic habits of eating a healthy diet, exercising regularly and getting the right amount of sleep are all key here.”

A structured daily routine is also important, he said. Creating and sticking to a daily schedule can help not only with staying on task but also with creating designated times to deal with stressors.

Danovitch also recommends taking time for meditation, time in nature and other self-care, along with social engagement, even if it’s virtual. Maintaining strong social networks has proved to have positive effects on mental health and on overall health.

“If your stress levels are so high that you find yourself unable to manage everyday tasks, or if you’re becoming overwhelmed with anxiety, it’s time to reach out to your primary care doctor or a mental health professional,” Danovitch said.

Read more on the Cedars-Sinai Blog: Dialing Back Pandemic Drinking