Tips for Staying Active During Self-Isolation and COVID-19

**By Priya Kanwar, MD and Bandana Sharma, MD**

Self-isolation during this pandemic can take a heavy toll on one’s mental and physical well-being. Many of us are still figuring out our new routines and being confined to a single space doesn’t help, particularly if it’s small, cramped or shared. Some of us are probably feeling completely helpless or hopeless. One of our best defenses to these low feelings and feelings of defeat is to stay physically active.

Activity strengthens both body and mind, releasing endorphins – or “feel-good” chemicals – that naturally relieve pain and boost well-being. Exercise increases immunity, while reducing the risk of cardiovascular disease, type 2 diabetes and other chronic diseases. It improves mental health, helps with sleep and is shown to even reduce depression.

Though exercise is beneficial all of the time, it can be harder to do during quarantine. Here are five ways you can stay active and engaged while quarantining at home during COVID-19:

Create a home gym area

Exercising with children during self-isolation and COVID-19You don’t need a lot of space or things to create a home gym. Identify an area that is at least the size of an exercise or yoga mat to do simple body weight exercises, like push-ups and sit-ups. Add in weights, bands and any other items you might have lying around. Get inspiration from free online videos and other apps on your phone or computer. Join a challenge or fitness club to stay motivated virtually.

Go for a walk

Brisk walking is a moderate intensity aerobic exercise that is safe for most people. In Washington state, we are allowed to walk outside in our neighborhoods if we uphold social distancing measures. We have many beautiful parks and trails in the area that you can take advantage of (be sure to pay close attention to current closures). The Centers for Disease Control and Prevention (CDC) recommends at least six feet between you and others.

Stand up!

While most of us are spending more time at home, try to stay moving and avoid being sedentary by setting up a plan. For example, stand up and walk or move around for five minutes for every hour you are sitting. If you’re working from home, consider investing in a standing desk.

Do household chores Gardening is a good activity during self-isolation and COVID-19

Household activities such as mopping the floor, scrubbing the tub, gardening or even walking up and down the stairs can, surprisingly, be a great cardio workout. Next time you’re cleaning, stay mindful that it can double as a workout.

Take care of your mind

Numerous studies show meditation and mindfulness help with reducing stress and anxiety. Phone apps can be helpful for those just getting started.

A few notes about safety:

We advise that you avoid crowded areas and public playgrounds during this time. The CDC now recommends wearing cloth face masks in public settings if social distancing is difficult to maintain. Keep this in mind when you’re engaging in outdoor activities like walking, jogging or biking. Also, avoid touching your face during workouts – wash hands frequently, and disinfect all equipment and surfaces before and after a workout.

It’s as important as ever to rest, exercise, eat balanced meals and be kind to one another. Remember, this is a temporary phase and will pass. You got this!

Priya Kanwar, MD is an internal medicine doctor who practices at Virginia Mason Medical Center at University Village. Dr. Kanwar specializes in internal medicine and primary care. She is board certified by the American Board of Internal Medicine and is a member of the American College of Physicians.

Bandana Sharma, MD, is a primary care doctor who practices at Virginia Mason Medical Center at University Village. She specializes in primary care, preventive medicine and adolescent care. She is board certified by the American Board of Family Medicine. Dr. Sharma is a member of the American Academy of Family Medicine.


Practicing Mindfulness in a Time of Uncertainty and COVID-19

**By Astrid Pujari, MD**

The coronavirus, or COVID-19, is challenging all of us to find inner strength during a time of much uncertainty in our world. Each of us is affected by this health crisis, and we are all learning to navigate our “new normal.” While we cannot control our external environment, we can control our reaction to it and our thoughts, which is why staying mindful is so important right now.

As a trained physician in integrative holistic medicine, I want to share with you how to practice mindfulness, what it is and how it can help strengthen and steady our minds.

What it means to be mindful

Being mindful is about learning to respond rather than react. In any event we go through in life, whether positive or negative, we will experience an internal reaction first. Then, there’s a brief moment where we decide what happens next – what we say or what we do.

Most of the time, if we are not present with our thoughts, we will react based off of past experiences, fears, programming and fight-or-flight responses. These reactions might not be as helpful as we intend. Instead, we need to pause and focus on the words, the triggers, the events we are experiencing and ask ourselves in that moment how we really feel. Whether it’s thinking about COVID-19 or getting stuck in traffic, being mindful lets us choose how we want to be – and often a more sound and understanding response.

Reacting vs. responding

Let’s first understand the difference between reacting and responding.

As our senses take in any event – imagined or real – information travels through our limbic system. Connected to different parts of the brain, the limbic system is instinctually wired to respond immediately. When we react, this is what is being exercised. Think of it like being on autopilot.

Thinking vs. reacting supports better problem solving in stressful times.Yet, as humans, we have a slower track in our minds, which processes a lot more information and context as events occur. Because it does this, it activates a different area of the brain, the frontal cortex. This area allows for long-term thinking and long-term planning. When we respond, we are exercising this more thoughtful function.

So, when we confront experiences in our day-to-day lives, we have two options. We can react to it based on instincts and past experiences, connected to our limbic system’s desire for immediate reaction. Or, we can respond after thinking it through.

Mindfulness boosts resiliency in times of crisis

With COVID-19, most of us are reacting rapidly driven by fear and the unknown. Yet, these fight-or-flight responses shut down our ability to be resilient in times of uncertainty and stress.

Mindfulness can help boost our creative thinking and problem-solving by exercising a response, not a reaction. In turn, we may be able to envision more constructive solutions and think more positively, or at least calm our minds, even during difficult and trying times as we face COVID-19.

How to practice mindfulness during the COVID-19 outbreak

Breathe deeply
When we’re in a fearful state of mind, our breathing shallows. We must breathe to relax. Deep breathing offers an opportunity for us to deal with the emotional and mental stress. To start, I like to follow the Dali Lama’s guidance: place your hand on your heart and breathe in naturally. As you do this, cherish yourself and feel that cherishing of self. When you breathe out, cherish others – in your life, in this world. [Watch Dr. Pujari demonstrate several easy breathing techniques here.]

Focus on your body during simple activities
We consider many routine activities in our lives to be thoughtless, like hand washing or brushing our teeth. These routines are wired into our brains and muscle memory. However, by focusing on these simple activities – the feeling, sound, smell, look, taste – we open ourselves up to new feelings and perspectives. Next time you wash your hands, take note of how the water feels on your hands; what the soap smells like; the sound of the water coming out of the faucet; and even how your hands feel once you’re done. Before you know it, you’ll be mindful in many other areas of your life.

Listening to music is a mindfulness practice that can lower stress.Listen to soothing music
Music is a powerful way to relax our minds and generate positive, calm emotions. Certain pitches, tones and rhythmic structures can center us in the present. Listen to songs that fit your mood. Playing music in the background while you work or do other daily activities such as showering or getting ready can subtly soothe you and get you in the right mindset to achieve your daily goals. When feeling tense, I often listen to “Weightless” by Marconi Union. Designed to reduce anxiety, research has found this song helped reduce anxiety in 65% of listeners.

Take a break from watching the news and your social feeds
Many of us probably feel exhausted or overstimulated by the constant, unsettling COVID-19 news, yet we still want to be informed. Consider limiting the amount of time spent on your phone and online and make “instead of” time, where you do something for YOU.

Astrid PujariAstrid Pujari, M.D. is board-certified in internal, integrative and integrative holistic medicine. She practices at Virginia Mason’s Center for Integrative Medicine. Dr. Pujari specializes in holistic support for cancer, women’s health and functional medicine, holistic treatment options for gastrointestinal issues and mind-body tools.

Finding Calm in a Crisis: Changing What We Tell Ourselves

**By Bethany Davis, LSWAIC**

“I’m feeling too much all at once.”

Is this what you think when people ask “how are you” during the COVID-19 crisis? If so, you’re not alone: the impact the pandemic is having on our lives, families and communities makes higher stress a natural response. We want to know when this will end, how to stay protected, what will happen to our loved ones and so much more.

What I see as I work with people is that it’s not the course of the crisis that’s having the most effect, but more what they’re telling themselves about what’s going on. Our self-talk can undermine our sense of how safe we are, as we sort through not only a morass of information, but changes in our work, daily routines and relationships.

Here are four key areas in which redirecting our self-talk – and taking some simple actions – can help us feel more grounded in in a storm of emotions.

Minding the monologue

Does any of this self-talk sound familiar?

  • I am unproductive, I should be doing more.
  • I’m feeling alone.
  • This reminds me of feeling depressed, maybe that’s coming back.
  • This is how it’s going to be forever.

It’s important to know it’s possible to adjust our framework. Think of it like changing a lens on a microscope; seeing things in different focus can break the cycle of thought patterns that tend to feed anxiety and obsessive thinking. Here are examples of how to reframe your self-talk:

  • Staying home during this crisis is not a reflection on my self-worth or work ethic.
  • I can still maintain good relationships and reach out to those I love.
  • It’s normal to feel down when distancing, but it is not permanent.
  • This situation is temporary.

Be aware of “should” during self-talk, as in “I should be handling this better,” or “I should be more grateful.” Should and shouldn’t feed negative self-judgment.

Examining Isolation

dog-comfortTime to change that lens again! What are you telling yourself about being physically alone? Shame, blame or depression are some of the feelings that may come up when we are isolating from others. Switching your mindset can start with considering the difference between being “alone” versus being “lonely.”

Remember that we are temporarily distancing ourselves for health precautions. We are not cut off from relationships, friendships or love. We all count on these connections to check in and feel OK, and we can make still make those connections while distancing. In the meantime, try being curious about what feelings come up about being alone. Don’t see them as good or bad, but as evidence that everyone’s well-being depends on human connection.

Creating Feelings of Control

A good single phrase for self-talk when you feel out of control: “I’m going to be OK.” We’ve all heard the stories of panic buying, which may be an attempt to feel more in control. In moments of being overwhelmed by a perceived need, it can help to physically pause to regain a sense of calm. Try opening your hands while sitting in a posture of acceptance, close your eyes and take deep breaths.

Remember activities that you can control: I can go outside or take a walk. I can FaceTime or call family members or friends. I can listen to music. I can pick up an old project or start a new one. I can write down my thoughts or write a loved one a letter. I can sit in the sun.

Engaging Joy  

So much is happening in our world now, and if we’re being honest, it’s taking a lot of our energy and mental space. Consider giving your brain a break from scrolling through the endless crisis news and social media threads.

Here’s a question: When was the last time you felt happy? What were you doing? For me it was FaceTiming with my niece and nephew, sitting in the sun, calling my grandmother and looking up dog memes online (try it!) If you can remember something you enjoyed last week, try to think of how you felt in the moment. Whatever it was, try to do more of that, more often.

Another pathway to joy is through empathy and compassion for others. Once you’ve recognized the importance of self-talk and showing compassion for yourself, holding it for others becomes possible. Opening our minds to what people outside our circle are facing helps switch off our negative thought patterns and ease resentment about our own situation. We can think of (or maybe we know) people who work in health care, or who’ve lost their job, or even have symptoms and are stressed and self-isolating. Recognizing that we all face different challenges can open our capacity to feel joy again.

If You Need More Help

There will be times when all of us feel more stress than we have the tools to handle ourselves. If you have resources or access to a therapist via an online format, this would be a great time to connect to help you build on a more positive framework. The King County 24-hour crisis line offers immediate help and translation services for over 155 languages: (866) 427-4747.

Feeling anxious – or a variety of other emotions – during this crisis is completely normal. What can help is noticing patterns of thinking that get in the way of experiencing pockets of happiness and calm that can keep us moving forward in difficult times. We may all experience pain, heartache and loss, but soon we will all know the joy that still lies ahead.

Here’s some joy you can pocket to get you started, from the poem “Invictus,” written by William Ernest Henley in 1873, while recovering in an infirmary:

“It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate,
I am the captain of my soul.”

Bethany.DavisBethany Davis, LSWAIC, is an Oncology Social Worker who enjoys writing about mental health.