Dealing With Stress: Healthy Habits and Resources
Feeling anxious or showing signs of stress is common during stressful times, such as the COVID-19 pandemic. Recognize the signs, encourage healthy habits and stress-relief methods, and use appropriate resources when help is needed.1 Start with the methods below. See the chart on the second page for additional resources, especially when a higher-level intervention may be needed. Call 911 in an emergency or if someone appears to be in crisis.
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Identify
Signs of Stress1 |
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Behaviors |
Body |
Feelings |
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changes in energy or activity level (increase or decrease) decreased ability to experience pleasure/have fun increase in alcohol, tobacco use drug misuse (e.g., opioids, benzos, illicit drugs) irritability, frequent crying, or excessive worrying difficulty concentrating, relaxing, or sleeping |
gastrointestinal (e.g., stomachache, diarrhea) pain (e.g., headaches, joints) tremors or muscle twitches chills and/or sweating loss of appetite or excessive eating |
anxious or fearful depressed guilty or angry heroic, euphoric, or invulnerable not caring about anything overwhelmed by sadness |
Address Mental Health Emergencies (i.e., if you think someone is contemplating suicide)2-7
- Ask about suicidal thoughts or plans. Asking does NOT increase suicide risk.3
- Listen without interrupting or judging. Tell them you want them to live.
- Connect people to resources (see the chart on the next page).
- Example resources and training programs on suicide prevention include:4-7 QPR (https://qprinstitute.com/), Ask Listen Refer (https://www.asklistenrefer.org/), Care, Assess, Respond, Empower (CARE) (https://youth.gov/content/care-assess-respond-empower-care), and LEARN (https://intheforefront.org/learn-saves-lives/).
Encourage Healthy Ways to Relieve Stress
- Stay up to date on what is going on in the world, but avoid overexposure to the news.1
- Use reputable sources for information (e.g., national organizations, government resources).1
- Stay connected with friends and family.1 When face-to-face visits are not possible, consider other options (e.g., phone calls, video chats, text messages).
- Live healthy: get plenty of sleep, eat healthy foods, drink plenty of water, limit alcohol and caffeine intake, avoid tobacco/illegal drugs, and exercise regularly (e.g., walking, biking, online fitness class).1
- Practice relaxation1 (e.g., reading, listening to music, meditation, mindfulness apps [see below]).
- Consider use of apps and other online support options (see examples below).
Examples of Relaxation or Mindfulness Apps (available for download on Android and iOS)
- CBT-I Coach: helps with anxiety and insomnia
- Moodpath: helps with depression and/or anxiety
- Mindfulness Coach: learn mindfulness and meditation skills to help with depression and anxiety
- PTSD Coach: helps address trauma
- Mindshift: helps teens and young adults who have depression or anxiety
Examples of Online Support Options
- Health Unlocked (https://healthunlocked.com/anxiety-depression-support/about): online anxiety and depression support group through the Anxiety and Depression Association of America.
- Mood Disorders Society of Canada Forum (http://www.mdsc.ca/forum/): online forums for a variety of topics including general mood disorders, bipolar disorder, depression, addiction, etc.
See the table below for more resources, websites, phone numbers, text lines, etc.
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Examples of Available
Resources |
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Organization |
Website/Phone
number/Text info |
Other
information |
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Substance Abuse and Mental Health Services Administration (SAMHSA) |
National Helpline: 800-662-4357 Disaster Distress: 800-985-5990 Text “talkwithus” (English) or “hablanos” (Spanish) to 66746 |
SAMHSA treatment locator: https://findtreatment.samhsa.gov/ SAMHSA link to “psychological first aid:” https://store.samhsa.gov/product/Psychological-First-Aid-for-First-Responders/NMH05-0210 |
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National Alliance on Mental Illness (NAMI) |
800-950-6264 Text “nami” to 741741 |
Offers free, peer-led support group for adults with symptoms of a mental health condition: https://www.nami.org/Support-Education/Support-Groups/NAMI-Connection. Warmline (peer-run support line) directory: https://www.nami.org/NAMI/media/NAMI-Media/BlogImageArchive/2020/NAMI-National-HelpLine-WarmLine-Directory-3-11-20.pdf. |
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National Suicide Prevention |
https://suicidepreventionlifeline.org/ 800-273-TALK (8255) (English) 888-628-9454 (Spanish) |
Will be able to dial "988" to reach the lifeline in the US (starting July 2022) and Canada (date yet to be determined) |
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National Domestic Violence Hotline |
800-799-7233 Text “START” to 88788 |
Interactive guide to safety planning: https://www.thehotline.org/plan-for-safety/create-a-safety-plan/ |
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Crisis Text Line |
https://www.crisistextline.org/ Text "home" to 741741 (U.S. and Canada). (Can also text "hello" or "start" in the US.) |
Can also be accessed via Facebook Messenger or WhatsApp. |
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Canadian Mental Health Association and Crisis Services Canada |
https://cmha.ca/find-info/covid-19/ https://www.crisisservicescanada.ca/en/ 833-456-4566 (866-277-3553 in QC) Text 45645 (available 4 pm to midnight EST) |
Text support is only available in English (not French). Offers a peer support training program (https://peersupportcanada.ca/). Offers tips to respond to employee anxiety (https://cmha.ca/news/6-tips-to-respond-to-employee-anxiety-about-covid-19). |
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Canadian Centre on Substance Use and Addiction |
833-235-4048 |
Information sheet outlining potential risks from alcohol and cannabis use during the COVID-19 pandemic: https://www.ccsa.ca/covid-19-alcohol-and-cannabis-use-infographic |
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Mental Health First Aid |
Offers skills-based training on mental health and substance-use issues. Access resources (e.g., general mental health, anxiety, depression, substance use) at https://www.mentalhealthfirstaid.org/mental-health-resources/. |
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Project Leader in preparation of this clinical
resource (360503): Beth Bryant, Pharm.D., BCPS, Assistant Editor (last modified February 2022)
References
- Substance Abuse and Mental Health Services Administration. Coping with stress during infectious disease outbreaks. 2014. https://store.samhsa.gov/product/Coping-with-Stress-During-Infectious-Disease-Outbreaks/sma14-4885. (Accessed February 10, 2022).
- QPR Institute. Question. Persuade. Refer. https://qprinstitute.com/. (Accessed February 17, 2022).
- National Institute of Mental Health. Frequently asked questions about suicide. Revised 2021. https://www.nimh.nih.gov/health/publications/suicide-faq. (Accessed February 17, 2022).
- Susman D. How using ‘QPR’ can prevent suicides. February 19, 2018. Psychology Today. https://www.psychologytoday.com/us/blog/the-recovery-coach/201802/how-using-qpr-can-prevent-suicides. (Accessed February 17, 2022).
- Asklistenrefer.org. Online suicide prevention training program. https://www.asklistenrefer.org/. (Accessed February 17, 2022).
- Youth.gov. Care, assess, respond, empower (CARE). https://youth.gov/content/care-assess-respond-empower-care. (Accessed February 17, 2022).
- Intheforefront.org. Forefront suicide prevention LEARN saves lives. https://intheforefront.org/wp-content/uploads/2021/04/Adult-LEARN-the-Steps-to-Prevent-Suicide-Overview-2021.pdf. (Accessed February 17, 2022).
Cite this document as follows: Clinical Resource, Dealing With Stress: Healthy Habits and Resources. Pharmacist’s Letter/Prescriber’s Letter. May 2020.