Managing stress during COVID-19 scare

News of COVID-19, also called the coronavirus, has been shared widely in recent weeks, but it is important to care for your mental and emotional health as well. Many people affected by breast cancer, whether in active treatment now or long past it, are worried about COVID-19. But recommendations to protect yourself from the coronavirus, such as staying home and limiting contact with other people, can also add to the stress and anxiety of this moment.

Living Beyond Breast Cancer CEO Jean A. Sachs, MSS, MLSP, spoke with licensed psychologist Pamela Ginsberg, PhD, about managing the stress, anxiety, and loneliness that may result from COVID-19 and social distancing. Listen to learn ways you can stay calm and present during the public health scare and manage your relationship to media about COVID-19 so you stay informed without adding stress. Listen to the audio, or read the full transcript below.

Pamela Ginsberg, PhD
Pamela Ginsberg, PhD, is a licensed psychologist who specializes in women’s health and wellness.  With over 25 years of experience, Dr. Ginsberg works with women with all cancers at all stages, with a special interest in working with women with metastatic breast cancer. Read more. 

 

 

Jean A. Sachs, MSS, MLSP

Chief Executive Officer, Living Beyond Breast Cancer

Jean began her work with LBBC in 1996 when she became the organization’s first executive director; she was named CEO in 2008. Jean brings a lifetime of women’s advocacy experience to her role as CEO. She lives LBBC’s mission everyday by speaking with newly diagnosed women about their needs and gaps in support. Read more.

 

Jean Sachs (00:00):

Hi everyone. This is Jean Sachs, the CEO of Living Beyond Breast Cancer. I wanted to pull on some of our experts in the community to talk about what I know everybody is feeling these days, which of course is the impact of COVID-19. I know for our community who's also been impacted by breast cancer this can be a really anxious and stressful time. I'm thrilled [to talk with] Dr. Pamela Ginsberg, who's been a longtime friend of Living Beyond Breast Cancer, she's a licensed psychologist who specializes in women's health and wellness. She has had more than 25 years of experience working with women at all stages of cancer and has an ongoing interest in helping her patients manage stress and uncertainty, which is something we certainly could use right now. Welcome, Dr. Ginsberg.

Pamela Ginsberg (00:57):

Thank you, Jean. I appreciate it. I'm happy to be here.

Jean Sachs (01:01):

I thought maybe we could start, with just giving, what are some tools in the toolbox that we can pull out when we're starting to feel overwhelmed?

Pamela Ginsberg (01:15):

Well, there's lots of tools that most of the people who have had breast cancer or have breast cancer are probably already using in their lives. Let's just talk about some of the basics and maybe reconnecting with some of our basic health practices that really help us in times of stress and anxiety. The things that everybody knows about. Getting outside, I think it's a really important thing to not be afraid to go outside. Getting some fresh air, getting some sunshine is always good for us. Taking a walk. We have to make sure we're still eating well. It's easy to panic about food availability, but you know, most people will be able to eat normally and eat well during this period of time. It's really important to connect with your social network, with your friends and your family, and that you’re making phone calls and chatting with people who are also maybe feeling anxious and panicky about what's going on.

I really encourage people to talk about things other than COVID-19. You know, all of those other things that are going on in your lives as well. I'm a big fan of meditation. Anybody who knows me knows that I always recommend meditation. Meditation is a great way of quieting your system down a little bit; very helpful when you are feeling anxious. I want you to see this as an opportunity to maybe catch up on the sleep that you don't get enough of [and] to catch up on conversation and time that we know that we always complain we don't have enough of.

Jean Sachs (02:57):

Those are great. I love that you mentioned try to talk about something else because I am certainly finding in my life that anytime I run into someone or someone calls me there's a good 10 to 15 minutes talking about what is going on. How do you steer that away [from COVID-19] or just have a practice of not needing to talk to everyone about it?

Pamela Ginsberg (03:25):

Well, I think that we can say, as we call somebody or text somebody, say, “I'm sick of talking about this, can we talk about something else?” My guess is that other person will also be happy to talk about something else. We have plenty of opportunity to talk about this and some of the practical things that we need to understand, but we can go on and on and on about this in a way that I think becomes counterproductive and just serves to fire up our systems in a way that is not good for us. There's such a thing as emotional contagion. We talk a lot about contagion right now because this virus is very contagious, but you're much more likely to fall victim to the emotional contagion of this situation than you are to fall victim to the actual virus itself. Be careful about not being contagious emotionally and restricting what's coming in so that you're not a victim of some of the emotional contagion.

Jean Sachs (04:31):

That's great. I have read some articles on that. For anyone who wants to do a Google [search] about emotional contagion, there are some really good resources out there that talk about that. I know Pam, just from working with you in the past, that you have a great practice of setting time aside for worry. Can you share that?

Pamela Ginsberg (04:53):

Yeah. One of my favorite little tools is dedicated worry time. For anybody who's had breast cancer there's a lot of stuff to worry about and it's easy to become obsessed with thinking about it and thinking about it and worrying and worrying and worrying about it. So what I recommend for people is having dedicated worry time. Give yourself 10 minutes or 15 minutes or whatever you need, really even 30 minutes of time where you set aside from 1 o'clock until 1:30. That's going to be my dedicated worry time and I'm just going to worry the heck out of it for that period of time. And then I'm going to wrap it up and put it away for a while and see if I can manage to not think about it as much and not worry about it because I'll have my dedicated worry time again tomorrow. I also recommend maybe pairing your dedicated worry time with your media time. So the time that you spend catching up on the news of the day, I'm recommending to people to do that maybe twice a day, once in the morning and once around dinnertime, not too close to bedtime, just to make sure you're updated on what's happening around you. And if you want to pair that worry time with a half-hour of news in the morning and a half-hour of news at dinnertime, I think that that's a great way of doing it.

Jean Sachs (06:14):

That's so helpful. We talked right before this interview and I said I need help with this because I'm finding myself, right before I go to bed, turning my phone on and getting the latest news. And that is absolutely the wrong time to have your worry time. So I'm going to work on that as well.

I want to just spend a little bit of time talking about some of the unique needs for those that might be in active treatment for breast cancer, whether they have early-stage disease or metastatic, but they may need to go to the hospital, possibly every day if it's radiation or a couple times a month for chemotherapy or scans. They really can't easily practice social distancing, which we've all been asked to do. And they also may be immune-compromised. For this group that has another layer, what are some things that might be helpful for them?

Pamela Ginsberg (07:13):

We have to think about social distancing on this continuum of: I'm going to do as much of it as I possibly can. For many people, we cannot do 100 percent social distancing, but I want you to do as much of it as you possibly can. We also have to trust that your healthcare system is taking every precaution in their power to keep their patients safe. Anybody who is suspected of having this virus, they're not even going into the hospital in the regular entrance anymore, so hospital systems are doing a good job to stay on top of this as much as they possibly can and keep their patients safe. We just have to trust that you don't want to compromise your treatment.

I'd really encourage you to contact your medical professionals and have a conversation with them so that maybe they can put your mind at ease. This is not about not living life, it's about living life under certain restrictions right now. And I think that cancer patients have already developed an expertise in managing uncertainty. You guys are ahead of the curve in managing uncertainty because you've learned to do that already. This is about more of that. More managing uncertainty, knowing what's within your control and knowing what's not within your control.

Jean Sachs (08:47):

That's helpful. I have been hearing, as part of hospitals getting ready for this and protecting their patients, they're limiting who can actually come into the hospital. You might not be able to bring your partner or your friend if you're having chemotherapy or if you're having surgery. I know for some people that is a big comfort for them. What are some of the things they can do to feel more comfortable without having a loved one with them?

Pamela Ginsberg (09:18):

There are a lot of limits on who can come into a hospital [or any medical setting right now]. You should find out about that prior to going to your medical appointments. And I would connect with a loved one or a friend so that you can FaceTime with them or you can text with them as you're there so that you do feel connected to somebody, even if it's not somebody sitting right next to you at that time. But prepare for that. And I think preparedness in general is smart. If you know that you're going to an appointment on a certain day, make sure there's people around you who know, who can wait in the parking lot for you, whatever it takes to feel like you're not alone.

Jean Sachs (10:03):

Yes. Right. And this is hard. We really do hope it doesn't last too long, but not knowing how long it's going to last is another challenging thing to reconcile.

Pamela Ginsberg (10:17):

I think it's one of the hardest things to reconcile. I always think that one of the hardest things of any unknown situation is that not knowing what the end date is, not knowing when we're going to get back to normal. It's actually a really difficult thing. Human beings don't do very well with uncertainty in general. And so the timeline, the uncertainty timeline is actually a particularly difficult thing that human beings have trouble with. But I want people to recognize [and] to not be catastrophic in their thinking about this. Focus on what you can control and what you can’t control and trying to be as practical as you can be. The moment we go into panic or catastrophic worst-case scenario thinking, we stop making good judgements, we stop making good decisions under those situations. I want you to try to be as introspective as you can be about kind of what's going on in your own thinking.

Jean Sachs (11:14):

I want to pick up on what you said about decision making because it is true in these situations when you are stressed is often when you make the wrong decision and the last thing you want to do is have a car accident or fall or cause something else to happen during a time like this. So being really mindful of taking that extra breath to say, “OK, what am I doing next?” And calming yourself down.

Pamela Ginsberg (11:43):

Exactly. And that's where meditation and mindfulness can be really helpful. And again, for those people who practice it, I want you to turn to it more frequently during the course of your day. For those people have never practiced it. You have some time right now. This is a great time to maybe play around with that a little bit. My favorite mindfulness app is called Headspace, and Headspace is offering free services right now, so you can log on to the Headspace app and get their services for free.

Jean Sachs (12:10):

I also do think because a lot of gyms and yoga studios have closed. There's a lot of free classes that you can take advantage of online as well. All things that, while we have this extra time not being able to leave the house or working remotely, to take advantage of.

We're going to come to an end, but if people want to consume information, are there any trusted sites, particularly around cancer and COVID-19 that you would recommend?

Pamela Ginsberg (12:41):

Yes. So obviously, you know, we want trusted sites because there's a lot of stuff out there, especially on social media, that I would really encourage people to stay away from. As far as COVID-19 in general, you want to stick with the CDC site and your own state's department of health. For cancer-specific sites, I found a few that I thought were very helpful. Cancer Support Community has information on their site that they're updating every day and so does the American Cancer Society and Cancer.net is another website that is updating their information every day. I know MD Anderson is doing something and the American Lung Association is also doing something. You want to stay with these trusted organizations that are not just going to give into the hype and the panic that's going on right now.

Jean Sachs (13:34):

That's really helpful. And of course the CDC is always an important site to look at. And be careful about what pops into your inbox or on your newsfeed; just because somebody says something or writes something doesn't mean it's true. Something I think we have to always remember with information traveling so quickly.

Pamela Ginsberg (13:54):

There's also a phenomenon called group think. If people have never heard of this, group think is a phenomenon when people are in a group and they're talking about something, it tends to get more and more exaggerated. That's kind of the Facebook phenomenon. If you're on some of these social media groups, it can easily get off-track and go into a direction that is completely unhelpful. So if you are recognizing that you're kind of going down that rabbit hole, pull back, go to some of these trusted sites [to] get your information.

Jean Sachs (14:27):

That's great. This has been so helpful. I really appreciate your time. This is something we want to try to offer to our community as much as possible as we go through these next weeks. I want to remind everyone that Living Beyond Breast Cancer has information on LBBC.ORG specifically on COVID-19, tips for managing stress, and we have a number of articles and [podcasts] you can listen to. Please take some time to go and look at our site. Also our peer-to-peer support helpline is open and running and the number is (888) 753-5222. You can find that number on LBBC.ORG [and] we will match you with another woman who's been diagnosed. I think this is the time where peer-to-peer support can be really, really helpful.

For those of you that have been diagnosed with breast cancer young, under the age of 45, we have a closed Facebook page. If you go onto our website, you can learn how to join up with that community. They've been having some really helpful conversations and connecting people who really understand what you're facing.

Thank you again, Dr. Ginsberg. And to everybody, we are thinking of you. One thing we have to remember is we're all in this together. No one is exempt from this one. So we need to just be there and support each other.

Pamela Ginsberg: (15:54)

Thank you, Jean. I think that that's a really important point. Look for the silver linings and I want everybody to just put love and compassion in the forefront as we move through this situation.

Jean Sachs: (16:06)

That's right. We're only going to get through it if we all do our part.