The COVID-19 coronavirus pandemic has affected everyone in some way – many of us are unable to work, unable to find access to child care or other important resources (one friend of mine has even been barred from doing laundry in his building). For some, like someone I know of who runs a milk delivery company, the pandemic is like an early Christmas present. Significantly and unfairly, the pandemic most adversely affects those who are most vulnerable: people living in or close to poverty who are out of work, people who are homeless, and those at highest risk to develop illnesses.
An important, but often overlooked group impacted by COVID-19 coronavirus are those who use substances. That includes those who rely on alcohol, cannabis or other drugs for medicinal or functional purposes (such as anxiety management), injecting drug users who rely on access to safe injection sites, and users of a variety of other substances for whom access has now dried up or become increasingly unreliable.
Imagine having to go device-free for a week, or longer – no phone, TV, computer, or other screen. For many of us this would involve literal symptoms of withdrawal, as we have become accustomed to using screens to cope with negative emotions, stress, anxiety, and to connect with others. I’m willing to bet you couldn’t, or wouldn’t, pull it off. A substance user’s drug of choice likely serves a similar function and is very likely quite painful to suddenly lose access to, without any sense of choice or control. My colleague very kindly reminded me of the difficulty some people will go through losing access to substances during a very uncertain and stressful time, and I feel sad to think of the number of us that will go through painful withdrawal symptoms (physical pain, uncontrollable anxiety or panic, and severe depression are just a few) and as a result will be forced to find other ways to cope.
People are incredibly resilient and will generally find ways to get through difficulties whatever the cost. I wanted to talk a little bit about the ways we can cope with difficulties, even in the face of withdrawal from something as mild as social isolation or as severe as substance addiction. Recovery from substance dependency involves building recovery capital, which is a blanket term referring to resources (both external and internal) that allow us to slowly build up capital – a wealth of other ways to cope. There are hundreds of examples, but some key themes are relationships with others, health (physical, mental, and emotional), strategies and tools, and a relationship with oneself.
Substances can be an effective tool in the short-term, but they have shortcomings: they don’t tend to last very long, they take a physical toll, and they can keep us away from some opportunities for the growth that comes from going through difficulty with the right support. Substances are considered part of passive coping, just like video games, junk food, and ignoring a problem. Passive coping is not bad, it is an important resource and we don’t want to overuse it. Active coping is also an important resource: exercise, diet, certain types of social support, therapy, learning, and other health behaviours fall into this category. Simply put, active coping is anything we do to directly cope with a difficulty, and passive coping tends to avoid the implications of a difficulty. The trick is striking a healthy balance between the two.
If you have recently lost access to substances or access to other important habits, I’m really sorry – you didn’t get to have a choice in the matter; an invisible and seemingly uncaring force made the decision for you. That really, really sucks, and now you’re stuck managing as best you can. Some that I have talked to will use tools such as exercise or meditation to achieve another type of “high,” and focus on emotional, spiritual, or intellectual pursuits when they have the energy to do so. When they don’t, they will use whatever means necessary to get through the really hard moments: sleeping a little more, indulging in TV or video games, venting to friends, or eating a little extra sugar.
You will find a sample list of different coping tools and a couple resource links at the bottom of this article. However, I’m not really here to give a bunch of advice, as everyone is different, and there aren’t any one-size-fits-all solutions. If you want help taking care of yourself right now and want to talk about creating a short-term plan, let me know and I can help with that. But you know yourself best, and you know what will get you through this better than anyone else does, and hopefully you know when you might need to seek support. Mostly, we just want to say that whatever your situation, we are thinking of you and rooting for you to get through it, because there is a lot of uncertainty and difficulty for a lot of us right now. Always feel free to reach out, and most of all, take care of yourself.
Tips for the “Green Zone” – when we have some energy or motivation:
- Don’t overdo it – quality over quantity. Give yourself a realistic and short amount of quality time (say 15 minutes) to spend on something that your ideal version of yourself would do: go for a walk or a run, listen to some music, do yoga, spend some time reading, writing, singing, or drawing, complete a short work task, organize your cupboards – whatever. When you’re doing this, try to let all your focus rest on the activity at hand. Here’s a quick video tip from a children’s book I’m a fan of.
- Try meditation. Focus for a few minutes on your breath, and spend some time being curious about yourself: how do I feel at this moment? What physical sensations do I notice? Do I feel anything towards myself or towards those sensations? Try to avoid positive or negative judgments during this time, and if they arise, just notice that they are there. The goal is just to be, to observe yourself internally at that moment.
- Spend time cooking yourself a healthy meal from scratch, and eating it without any distractions, focusing on how good it tastes, and feeling good about yourself for putting the energy in to make it. If you can, even better to share it with someone.
Tips for the “Yellow Zone” – when our stress is present but manageable:
- Notice what thoughts and feelings are coming up with as much compassion as possible. Imagine the things that are happening internally are happening to someone you really care about (real or imaginary). What would you tell them? How would you want to care for them? Try to identify a small way you could care for yourself in that moment. If all else fails, take some deep, slow, breaths.
- Exercise. Get your blood pumping and get moving, this will give you an adrenaline spike to help you get through the next while. If you are tired later, you’ve earned a break! Take a nap.
- Put on some music to match your mood, and paint, draw, or write along to it.
- Call or chat with someone. Most of us have time on our hands – talk (or even vent) about what is stressing you, ask how they are doing and try really hard to listen well. When we share with others, or work hard to understand others, our relationships deepen and we feel closer and more comfortable. If you’re not up for a conversation, just play some online video games together. If you are struggling with something specific, try to find an online chat group that specializes in that type of thing. If substance use is your thing, there are tons of online chat groups full of people who have good advice and good support, all anonymous and for free.
- If you have a therapist, an online session might be a good idea.
Tips for the “Red Zone” – When the bomb hits or is about to hit:
- Breathe. Inhale for 3-5 seconds, hold for 2-3, and exhale slowly for 7-10, like you’re blowing on something to cool it.
- Douse your head in cold water for a few seconds – this activates a survival “dive reflex” that calms the body. You can also try grabbing some ice cubes and squeezing them in your hands, focussing on that feeling and seeing how long you can go before having to let go. It’s pretty hard, and good at redirecting the brain.
- Reach out to whoever feels safe to reach out to, in whatever way feels ok.
- Feel free to use your favourite passive coping mechanism: watch a movie, eat something (preferably deliberately slowly), try to take a nap.
- Imagine or daydream.
- Write or draw – destroy some paper with whatever you’re feeling at the time.
There are countless other things you can do, and lots of online resources for meditation, emotional regulation, practical addiction support. Again, individuals vary wildly, so if you want help creating a specific plan for yourself, feel free to reach out to a mental health professional. We’re in this together, and we’re rooting for you here at Alongside You.