In his timely book, Ronald R. Parks, MPH, MD, examines the impact of COVID-19 or other forms of crisis, loss, or tragedy on individual mental health.
From his perspective as a Board-certified psychiatrist, a holistic healthcare practitioner, and a caring, concerned teacher, Dr. Parks offers helpful insights and suggestions designed to empower those with ongoing emotional challenges and those who want to maintain optimum mental and physical health. Early recognition and action are crucial, and so each chapter provides simple tips for supporting well-being in the face of unexpected events.
Blending research, historical events, and his own life experience, Dr. Parks has created an easy-to-understand, practical guide to help readers survive and thrive during troubling times.
In the COVID-19 Pandemic, many have experienced extreme personal loss, trauma, and mental health challenges. Peoples’ responses have similarities to those seen in survivors of natural disasters.
This book presents many essential elements needed to identify and find the path to healing and wellness. Insight, directions, and answers come from holistic medicine, psychology, psychiatry, and natural medicine perspectives. Self-help techniques are imparted along with valuable, ageless wisdom from respected scientists and spiritual teachers. Stories are shared from the author’s personal and clinical experience.
Dr. Sid* (endearingly called just “Sid” by the healthcare workers at the larger inner-city hospital where he had worked for the past fifteen years) carefully made his way through the nearly deserted city in the early morning darkness. It was an eerie scene of desolation and emptiness. He felt anxious and depressed, dreading what would soon face him, as he parked his car near the imposing four-story hospital structure. Passing through the emergency room to get to his office on the second floor, he immediately noticed the anguish and terror in the faces of the many people sitting in chairs or on stretchers in long lines reaching out into the streets. The COVID-19 pandemic had caught everyone unprepared.
Walking towards the elevator, he had an increased, pounding heartbeat and an arising of suffocation, danger, and darkness, bringing with it a sense of doom and helplessness. Grotesque images, hidden deep in his memory, emerged; these were scenes of his battlefield experiences, including witnessing people dying after a bomb had exploded in their compound. Nauseating flashbacks appeared of body parts strewed everywhere. As a medic, he had been overwhelmed, as there wasn’t adequate medical personnel for the wounded and dying. He also remembered the sickening smell of burning flesh. Their small field hospital had failed to be adequately prepared or equipped for that level of disaster. His final memory was of his attempting to find and triage the living and to salvage life, of blacking out, then waking up later in the field hospital with a minor head wound from flying shrapnel.
Refocusing, Sid adjusted his facemask and got onto the elevator, which was empty this time of the morning. He realized that he was nearing a breaking point, a product of all the stress of working in the overwhelming situation of caring for dying patients and witnessing so much death. The hospital and city were now in the worst part of the pandemic onset. Like many, his hospital had suffered from staffing losses and inadequate supplies and equipment to manage such an unexpected catastrophe. Also, he realized that his age now placed him in one of those high-risk groups for severe disease and death from the virus. He had experienced the reality of coping with life after loss with the death his wife and son, and later his mother’s dying from COVID-19. He realized now that he hadn’t taken the time he needed or reached out for necessary help and support. Instead, his days had become mostly focused on his work, where he felt appreciated. And Sid had also become less active in his free time and had gained weight, exhibiting early signs of heart disease, high blood pressure, and diabetes.
After grabbing a cup of coffee and getting dressed in protective clothing and mask, Sid reached the intensive care unit for rounds with the nurse and new, young intern. They discussed the recent deaths of patients who had expired during the night. The three completed rounds about mid-morning, making some medication changes, examining patients, and writing new orders. Frantic families called to find out their loved ones’ status, calls to which he would have to attend. On his way out of the ICU, Sid grabbed the list with the families’ phone numbers so he could make calls either with the good news of progress, no change, or to report of downward turns or the death of loved ones. Halfway down the hall to his office, Sid felt suddenly like an elephant was sitting on his chest—crushing the life and breath out of him—and he crumpled to the floor. The pain continued through his left arm and chest, and he had difficulty catching his breath. The next thing he knew, he was waking up in the coronary care unit. One of his younger colleagues, a cardiologist, told Sid that he was stable but had suffered a significant heart attack. Relieved, on the one hand, that he wasn’t dying of COVID, he was also shocked by the major heart attack.
Lying in his hospital bed, Sid believed that his heart attack resulted from the overwhelming combination of culprits including stress, anxiety, aging, an undesirable lifestyle and remnants of his PTSD from war trauma, as well as residual grieving from the death of loved ones. Living and practicing in a pandemic, among so much devastation, had also triggered memories of many personal losses and reminders of his previous war experiences and of losing his home, wife, and young son during a hurricane.
Fortunately, Sid survived his heart attack and even experienced a bit of an awakening about changing his lifestyle. Now he could find a more suitable and less demanding work situation. Sid had also appreciated the young intern who came to visit and spent time with him on the coronary care unit. Both could listen to each other and share their individual life stories, with their respective trials and tribulations, the good and bad times, losses and blessings, and what could still be valued in gratitude. As they shared, the young intern cried; his wife had recently suffered the stillbirth of what was to have been their first child. And so Sid realized that it was a blessing for both of them to share and talk. The presence of the young intern also reminded him of the son he had lost. After he left the hospital, Sid kept track of the young doctor, later becoming an appreciated support and mentor for the intern, and was treated as a family member.
(*To protect the confidentiality, stories in this book are composites of clinical experiences and do not represent actual persons.)
THE IMPACT OF THE CORONAVIRUS (COVID-19)
The rapid spread and potential for severe illness brought by COVID-19 have dramatically increased anxiety, depression, associated diseases, and deaths. While some fear and anxiety probably help motivate people to adhere to public health guidelines (to prevent getting the virus, carrying the virus, and infecting other people), too much stress can also lower immunity, reduce the amount of needed restorative sleep, and increase infection vulnerability. Such emotional distress and mental impairment can also cause a loss of work time, disruptions in relationships, drug addictions, overdoses, and suicides. The less anxious or (perhaps worse) the misinformed people who ignore basic public health guidelines can contribute to the loss of control of the viral spread, with all its dire consequences.
Besides impairing immunity, anxiety can lead to increased hoarding or over isolation. People might get needed supplies in order to stay at home and to avoid risky public venues. However, in these anxious times, the risk is to become obsessed and addicted to watching too much TV, consuming news reports that feed fear and worry while offering limited practical information about disease prevention or control.
For those feeling overwhelmed in the current crisis, with symptoms of increasing anxiety, panic, or obsessiveness, this may be the time to consider getting support or outside help. Cascading emotional distress might otherwise contribute to emotional collapse and severe depression; therefore, recognizing and managing fear and anxiety is essential to maintaining healthy emotions and moods.
MANY PEOPLE DON’T SEEK OR RECEIVE HELP
Anxiety disorders affect 40 million adults, or 18.1% of the U.S. population, every year during typical, non-coronavirus times, making anxiety the most common mental/emotional/psychological condition in our country. Anxiety and related disorders account for a significant portion of the U.S. mental health budget. A considerable number of people with an anxiety disorder also have at least one other accompanying psychiatric condition. These disorders can cause overwhelming, debilitating anxiety and fear that can become worse if not treated. And yet less than 30% of individuals with these problems seek treatment, and many go undiagnosed by their primary healthcare providers.
FEAR
Fear can paralyze a person through a loss of productivity, of effectiveness, and of quality of life. And today’s unique atmosphere of a viral COVID-19 pandemic is overwhelming for many. Even with stimulus packages enacted, our nation is experiencing a collapsing economy. In the face of these events, unchecked fear and worry can build to a loss of confidence, insecurity, and significant emotional states, including anxiety, panic, and depression. Mental Health America (MHA) has been conducting online screenings for six years, and with over 5.5 million completed, it’s the United States’ most extensive screening program. Data from their recent online mental health screen showed a significantly greater moderate-to-severe depression or anxiety rate than in a similar study before the pandemic. A quarter of study participants cited grief, loss, and financial concerns as contributors to anxiety and depression. Current events appeared as a significant factor in the development of mental health problems as well. Respondents who screened positive for depression reported increased thoughts of suicide or self-harm on at least half of days and up to nearly every day.
According to a two-month July 2020 survey from the reputable Kaiser Family Foundation, more than half of the U.S. population have experienced adverse effects from COVID-19-related stress. The question asked was, “Has worry or stress caused you to experience any of the following in the past two months?” followed by a list of health effects. Frequently reported difficulties included problems with sleep, poor appetite or overeating, mental health issues, headaches, stomachaches, temper difficulties, increased alcohol, drug use, and worsening of existing chronic illnesses such as diabetes and hypertension.
PEOPLE WORRY ABOUT SUSTAINING THEMSELVES AND THEIR FAMILIES
Since the onset of the pandemic, the weakened economy has wiped out the five prior years of economic growth, driving fears of a more prolonged recovery, as was seen during the Great Depression. With growing unemployment, losses of businesses and jobs, and uncertain access to government-funded aid, the current surge in coronavirus cases and deaths in the U.S. and concern about further business shutdowns have led to decreases in consumer confidence and spending.
Faced with the many new demands and measures needed for surviving the pandemic, anxiety and fear can soar for many people. These demands include:
• Avoiding close personal contact with social distancing
• Wearing masks
• Doing frequent hand washing and sanitizing of surfaces
• Staying out of closed spaces occupied by potential coronavirus carriers, such as places of usual recreation, eating or drinking, shopping, working, and entertainment
WHO IS SUSCEPTIBLE?
People who are more apt to have heightened worries are older individuals, people with medical issues like smoking, chronic airway disease, obesity, diabetes, and individuals living in high-risk environments such as nursing homes or crowded spaces. Essential workers and people who have gone back to work are always aware (or at least they should be!) of the safety measures needed to prevent spreading the virus. Therefore, stress and fears can be an overwhelming reality; these are already frequently higher in disadvantaged, minority communities and amongst essential workers where higher rates of COVID illnesses and deaths occur.
Contributors to a higher spread of the COVID-19 virus are poverty, lack of healthcare resources, living in less healthy environments, and the existence of health vulnerabilities such as obesity, diabetes, and hypertension. Also, the economic disparity of people in the U.S. living below the poverty line will most likely increase as the current pandemic continues and unemployment grows. With the supply of basics such as food and shelter threatened, fear, anxiety, and panic will probably increase among the disadvantaged. Higher demands will then occur on the government and on all able citizens to create an increased flow of opportunities and financial help for such individuals and communities in need. Thus, getting past the current crisis will require the best leadership and personal efforts to address these critical issues and threats to well-being.
Individuals are also more prone to anxiety and mood disturbances if they have a prior history of significant trauma. The residual effects of traumatization occur in individuals who have experienced life-threatening situations, losses, or severe illness, or who are victims of or witnesses of violence, near-death experiences, auto accidents, exposure to natural disasters or war, earlier life deprivations, or abuse. Post-traumatic stress disorder (PTSD) is an example of the recurrence of anxiety states and related physical and emotional symptoms from such residual prior traumatic experiences.
THE BEST STRATEGIES
Like the risk of getting a COVID-19 infection when in a closed space with other infected people, fear and anxiety can likewise rise dramatically by being “caged-in” or stuck in one’s inner thoughts and emotions. Levels of fear and anxiety can also become compounded when individuals are caught in tight quarters with others who are experiencing fearful states. Avoiding getting help, counseling, or therapy, especially if there is a history of unresolved trauma from the past, will increase the likelihood of developing severe mental health issues or illness. Those having a history of trauma or living with others who have an unchecked emotional or mental illness should seek help or guidance early, preferably as soon as they experience growing fear, worry, or anxiety. Early identification of feelings or symptoms of unhealthy emotional or mood states is an initial step in knowing when to get help or support. Prompt attention and early intervention may also prevent the progression of persisting fear and worry toward more severe and chronic disruptions in one’s well-being and mental health, such as continuing anxiety and depression conditions.
BE ALERT TO THE SIGNS
Signs of anxiety may include:
• Being frequently nervous, irritable, moody, or on edge
• Feeling a sense of impending danger or doom
• Increased or rapid pulse/heart rate, palpitations, and dizziness
• Fast or troubled breathing and sweating
• Increase tiredness, weakness, and wanting to sleep more
• Muscle tension, fatigue, and trembling
• Difficulty concentrating and getting things done
• Having trouble sleeping, with more frequent nightmares
• Experiencing digestive problems and changes in appetite
• Panic attacks, which appear suddenly and increase in intensity over several minutes, peak, and usually go rapidly away
If any of these symptoms persist, please consider seeking appropriate support.
PANIC ATTACKS
Panic attacks can occur due to growing anxiety. Panic differs from fear and other types of anxiety. They include severe anxiety, muscle tightness, trembling, fast heartbeat, fast or troubled breathing, dizziness, impaired concentration, palpitations, sweating, and sleep disturbances. Also, panic attacks are often unprovoked, appearing suddenly and increasing in intensity over several minutes, peaking, and then rapidly subsiding over 20 to 30 minutes. An episode can occur as a one-time event or can repeatedly occur, triggered by something remembered, or it can appear without warning, and occasionally when awakening from sleep. These episodes can be very disruptive, disturbing, and disabling. One explanation for the cause of the panic attacks is that the body’s typical alarm system of mental and physical responses to an actual threat, the “fight-or-flight response,” gets triggered and activated even when there is no real threat present.
MOUNTING ANXIET Y AND FEAR
In “normal” times, panic attacks possibly occur in 20% of the U.S. population at least once in their lifetimes, or in 3% of the population at any given time. With the heightened fears over illness and related concerns (personal and family safety, work, career, paying the bills, getting needed food, shelter, medications, etc.), panic attacks are likely to become more prevalent and widespread. By altering support systems, the usual public health measures to prevent the spread of illness (such as social distancing, sheltering in place, and avoidance of community activities) could make some more vulnerable to panic episodes. Identified causal or contributing factors to panic attacks include:
• An actual or transient medical problem such as a middle ear infection, allergies, mitral valve prolapse (often a mild dysfunction of this heart valve closure), hyperthyroidism, or low blood sugar
• Earlier life history of significant trauma or post-traumatic stress disorder, with embedded memories of prior trauma, increase susceptibility for panic episodes in an already highly anxious and hypervigilant person
• Medications use or withdrawal, stimulant or substance use, or abuse (caffeine, alcohol, opiates, etc.) can lead to greater vulnerability to panic attacks
• Overuse of stimulants like caffeine or non-prescribed or unnecessary stimulant drugs, or drugs of abuse as methamphetamine or cocaine
• Life events involving significant stress, losses, threats of damage, or the feelings of increased vulnerability may precede panic attacks, such as the current mounting fears over the coronavirus
Panic disorder can become recurrent and disabling. If the panic episode occurs in a specific setting, as in a store or car, irrational fears or phobias about these situations may arise. If a person avoids these situations, he or she can become increasingly housebound, unable to drive, and develop agoraphobia (fear of public places). If the person doesn’t receive effective early treatment, increasing incapacitation in life activities can result.
PAST TRAUMA
The American Psychological Association (APA) defines trauma as “an emotional response to a terrible event such as an accident, rape, or natural disaster.” They continue: “Immediately after the event, shock and denial are typical. Longer-term reactions include unpredictable emotions, flashbacks, strained relationships, and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”
Significant trauma also is a situation or event which may be recurrent, as can happen with severe emotional or physical abuse. The original, horrifying experience is usually coupled with the overwhelming fear that one's life, physical safety, or psychological integrity is at risk, without the ability to defend one’s self or to survive intact. The full emotional or physical reaction to the event or situation happens either immediately or later on.
COPING WITH DEPRESSION
Depression has similarly increased during the COVID-19 pandemic, either with or without anxiety and panic attacks. Signs of significant depression may include:
• Feeling down, guilt, hopeless, helpless, sad, or irritable (“pushing people away” or not getting along with others)
• Loss of one’s usual interests or pleasure in doing things (anhedonia)
• Changes in sleep patterns, such as trouble falling asleep, not getting restful sleep, sleeping too much, not wanting to get up, or staying in bed much of the day
• Feeling tired, a loss of vitality, or having little energy
• Poor appetite, overeating, weight loss or gain
• Frequently feeling bad about oneself, such as feeling worthless or as a failure
• Trouble concentrating or remembering things
• Slowing down of speech or movements and/or having a frequent sad face
• Being fidgety or restless more than usual
• Difficulty functioning at home or work
• Withdrawal and isolating self from others
• Spending more time on TV, computers, tablets, or cell phones
• Being preoccupied with watching movies or the news
• Thoughts of dying, self-harm (suicidal thoughts), or harming others (homicidal thoughts)
All the listed symptoms or behaviors of anxiety, depression, or panic attacks may be only slightly present, noticed at times, or be very pervasive in a severely affected person’s daily life and activity. If a person feels that life has lost its meaning and is not worth living, and/or has suicidal thoughts or feelings about hurting oneself or others, it is time to act and seek outside help from a qualified mental healthcare professional or resource.
For immediate or crisis help, call your local suicide hotline (1-800-273- 8255, 1-800-273-TALK, 1-800-273-8255), or 1-800-SUICIDE (1-800-784-2433) for the National Suicide Prevention Lifeline.
REMEMBER THE CHILDREN!
Children are also susceptible to COVID-19 infections. There is a growing recognition that the younger part of the population is also at significant risk for fear, anxiety, and mood problems during these pandemic times. Signs and symptoms of impending trouble might be different for children than that seen in adults. Such behavior or emotional changes in children might include:
• Temper tantrums, acting-out behaviors as being destructive, getting into fights or arguments
• Sleep difficulties and nightmares
• Showing decreased interests in things they usually enjoyed
• Being more sullen or apathetic or becoming more hyperactive
• Not wanting to take part in playful or recreational activities with themselves or with others
• Not eating well, gaining or losing weight
• Loss of concentration, attention, and becoming more distractible
Some of these children’s changes may be a warning sign for seeking support or help for the younger at-risk and vulnerable family members. Early recognition, getting support, and seeking assistance is critical for preventing and reducing the risk of chronic emotional and mental impairments and related physical illnesses.
HOLISTIC, HUMANISTIC, TRANSPERSONAL, OR HOLOTROPIC THERAPIES
When severe and recurrent fear and anxiety persist, help and relief can be possible with an effective therapeutic intervention. Ideally, the intervention helps the person to:
• Get unstuck from unhealthy patterns of behavior, rigid beliefs, and fearful or painful memories
• Reduce or eliminate anxiety, panic, addictions, and trauma-related symptoms
• Focus more on the present and the here and now, rather than the past or future
• Become more present, mindful, and aware
• Improve energy, focus, concentration, daily functioning, and skills to prevent relapse or recurring symptoms
• Develop greater acceptance and compassion
• Regain the wisdom and the balance of personal power, self-needs, and the needs of others
• Reestablish social support and networks
Therapies for anxiety, mood impairments, and prior trauma, such as Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive- Behavioral Therapy (CBT) interventions, are often beneficial. 3 Holistic, humanistic, transpersonal, or holotropic therapies may involve:
• Education about the body’s physiological reaction to fear and threat
• Use of experiential techniques, talk/listening, person to person, and group therapies
• Desensitization to the various physical sensations or triggers of panic through the exposure of a
person to the actual object, situation, or thought
• Catastrophic-thought-reducing techniques
• Learning relaxation, breathing, and stress management techniques
• Restructuring dysfunctional thoughts and patterns
• Gaining personal insights and the realization of one’s inner strength and vision to overcome obstacles
• Transforming from being the victim of a horrible traumatic experience and memories to a broader
perception of life, one’s power, and potentialities
• Acceptance that the mind is continually moving toward the healing of its own emotional and mental health
• A personal commitment to supporting the healing process and therapeutic work as needed
• Supporting the person’s process and strengths to release frozen past traumatic memories and constricting defenses, to regain energy flow and vitality
• Help for regaining flexibility and getting unstuck from rigid core beliefs and attitudes, in order to experience an expanded vision and perspective about life outside of the narrow constraints of a limiting mind-ego
Such approaches can help an individual to reduce stress and anxiety.
UNDERLYING MEDICAL CONDITIONS
Unfortunately, healthcare providers are often not familiar with the potentially devastating and disabling effect of the improper treatment of anxiety-related conditions. Management of anxiety is usually done with a tranquilizer, an antidepressant, or reassurance by a conventional healthcare practitioner. A thorough evaluation by a qualified medical and mental health practitioner with skills and expertise in working with anxiety, panic, and mood difficulties is often warranted, helpful, and is a better route when available. Finding caring and valuable help, when possible, may get at the deeper issues and the roots of anxiety conditions, rather than simply suppressing symptoms.
Holistic and natural therapies can be the most effective treatment course when combined with more traditional treatment. Some positive complementary approaches for consideration are:
• Lifestyle modifications and life skill enhancements
• Mind, body, and spiritual practice such as yoga, chi gong, mindfulness, meditation, creative arts, exercise with mindfulness as running, swimming, biking, or dance
• Stress management and relaxation techniques
• Acupuncture and massage therapies
• Targeted nutritional therapies, botanical medicine, and nutritional education about dietary choices, and micronutrients (as with herbs, vitamins, minerals, essential fatty acids, and even amino acids, the smallest units of protein and a precursor of brain neurotransmitters, which can sometimes help relieve anxiety and milder depression in combination with other natural and complementary therapies)
Medication may also be of value in resistant or severe emotional or mental health conditions, such as major depression, if natural treatments have not worked. Antidepressants or tranquilizers used by conventional medical practitioners can sometimes bring more immediate relief. However, their long-term use is controversial due to the possibility to cause other medical issues. Once in use, trying to stop medication can lead to relapse or, with some tranquilizing drugs or alcohol, can cause withdrawal seizures. Thus, medicines may not have the same lasting effect and benefits as useful therapy programs and natural alternatives.
TIPS: TWENTY-ONE INTENTIONAL WAYS TO REDUCE ANXIETY
1. Reduce the time watching, checking social media, or listening to news stories on your TV, computer, or smartphone when home or in the workplace. Check only once or twice per day to keep informed. Pick unbiased and truthful news outlets that do not have partisan political ties. Avoid misinformation or politically motivated reporting about the virus, pandemics, or politics. Hearing about the problems repeatedly during the day can lead to increased worry, anxiety, tension, poor sleep, or worse.
2. Instead of too much inactivity, such as passive watching, listening or obsessing about current worries or events, take frequent time- outs with regular exercise. Active movement includes stretching and eating healthy meals (avoiding sweet binging and over-snacking on high-sugar and high-caloric food or drinks). Enjoy periodic relaxation times with deep breathing, meditation, or yoga. Sleep to get adequate restorative rest.
3. Cut down or stop smoking or vaping, which put you at higher risk for a COVID-19 infection. Use a nicotine patch if necessary.
4. Avoid alcohol and non-prescription drugs.
5. If working from home or in the workplace, take more frequent breaks, stand more, or take outside walks.
6. Keep to a regular exercise schedule such as 15 to 30 minutes one to two times per day. Beneficial exercise can take many forms. Examples are walking, biking, walking stairs, housework, or an exercise routine. Other choices are taking part in an online group exercise program, or in a circuit exercise routine, including push-ups, lunges, jumping jacks, and running in place. Do relax, enjoy, and allow any worries and fears to move to the background of your awareness as you fully embrace the physical movement, breathing, and letting go of tension.
7. After doing an excellent exercise routine, you can treat yourself to a nice hot bath with two or three cups of Epsom salt and a few drops of essential oils as lavender oil to melt away any remaining tension.
8. Get outside and into natural settings. Being in and closer to nature is very calming and healing. Move, breathe, take in the beauty and harmony that abounds around us.
9. Get involved with enjoyable recreational or artistic activities like art, writing, and craftwork. It is the time for creative homeschooling if you have children.
10. Read an excellent book.
11. Complete home construction projects or prepare new recipes and meals.
12. Enjoy listening to music, dancing, or watching a good movie.
13. Complete a crossword or jigsaw puzzle.
14. Watch a comedy show for some humor and laughs.
15. Stay socially connected with friends, family, and community through video chats, texts, emails, phone calls, or social-distanced meetings, with face masks, if needed. Share your concerns about what you're experiencing. Value what has made you laugh amidst all the outside turmoil.
16. Learn or do yoga, mindfulness practices, meditation, or beneficial exercise routines to help with stress reduction and relaxation. Look for some interesting instructional videos that you can watch online with your computer or smartphones.
17. If the time and resources are available, take part in an online virtual certification, continuing education, or a university degree program.
18. Let the current pandemic crisis—a time of significant disruption and travails—be a time to do an in-depth review of what is essential and meaningful. Meditate and reflect on what is beyond your fears and self-preoccupations. Be aware of our small but significant connection with everything outside of ourselves. Find some inspirational readings or online materials and teachings from the spiritual, mystical, or faith traditions which inspire you.
19. Find some meaning and purpose in the turmoil and tragedy that surround us. Being more centered and grounded will bring better preparedness for what may unfold in the coming days, which may call for the strength and the spirit to do the best for yourself and others while not giving in to fear or over-focusing on personal issues and losses. Allow the current crisis and stresses to inspire you towards living a simpler, more meaningful life, to serve better the greater good, the community, and the environment. Be encouraged to be socially active to bring about positive change.
20. Do absolutely nothing, be in the moment, breathe, take it all in that is, including trouble and worry, but also what is comforting, beautiful, and inspiring for you—all of that for which you can be thankful. Taking a respite, a time-out to refill your reserves, will help you to regain your resilience and strength, so that you can move on with purpose, gratitude, and hope.
21. Finding the best path for yourself to move through fear and anxiety is of central importance during these stressful times. Be constantly aware and get the help you need at the first signs of distress. Be prepared to offer service and support to others with emotional difficulties. This is the time for exceptional acceptance and compassion towards oneself and others as ever-changing feelings, emotionality, insecurities, and vulnerabilities challenge us. Be prepared to offer service and support to others with emotional difficulties. This is the time for exceptional acceptance and compassion towards oneself and others as ever-changing feelings, emotionality, insecurities, and vulnerabilities challenge us.