While ideally these times of being in such close quarters with our loved ones would lead to quality time and growth, for most of us, it is bringing out our anxieties surrounding these uncertain times and creating discord and annoyance instead. These times are difficult for everyone; men, women, children, the elderly, though it could be doubly difficult with those struggling with addiction or are in recovery. Addiction here is any kind of addiction- addictive thinking, substances, behaviors, or impulses. I am writing this in an attempt to offer an understanding as well as applicable techniques to help us all get through this time of isolation and confusion.

Stress is something that a person struggling with addiction is constantly aware of. They have the incessant nagging of the reminder of being “dysfunctional” and the anxiety of having to maintain their temperance. Any added stressors where they may feel even more powerless over the outcomes such as the coronavirus pandemic would greatly impact the feelings of safety and stability for anyone but most definitely those struggling with addiction. From a brain and somatic/body-based perspective, I would say stress activates the survival mechanisms, the (fight, faint, freeze or flight) for everyone. It elevates levels of anxiety and triggers the limbic system to respond somatically, which creates the physically uncomfortable experiences we have of like, racing heartbeat, restlessness, headaches and body aches, tightness of chest, being chronically out of breath, etc. For addicts, the way they have historically calmed those physical symptoms has been through substance use. Where non-addicts are able to find other ways to calm those symptoms using alternative methods, addicts have historically only been able to do it with substances, or found substances do it quickest and most effectively, which is incredibly tempting if their symptoms are extreme. Addiction is very much about relationships and using their relationship to their choice of drug in lieu of fostering healthy relationships with people. And these procedures of forced isolation will highlight the feelings of loneliness that they have at one point assuaged through people, control, food, sex, shopping, drugs, alcohol etc. It will be much harder to fill that gap without the support of social outlets, outings, outdoor/ indoor activities, services that provide 12 step or similar programs and could result in relapses. Financial uncertainty is also causing stress and are triggering cravings in those struggling with addiction which not only heightens the need for escape, but the isolation is creating favorable conditions for relapse.

A-People in “recovery” are more susceptible to relapse because they have developed and are working on maintaining a healthy routine which has now been either slightly impacted or completely disrupted. Ensuring that they are keeping a routine which includes a regular sleep schedule (no napping), showering, getting dressed, going outside, eating, and doing something that feels rewarding and productive. Continuing online exercising, isolated walks/runs, hikes, outdoor solitary activities that are safe are necessary to break the monotony of feeling cooped up or trapped inside the home.

B- Staying in regular touch with loved ones BY FACETIME or other video services, because it is as close to eye contact as we can get, which is hugely important for human connection, especially when touch is not possible. Eye contact is something we typically struggle with because of our levels of distraction anyway (it’s shocking how just having couples work on intentional eye contact can transform their relationships), but when touch is off the table, and now under these circumstances, we have to, with INTENT, up the amount of connection with loved ones as much as possible. SMART recovery offers online meetings that can provide the engagement found in social support.

C- Use somatic calming practices regularly, not just when triggered. This would be things like meditation, body calming exercises, guided meditations, etc. Some apps are (I think) making some features available for free during the crisis. Apps like Headspace and Calm are great for this. As much as we can organically and intentionally calm those somatic responses to stress and anxiety as possible, our minds will actually follow, calming our emotional response to the stress. Stress is not just the things that are being put on you, but at times things that are unknown or uncertainty or the absence of these freedoms that bring about these manifestations of stress and anxiety. HALT is an acronym that is helpful to address: Hungry. Angry, Lonely, Tired. When you are experiencing more than one of these at any given time, you are your subconscious fears worst enemy. Things that we could otherwise cope with and talk through will become triggers. Managing these 4 things throughout the day and making sure not more than one are suffering at any given time will help keep emotions at baseline. 4, 2, 8 is a breathing technique that works as a direct link through the Vagus nerve to the brain to take the person out of the anxious state in activating the amygdala. Breathe in for 4 counts, hold for 2 counts and breathe out for 8 counts.

In addition to the above, I would say limit exposure to the news. It is important to remain informed, but over exposure can create more anxiety and even panic. Along those lines, I really emphasize listening ONLY to doctors and public health experts (like zoonotic disease experts, epidemiologists, disaster prevention and preparedness experts, pandemic modeling experts, etc.). Doctors and public health experts’ sole focus is the health of the people. Doctors in particular have an oath, and more importantly, laws and ethical codes that bind them to communicating accurate information to the general public. They can be trusted to give accurate information. I suggest connecting with doctors who are family or friends and asking them what their sources of information are so that they can follow the same sources.

 Check in with loved ones frequently, and perhaps even send them care packages. Listen to them and emphasize as an outside perspective that this situation is TEMPORARY, because they will need to hear it. Remind them of the strengths that they have leaned on to achieve their “sobriety” and healthy/ functional lifestyle- the ability to take things a day at a time the long term vision to see past the pandemic and see a positive future (as someone who struggles with an addiction, they had to be able to envision a better future for themselves in order to have hope to get past their addiction)... things like this. Most importantly, they have to listen with absolute nonjudgment and not panic. People with addictions have a REMARKABLE sense of survival, incredible strength and resilience, and an ability to see past dark days. They have worked really hard, and they know what it is like to face nearly insurmountable odds and have a lot of experience to offer from that perspective. The best thing we could do is learn from their strength and resilience, listen to them and their experiences, ask for their perspectives, and in this way, not only are we supporting them and helping them feel connected and worthy and loved, we are helping ourselves as a witness to their history and strength. 

We, in this field of mental health, are using this opportunity to continue to build strength and resiliency while enforcing the need for healthy coping mechanisms. We are continuing to offer sessions through telehealth as at times, we are the only escape and voice of reason for our clients based on where they are in their journey. We are encouraging our clients to use this time to reach their goals that they otherwise do not have time for; self-care, exercise, more family time, spring cleaning, picking up a new craft, establish a new habit etc. We are using our social media to reframe this time of isolation as a reset to the new year resolutions.

Anxiety is just our minds way of trying to tell us that something is amiss and that we are losing control. The best way to manage this anxiety is to do the things that bring control over the situation. To gather just enough information to be able to maintain your sense of safety and to know what to look for and what to do in the meantime. Then telling yourself what it is that you are doing or have done to control what you can. Staying home is something we are actively doing to prevent the spread, even though it does not feel as active. Washing our hands, reducing how much contact we have, keeping up with personal hygiene and physical care to strengthen our immune systems are all active and conscious choices to control the situation.