Anxiety and Relapse: Managing Stress During COVID-19

The coronavirus has the world firmly in its grip, and it appears the crisis is far from over. As the pandemic continues to claim lives and put much of daily life into uncertainty, the anguish of dealing with the public health emergency is affecting millions, including people who are in recovery from or dealing with substance addiction.

It is common to experience instability during a crisis, and it is times like these that substance use and addiction rates tend to spike as people try to cope with a changed reality. 

Critical support systems can give way to fear and stress, and this can prompt people in recovery to pick up alcohol or drugs, thus jeopardizing the work they’ve done to remain sober. For others, using substances to deal with a health emergency can be a slippery slope that leads to a life-threatening substance use disorder.

Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), recently spoke with U.S. News and World Report about how the coronavirus can affect people’s use of drugs and alcohol.

“Whenever there’s been a catastrophe like this, there is an increase in drug consumption across the board. Our alcohol drinking goes up, smoking goes up, and people relapse,” Volkow said. “We do know that drug-taking is one of the ways that people try to cope, and unfortunately, this can have very adverse effects.”

Substance Use During COVID-19

A recent report from McKinsey & Company, a global management consulting firm, provides a snapshot of substance use trends that are emerging as the world deals with the pandemic. Its researchers found that:

• 1 in 4 people reported binge drinking at least once in the past week;
• 1 in 5 people reported taking prescription medications for nonmedical reasons; and
• 1 in 7 reported using illegal drugs.

Many states have issued “stay-at-home” orders in an attempt to curb the number of COVID-19 infections and keep hospitals and healthcare centers from becoming overwhelmed with cases. As a result, forced isolation can lead one to pick up substances again because the person feels bored, lonely, or upset. 

Isolation is also one of the most challenging parts of this crisis for people with substance use disorders to face. Healthline underscores this, writing, “Add general anxiety surrounding a virus and addiction avoidance becomes even more difficult.”

What Is Relapse?

Anxiety, depression, and other mental health disorders can trigger a person to pick up an alcoholic drink or a drug. This can lead to a decision to continue to use, and relapse can soon be underway.

Relapse is a return to substance use after a break. The process is gradual and can unfold over weeks or months before the first drink or drug is used. Understandably, a crisis like the coronavirus can speed up the relapse process. 

It recommended that substance addiction be treated like other chronic illnesses, such as asthma, diabetes, and hypertension. 

A relapse also does not mean that earlier substance abuse treatment has failed. It is an indicator that treatment for the disorder needs to be reinstated, adjusted, or changed to facilitate a return to recovery.

How to Practice Self-Care 

Any thought about going back to substance use after one has made the decision to quit using is worth closely evaluating. If you or someone you know isn’t dealing with the stress of the coronavirus pandemic well or is feeling anxious, it’s important to acknowledge that and reach out for help. No one has to do this alone. There are virtual support groups among people who truly understand recovery, and they are there to offer guidance and a place to express your feelings. If you want to try to manage these feelings on your own, there are things you can do.

Below are positive steps to take to handle negative emotions at such a high-stress time. First, remember to take each day one at a time, and be mindful that stress and anxiety do not have to take over your life. You can be in control. Keeping a daily routine and engaging in activities that make you feel good can make staying home more manageable.

Many people are concerned about how to keep themselves and their loved ones safe during this time. Healthcare officials have advised us to:

• Wash our hands with soap and warm water vigorously for at least 20 seconds. Make sure to do this after you have been in public places, such as the grocery store.
• Wear a protective mask that covers the nose and mouth if you go out in public. You can make a cloth face covering from everyday household materials. For best results, follow the guidance of the U.S. Centers for Disease Control and Prevention.
• If you have to sneeze or cough and do not have a tissue, do so into your elbow, upper arm, or hand.
• Clean and disinfect often-used items in your vehicle and home. For vehicles, these include the steering wheel, door locks, entertainment control knobs, and gear shift. In the home, this includes remote control devices, toilet handles, sinks, countertops, doorknobs, and light switches, among other things.

In addition to engaging in daily housekeeping and hygiene practices, there are things you can do to feel a sense of control and personal responsibility. Consider:

• Limiting your news intake. Instead of reading or listening to stressful news reports, watch an entertaining movie, TV show, or take in a good book.
• Watching your social media use. You may want to do a “digital detox” and avoid social media outlets for a specific time. This can be a few hours each day or a whole day or weekend. It also can be longer if you need more break time.
• Listening to music, putting together a puzzle, or playing a board game to keep your mind busy and distracted from negative thoughts. Now could be a good time to start a hobby that engages your brain in new and fun ways.

You can also find more tips on how to protect your mental health and well-being at the website of the National Alliance on Mental Illness. In addition to recommending that a mental health treatment plan be followed, the organization also shares why practicing mindfulness and acceptance techniques can help. 

If you’ve tried these or similar things and find that you need more help, do not hesitate to reach out to a mental health professional or facility that specializes in treatment for substance use and mental health disorders. These centers can connect you with licensed therapists to help you manage stress, anxiety, and other overwhelming emotions of the coronavirus crisis.

Sources

Why COVID-19 Poses Added Dangers for Drug Users. (n.d.). Retrieved from https://www.usnews.com/news/healthiest-communities/articles/2020-04-02/coronavirus-poses-added-dangers-for-drug-users-nora-volkow-says

About the author(s) Erica Hutchins Coe is a partner in McKinsey’s Atlanta office. Kana Enomoto is a senior expert in Washington. (n.d.). Returning to resilience: The impact of COVID-19 on mental health and substance use. Retrieved from https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/returning-to-resilience-the-impact-of-covid-19-on-behavioral-health?cid=other-eml-alt-mip-mck&hlkid=3201130c8ae4497b9c2b0cd269b835e6&hctky=10146002&hdpid=12f6968c-21f7-4117-be80-642a4d689e86

Drinking Levels Defined. (2019, November 26). Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking

Melemis, S, (September, 2015). Relapse Prevention and the Five Rules of Recovery. National Center for Biotechnology Information. Retrieved April, 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/

National Institute on Drug Abuse. (2018, July). Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

“Recommendation Regarding the Use of Cloth Face Coverings.”Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 3 Apr. 2020. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

“How to Protect Your Mental Health during the Coronavirus Outbreak.”NAMI. Retrieved from https://www.nami.org/Blogs/NAMI-Blog/March-2020/How-to-Protect-Your-Mental-Health-during-the-Coron

Wong, C. (2020, April 3). Mindfulness Meditation: What It Is and How to Practice. Retrieved from https://www.verywellmind.com/mindfulness-meditation-88369