Dealing with the new realities of our world can be overwhelming and stressful for you and your loved ones. Crossover’s mental health providers are available to help you maintain an appropriate balance and optimistic perspective while staying informed and healthy during COVID-19. For any mental or physical crisis you may encounter do not wait to get support.

We understand home is not always safe. You are not alone. Don’t be afraid to get help if you need it, and to give help if you can.

National Domestic Violence Hotline
Call 1-800-799-SAFE (1-800-799-7233)
Text LOVEIS TO 22522

Crisis Text Line
Text HOME to 741741 Available 24/7 for victims of abuse and any other type of crisis

If you suspect child abuse
Childhelp (for parents, children, and concerned individuals)
Call 1-800-4-A-CHILD (1-800-422-4453)

National Drug Helpline
Call 1-844-289-0879

National Suicide Prevention Lifeline

• 1-800-273-TALK (1-800-273-8255) in English
• 1-888-628-9454 en Español
• Emotional wellbeing during the COVID-19 outbreak

Lifeline Crisis Chat

• Online chat available 24/7

National Helpline
Call 1-800-662-HELP (1-800-662-4357)
Available 24/7, 365-day-a-year for free, confidential treatment referral and information in English and Spanish

It is important to get professional help or stay connected with your therapist.

Feelings of anxiety take many forms and affect many people. For example, you may have been, or could be, diagnosed with panic disorder, post-traumatic stress disorder (PTSD), or obsessive-compulsive disorder (OCD).

Most therapists will work with you by phone or video during COVID-19.

Recognize the signs of stress
Stress can cause symptoms like:

• sadness, confusion, irritability, anger, uneasiness, and suicidal thoughts
• lack of concentration, efficiency, and productivity
• social withdrawal from others
• interpersonal problems (like defensiveness, communication concerns)
• sleeping problems (like insomnia, nightmares)

Staying up to date with information from reputable news sources like the CDC and the World Health Organization is important.

However, there is a lot of uncertainty surrounding the virus. It is important to manage what you can with the information you are provided but also release the need to control what you cannot.

It is a natural response to an external pressure that disrupts your equilibrium. Recognize your stress and do healthy things to reduce stress.

We can’t control what’s happening in the world right now, but we can control our behaviors and take steps to prevent poor sleep.

Here are some daytime and nighttime tips to get better sleep.

Daytime tips to help with sleep

• Keep a consistent routine. Get up at the same time every day.
• Get morning light. Light is the main controller of the natural body clock.
• Exercise during the day helps improve your sleep quality at night.
• Don’t use your bed as an escape. Stay out of bed during the day, and limit naps to 30 minutes.
• Avoid caffeine late in the day.
• Helping others may help with feelings of uncertainty or unease.

Nighttime tips to help with sleep

• Prepare for bedtime by shutting off the news and devices. Too much information can make it harder for your brain to turn off, and the light (even dim light) from devices may interfere with your body clock.
• Curl up with a book or listen to calm music.
• Minimize alcohol intake. While you may think it helps you to fall asleep, it leads to more sleep problems at night.
• Set a regular bedtime. Stick to your schedule.
• Reduce stress. Try some slow breathing or yoga. Our online webinars have also helped our members to reduce stress and learn meditation.
• Create a comfortable sleep environment. Sleep in a cool, dark, and quiet room.

During this time of increased stress, uncertainty and change, many people are experiencing an increase in anxiety and worry. Those who may have existing anxiety conditions may start to feel a loss of control over symptoms they previously were able to hold in check. Mindfulness has been shown to decrease stress and anxiety and is linked to better coping.

Below are some simple mindfulness techniques which can be used to help decrease stress and anxiety.

5 mindfulness activities

• 5-4-3-2-1 Technique: Name 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, 1 thing you can taste
• Breathing Exercise: Spend 5 minutes engaging in mindful breathing. Become mindful of your breath. Does your breath have a sound? Where is your breath in your body? Is it fast or slow? Notice your breath as you breathe in and out.
• Body Scan: Lie on your back with your arms at your sides and palms faced up. Gradually focus your attention on each part of your body from head to toe or vice versa. Notice any physical sensations, thoughts, or emotions with each body part. Remember to maintain a nonjudgmental stance: notice your body without judgment.
• Walking Exercise: Find a quiet space that you can walk for about 15 feet. Start walking forward slowly, focusing on the experience of walking. Notice any sensations with each step, in addition to any thoughts and emotions that arise. Notice the experience of standing, walking, and maintaining balance.
• Progressive Muscle Relaxation: This exercise involves a tensing and relaxing of each muscle group in your body, from head to toe or vice versa. Breathe in as your muscles tense, and breathe out as you relax them. Tense each muscle (but not to the point of pain) for about 7 seconds, then quickly relax the muscle. Relax for about 15 seconds before moving to the next muscle group. Notice how the muscles feel when they are tensed and how they feel when they are relaxed. When you are done with the exercise and have tensed each muscle group, gradually bring your attention back to the present.

Right now, it is important to recognize the signs of unhelpful or excessive pandemic-related anxiety, and to utilize effective coping strategies to increase our anxiety tolerance during these uncertain times and make us more confident and prepared to respond to pandemic-related challenges and adjustments.

Physical Signs:

• Increased muscle tension, particularly in neck and upper back
• Fatigue • Disrupted sleep (frequent waking up) or insomnia
• Restlessness
• Increased heart rate and blood pressure
• Chronic stomach pains or digestive issues

Behavioral Signs:

• Isolating from others and decreasing hobbies/pleasant activities
• Excessive time spent seeking out COVID-related information (e.g. news, CDC website, etc.)
• Seeking reassurance from others
• Increased substance use, such as alcohol but also caffeinated beverages
• Inability to complete tasks (“Jumping from one activity to the next”)
• Impaired performance in major life roles (e.g. work, school)

Mental Signs:

• Increase in worrying (e.g. “What if” thoughts) about a variety of topics
• Increased negative thoughts experienced as unwanted or intrusive (“Can’t turn my mind off”), particularly late at night or early in morning
• Difficulty concentrating forgetfulness, inattentiveness
• More pessimistic, quick to go to “worst case scenarios”
• Increased attention and focus on health or physical symptoms

Emotional Signs:

• Excessive anxiety that person experiences as “out of their control”
• Feeling constantly overwhelmed
• Panic attacks
• Frequently changing moods
• Irritability
• Feelings of hopelessness or helplessness

Below are a few evidenced-based techniques, suggestions and resources that can be utilized during moments of increasing anxiety or in general during our daily lives.

If you are feeling in need of more support, please reach out for professional help or re-establish connection with an existing provider. Many therapists will work with you by phone or video during COVID-19 and most states have eased restrictions on providing tele-psychotherapy during the pandemic to allow greater access to care.

• Avoid overconsumption of news: Many people, when feeling anxious and uncertain, seek out more information on whatever is causing them stress as a way to reassure. During the COVID pandemic, many have reported spending hours watching news reports, reading over the CDC website or tracking statistical information. Unfortunately, these behaviors often result in more time and energy spent worrying about things that remain outside of our control. Try to limit yourself to a small amount of time each day for COVID news consumption (would not recommend more than 30 minutes each day) and think about other, healthy behaviors you could substitute into that time (e.g. Going for a walk, calling a friend, engaging in a new hobby).
• Avoid isolating and seek safe social interactions: We are more likely to experience anxiety and worry when we are alone due to our mind having more space to hold and engage with anxious thoughts. This has been compounded by our need to remain safe through social distancing and removal from our normal social interactions (e.g. work, gym). Think of ways each day to remain connected and engaged with your social relationships even if from a distance. Some examples could be a weekly virtual “Group Movie Night” or have you and a friend virtually make a recipe together from your kitchens.
• Need for Self-Care: It is important to recognize the extraordinary circumstances and stress everyone is under during the pandemic. This has a way of showing up not only emotionally through anxiety and depression, but also physically by increased fatigue and mentally through reduced concentration and forgetfulness. Make a point each day to do one nice, healthy thing for yourself as a way of slowing yourself down and showing gratitude to yourself for your resiliency. Some examples are taking a long, warm bath/shower or sitting outside and slowly enjoying a nice cup of coffee or tea.
• Be Mindful: If you begin to feel stressed or anxious, use mindfulness techniques to help de-stress.
• Know the signs to seek professional support: Mental health care utilization has increased during the pandemic, and that’s a good thing. It means people are recognizing a need for additional support and finding help available when they reach out. If anxiety has reached a level where it’s taking up most of your time in the day and making it difficult to function in important life roles such as at work, please consider reaching out to a provider for support. If you’re feeling the need to talk to someone immediately, dial 911 or use the Crisis Text Line—free, confidential, and available 24/7. Text SHARE to 741741

The COVID-19 pandemic has taken the lives of over 200,000 Americans, causing unimaginable levels of emotional pain, suffering and grief for surviving family members. Processing these losses, as well as the death of loved ones from non-COVID related reasons, has been made all the more difficult by our lack of ability to gather in-person as families and communities to mourn.

As a result, traditional coping supports and outlets that would help us through our grief are unavailable to us, leading many to feel isolated, lost and “stuck” in their grieving process. This can put people at increased risk for a mental health condition known as Complicated Bereavement, in which symptoms of severe grief and mourning persist for several months and cause a serious negative impact on functioning and overall health.

Because maintaining a support network and remaining connected to your emotions during grief are so important, below is a list of a few helpful coping suggestions and COVID-related adjustments that can help reduce the risk of complicated bereavement and help individuals navigate their grief:

• Remember that grieving is a process that it takes time to resolve. Be careful not to hold yourself to expectations or timelines for when you should start feeling better or “haved moved on”.
• Allow yourself to hold and sit with your feelings, even if they seem overwhelming. Avoid trying to suppress or distract yourself from negative feelings, as trying to “shut it out” will only cause the feelings to linger and stifle movement through your grief.
• Seek outlets for your emotions and memories of your loved one, such as writing, artwork, music, cooking. Expressing your grief in this way helps you feel more in control of the emotions and increases your connection with positive memories of your loved one.
• Create a memorial to your loved one that you and others can contribute to. Some ideas people have used during COVID are a virtual book or webpage where people can share memories, pictures and stories, or a creating a physical reminder of the loved one, such as planting a tree or starting a garden.
• Prioritize staying connected with others, even if it means virtually. Problematic grief is more likely to develop when we’re isolated, so making a point to plan distanced social interactions is very important during a time of grief. Some examples of this could be planning a shared weekly virtual activity with a friend or family member, such as watching a movie or cooking.
• Consider holding a virtual memorial event for your loved one. If this feels overwhelming from too many people attending at once, consider a core group of family being present and asking guests to “arrive” at specified time points and to briefly share their condolences or a statement with the family.
• Consider reaching out for extra support, particularly if feeling lonely or isolated. Along with tele-therapy, other virtual support options include religious leaders in your faith community, local grief support groups, and national grief hotlines.

The CDC emphasizes that alcohol use can alter thoughts, judgements, and decisions-making skills. It can alter judgment and increase risky behaviors. If these behaviors include not maintaining social distancing or not wearing a mask properly, then this can increase your risk of developing COVID-19. It is important to understand that drinking alcohol does not protect you from COVID-19, instead it increases your risk for COVID-19.

The CDC also states that alcohol can also make it harder for your body to fight off infections. This can increase the length of an illness as well as increase risk of complications. Pneumonia and acute respiratory distress syndrome are two conditions that can occur with alcohol intake. These conditions can also occur with COVID-19.

Alcohol can also worsen anxiety, depression, and other mental health conditions. Alcohol can also affect the quality and duration of sleep, making it harder to deal with stressors. Avoiding alcohol is probably ideal during the pandemic, but if you do choose to drink, then drinking in moderation or less is best. Moderate drinking has been defined by the 2015-2020 Dietary Guidelines for American as up to one drink per day for women and up to two drinks per day for men. Certain people, such as pregnant women, minors, and people taking certain medications should not drink any alcohol at all.