Staying Well During a Public Health Crisis

On Friday evening after work, I took the subway downtown from the hospital, making a stop at the grocery store on my way home. This might not sound unusual, but everything about it was. First, I rarely shop for groceries on a Friday evening. Second, the NYC subway was nearly empty, fairly pristine, and had that just-cleaned-with-bleach aroma. Third, it was slim pickings at the grocery store, with very little in the way of frozen goods, breads and grains, or even certain perishable items.

I had already been thinking, more broadly, about how the unfolding novel coronavirus (COVID-19) pandemic might affect my psychotherapy patients. But when I took in the breathtaking sight of a depleted grocery store, my mind became busy imagining and empathizing with what this experience may be like for some individuals with eating disorders.

Maybe anxiety and uncertainty lead you to restrict what you eat. Or, perhaps stress increases your risk to experience episodes of eating in which it’s hard to control what or how much you eat. Maybe it’s incredibly hard to be flexible with your food choices. And maybe the structure of showing up, in person, to do a job or take a class helped you to maintain a regular eating pattern. It could be that social distancing is putting you at a distance from the support squad who cheers you on when meals are tough or you’re having one of those days when you just don’t feel great in your body. Or that social distancing is leaving you with no distance from family or roommates who don’t always know what to say that will help.

If these ifs resonate with you, here is what I can offer with certainty in a time of grave uncertainty:

1. Eating – and eating regularly, three meals plus snacks – will help. If you are at risk of undereating, staying nourished is critical. It will help fuel your tank to manage a potentially prolonged period of stress. It will help with regulating your emotions as much as possible, offering protection against low mood or further heightened anxiety. If you are at risk of binge eating, maintaining a steady pattern of eating will protect you from re-entering a cycle of over-, then under- doing it with food.
2. Structure – even if artificially imposed – is key. Can you devote a space in your home where your meals and snacks will be eaten, a space for work-related activities, and a space for leisure activities? Can you create a rough sketch of the day ahead, blocking out times when you will and won’t be eating? Once you’ve got a geographical plan and general timeline, you can get more specific in plugging in the gaps.
3. Think of your anxiety like an unwanted houseguest – the visitor who has not yet booked his or her return ticket home. Given these extraordinary circumstances, anxiety may be moving in for a while. This guest is rude, constantly trying to distract you when you’re trying to go about your business. Rather than wasting energy trying to boot this guest out the door, consider alternative uses for that energy. Maybe you determine that checking and re-checking the news drives fluctuations in how rude the anxiety is, how loudly the guest tries to interrupt you. Well, then set some limits on when, how often and from which sources you consume the news:
   • You could pick a time to watch the news on TV – preferably not around mealtimes or right before bed.
   • Or, you might set a timer to keep yourself from needless, excessive scrolling on your preferred news site.
   • As for where to get the updates to trust, try the website for the Centers for Disease Control and Prevention for current information.

And since anxiety likes to speed things up, to blaze a trail far into the future, also get curious about activities or strategies that ground you in the present moment. Think:

• • A gripping novel or podcast
  • A group video chat with old friends
  • Family game night
  • Playtime with your pet in your yard
  • A creative project for which you never quite made the time.

As long as you choose something in line with what really matters to you (and not your anxiety or your eating disorder) that helps you feel rooted in the right now, you are on the right track.

If you feel like you’re being pushed to the limits of your flexibility, please know that you are not alone. We may be at the edge of our collective comfort zones, but if there is one thing I’ve learned from my clinical work over the years, it’s that sometimes, this is where the magic happens – the creativity, the drive, the industriousness to keep plowing forward.

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