In the aftermath of the coronavirus, healthcare providers have to make life-altering decisions about who gets treatment and who doesn’t.
They are now being asked to work even longer hours, even for less money, and are being asked to sacrifice their own lives and their family lives for the public good.
Few people in healthcare have had real-life triage experience in which a large number of life-and-death decisions had to be taken due to equipment shortages that raise their risk of suffering moral harm as a consequence of their work.
That “moral injury” is a concern for mental health, and is often manifested in the form of Post Traumatic Stress Disorder, otherwise known as PTSD.
And, strikingly similar to battlefield medicine is the fight against coronavirus: desperate and relentless encounters with patients, an environment of high personal risk, an unseen lethal enemy, extreme physical and mental fatigue, inadequate resources and endless accumulations of the dead.
And this is where developing a practice of yoga and meditation becomes even more critical for healthcare workers.
The Science on Yoga and Stress Reduction
I suggest that a regular yoga practice can have the power to reduce the impact of exaggerated stress responses and can be useful for both anxiety and depression.
A person may be able to modulate their stress response system by reducing perceived stress and anxiety through a yoga practice.
This, in turn, decreases physiological excitement—for example, decreasing heart rate, decreasing blood pressure, and easing breathing.
There is also evidence that yoga practices help to improve variability in the heart rate, an indication of the body’s ability to respond more flexibly to stress.
Doctors need to check their stress “thermometers” during this critical time. Ask yourself if you have signs of burnout or secondarily traumatic stress. Including:
Suffering, depression or apathy
Simply feeling frustrated
Felt distant or separated from others
Feeling tired, stressed or drained
Feeling like a failure or that you can't help
Excessive worry or fear over something wrong
Quickly surprised, or "on guard" all the time
Has physical signs of stress (e.g., heart racing)
Nightmares or recurring thoughts concerning the traumatic situation
The impression that suffering to others is yours
If you feel all of these, or even if you feel momentarily overwhelmed with everything, there are a few ways to alleviate stress during these hectic and intense days:
Stop, take a breath and be calm. For centuries deep breathing was a soothing technique.
Easy ways of reducing stress include taking in a deep breath and slowly letting it out. Do this several times, and repeat all day.
Alternatively, try mindfulness: bring attention to the experience and allow it to be there, not judge it and know it is going to pass.
If you need some help, breathing apps and meditative guidance such as Calm, Breethe, UCLA Mindful, Mindfulness Coach, Headspace and Ten Percent Happier are available.
A little exercise can make the stress burn off.
If people can just do some exercise, just walk around or stretch out — just to sort of calm your body’s tension, it'll help. If you relax your body’s stress you relax your mind 's anxiety.
There are two things you have to do with doctors who are specifically concerned with Covid-19 patients—or just those tangentially impacted by the crisis—you’re out there on the front lines looking after patients.
Please exercise impeccable control of infections, and be aware of your own sense of wellbeing or distress.