by Sarah Turner, PhD Candidate; Natalie Mota, PhD, C.Psych; James Bolton, MD; Jitender Sareen, MD FRCPC
There is a lot of anxiety surrounding the COVID-19 pandemic. Not only is there concern about getting sick, but financial strain, social isolation and uncertainty of the future are contributing to an increasingly concerned and nervous society. Many people have learned coping strategies to deal with anxiety, such as going to the gym, talking with friends and family, or attending peer support groups. Unfortunately, many of these supports have been eliminated or reduced due to social distancing requirements. The combination of global stress with restrictions on healthy coping strategies can lead to an increase in risky behaviours, such as consumption of alcohol and drugs to cope with COVID-19-related anxiety.
A recent report from the Canadian Centre on Substance Use and Addiction found that 18% of Canadians reported an increase in alcohol consumption while staying at home due to COVID-19.1 Twelve percent reported decreasing their alcohol intake, while 70% reported that is has remained the same. The major reasons for increasing alcohol included a lack of a regular schedule, stress and boredom. In addition, the same study reported 6% of Canadians have increased their cannabis use due to COVID-19, with 4% decreasing and 90% remaining the same. The same reasons, including lack of a regular schedule, stress and boredom were the most common reasons for the increase. While US statistics are not available, they are likely similar.
These numbers are important because increased alcohol and drug use can increase anxiety problems and potentially lead to a co-occurring substance use disorder. Our 2018 review paper summarized the evidence showing that those who report using alcohol or drugs to cope with feelings of anxiety or depression were more likely to go on to develop an independent substance use disorder. It is important to be cautious and aware of when a casual drink turns into a regular way to cope with stress. The Centre for Disease Control (CDC) dietary alcohol guidelines allow up to one drink a day for women and up to two drinks a day for men.3 Drinking in larger quantities and more often has the potential to lead to substance use problems.
There are many other healthy ways to deal with the anxiety surrounding COVID-19 and to combat the struggles of an irregular schedule, stress and boredom.Some recommended practices include 4,5:
- Choose what you listen to. An overload of information from multiple sources can be harmful for anxiety management. We recommend you limit your news consumption and check trusted sources such as the CDC and the World Health Organization. Avoid using comments from social media as your news source.
- Try to maintain a schedule. Maintaining a regular schedule can help reduce boredom and provide structure to the day. For those unable to work, planning ahead and blocking time to do regular activities can help to create a routine.
- Prioritize healthy eating, sleep and exercise. It is important to care for your basic needs, like getting enough sleep, eating well, and exercising outside or in the home. Now may be the time to try and online workout or yoga class or learn to cook with a new healthy ingredient. These things will help maintain physical and mental health.
- Practice self-compassion. Remember that it is natural to feel anxious and stressed during a pandemic and that these are not bad or wrong feelings. You may have intrusive thoughts such as “I’m not being productive enough” or “this will never end”. Comfort yourself the way you would a good friend by allowing your thoughts and feelings to be felt and heard. Then, practice breathing techniques6 and positive self-talk to help get through periods of heightened anxiety until the feelings resolve.
While using alcohol and drugs may be an attractive way of coping with COVID-19 anxiety, it can lead to greater problems in the long term. Engaging in healthy coping strategies, like the ones above, are effective for reducing anxiety and will encourage and promote mental health as the world deals with the COVID-19 pandemic.
Canadian Centre on Substance Use and Addiction. Summary Report. 2020 April. Retrieved from: https://www.ccsa.ca/sites/default/files/2020-04/CCSA-NANOS-Alcohol-Consumption-During-COVID-19-Report-2020-en.pdf
Turner S, Mota N, Bolton J, Sareen J. Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depress Anxiety. 2018;35(9):851–60.
Centers for Disease Control and Prevention. Dietary Guidelines for Alcohol. 2019 December 30. Retrieved from: https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm
The American Psychiatric Association. Coronavirus and Mental Health: Taking Care of Ourselves During Infectious Disease Outbreaks. 2020 Feb 19. Retrieved from: https://www.psychiatry.org/news-room/apa-blogs/apa-blog/2020/02/coronavirus-and-mental-health-taking-care-of-ourselves-during-infectious-disease-outbreaks
Centre for Disease Control. Stress and Coping. 2020 April 16. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
Anxiety Canada. Calm Breathing. Retrieved from: https://www.anxietycanada.com/articles/calm-breathing-audio/
About the Authors
Sarah Turner is a PhD candidate in the Department of Community Health Sciences at the University of Manitoba. Prior to starting her PhD, Sarah held a Research Associate position in the departments of Psychiatry and Community Health Sciences where she conducted research on anxiety, depression and adverse childhood experiences. Sarah has published over 35 peer-reviewed publications and helped to initiate a yoga program to promote mental health for hospital inpatients in Winnipeg, Manitoba.
Dr. James Bolton is a Professor of Psychiatry at the University of Manitoba in Canada. His clinical work focuses on emergency psychiatry and psychotherapy for suicidal individuals. Dr. Bolton is an adjunct scientist at the Manitoba Centre for Health Policy where he conducts register-based research on suicide, bereavement, and psychiatric epidemiology. He is involved in national advisory work on suicide prevention for the Public Health Agency of Canada and the Canadian Institute for Health Information.
Dr. Natalie Mota is an Assistant Professor in the Department of Clinical Health Psychology at the University of Manitoba and a Clinical Psychologist at the Operational Stress Injury Clinic in Manitoba, Canada. She has published over 70 peer-reviewed publications with a focus on understanding the psychological and physical impacts of trauma exposure and on studying resilience factors that mitigate the negative effects of traumatic stress. Her clinical expertise is in the assessment and treatment of posttraumatic stress disorder, anxiety disorders, and suicidal behaviour.
Dr. Jitender Sareen is Professor and Head of the Department of Psychiatry at the University of Manitoba, Medical Director for the Winnipeg Regional Health Authority Mental Health Program, and Provincial Co-Lead for Mental Health and Addictions for Shared Health. Dr. Sareen has published over 375 peer-reviewed publications in the areas of traumatic stress, anxiety disorders, indigenous suicide, psychiatric neuroimaging, and military mental health.