The COVID-19 pandemic has been a time of increased stress for nearly everyone. But essential workers, people living paycheck to paycheck and those with underlying health conditions are especially vulnerable.

Essential workers in health care settings, for example, are coping with all kinds of stress such as the risk of exposure, concerns about sufficient personal protective equipment and increased workload. They also have the added stress of needing to make critical decisions concerning severely ill people and coping with the traumatic outcome when patients, colleagues and loved ones become ill or die.

Unfortunately, there’s nothing we can do to erase these painful experiences. However, there are things people can do to increase the chance of a full recovery. We have shared a few of those strategies below. First, we discuss what is most common when it comes to trauma and grief and how to tell whether you are experiencing problems that require professional help. Then, we review four skills that can help you manage trauma and grief on a day-to-day basis.

Information about trauma and grief, and signs for when professional help is needed

What is trauma, and how does it affect us?

“Trauma” is a widely used term that has different meanings to people. Mental health professionals use the word trauma to describe experiences where a person suddenly and unexpectedly watches someone die, becomes a victim of violence (such as a sexual assault or armed robbery), or experiences a natural disaster, accident or other tragic event.

Traumatized people can experience a number of symptoms, including flashbacks, nightmares or repeated upsetting thoughts about the event. These people may feel anxious and irritable, have trouble remembering the event or temporarily lose touch with reality. They could have difficulty concentrating or experiencing positive emotions. Physical symptoms, like a racing heart or labored breathing, also may occur.

What is grief, and how do we react?

Grief refers to the experience of mourning that often follows the loss of a loved one, regardless of whether their death occurred in a traumatic way. There is no right or normal way to grieve. People experience a wide variety of negative emotions when grieving, including anger, anxiety, apathy, fear, helplessness, guilt, loneliness, numbness and uncertainty.

Someone who’s grieving may have trouble concentrating or making decisions. They may experience crying spells, difficulty sleeping, excessive tiredness, physical health problems and social isolation. While grieving, they also may feel positive emotions, such as gratitude that the person who has died is no longer suffering or appreciation for the support they or their loved one received.

What are the signs that we need more help?

Experiencing symptoms associated with trauma and grief are common for several weeks after experiencing the trauma or loss, and are not necessarily a sign that anything is seriously wrong. It’s how our brains and bodies respond when something horrible and shocking has happened.

But if trauma or grief symptoms persist for months after the traumatic event or loss and make it hard for you to work or function in your relationships, it may be time to think about reaching out for professional help.

One of the most common ways to find help is to work with a psychologist or psychiatrist or join a local therapy or support group. On the Guide for Finding Resources page of this website, you’ll find phone numbers and web addresses for different mental health resources where you can seek professional help for trauma or grief.

Skill 1: Ask for support

When you experience a traumatic event or a painful loss, it’s normal to want to spend some time by yourself to recover. However, spending too much time alone can lead to negative outcomes. So it’s important to reach out for support even when you don’t feel like it.

There is no right way to do this. However, the best support often comes from people who are:

• Good listeners
• Able to empathize with what you’re experiencing
• Accepting and validating of what you are going through
• Able to be patient and make no demands of you

You might turn to a loving and supportive family member or friend. Perhaps the right person is someone from your work or a colleague in your field. They may have similar experiences with trauma and loss.

If you have a religious or spiritual affiliation that is important to you, consider reaching out to leaders or members of your church, synagogue, mosque or other spiritual organization.

It is helpful to make a list in advance of the people or groups that you could contact for support. Your list could include a few notes on why you chose them, what you hope to request, and how you will reach out.

On your own: Make a list of people to whom you may reach out for support.

Skill 2: Practice balanced thinking

It’s normal to have negative thoughts after a traumatic event or loss. You may think, “I wish that had not happened to me” or “I’m afraid that this is going to happen again.” After losing a loved one, you may think, “If only I got a chance to say goodbye” or “I don’t know how I am going to cope without this person.” These thoughts are common and may even help you express strong emotions or figure out what you need to do to heal.

Unfortunately, negative thoughts can also be inaccurate or unhelpful, such as thinking, “It’s all my fault that this happened,” “I am a terrible person for not doing more to prevent this” or “I will never recover from this.” Thoughts such as these could ruin our mood and make us less productive and more likely to distance ourselves from others.

When you feel yourself engaging in negative thinking, take the following steps to create more balanced thinking:

Step 1: Try to identify a specific thought that is accompanying a negative emotion.

Step 2: Consider the evidence for and against that thought.

Step 3: Think about whether you are missing important information about the situation. Taking this information into account might help you find more helpful ways of thinking about the situation.

Step 4: Based on the questions you asked yourself in Steps 2 and 3, try to come up with a more balanced thought that takes all of the evidence into account.

Remember, we have little (if any) control over what thoughts come into our mind, but we do have control over how we respond to them. Responding using the four steps above typically helps people feel a bit better about the situation and can serve as important practice for the next time something bad happens.

On your own: Try out the steps to create more balanced thinking.

Skill 3: Focus on what you can control

Unfortunately we can’t change the past. The fact that it’s beyond our control can make us angry, sad and frustrated. We also can’t predict or control when waves of sadness or upsetting memories will come over us. This unpredictability can create anxiety and make us feel like we always have to be on guard.

One skill that can help is to focus our attention on something that we actually can control. To take a specific example, we can’t do anything about the death of a loved one, but we can control our interactions with the people around us. When you are feeling helpless or thinking about a loss, try to refocus your attention on an engaging, meaningful activity, like calling someone you love, exercising, practicing a skill or hobby, playing a game or relaxing with a good book.

On your own: In advance, make a list of potential engaging activities.

Skill 4: Practice self-compassion

Finally, whenever you are stressed out, feeling emotional pain or having self-critical thoughts, take a break to practice self-compassion, using the process developed by Kristin Neff, PhD, from the University of Texas at Austin. This practice was covered in the “Stretched too Thin” segment of the COVID-19 Care Package.

On your own: Review and incorporate the self-compassion steps.

Try one or more of the techniques

This is a very stressful time with many members of our community experiencing traumatic events and grief. If you are experiencing this type of stress, we hope that you will find some relief by practicing the four skills highlighted in this segment of the COVID-19 Care Package. If you need additional help, please reach out for professional support either through your normal care provider or by using the links provided on the Guide for Resources page.

Downloadable resources to use on your own

Information Sheet:

• Recovering from Trauma & Grief

Pre-Work List:

• Potential Helpers
• Engaging Activities

How-to Guides:

• Practice Balanced Thinking
• Self-Compassion