Q&A: Psychiatry Chief Dr. Gustavo Turecki’s COVID-19 stress management tips

Dr. Gustavo Turecki on the importance of establishing routines, staying physically active and taking it one day at a time
Gustavo Turecki, Chair of McGill’s Department of Psychiatry

Renowned expert in depression and suicide, Dr. Gustavo Turecki, Chair of the Department of Psychiatry, McGill and Chief of Psychiatry at CIUSSS Montreal West Island, and psychiatrist and researcher at the Douglas Mental Health University Institute, shares some tips and perspective about how to cope with stress and anxiety during these extraordinary times. He spoke to us by phone from his office at the Douglas on March 24.

What do you think are the main sources of stress for people related to the pandemic?

I think one of the big sources of stress is the situation of alert and change and unknown that our society is going through right now. It generates stress and fear – which are normal reactions. We like to have routines and when we get out of them, it affects us. The issue is how we individually manage things and a lot has to do with each person’s understanding and their interpretation of what’s going on.

What are some things people can do to manage their stress levels?

Number one is to establish a routine in this new reality as much as possible. Allow yourself to be involved with pleasurable activities in your free time, disconnect a little bit, do things to allow your brain to disconnect. Do physical activities as much as possible, go outside for a walk or a run, keep physically active. And although it’s difficult because of the requirement for social distance, try to be with people you like.

It’s important that people keep in mind to go one day at a time. I also think it’s important to accept that we’re going to be more anxious and that’s normal. We should try to understand what generates most of our anxiety and look at mechanisms to de-dramatize whenever possible.

How can people cope with the feeling that they are not in control?

A big part of this is recognizing what is under our control and what isn’t. If you are worrying, for example, that you cannot do things you like to do because everything is closed, that’s completely useless. Worry about things you can control – like protecting yourself from the virus – rather than things that are outside your control.

Do you have any advice for people feeling frustrated by their work or study situation – for instance, researchers and trainees who can’t access their labs?

That’s not under their control – the labs are closed. Don’t worry about it, relax. Understand that solutions will be found, whether the funding agencies will adapt and adjust or something else. You’re not the only one, there are a lot of people in the same situation.

Are health care providers particularly vulnerable?

I work in mental health and I can tell you people are anxious, and I hear from my colleagues in other fields that people are anxious. But I think that people are coping overall.

Depending on what work you do, there are different added-on levels of stress. If you are a frontline health worker, you have to deal with a lot of changes right now, a lot of uncertainty. We are in a crisis right now, obviously, but the worst is yet to come and I think that generates a lot of these feelings of anxiety. The situation is alarming, we read about what is happening in Italy, so we know something bad is going to happen.

How are your own stress levels right now, Dr. Turecki?

It’s been intense. I can certainly say that my levels of stress are higher than usual, like everybody else, but they’re manageable.

What’s the impact on your day-to-day routine?

We have had to cover for colleagues who are in quarantine – for instance, I am on call tonight. I also have a lot of administrative responsibilities for clinical services and because of the current situation, we have had to do a lot of reorganization to adapt our practices to the current needs to increase social distance and protect against the virus.

How should supervisors or department heads be talking to their staff, trainees and students to help reduce stress?

It’s important for people who have staff who report to them to talk to them regularly, to make sure they have the appropriate information and make sure they are doing well. I think that a lot of anxiety comes from misinformation and conflicting information. So it’s important to provide the right information, that it comes to them in a clear way and regularly. The Ministry of Health has a number of bulletins and that is the information people should look at.

Is there a risk we might make people more anxious by overloading them with information?

It’s true there are a lot of emails, so it’s important for people in leadership positions to talk to the people who report to them, via Zoom or by phone, and make sure they summarize the information and make it accessible. And then people can go and validate or find their own sources. That is one way of decreasing anxiety.

How should people talk to their kids about the pandemic?

It’s important for parents to communicate to children, in a way they can understand, what’s going on. Information should be provided to children in a way that’s accurate but in  language they can process, and at the same time, conveying a notion that they are protected, that there’s nothing to worry about, and that things will go back to normal.

What should people who already suffer from depression or anxiety be doing?

People who suffer from these have a hard time regulating their emotional responses to situations like this and so things tend to be amplified. That’s why I think that it’s important that services remain available and people should seek help when it’s necessary.

Should we be worried about the effects of prolonged social isolation?

Social isolation is probably not the best term. We need to characterize this a little differently. When you’re the only person who is isolated, it’s one thing. But if everyone else is in the same situation it feels less bad. The other thing is that though people are isolated from physical contact and their routines have changed, they are still in contact through social networks, phones, all kinds of modalities. And it’s temporary. That’s not the same as being isolated when you don’t have any social network to count on and you cannot share things – that’s a very different thing. I would be cautious about exactly what the long-term effects will be.

Any final words of wisdom?

We should remind ourselves this is going to go away. This is going to be for another few weeks or a couple of months, but then life will go back to normal.