Coping with Uncertainty

While life is often fraught with uncertainty, as we cannot predict the future, constructing a framework to draw from, helps us in having a grounded idea of what our next steps might look like. In the early months of 2020, our collective sense of certainty dissolved in what felt like a moment’s notice. The COVID-19 pandemic created a lot of change that is sudden and quickly evolving, leading to a perpetual state of uncertainty for many.

Oftentimes, we are hard on ourselves for struggling when things do not go as planned. During these challenging times, it is important to remember to practice self-compassion, patience, acceptance, warmth, and kindness towards ourselves. Remember, uncertainty impacts us all differently and can bring up conflicting emotional responses! Please continue reading to find out more about uncertainty, the impact on our mental health, Pandemic considerations, and ideas for coping including "6 Steps For Building Your Tolerance For Uncertainty."

• How Uncertainty Manifests and Impacts Mental Health
  • Uncertainty impacts us all differently. The nature and level of uncertainty plays a role in physiological and behavioral responses. People often respond to uncertainty differently based on individual, cultural, and community factors. Some people can “roll with the punches,” adapting to changes quickly, while others struggle with the unknown and are likely to experience changes in mood, sleep/appetite patterns, and coping. Intolerance to uncertainty is also linked with stress, anxiety, depression, panic attacks or disorder, and compulsions.
  • Stress
    • Stress is a common response to uncertainty. Symptoms of stress can include racing thoughts, forgetfulness, inability to focus, increased heart rate, appetite changes, sweating, restlessness, nausea, physical pain in the body, irritability, fatigue, feeling overwhelmed or out of control, procrastination.
  • Anxiety
    • Another common response to uncertainty is anxiety. Symptoms of anxiety can include racing thoughts, increased heart rate, sweating, restlessness, nausea, hypervigilance, irritability, inability to focus, fatigue, feeling fear, lack of sleep. Symptoms of a panic attack include accelerated heart rate, sweating, shaking, shortness of breath, discomfort in the body, nausea, lightheadedness, depersonalization and fear of dying or losing control.
  • Cognitive Distortions
    • Cognitive distortions are a common response in times of uncertainty. Cognitive distortions are inaccurate thoughts that contribute to negative thinking patterns and emotions. Cognitive distortions one may experience in times of uncertainty are catastrophizing: assuming the worst possible outcome, underestimating coping ability: belief that one does not have the ability to cope with difficult events, and jumping to conclusions: assuming outcomes without having sufficient data.
  • Depression
    • Depression can develop in times of uncertainty. Individuals with depression may find themselves experiencing persistent sadness, loss of interest or pleasure in activities, low mood, irritability, sleep disruptions, fatigue, changes to appetite, lack of focus or motivation, or thoughts of self-harm.
  • Obsessions and Compulsions
    • While the majority of people experience less intense symptoms and distress, obsessions (unwanted intrusive thoughts) and compulsions (repetitive behaviors or thoughts) may manifest or increase as a result of uncertainty about transmission of disease to others or self contamination.
  • Pre-existing Mental Health Concerns
    • For those with pre-existing mental health concerns, uncertainty may cause exacerbation of symptoms, circumstances may disrupt social connections with support systems, or one may find that established coping strategies are less effective.
  • If you find yourself experiencing any of these symptoms, know that you are not alone and that there are steps you can take to manage stress, alleviate anxiety, and better cope with uncertainty.

• Uncertainty During the COVID-19 Pandemic and its Impact on Mental Health

  • As previously noted, dealing with uncertainty can have a profound effect on stress and our mental health. Thus far, throughout the existence of the COVID-19 pandemic in the U.S., we have seen an increase in symptoms of anxiety and depression, feelings of loneliness and social isolation, sleep difficulties, decreased motivation, loss of concentration, increased substance use, higher levels of domestic violence, more frequent suicidal ideation, and trauma-like responses (see Additional Resources for references).

  • Grief During The Pandemic:

    • It is important to acknowledge that the pandemic has led to much grief and loss, showing up in different ways. Traditional forms of grief can include losing loved ones due to illness; to anticipatory losses, such as missing out on formals, commencement ceremonies, and other memories to be made throughout a semester cut short.

      While these are undoubtedly difficult aspects of life to navigate, there is something tangible about these losses. Much of the uncertainty associated with the COVID-19 pandemic leads to a sense of ambiguous loss. These are the unimaginable losses that impact our ability to know precisely what we are dealing with. Ambiguous loss can present as concern about what the state of the world might look like moving forward, worry about the country’s economy and one’s financial stability, living with the threat of potential infection, wondering whether we can safely resume regular aspects of our lives that we once took for granted, as well as negotiating many other unknowns, making sense of quick-changing information, and living with other non-answers.

  • Shifting Everyday Lives
    • During the time of physical distancing, there is a likelihood of being separated from support networks, living with individuals we may not always get along with, and not being able to maintain our regular routines and self-care regimens. These drastic shifts in our everyday life have the potential to contribute to poorer mental health outcomes and decrease our overall emotional wellbeing. This becomes compounded when living within a state of uncertainty amidst all these changes, and can exacerbate preexisting mental health conditions and/or allow for new mental health concerns to develop and emerge.
  • Fear and Worry
    • While it is near-impossible to separate out the direct influence that uncertainty itself has on these outcomes alone, it is important to note that it absolutely plays a factor. Much of the ambiguous grief that we are experiencing leads to worry, which can exacerbate distressing symptoms and behaviors. For some, fear of visa- or DACAmented-status may be at risk. Those who live in underserved communities and hold marginalized identities may live with the uncertain knowledge of whether they’ll have access to basic necessities as they navigate a changing landscape due to shifts in supply and demand. For others working as health care professionals and other essential employees, there may be a constant fear of risking infection and/or seeing people who are gravely ill, and wondering when this might end and what resources might be available to help support them. Additionally, while many may have acclimated to their “new normal” of working from home and leaving the house solely for walks, there is an unknown sense of whether everything will revert back to the ways they were and whether or not a second wave of the virus will hit.

It is important to note that these are very difficult times for all of the world’s population, and the uncertainty of not knowing when things will change for the better and become more tolerable only makes it more challenging to navigate. And, with that said, it is not all doom and gloom. There are tangible steps that can be taken to make our uncertain future more manageable on many different levels and improve our overall mental health and emotional wellbeing.

• Coping with Uncertainty
  • It is clear that uncertainty can, at times, trigger cognitive and physical symptoms of distress. Sometimes this distress can leave people feeling unsure of how to cope. This section provides some suggestions on how to work with uncertainty in our lives
  • Determine what has helped you cope with uncertainties in the past/currently
    • We deal with varying levels of uncertainty all the time, whether we are aware of it or not. For example, you might not know what you are going to eat for each meal on a given day. You might deal with this uncertainty by scheduling your meals and the content of those meals at the beginning of your day, or you might not schedule anything and accept that you will find things to eat when the time comes. While sometimes automatic, these processes are very helpful in allowing us to manage all kinds of uncertainties. Explore helpful ways in which you have dealt with uncertainties of varying levels in the past and even currently.
  • Identify and acknowledge what is uncertain
    • Sometimes we know exactly what we feel is uncertain, and other times we avoid determining this to mitigate further anxiety. However, it is difficult to cope with something that has not been identified. It can help to write down the uncertainties on your mind to visualize them (e.g., “I do not know when this pandemic will be over”; “I am unsure if my family is doing ok”). This simple starting point can help to provide clarity and even relieve some mental stress.
  • Recognize and identify the way these uncertainties make you think and feel.
    • After you have identified the uncertainties on your mind, it can help to determine how these uncertainties impact your thoughts and feelings. If you wrote down your uncertainties (see above), consider writing down the thoughts and feelings that come up for you next to each of the uncertainties you listed. Having awareness of our thoughts and feelings can help guide what we need and how we can cope.
  • Determine what is in your control, and what is not in your control.

    • Oftentimes we come to the conclusion that something that is uncertain is completely out of our control, while other times we try to control everything that is uncertain. The key here is to determine what is realistically in your control, and what is realistically out of your control.

       

      For example, if the uncertainty is “I do not know if my family is doing ok”, the following might look like:
      a. In my control: I can schedule times to call them and check-in; I can offer to grocery shop for them; I can ask them other ways that I can support.
      b. Not in my control: I cannot control their health outcomes; I cannot control them or their life choices.

  • Perspective taking
    • As you reflect and list your thoughts about what is uncertain, it is also important to consider whether these thoughts are put into perspective or not. In other words, are your thoughts around the uncertainties realistic? It is common for thoughts to unintentionally become distorted in various ways that can fuel distress and anxiety. Some common examples of this include:
      a. Catastrophizing: “Nothing will ever be the same”
      b. Jumping to Conclusions: “This pandemic is never going to end”
      c. Polarized Thinking: “I didn’t have time to call my family, so I am a bad person”
  • Build structure
    • When things are uncertain, it can help to find ways to maintain structure in your day-to-day life. Reflect on how you currently build structure in your life; do you have a preferred scheduling system? What goals do you currently have, and are they SMART (Specific, Measurable, Attainable, Relevant, Time-bound)? What can you do to hold yourself accountable to maintaining structure?
  • Gratitude journaling
    • It can be difficult to not magnify on the negative when having to work with uncertainties. One way to mitigate this is by making a list of things you are grateful for or passionate about. Start with what first comes to mind, and then challenge yourself to find things in your life that you often do not think about but are grateful for. Consider journaling more in depth about a few things you come up with and include why you are grateful for them.
  • Mindful of the present moment
    • When we are overwhelmed about things that are uncertain, we tend to disengage from what is happening in the present moment. However, finding ways to stay present and tuned into not only your surroundings but also yourself can be a useful strategy. Consider taking a few deep breaths, and then take a few minutes to identify 5 things you see, 4 things you hear, 3 things you smell, 2 things you feel, and 1 thing you taste (modify based on your abilities and comfort). This can be a quick way to ground yourself and take pleasure in the present moment.
  • Shared experience
    • There are times when uncertainties are unique and specific to your life, and there are also instances where uncertainties are applicable to numerous people. In this case, it can be helpful to talk with someone to process as well as connect over shared experiences.
  • Religion/faith
    • If you are someone who identifies with a particular religion or faith, how has it played a role in your life? Is this something that could be a helpful source of support?