Overcoming Pandemic Fatigue with Lifestyle Medicine

It has been a long one and a half years since the global pandemic, and even while there is a glimmer of hope with the Covid vaccine rollout, many of us are experiencing “pandemic fatigue”. People may say “I’m ok”, “I’m fine” or “I’m managing” but deeper down many are losing their optimism, feeling anxious, and are overwhelmed and lonely.

So what is pandemic fatigue? According to the WHO it is a natural and expected reaction to sustained and unresolved adversity in peoples lives. It is the mental exhaustion due to the prolonged alertness to danger as well as the uncertainty of the future. This expresses itself as feelings of hopelessness and a demotivation to continue to follow protective behaviors. (Hello, under-the-nose mask-wearers!)

We all want the same thing – to remain healthy, mentally, physically and emotionally. We are all missing our “normal” activities of meeting up with friends, going to restaurants, going to the theater, to the gym, and being able to travel. To varying degrees, we have all been lonely, disconnected and stressed. As a Lifestyle Medicine doctor, I would like to share with you, how to safely overcome these problems to help regain your health and sense of well-being.

Humans evolved as social creatures, dependent on each other for survival. The lack of social connection or feelings of loneliness causes us an enormous amount of stress. The body’s natural stress response, the “fight or flight” sympathetic nervous system releases adrenaline and cortisol, raising your heart rate and blood pressure and while this is an important reaction for survival, when the stress reaction is prolonged, this leads to harmful effects to our health.

Stress, which is vaguely defined as emotional strain or tension, during pre-Covid times was named by the WHO as “the health epidemic of the 21st century”. We now have the global pandemic plus the ensuing stress caused by the pandemic compounding the issue. Chronic stress turns what should be a temporary physiologic response into a chronic elevation in blood pressure, blood sugar levels, and inflammatory markers. This in turn leads to a higher risk of heart disease, strokes, diabetes, infections and even cancer. A large meta-analysis published in 2015 correlates a 26-29% increased likelihood of death from all causes when experiencing loneliness and social isolation.

The antidote to this chronic activation of the sympathetic nervous system, is the restoration of the parasympathetic nervous system. This can be accomplished in multiple ways, including regaining interpersonal connections, stress reduction techniques (such as deep breathing and meditation), the Japanese practice of forest bathing (shinrinyoku), and exercise.

Stress relief is highly individual, so find what works for you. If you find listening to music or journaling calms you, take some time to do this every day, even if it is for 10 or 20 minutes a day. Deep breathing, yoga, and meditation connects the mind and body to actively calm and activate the parasympathetic nervous system. Taking a hot bath a few hours before bedtime will not only relax but also help you sleep better at night.

In order to find personal connection in this “socially distanced” world also takes intentionality. Set aside certain times of the day to be your time to make your phone calls to friends and family to let them know you’re thinking of them. Older individuals are particularly feeling isolated and I make sure to say “ohayou gozaimasu” to neighbors and elderly persons on their morning walks. Meeting with friends outdoors is a wonderful way to reconnect, walking through parks, enjoying the greenery, even if not fully “forest bathing” has benefits of reducing your stress hormones and improving the function of your immune system.

During exercise sympathetic activity is initially increased, raising heart rate, oxygen and blood flow to the skeletal muscles, and then during recovery the parasympathetic system kicks in, releasing endorphins and serotonin (“feel good” hormones), restoring balance to the stress response. While over training can cause undue physical stress, moderate exercise (getting your heart rate up, sweating, increasing your respirations to a level where you are still able to talk) for 150 minutes a week results in a healthier stress response. Not to mention the added benefit of better cardiovascular health, improved sleep and mental well-being.

Furthermore, exercise not only gives emotional and physical strength, but increases neuroplasticity through the release of brain-derived neurotrophic factor (BDNF). BDNF, which is released through exercise, improves neuronal growth and connectivity, giving you larger cognitive reserve, better memory function, and mental resilience.

Even though we are in the rainy “tsuyu” season, there are plenty of exercises that can be done indoors using YouTube videos at home for balance, strength training, cardio, or yoga. Even if there is a light rain, being amongst green surroundings and breathing in petrichor, that earthy scent of rain, which humans are particularly sensitive to, evokes a pleasant calming effect.

While there is light at the end of the tunnel, the pandemic is not yet over. We must resist the urge to become complacent until the majority of us are vaccinated and science tells us that it is safe to live as we did before. Although many things have been beyond our control, in this new era, we have the ability to take control of our physical and mental health to gain peace of mind.