Dr-Astrid-Pujari-SmilingThese past few months have been stressful, whether you’re trying to balance working from home and parenting, dealing with the economic impacts of COVID-19 or simply feeling overwhelmed with uncertainty. Many people who live with autoimmune diseases are feeling even more anxiety because their disease may put them at higher risk for complications if infected with COVID-19 – which also creates barriers to necessities like leaving the house, grocery shopping and getting medications.

We recently asked Astrid Pujari, MD, medical director of integrative medicine at Virginia Mason, to share her recommendations for staying healthy during this time. She offered several tips on how people with autoimmune disease can relieve stress.

Managing Stress to Stay Healthy During COVID-19

When it comes to managing stress and staying healthy, Dr. Pujari starts with a basic principle.

“Western medicine often puts physical and mental health in two separate chairs — there are even two different medical diagnosis codes,” Dr. Pujari says. “But in reality, you can’t separate them: Our minds, bodies and emotions are all wrapped up in one.”

Dr. Pujari knows autoimmune disease doesn’t only make the body sick, it takes a toll on overall well-being. That’s why she uses a holistic approach to help people manage all aspects of living with autoimmune disease — from recommending dietary changes to offering advice on how to unwind.

During COVID-19, she encourages people with autoimmune disease — and everyone else — to manage stress and stay well by tending to every aspect of their health. Consider implementing the following tips from Dr. Pujari:

Foster Your Relationships with Others

“Healthy relationships are part of health,” Dr. Pujari says. “I encourage people with autoimmune disease to take this time to develop and nurture healthy relationships.”

How to get started: Connecting through technology is easier than ever. This may mean calling friends and family you haven’t heard from in a while, participating in virtual events with coworkers and community members, or getting a group together for a virtual game night.

Foster Your Relationship with Yourself

Reducing stress and staying healthy also comes from making time for yourself. For people with autoimmune disease, this can be especially important: Dr. Pujari sees many patients who are hard on themselves and stressed about the many ways their disease impacts their lives — and she helps them relieve that stress by showing them how to take more time for themselves.

“With autoimmune disease, a very important piece of health is healing the relationship with the self,” she says. “I help my patients do this in many ways, often using visualization, mindfulness and meditation. It's all about what works for you. There’s no cookie-cutter solution.”

How to get started: Start by asking “What can I do to be kind to myself today?” That may mean making time for something you enjoy, like taking a walk or trying a new recipe. It could also mean trying mindfulness or meditation.

Learn and Use the Secret Ingredient to Happiness

Living with autoimmune disease can be overwhelming, from the stress that comes with the uncertainty of disease to the fatigue, pain or discomfort that comes with these illnesses. Being stuck at home and disconnected from your typical life can make that even worse.

For people who are feeling down or for anyone who’d like to feel a little better, Dr. Pujari has a simple remedy: Practice gratitude. Studies show simple exercises for practicing gratitude can significantly increase happiness and decrease depression and stress.

“Practicing gratitude means noticing and appreciating the good in the world,” Dr. Pujari says. “It can be for a person, relationship or other aspect of your life you may take for granted.”

How to get started:

  • Write down three things you’re grateful for or three good things that happened to you. Do this regularly and be as descriptive and specific as possible.
  • Write a thank you letter to someone and share it with them.
  • Keep a journal of things you’re grateful for at home, work, school or elsewhere. Researchers in one study found keeping a journal of things you are grateful for at work had a strong impact on psychological well-being, decreased depression and improved sleep.

Build Resilience by Focusing on the Positive

During the pandemic, Dr. Pujari says her patients with autoimmune disease have been sharing that social isolation is nothing new — many already feel socially isolated because of the barriers and challenges that come with their condition.

“They’ve even shared that it’s been a relief for other people to start to understand what they live with every day,” she says.

Still, COVID-19 has pushed this isolation to a higher level. Building resilience, the ability to recover from or adjust easily to misfortune or change, is another tool for staying healthy during COVID-19.

“This is a very difficult time, but we need to remember there's a tremendous amount of good happening right now,” Dr. Pujari says. “That’s how we build resilience.”

How to do this: Dr. Pujari shared a few examples of positives to focus on.

“Studies are showing carbon emissions are the lowest they’ve been since World War II,” she says. “CEOs are giving up their salaries to pay their front line workers. And we’re advancing tools and technologies that make accessing healthcare and other vital services easier.”

She also encourages everyone to think about the positive things in their lives, and make a practice of it by writing them down. To drive home this message, Dr. Pujari shared a poem, anonymously written in the time of COVID-19.

“Don’t think of this as the end of the world,” she shared from the poem, “it's the most remarkable act of global solidarity we may ever witness.”'

Anonymous Poem Shared by Dr. Pujari

When you go out and see
the empty streets, the empty stadium, the empty train platforms
don’t say to yourself, ‘it looks like the end of the world.’
What you’re seeing is love in action.

What you’re seeing is that negative space is how
we do care
for each other,
for our grandparents, for our immune-compromised
brothers and sisters,
for people we will never meet…

…..take a moment
when you’re out on your walk, or on your way to the store,
or just watching the news,
to look into the emptiness and marvel at that love.
Let it fill you and sustain you.

It is not the end of the world,
it is the most remarkable act of global solidarity we may ever witness. - Anonymous

Read more stories to make you feel good during COVID-19: Meet the nurse who’s working around the clock to support her family, COVID patients and type 1 diabetes (T1D) patients, and the ten-year-old who’s helping BRI fight T1D despite the pandemic.

Living With A Disease

May 14, 2020

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