In the last week, Houston therapist Kara Smith has had to field several questions about COVID-19.

One client asked if everyone who contracts the virus dies; another asked if she will suspend her practice. A third asked if the virus can be passed to pets.

I am seeing a wide range of reactions to this pandemic, said Smith, a licensed clinical social worker. As stories arise, such as the cancellation of the Rodeo and the remainder of the NBA season, clients anxiety levels are rising. Many clients are worried about losing their jobs, especially those in the supply chain, oil and gas, or travel and leisure industries.

But people who do not normally seek mental health services are feeling an uptick in anxiety as well, partly due to a sudden sense of loneliness and isolation, as working from home and social distancing become more prevalent.

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Mental health, self-care practices one can do alone from home

For your body:

Eat more nutritional foods

Drink less caffeine

Eat less sugar

Exercise

For your mind:

Deep breathing

Mindfulness

Journaling your thoughts, body sensations and emotions

Play games

Do a crossword puzzle

Read a book

Limit exposure to coronavirus media to one or two times per day

Yoga

Learn something new

Discover new music

For your spirit:

Read religious, spiritual or metaphysical literature

Watch a religious, spiritual or metaphysical video or listen to a podcast

See if your place of worship will offer online streaming or religious services

Connect with nature (go outside, care for a houseplant, look out the window at nature)

Spend time with your pets

Meditation

Reach out to someone outside your household at least once a day. It is important for us to stay connected to others during this time.

Source: Kara Smith, Houston licensed clinical social worker

What are people the most afraid of? Other people, Smith said.

The most difficult thing for most of my clients to do is to trust that other people are protecting us as much as we are protecting ourselves, she said. As we hear stories about people who were asked to self-quarantine going to crowded places, the ability to trust those around us to do the right thing decreases.

These heightened feelings are normal, and its important to understand the difference between anxiety, obsessive compulsive patterns and coronavirus news-induced feelings of panic.

Dr. Elizabeth McIngvale is the co-director of the Houston OCD program and president of the Peace of Mind Foundation, a nonprofit organization with the goal of helping people who suffer from various types of obsessive compulsive disorder.

Certainly during this time, we see a lot more increased fear responses and anxiety, McIngvale said. What were seeing are more patients who arent normally at our clinic. Were really seeing anxiety and panic take over and be part of the general population at this point.

Anxiety levels spike in a general population during times of uncertainty, like when theres a hurricane in the Gulf. But with a virus like COVID-19, which is spread person-to-person and takes days to show symptoms, there is an extra level of fear. Constant news updates, mile-long lines at grocery stores and supply shortages can contribute to a collective feeling of urgency or panic.

Theres this added level of responsibility that if Im not cautious enough, I can catch it, spread it and itll be my fault, McIngvale said. Youre going to definitely see that people are making decisions based on risk.

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Measures to slow the spread of coronavirus have extended much further than wash your hands for 20 seconds. Most large gatherings have been canceled, and companies are encouraging their employees to work from home if theyre capable. This weekend, the House of Representatives passed the Families First Coronavirus Response Act, which mandates employers provide paid sick time to employees who qualify.

Americans crave communion with others, and self-isolation can play into a greater feeling of anxiety, and in some cases, depression.

As people isolate more and socialize less, they are more prone to feelings of loneliness and restlessness, if not anxiety and depression, Smith said. If people are asked to remain at home for days, it may also bring up trauma memories of Hurricane Harvey, leaving people feeling trapped, isolated and helpless.

The best thing to do is take better care of ourselves in body, mind and spirit, Smith said.

McIngvale and Smith both recommend limiting exposure to coronavirus media to one or two times per day because constant exposure can increase feelings of anxiety and panic.

Also, find a credible source, like the Centers for Disease Control and Prevention or a trusted media source,, and only get information from there. Pay attention to recommendations and guidelines, but try to avoid the rest if youre feeling uneasy.

Finally, use the appropriate amount of caution, but dont overdo it.

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When anxiety is taking over, we start to see 20-second recommended hand washes turn into multiple hand washes and an inability to leave the kitchen because theyre stuck washing their hands, McIngvale said. When is it a normal response or when is it (obsessive compulsive) or anxiety taking over?

Social distancing can also affect people who rely on in-person communities, such as Alcoholics and Narcotics Anonymous, to stay accountable in their recovery from drugs and alcohol. A good alternative is In The Rooms, an online support group website with video meetings.

Many therapists, including Smith, offer video therapy appointments in lieu of in-person visits. Its important to stay accountable and on top of your mental health even if youre under quarantine, McIngvale said. At area hospitals, telemedicine apps are being used in as many consultations as possible, especially those not related to coronavirus.

Anxiety and a little bit of uneasiness are normal during this time, McIngvale said. But most people should return to functioning. If its consistent and affecting your life, seek help before it causes any major disruption.

julie.garcia@chron.com

Twitter.com/reporterjulie

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Julie Garcia is a features reporter at the Houston Chronicle focusing on health, fitness and outdoors.

Originally from Port Neches, Texas, Julie has worked as a community journalist in South Texas cities since 2010. In Beaumont and Port Arthur, she wrote feature stories and breaking news before moving to the Victoria Advocate as an assistant sports editor writing about high school sports and outdoors. Most recently, she worked at the Corpus Christi Caller-Times in areas spanning city and county government, new business, affordable housing, breaking news and health care. In 2015, she covered the Memorial Day floods in Wimberley, Texas, and in 2017, she was a lead reporter covering Hurricane Harvey as it affected the Coastal Bend region. These experiences have pushed her toward exploring environmental journalism and climate change.

A textbook water sign, Julie is an advocate for people feeling their feelings and wants to help people tell their stories. When not at work, shes probably riding around in her Jeep looking at all the tall buildings.

Have a story to tell? Email her at Julie.Garcia@chron.com. For everything else, check her on Twitter @reporterjulie.

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How to keep your mental health in check during the coronavirus pandemic - Houston Chronicle