As a result of the COVID-19 pandemic, the structure of many people’s households has changed dramatically. Young adults who were away at college had to return home when schools closed, and many will still be at home this fall as schools continue to limit on-campus classes. Some people chose to move in with family after job loss strained their finances. And some families chose to temporarily move older relatives out of independent and assisted living communities to limit their potential exposure to the virus.

These changes have the potential to make an already stressful situation–people worried about getting ill, trying to help children with remote learning, adjusting to working remotely or to increased health risks at their places of employment, and dealing with financial strains from job loss and other financial issues caused by the pandemic–even more stressful. That ongoing, heightened level of stress can negatively impact both physical and mental health.

Manage stress to protect your mental health

You can take several actions to better manage stress and reduce the risk of mental health issues such as depression, anxiety, and alcohol and substance misuse while living with extended family.

Communicate honestly and often. Lack of communication allows negative feelings to build. Family members may think their concerns should be obvious to others or may be hesitant to express themselves frankly for fear of hurting others’ feelings or starting an argument. Arranging both formal and informal opportunities for communication can help family members better understand each other’s concerns, grievances, and fears and provide an opportunity for conversation. One approach is to hold a regular family meeting where each person can say what is on his or her mind without judgment from the rest of the group. Informal check-ins are also valuable, especially if you notice that a family member seems upset, withdrawn, or has a shorter temper than usual. Simply ask if there’s anything they would like to talk about. The goal is not for you to solve the problem, but to provide the chance for the person to be heard and for you to work together on a possible solution and ways to provide support.

Set and respect boundaries. Lack of privacy or the opportunity to spend time alone can markedly increase stress. Whether it’s your young adult children, your parents, or even in-laws, everyone should have the chance to set boundaries, which, when respected, will reduce friction and stress. The issues will be somewhat different for each family, but common issues can include child-rearing and discipline, work routines and the need for a quiet workspace, sharing household chores, bedtime, screen time, financial contributions to the family budget, and the structure of mealtime. For example, is everyone expected to eat the same food and take part in routines like family dinner?

Develop and maintain a routine. Lack of structure can increase feelings of depression and anxiety for some people, especially young children, teens, and older family members living with cognitive problems like dementia. As much as reasonably possible, try to create and maintain a consistent daily routine. Get up and go to bed at a consistent time, have meals at generally the same time, take part in regular physical activity like going for a walk, and get dressed rather than wearing pajamas or sweats all day. It’s also helpful to differentiate weekday and weekend routines to try to emulate pre-pandemic life and avoid feeling the same every day.

Seek help. If you or other family members are experiencing significant, ongoing symptoms of depression or anxiety, if a pre-existing mental health issue is being exacerbated by stress, or if someone is misusing alcohol or substances as a way of coping with stress, talk with your doctor and ask for a referral to a mental health specialist. Many mental health providers offer phone or video appointments, which can make it easier to access the care you need. You can also connect with mental health providers through your health insurance or by contacting the SAMHSA (Substance Abuse and Mental Health Services Administration) helpline at 1-800-985-5990 or on the web.

Miles J. Varn is chief executive officer, PinnacleCare, and can be reached on LinkedIn.

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