How to Hack Stress — Empowering Yourself in the COVID-19 Era

Steven Chan, MD MBA
Mental Power Hacks
Published in
14 min readMay 27, 2020
Stress-free, pre-COVID-19 and pre-social distancing. Photo licensed from StockUnlimited 1930538

These are difficult times. Incredible changes. Uncertain times of enormous stress. In 2020, we’ve seen the worst single-day drop in U.S. stock market history. Over 30% of value wiped out — affecting peoples’ retirement accounts. Unemployment has shot up drastically. And the SARS-Cov-2 virus and COVID-19 disease pandemic has decimated businesses in tourism, services, and hospitality.

The American Psychiatric Association also has noted COVID-19’s impact on mental well-being with increased anxiety. The APA Headlines e-mail newsletter recently summarized it thus:

The Washington Post (4/17, Searing) reports, “Daily stress and worry plague a majority of American adults — 60 percent, according to a new nationwide Gallup poll, conducted from March 21 to April 5.” The result “represents what Gallup describes as an ‘unprecedented’ increase in the number of anxious Americans, a statistic that it says generally shows little change over time.” It is believed that “economic and health fears brought on by the novel coronavirus pandemic…have sparked the spike in anxious Americans.”

This has affected me personally & professionally. These events make me fear the unknown. I’m more uncertain about the future. And, I have doubt that this will let up, given the current trajectory, lack of reliable treatment, and lack of a vaccine — although there are many brilliant colleagues & scientists working on stemming the tide. As a result, I’ve had sleepless nights. My eyes are glued to the constant stream of bad news.

But amidst all this, I’ve found key ways to keep stress down, stay fit, and maintain what I can in life. My behaviors, my actions, and my definition of success and productivity have adapted to today’s stress and changes.

And that’s because I already faced my own death.

Waiting for the nephrologist at the hospital (Photo: Steven Chan)

Sacrificing myself: the stress of kidney donation

Six months before the COVID-19 pandemic, I visited my brother and my sister-in-law on the East Coast. We were all grim and sullen.

That’s because, a few days before the trip, I learned from the kidney doctor that they no longer needed me as a kidney donor.

My heart sank. I remembered thinking, “what do I do now?” I was supposed to be — and I wanted to be — the kidney donor!

See, my brother had something called end-stage renal disease. His kidneys nearly stopped functioning. He almost died. He needed a new kidney.

The best possible outcomes for people with this disease is to receive a kidney from a live donor. Often, a family member — like myself — could be the optimal match to donate one of their two kidneys. A family-donated kidney is more genetically similar, and hence, more optimal. Surgeons would then graft the donated kidney onto my brother.

Seeing kidney models in the nephrologist office (Photo: Steven Chan)

What would happen if I died?

But I felt scared. “Kidney donation” is a nice way of saying that you’re getting a major intra-abdominal organ removal, a nephrectomy. I felt worried about becoming disabled. Worse, I expected to feel very fatigued and in pain for weeks after my surgery. Even worse, there was a risk of death.

I had to do everything I could to lower the risks.

So, for two years, I prepared myself to be the kidney donor. I watched what I ate. I exercised almost every day to lose weight — more so that I could survive a surgery.

Two years flew by: flights back and forth to the East Coast, medical tests, lab tests, and imaging tests.

Aboard a cross-country Alaska Airlines flight for medical check-ups (Photo: Steven Chan)

And so I prepared my life in case of death. I bought life insurance, disability insurance, and health insurance. I filled out all the paperwork to choose my beneficiaries who would get my funds.

Despite all this, I still took time to enjoy myself. I (responsibly!) lived it up. I traveled to Honolulu, vacationed in the East Coast, basked in New York City, and grooved to concerts in San Francisco.

Then, I realized I wanted to teach others about success, productivity, and happiness. Mental Power Hacks was born. It was a way for me to pass on life lessons and mental empowerment to those in my community — and my future children.

Relief and stress

Fast forward to 2019. Once I heard the news from the nephrologist that I would no longer be donating a kidney, it was a mix of emotions. I was one week away from donating my kidney to my family member.

When I received the news that I was no longer the kidney donor, I felt like part of my identity was ripped away from me. I felt, actually, like I could have done more. And I wished I still were donating a kidney, even though I was deathly afraid of undergoing surgery.

This story has a happy outcome. My brother secured another live kidney donor.

As for myself, I felt like I was now in a position to search for the next phase of my life. I was free of the obligation of self-sacrifice. Having that sort of burden lifted off the shoulders felt empowering.

San Francisco — eerily quiet in the midst of a pandemic (Photo: Steven Chan)

Fast-forward to today’s Coronavirus…

…and now I — and many of my colleagues, friends, and family — face death once more.

SARS-CoV-2 is a coronavirus that causes the COVID-19 disease. It’s highly infectious. It can lay dormant for a week or more, before it fully takes over and causes severe flu-like symptoms: fever, chills, and cough, to a full-blown lung shutdown.

Because of how easily it spreads, many cities around the world have mandated business shutdowns and limited group activity. In a series of quick actions, my university and work groups have enabled our students to work from home. We have shifted as much as we could to telehealth and virtual visits. Our state has banned sit-down service at restaurants, cafes, fitness gyms and clubs, only allowing takeout food and grocery shopping. And, our universities have sent students home to prevent the spread of illness.

As of this writing — April 2020 — there are limited tests available. There are no definitive cures. And, because of supply shortages and staff shortages, there’s only so much that hospitals, physicians, and nurses can do.

How COVID-19 stressed my life

Before, my schedule consisted of waking up, hitting the gym to exercise, heading to work, then taking public transit back home. I might stop by and wander around the grocery store on the way back. On weekends, I would write papers and read research in coffee shops, walk around downtown malls, and meet with friends over brunch.

Now, all that has changed. I can’t go to the gym — they’re all shut down. Going to grocery stores increases my risk of contracting the disease. I can’t ride the bus or take the train. Any sort of contact with anyone is a risk, because I have no way of knowing if they actively have an infection. This disease spreads insidiously and silently.

My schedule has drastically changed. I drive to and from work in virtually no traffic. Work continues in the medical center with minimal contact with others. Now, I conduct disaster planning and telemedicine setup. I call patients on the phone, educating them about this disease, and why we’re trying to keep them safe.

Your life likely drastically changed. You may have to care for children at home who can’t go to school. You may have been laid off or furloughed, with few funds left to help. It might feel like one little slip-up could lead to danger to you and your household.

It’s a time of extreme stress.

“This Is Fine” meme

But, there are plenty of ways to hack your stress and anxiety:

Hack your stress

Stress can be useful. Stress compels us to act, to motivate us, and to execute to solve a problem. We need stress in our lives to produce constraints. If we had no stress, we wouldn’t feel like changing things.

But too much stress makes us feel overwhelmed. Too much stress is distress.

Much of the stress can be caused by uncertainty. When you’re not certain how bad things will get, what will happen to your career, or what will happen in case you contract a virus, you need to arm yourself with knowledge and facts from reliable, trustworthy sources.

To deal with distress, I suggest changing how you feel about stress, how you act on stress, and change the stressors entirely.

First, arm yourself with facts.

Let your rational mind take over. Learn about things as much as possible through others’ experiences. Learn how others overcome, anticipate, and plan for problems.

Learning can be stressful. However, it’s far worse closing your eyes and ears, and imagining, feeling, and reliving negative fantasies, all the worst possible outcomes in your head.

So empower yourself with facts. Be like Spock. (Or Tuvok. Or Michael.)

When I decided to be a kidney donor, I minimized fear and uncertainty by learning more about the disease, what happens to donors following surgeries, and researching the risks and the benefits.

Reliable, trustworthy sources can include some of the most boring, impartial organizations that don’t sensationalize stories. If you are worried about, say, a particular disease, turn to the World Health Organization, universities such as UCSF (University of California, San Francisco), and medical journals. Don’t look so much at tabloid or sensationalized sources. The University of California’s website, for instance, brings together easy-to-digest news from its top universities and the latest research.

from TheCounselingTeacher.com

Second, focus on what you can control.

Realize that much of the news media reports on things that may not be under your control. There are lots of things you can’t control:

  • how your co-workers behave in the workplace
  • what your boss says
  • what a disease does to infected people

Recognize that there is absolutely no point in fretting about these things — because you cannot do anything about it!

Instead, focus your energy and attention on what you can control. You might find you have lots to occupy your mind already, such as:

  • your behavior in your workplace
  • your responses to co-workers
  • how you react and respond to your boss
  • ways to reduce your chances of contracting the virus
Imagine a person lying on bed, wide awake, with piles of lavender plants on them.
Meme: Lavender reduces stress!

Third, take concrete actions to improve the situation.

Come up with feasible actions. This lets you prepare for the worst while hoping for the best. Contingency plans help you act in moments of distress. Change things to make it the most optimal as possible.

But recognize that it can’t be entirely perfect. Peace of mind can include feeling like you’ve made an effort to reduce the risk, do what you can and then just accept the result that comes. Why? Often times, if things don’t work out, you can keep your expectations low.

You might be surprised by life when your expectations are lowered. Life then underpromises and overdelivers, leading to pleasant surprises.

Recipe for hacking your worries & stress

Schedule a “worry hour” each day, where you catalog all your stress on paper. Allow yourself to worry about your stressors in this one, single hour.

(Now if one “worry hour” stress you out, start small: have a “worry time” of 20 minutes!)

What is one thing that worries you — that keeps you up over and over again?

Do these three steps:

  1. Think about the worst that could happen. Then, ask: Is this real? Is this likely to happen? Is this based on facts, or imagination?
  2. Think about what is most likely to happen.
  3. Brainstorm, in 5 minutes, all the possible ways you could reduce the likelihood the worst-case scenario occurs. And, the ways you could reduce the risks. These are the “hacks” — the actions you can take — that are within your control.

Repeat this for each worry you might have.

Once you come up with ways to hack your worries, figure out how to make those a reality:

  1. Check off the hacks you can accomplish quickly and easily.
  2. Set up a date to get those hacks done. Once you’ve done them, notice how you feel. You might feel more relaxed, more confident, and more in control. You might even feel like you’re ready to tackle on even more difficult hacks!
  3. Then, move on to your other hacks — especially the hacks with a bigger payoff, but perhaps are not as quick or as simple. Go and do more.

With the COVID-19 coronavirus, I had a brief moment of panic. I then looked at all the facts, and learned about how to reduce my risks of contracting this disease. I decided that the worst that could happen was that I fell ill if I were infected.

To hack away at this stress, I took steps to stock up on food, minimize contact with other people, and find ways to ensure I had enough emergency funds by cutting expenses. Systematically going through these steps let me stop dwelling on the uncertainty. Instead, I focus on things I can control.

“All negativity is caused by an accumulation of psychological time and denial of the present. Unease, anxiety, tension, stress, worry — all forms of fear — are caused by too much future and not enough presence.” — Eckhart Tolle, The Power of Now
https://mentalpowerhacks.com/download-the-mental-performance-hacks-slides
From the Mental Performance Hacks presentation at Talks At Google

Hack your anxiety

If stress is a reaction to circumstances, anxiety can linger and persist — making you feel tense throughout the day, feel on edge, and it difficult to relax. Apart from hacking your stress above, here are ways to deal with anxiety.

First, take a breath.

Recognize that anxiety comes in many forms — some are constant, while other anxiety rushes in all at once and culminate into a panic attack.

We might not always think clearly in the midst of such anxiety. We may forget to put words to the emotion we’re feeling. Some people feel they must go into attack mode, say things they don’t mean. They let the anxiety take over.

What’s important is to step back, look at the emotion, and identify what you’re going through. This allows your rational mind to take control of the wheel.

Second, abort the anxiety quickly.

Find ways to abort anxiety: listen to music, go for a walk, and take a bubble bath. Do some exercises: a light jog, jumping jacks, or yoga poses.

Get yourself out of the stressful situation. Do things that are restorative to you and relax you. Some people mistake “taking a break” as a way to scroll through social media feeds or instant messaging, which can lead to even more stress!

Set yourself up for no-stress success

Then, ensure you do specific things that allow you to lower stress and prevent anxiety in the future:

Get enough sleep.

Not getting sleep can make you feel more anxious, less in control of emotions, and less able to think clearly. But getting enough sleep will help you maintain control. Plus, multiple studies support sleep’s health benefits. If you want to learn more, I’ve posted on how to fall asleep faster on Mental Power Hacks.

Lifting weights (Photo: Steven Chan)

Exercise.

Burning off calories and moving muscles can reduce your stress levels. In addition, the aerobic exercise delivers more oxygen to your brain, allowing you to think more clearly. And, at night, you’ll fall asleep faster, sleep better, and sleep longer.

Express gratitude for what you have.

Thinking about the positive people, events, and belongings in your life can help reframe your perspective. And, saying “thanks” for these positive things in life uplifts your mood. Expressing gratitude is helpful after a rough day.

You can also express that gratitude to other people. This can help you realize how much good there is in your life. It helps others learn that you yourself are appreciative of them.

I myself threw a going away party before my anticipated surgery day, because I wanted to thank all of the friends and family in my life who have been there for me. It was an amazing experience: I threw a huge party for over 100 people, catered lunch and desserts, and rented space in beautiful Northern California, to entertain my guests.

Slow your thoughts.

Adopting mindfulness practices has shown to help reduce stress, boost empathy, increase self-control, and focus on concentration. It an also reduce depression and anxiety, and reduce suffering with many medical conditions such as chronic pain.

According to J.R. Martin in the Journal of Psychotherapy Integration,

Mindfulness is a “a state of psychological freedom that occurs when attention remains quiet and limber, without attachment to any particular point of view.”

With mindfulness, your focus lingers on the moment, without judgement or opinion. It often includes focus on an object or environment, and identifying what comes to the senses — sight, smell, taste, hearing, and touch.

Sometimes, mindfulness is coupled with meditation. That’s where you focus on allowing thoughts to flow by, from an observers’ viewpoint, to help reduce internal mental “chatter”, or the “monkey mind.” Key steps in meditation leads to more awareness of yourself, your body, and your emotions.

Mindfulness is where you are aware and accept the present moment & senses. Meditation leads to decreasing the mental chatter — the “monkey mind” — allowing thoughts to float by like clouds.
https://mentalpowerhacks.com/download-the-mental-performance-hacks-slides
From the Mental Performance Hacks presentation at Talks At Google

Finally, express your emotion in healthy ways

A lot of people may express emotion with unhealthy behaviors or harmful words. For instance, stress-eating has caused me to eat a lot of popcorn. Others may feel under duress and yell mean insults or make nasty, passive-aggressive retorts. These can lead to destruction of your relationships and job prospects.

Instead, express your emotion in healthy, constructive ways. These new ways are more constructive and less destructive:

Relaxing in downtown Boston (Photo: Steven Chan)

Journal. Write down your thoughts. The “worry hour” above can help, but you can even change that to a 10-minute write-down-all-the-stressors daily. You could go beyond journaling and use worksheets: structure your thoughts is to use worksheets are available online from sources like the Centre for Clinical Interventions.

Share your experiences. I myself joined a live kidney donor Facebook group. And I found that a helpful add-on to my reading medical textbooks and journal articles. Every day, I would read the latest questions and answers shared by those who have lived through donating a kidney. I myself am sharing my experiences now with Mental Power Hacks!

Discuss with a therapist. Psychiatrists, psychologists, social workers, and marriage & family therapists all are excellent persons with whom you could consult. Ensure that you ask what kind of therapy is offered, if there is a set number of sessions, and how long each session is.

Healthcare professional. If you feel like life is not worth living, or that you are having thoughts of doing something dangerous and risky, see a medical professional, consult a crisis hotline, or emergency services. Ensuring your safety and others’ safety is important.

© 2020 Steven Chan. All rights reserved worldwide. Copyright violation may subject the violator to legal prosecution. Photo: Stress-free, pre-COVID-19 and pre-social distancing. Photo licensed from StockUnlimited 1930538

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Steven Chan, MD MBA
Mental Power Hacks

Stanford professor • Addiction Psychiatrist & Clinical Informaticist • Founder & CEO of Mental Power Hacks (🙌productivity 💪🏽 success 🤜🏾 stress)