It’s okay not to feel “normal”

 by Carolyn Thomas      @HeartSisters

What is “normal” around here anyway? What the world is experiencing now during the COVID-19* crisis is unprecedented –  meaning nothing like this has happened before. A global viral pandemic is just not “normal”.  At least, to us.

We long to somehow translate each new development or warning or news report into what our brains can recognize as a return to normality. But there’s nothing about unprecedented events that should feel “normal” to any of us.    .

As Dr. David Gratzer, a psychiatrist at the Centre for Addiction and Mental Health (CAMH), told the Toronto Star recently:

“It would be unusual for people if they didn’t feel unsettled.”

Aside from the running updates of scary diagnosis and death stats, here are some of the breaking news reports we’re hearing this week:

  • “Citing ‘unprecedented impact’ of COVID-19, Air Canada lays off 15,000 employees.”
  • “Weddings, funerals postponed amid unprecedented COVID-19 pandemic”
  • “Provincial government will shut down all schools due to unprecedented threat of COVID-19.”

How is anything about those news headlines, all on the same day, “normal”?

Yet so many moments of my own daily life still seem “normal”, and that itself can feel odd. So much seems unchanged, yet everything has changed.

Because I’m retired, for example, I didn’t have to worry about losing my job or income, as millions of others have. When I leave home for my once-a-day walk, the sky is still blue, the birds still singing, the spring blossoms still exploding, right on schedule. All of these things seem “normal” – and that feels surreal.

Freshly-diagnosed heart patients are often advised to get used to something called the new normal as we begin to slowly adjust to the unnerving feeling that our old normal – the normal we knew and loved – is now gone, and we’d better get used to it.

We’re not fatalists. We’re realists.  As one of my wise readers astutely observed:

“I now have more balance in my life, because I have to.

I’ve written about a number of specific studies on this cardiac phenomenon of adapting to the abnormal – ranging from the common experience of being unable to believe that our earliest cardiac symptoms are actually happening, to the utter shock of hearing the diagnosis “heart disease” out loud aimed at you for the first time, and then somehow trying to make sense out of a life-altering condition that makes no sense at all.

An Oregon study, for example, reported in the Journal of Acute and Critical Care looked at how women living with coronary artery disease had tried to find some meaning in what they’d just gone through.(1)  Researchers found that meaning actually evolved over time in a process they called seeking understanding.

At the onset of symptoms, all of the women survivors studied described three early responses:

  • 1. denial
  • 2. being scared
  • 3. acknowledgement

Those responses may seem remarkably familiar now to almost everybody who’s trying to come to grips with the reality of the full scale of this COVID-19 pandemic.

We’re now still in relatively early days yet of this pandemic, which is why so many local, regional or national governments (and essentially all of Fox News) have not yet officially endorsed severe restrictions like physical distancing* and self-isolation* to help prevent the rapid spread of this virus over the next months (not weeks). These people are still mired in denial, unable to think straight or act decisively despite the overwhelming weight of scientific evidence.

What helps us when nothing seem normal?

The Centre for Addiction and Mental Health offers us practical tips for managing the stress and anxiety related to this new normal of COVID-19, along with this observation:

“High levels of anxiety and stress are usually fueled by the way we think.

“For example, you might be having thoughts such as ‘I am going to die’  or ‘There is nothing I can do’  or ‘I won’t be able to cope.’  These thoughts can be so strong that you believe them to be true.

“However, not all our thoughts are facts; many are simply beliefs that we hold. Sometimes, we have held these beliefs for so long that they feel like facts.

“So how do we know if our thoughts are true or are just beliefs we’ve grown used to?

Here are some ways suggested by CAMH that may help us work through and challenge our worries and anxious thoughts during this anything-but-normal time:

1. Start with catching your thoughts. When you’re feeling anxious or stressed, stop and write down what you are thinking. There may be more than one thought going through your mind when you are feeling anxious. (Hint: Your thought might sound something like ‘What if …’ or ‘I’m worried that …’)

2. Once you have identified a thought, challenge the thought. Ask yourself:

  • Is this thought true?
  • Is it 100% true and always true?
  • What is the evidence for the thought?
  • What is the evidence against the thought?
  • Has the thing I’m worried about ever happened before?
  • How did I cope?
  • What was the end result?
  • If you find it hard to let go of worrying, ask yourself, “What does worrying do for me? Is worrying actually helping me solve a problem, or is it keeping me stuck and feeling anxious?”

3. After working through these approaches, see if you can come up with a more balanced thought. For example, “I am elderly, and so many older people are getting extremely ill. I could die from this”  could be replaced with: “I am elderly, but I am also taking all of the recommended precautions, and I am taking steps to stay healthy. I am extremely likely to get through this and be fine.”

Dr. David Gratzer at CAMH also suggested two things that I too have been trying to do each day:

“Sticking to a regular schedule and exercising regularly can act as a coping mechanism. People should gravitate to things they find comforting.”

Stay safe, my heart sisters. . . 

.

Q: What do you find comforting while trying to make sense of unprecedented times?

1. Anne G. Rosenfeld et al. “Meaning of illness for women with coronary heart disease.” Heart & Lung: The Journal of Acute and Critical Care, March–April 2000, Volume 29, Issue 2, p79-154.

*Definitions

COVID-19: the name of a disease caused by the Corona virus, a family of common viruses responsible for the common cold and other more serious conditions like Severe Acute Respiratory Syndrome (SARS).

self-isolation: staying at home and monitoring yourself for symptoms, even if mild, to help prevent the spread of disease in your home and in your community.

physical (or social) distancing: staying at least six feet (2 metres) away from other people to lessen the risk of spreading the virus through coughing, sneezing or speaking.

.

NOTE FROM CAROLYN:   I wrote much more about how heart patients can manage the inevitable changes brought on by health crises in my book, A Woman’s Guide to Living with Heart Disease”.  You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 20% off the list price).

.

See also:

Read more Heart Sisters articles about COVID-19 and heart patients

CardioSmart (a report from the American College of Cardiology) on how COVID-19 affects heart patients

18 thoughts on “It’s okay not to feel “normal”

  1. Hi Carolyn,

    Aww yes, normal, what is that anyway?

    In Cancer Land we always hear about finding our “new normal”, and I’ve yet to figure out what exactly that means.

    These days, so much in my life remains normal. After all, I work from home. I still get out for my daily walk. I still go to the store once a week for groceries. (Now, I can’t go to the store til I come up with a mask of some sort. I am not a sewer, but I finally found some online to order. Hopefully, they will show up.)

    On the other hand, nothing feels normal. Such a dichotomy. Plus, when staying home is not a choice, it feels entirely different. Weird.

    I appreciate the suggestion that we challenge our thoughts when we find worries getting a bit out of hand. I’m not an over-worrier by nature, in fact, I’m sort of a procrastinator when it comes to worrying too, which hasn’t served me well at times.

    Once again, it circles back to balance. That seems to be a recurring key to self-care, especially during times like this.

    Thanks for the post. Stay well.
    x

    Liked by 1 person

    1. Hi Nancy – such a good point: “When staying home is not a choice, it feels entirely different….”

      Isn’t that the truth? I often think the same about when I needed to stop working after my heart attack (because of ongoing cardiac issues). It felt so horrible… But if somebody had asked me if one day, I’d like to take early retirement in my 50s, stay home and get money deposited into my bank account monthly, I would have jumped at the chance. But because none of those things were my own choice at the time, I really fought hard against that new reality…

      Ditto with being “told” to stay home.

      As I heard somebody say recently: “When previous generations went through national crises, they had to do things like go off into combat, or hide their families in bomb shelters in the middle of the Blitz. By comparison, we’re being asked to stay home and watch Netflix…”

      I love your ability to procrastinate about worrying. That might just be a useful coping tool!

      Stay safe… ♥

      Like

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  3. Hi Carolyn,
    As you probably have come across, the original root of the word normal is kind of strange: “Made according to a carpenter’s square,” from norma “rule, pattern,” literally “carpenter’s square.” I don’t know about you, but I don’t feel close to being like a carpenter’s square.

    My highest moment of personal anxiety in the new normal times we are in came after reading about the number of ICU beds and ventilators needed in Alaska, and we were short by about 5x what was needed.

    It took a long bath for me to calm down and figure out that my actual risk of catching the disease was about 50% and not surviving was about 10%, i.,e. about a 5% change of being one of the Covid Chosen.

    The odds of having another coronary event are higher than that. I think that means I need to be concerned much more about the right preventative life style for my heart, keep washing my hands, keep my distance… and take baths.

    I am also telling clients (and myself) what you wrote in the last post — it’s a matter of learning how to live “with fear” rather than “in fear”

    Thanks for your weekly posting.

    Liked by 1 person

    1. Hi Dr Steve – although I did study Latin all through high school (Catholic boarding school – we loved Latin!) I did not know that word origin of “normal”. Funny how such a specific meaning has expanded to such a broad interpretation used in all aspects of everyday life.

      I sure hope Alaska smartens up to ensure that more required equipment will be secured! There’s lots to be learned from Italy and Spain (a couple weeks ahead of us) on what worked and what didn’t work for them – the trouble is, Italians just didn’t believe that this virus would invade their country so weren’t prepared.

      My own current worry is not so much for myself, oddly enough, but about the shocking lack of appropriate personal protection (and political infighting over sourcing that protective equipment for those who are supposed to be caring for us in hospitals). It’s like sending firefighters into burning buildings without proper gear – that would NEVER happen…

      Keep enjoying those baths – they seem to be working!
      Stay safe…

      Liked by 1 person

  4. In part of today’s post, you talked about emotions women felt after their heart event. I’d like to put that into a context that I use a lot.

    “Normal” will always be changing for all of us because every present moment is beyond what happened even a moment ago, and our choices in the present moment create our future.

    So if we are cloning to some thought or picture of what was normal yesterday…we hold ourselves back from a brilliant future.

    Elizabeth Kubler Ross’ 5 stages of grief are not just something we move through if a loved one dies. They are a process we go through with any loss… including a loss of health or a loss of normal. The stages are Denial, Anger, Bargaining, Depression and Acceptance. Recognizing them, and moving through them is essential to feeling a bit more normal. However, many get stuck at Denial, or Anger or depression and don’t or can’t move on. That is when professional help can be a Godsend.

    Humans are amazingly resilient. I can enjoy being uncomfortable because I know I am growing. Having the tools to mine my discomfort and learning from it are a joy.

    Liked by 1 person

    1. This past week, I happened upon a study about post-normal times, a concept that helped to explain the profound distress that so many are experiencing right now (losing their jobs, not being able to pay their bills, separation from their families, worry about sick loved ones, etc.) In “normal” times, we have confidence in our facts and values, and we can take our time in making appropriate decisions about the future. But in “post-normal” times, researchers describe a sense of urgency, and a future that feels like a runaway train barreling into the unknown.

      So it’s tough to to get our brains wrapped around that “brilliant future” the train may or may not be taking us to.

      Stay safe, Jill… ♥

      Like

  5. Dear Carolyn…

    Thank You for giving your readers the specific tools needed to examine their own state of mind and change it. It is the cornerstone of my Spiritual Counseling Practice!! These are skills that we were never taught by our teachers or parents but they are the skills needed for all of humanity to move into more enlightened living.

    I just sent a manuscript into a publisher for a children’s book I have written called “Augista’s Garden”. The very first page has a single sentence “Thoughts are like seeds, tiny packets of unlimited potential”

    This is our key … Our life is a garden, we have the free will to choose thought-seeds that grow flowers or thought/seeds that grow weeds.

    Blessings!

    Liked by 1 person

  6. It is a surreal time for my elderly parents and myself. I am thankful we all live in the same house and are not separated. we are all retired and so like you, Carolyn, we do not have the worry of jobs.

    We live in an isolated part of the southern Ozarks, so “social distancing” is pretty much a way of life for us. While we carry on with our daily activities, we have agreed the normal seems so abnormal in light of this pandemic. We limit news and social media. We keep up with family, friends and neighbors by phone, email, messaging, and snail mail. We are as active as we can be physically(some days so much so) and eat as well as we can considering shopping is out unless one orders and picks up curbside. We are all high risk as are many family members.

    We are trusting and adjusting to these uncertain times.

    Liked by 1 person

    1. Thanks for sharing your perspective, Sue. I was reminded while reading that you live in the same house with your parents about some frightening news here (west coast of Canada) of what health officials are calling “clusters” of COVID-19 deaths at longterm care homes (about half of all deaths due to the virus across Canada have occurred in these facilities). One expert finally suggested this week: “If you can get your relatives out of seniors’ homes, try to do so as fast as you can!”

      You’re lucky that you and your parents are under the same roof, self-isolating together. Uncertain times, indeed.

      Please stay safe! ♥

      Like

  7. Carolyn: I know you are keeping safe too! NORMAL for me is judged by my life and the times when I thought that periods of calm was NORMAL.

    But alas, life gave me equal periods of “gosh, Mom was right!” Life gives you challenges that come on fast and consistently so you feel like there’s a target on your back especially when we are of the age of marriage and children. I thought this must be my NORMAL.

    Then my aging body started throwing more things at me despite my controls of a healthy lifestyle or things like accidents out of my control.

    Now this became my new NORMAL: handle all these layers with a misbehaving heart with microvascular dysfunction. My family too had new NORMAL with events both good and bad all of which impacted my new NORMAL.

    So I do not know what is NORMAL: I just know that today with another layer with COVID that just living life is NORMAL.
    Hugs to you!
    Joan

    Liked by 1 person

    1. Hello Joan – lovely to hear from you. I loved your take on this, that “NORMAL” seems to be a moving target indeed! It seems that every time we face one life crisis, and then the next, and then the next, it makes us believe (rightly or wrongly) that since we were able to survive ABC, so we will survive XYZ, too. Yours is a wise overview of this belief.

      Stay safe… ♥

      PS NOTE TO READERS: Please watch this video about Joan’s experience with coronary microvascular dysfunction.

      Like

  8. I’m male heart attack survivor. I read your blog thru email, even though it targets women survivors. It has a lot of ideas I can use. I don’t understand your slur to Fox news in today’s post.

    We we watch fox nearly every day for our news. We find that they are fully committed to getting information out about fighting the virus, much more so, than the other news channels. It makes me think you might have a different kind of infection.

    Gary

    Like

    1. Gary, I’m not sure what “different kind of infection” you’re accusing me of harbouring.

      I’m referring, of course, to the continuing denial, misinformation spewing from Fox since Day One (Limbaugh: “It’s the common cold!”; Pinsky: “It’s milder than we thought!”; Earhardt: “It’s the safest time to fly!”; Kudlow: “We have contained this!”; Hegseth: “The more I learn about the corona virus, the less concerned I am!”; Rivera: “Nobody has died of this in the United States!”) – and mocking dismissal of the actual growing COVID19 threat; ironically, some on Fox are now falsely claiming that they have “always taken this virus seriously” as if the broadcast evidence of them saying precisely the opposite is not available everywhere.

      Hardly “fully committed” to the truth…

      Stay safe.

      Like

  9. I’ve “been there, done that” with the “new normal”. I refer to the current changes as the New Now.

    Heart Sisters are used to making major adjustments to their lives to accommodate nasty news. Covid-19 is just another “adjustment” — but unlike many of our other changes, this one WILL pass.

    Liked by 1 person

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