Study: Some Ways of Coping With COVID Stress Are Healthier Than Others

Over the past year, the COVID-19 pandemic increased many people's anxiety and fear. While everyone found their own ways to cope, it turns out some strategies may be healthier than others.

One coping mechanism called cognitive reappraisal—or reframing your thoughts about a situation to put it into perspective—is commonly deployed in stressful situations to alleviate fear.

However, according to a new study by researchers at the University of Toronto, this particular coping mechanism might have done more harm than good during the pandemic.

Researchers found that participants who were able to reduce their fear amidst the threat of COVID-19 were mentally healthier, but also less likely to follow safety recommendations like wearing a mask or social distancing. The July study was published in the journal Psychological Science.

Reframing the Pandemic Led to Risky Behavior

The researchers reviewed data gathered from two separate surveys administered to 1,241 people in the United States. The surveys were given 10 times over a period of three months, starting when the pandemic first hit in February 2020.

The surveys assessed participants’ emotions about the COVID-19 pandemic as well as any depressive and anxiety symptoms.

Researchers asked participants to rate how often they used cognitive reappraisal to approach these feelings through questions such as “When you want to feel less negative emotion about the recent coronavirus outbreak (such as anxiety, disgust, or frustration), do you try to change the way you’re thinking about the outbreak?”

The researchers then cross-referenced the participants' responses with how often the participants practiced public health COVID regulations, such as hand washing, wearing a face mask, sanitizing surfaces, social distancing, and isolation.

The study's analysis showed that while reappraisal curbed fear and decreased participants' mental health issues, it also predicted less engagement in the health behaviors that were recommended by the Centers for Disease Control and Prevention (CDC) to slow the spread of COVID.

While cognitive reappraisal may have helped some people better understand their pandemic-related anxiety, the study's findings suggest that it may also have led to them underestimate the risks of COVID and be less compliant with public health regulations.

“We've been learning more about the unfortunate drawbacks that people can experience when they focus on reducing negative emotions in the face of stress,” study author Brett Ford, PhD, assistant professor of psychology at the University of Toronto, tells Verywell.

For example, in prior work, Ford's team found that people who can reduce their negative emotions about politics are less likely to engage in political action like donating, volunteering, or protesting.

“Findings like these suggest that focusing on 'keeping calm and carrying on,' a message that strongly suggests people should be avoiding negative emotions, might be counterproductive for promoting both mental and physical health," Ford says.

The Benefits and Drawbacks

The ways in which people respond to health threats are often driven by fear; an emotion that can motivate people to follow rules, behave with caution, and protect themselves.

To curb this feeling, people may rethink or reinterpret a situation to change how one feels about it. For example, telling yourself that the situation you are in right now really is not a big deal in the long run. 

The coping tool is rooted in the idea that the human mind sometimes gets stuck in a vicious cycle of negative thought patterns in response to stressful events. This, in turn, affects how people feel and act.

That said, the cycle can be broken; the skill can be useful for people who habitually resort to a catastrophic mindset or "all-or-nothing" thinking.

We all use whatever tools we have to cope with stress, but Ford says that we "need to understand the downstream consequences of using these tools, especially in the face of a community health threat like COVID-19."

Aaron Rodwin, a licensed master social worker at Humantold who was not involved in the study, tells Verywell the research "highlights the complexity of psychological ‘trade-offs’ that are associated with benefits and costs related to our emotional wellbeing in the context of a global pandemic.”

The research is among the first to show that some strategies that are meant to protect mental health may have the potential to jeopardize physical health.

What’s Missing From the Study

But Rodwin points out that the study did not look into moderating factors such as demographic characteristics that may help explain for whom these results apply.

For example, stratifying results by age, race, and gender could give us more information about coping mechanisms during the pandemic—especially since COVID has affected different groups of people in drastically different ways. 

Is There a Better Way to Use Cognitive Reappraisal?

Researchers also explored ways to use cognitive reappraisal without it becoming risky.

In their study, the researchers found that cultivating moments of socially oriented positivity—such as gratitude and inspiration—might be the most effective way to use cognitive reappraisal.

Scott M. Hyman, PhD an associate professor of psychology at Albizu University, says that while the researchers asked about the frequency with which participants used reappraisal as a coping strategy, they did not ask them how they changed their thinking about COVID.

Hyman says that there is a big difference between changing how you think in a healthy way to "have a more accurate view of a threat and reduce exaggerated fears" and an unhealthy way.

For example, it's helpful to tell yourself the threat of COVID is real but there are things that you can do to stay safe and treatments if you do get sick. On the other hand, telling yourself that the threat of COVID is exaggerated and there's no need to worry may put you in danger.

The latter, Hyman points out, is "basically denial.”

Healthy reappraisal is not meant to deny the seriousness of a problem in an effort to feel better; it's meant to help individuals critically and realistically evaluate the seriousness of a threat as well as the individual’s capacity to effectively cope with it.

“For example, it may also involve reframing a stressful situation in a different light or finding meaning in a tough situation,” Hyman says. “Such as, ‘This COVID situation is terrible but it has helped me to appreciate the importance of spending quality time with my family.’”

The study authors found that reappraisal to cultivate positive emotions—such as gratitude—was effective and was not associated with reductions in health-promoting behaviors. 

The surveys show that 89% to 97% of participants experienced at least some cultivating of moments of gratitude, admiration, inspiration, or social connection. These findings suggest these positive emotions were common responses to the pandemic, too.

“Fortunately, we found evidence for an alternative pathway that can avoid these negative trade-offs,” Ford says. “A strategy like reappraisal can be used many different ways and reappraisal is not only effective at helping people reduce negative emotion—it is also an effective way to increase positive emotion. For example, you might reconsider how a stressful situation could provide unexpected benefits, allowing people to cultivate moments of gratitude, admiration, or social connection.”

The bottom line: Ford says that "people who experienced more of these socially-rooted positive emotions were able to feel better without any costs to their use of CDC-endorsed health behaviors.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.