People who stayed positive early in the COVID-19 pandemic and looked for ways to learn from the situation are faring better than those who found other ways to cope, according to a new study that is among the first to examine the mental health impact of particular coping strategies in the context of the pandemic.

Researchers in Canada examined which coping strategies were the most effective at protecting people from the mental health consequences of the coronavirus pandemic during its earliest stages in April and May 2020. Coping, in this context, refers to a person’s cognitive and behavioral efforts to manage internal and external stressors. 

The first-of-its-kind study, published in the January edition of Canadian Psychology, investigates specific coping strategies for the COVID-19 pandemic and how these strategies relate to mental health and quality of life outcomes.

Amanda Shamblaw, a postdoctoral research fellow at the University of Toronto Scarborough and lead author of the paper, told The Academic Times that when the coronavirus first spread and caused lockdowns in North America, people turned to a number of coping strategies to deal with the stress. But not all were equally effective.

“The COVID-19 pandemic is a significant source of stress, and consequently, we are witnessing an increase in the rates of several mental disorders during this time,” Shamblaw said.

Using a sample of about 400 adults from the U.S. and Canada, Shamblaw and her colleagues administered one survey in April 2020 to measure how people were dealing with the stress of COVID-19 and conducted a follow-up survey one month later. Fourteen coping strategies were studied and categorized as either approach coping or avoidance coping. 

Approach coping strategies include active coping, planning, positive reframing, acceptance and use of emotional support. In the current study, people who used approach coping strategies had lower depression rates and better quality of life during the first survey, but not necessarily over time.

Avoidance coping strategies include denial, substance use, venting, behavioral disengagement, distraction and self-blame. The researchers found that within their sample, avoidance coping was associated with higher depression, higher anxiety and lower quality of life during the first survey, and associated with increased depression and anxiety over time. 

Of the 14 specific strategies that were studied, the most beneficial was the approach coping strategy of positive reframing, which is when people look for positive aspects of a situation and recognize how they can learn from it. The people who said that they turned to this strategy showed fewer mental health symptoms and a better quality of life in the follow-up survey.

The authors of the paper said that interventions focusing on reframing negative aspects of the pandemic may be most useful to improve health and well-being. Cognitive behavioral therapy is a form of psychological treatment that emphasizes cognitive reframing techniques, and has helped people with a variety of disorders work through dysfunctional thoughts. The researchers noted that cognitive behavioral therapy may work to treat the influx of mental health disorders caused by the pandemic.

Positive reframing is inherently a cognitive strategy, but it can be a catalyst for actions and behavioral coping such as discovering new hobbies and spending time with immediate family, Shamblaw said.

“It may be useful to disseminate cognitive behavioral reframing techniques to promote general well-being. For individuals experiencing significant mental health difficulties during the pandemic, [it] may be especially useful to consider cognitive behavioral therapy as this method is directly linked to the most effective coping strategy found in the current study,” the authors said.

In the first survey, 34% of participants reported having clinically significant depressive symptoms, and 29.1% reported having clinically significant anxiety symptoms. In the follow-up survey, the percentage of participants with depressive symptoms had dropped to 23.8% and the percentage with anxiety symptoms had dropped to 21.3%.

Participants who had lost their job as a result of COVID-19 used both approach and avoidance coping strategies more often than participants who had not lost their job. The most commonly used coping strategies were acceptance and distraction, but neither of them were particularly helpful, Shamblaw said. 

Acceptance coping had no significant effect on depression, anxiety or quality of life. And distraction coping was actually associated with increased depression, increased anxiety, reduced quality of life and overall worse mental health.

“The latter point is particularly important, since several recommendations in the media have suggested using distraction as a coping strategy, but when we look at the evidence, distraction might actually make things worse for people,” Shamblaw said.

The avoidance coping strategy of self-blame was also found to be particularly harmful for mental health. When people turn to self-blame, the researchers noted, they begin criticizing themselves and blaming themselves for things that have happened in stressful situations.

When the research team conducted the study in spring 2020, the pandemic-related stress that people were experiencing was acute, Shamblaw explained. Acute stress is short-term and usually stems from specific and unexpected traumatic events. Chronic stress, on the other hand, is prolonged and consistent, and can cause wear and tear on the body by increasing the risk for physical and mental illness. 

“Our study informs effective coping with the acute stress of the pandemic, but more research is required to help us understand methods of coping that are helpful with the long-term chronic stress now that the pandemic has persisted for a year,” Shamblaw said.

“The COVID-19 pandemic has simultaneously resulted in an increase in mental health disorders and a decrease in access to mental health supports,” she continued. “While we found positive reframing to be the most effective coping strategy, it’s also not always possible to cope on your own. Seeking mental health supports is critical for anyone experiencing significant negative mental health effects of the pandemic.”

The study, “Coping During the COVID-19 Pandemic: Relations With Mental Health and Quality of Life,” was published in the January edition of the Canadian Psychology journal. Amanda Shamblaw of the University of Toronto Scarborough was the lead author. Michael Best and Rachel Rumas, both of the University of Toronto Scarborough, served as co-authors.