What You Should Know:
When you hear, read, or watch news about an outbreak of an infectious disease such as COVID-19, you may feel anxious and show signs of stress—even when the outbreak affects people far from where you live and you are at low or no risk of getting sick. These signs of stress are normal, and may be more likely or pronounced in people with loved ones in parts of the world affected by the outbreak. In the wake of an infectious disease outbreak, monitor your own physical and mental health. Know the signs of stress in yourself and your loved ones. Know how to relieve stress, and know when to get help.

Know the Signs of Stress:
What follows are behavioral, physical, emotional, and cognitive responses that are all common signs of anxiety and stress. You may notice some of them after you learn about an infectious disease outbreak.
YOUR BEHAVIOR:

• An increase or decrease in your energy and activity levels
• An increase in your alcohol, tobacco use, or use of illegal drugs
• An increase in irritability, with outbursts of anger and frequent arguing
• Having trouble relaxing or sleeping
• Crying frequently
• Worrying excessively
• Wanting to be alone most of the time
• Blaming other people for everything
• Having difficulty communicating or listening
• Having difficulty giving or accepting help
• Inability to feel pleasure or have fun

YOUR BODY:

• Having stomachaches or diarrhea
• Having headaches and other pains
• Losing your appetite or eating too much
• Sweating or having chills
• Getting tremors or muscle twitches
• Being easily startled

YOUR EMOTIONS:

• Being anxious or fearful
• Feeling depressed
• Feeling guilty
• Feeling angry
• Feeling heroic, euphoric, or invulnerable
• Not caring about anything
• Feeling overwhelmed by sadness

YOUR THINKING:

• Having trouble remembering things
• Feeling confused
• Having trouble thinking clearly and concentrating
• Having difficulty making decisions

Know When To Get Help
You may experience serious distress when you hear about an infectious disease outbreak, even if you are at little or no risk of getting sick. If you or someone you know shows signs of stress (see list at left) for several days or weeks, get help by accessing one of the resources at the end of this tip sheet. Contact the National Suicide Prevention Lifeline right away if you or someone you know threatens to hurt or kill him- or herself or someone else, or talks or writes about death, dying, or suicide.Know How To Relieve Stress
You can manage and alleviate your stress by taking time to take care of yourself.

KEEP THINGS IN PERSPECTIVE:
Set limits on how much time you spend reading or watching news about the outbreak. You will want to stay up to date on news of the outbreak, particularly if you have loved ones in places where many people have gotten sick. But make sure to take time away from the news to focus on things in your life that are going well and that you can control.

GET THE FACTS:
Find people and resources you can depend on for accurate health information. Learn from them about the outbreak and how you can protect yourself against illness, if you are at risk. You may turn to your family doctor, a state or local health department, U.S. government agencies, or an international organization. Check out the sidebar on the next page for links to good sources of information about infectious disease outbreaks.

KEEP YOURSELF HEALTHY:
▪ Eat healthy foods, and drink water.
▪ Avoid excessive amounts of caffeine and alcohol.
▪ Do not use tobacco or illegal drugs.
▪ Get enough sleep and rest.
▪ Get physical exercise.

USE PRACTICAL WAYS TO RELAX:
▪ Relax your body often by doing things that work for you—take deep breaths, stretch, meditate, wash your face and hands, or engage in pleasurable hobbies.
▪ Pace yourself between stressful activities, and do a fun thing after a hard task.
▪ Use time off to relax—eat a good meal, read, listen to music, take a bath, or talk to family.
▪ Talk about your feelings to loved ones and friends often.

PAY ATTENTION TO YOUR BODY, FEELINGS, AND SPIRIT:
▪ Recognize and heed early warning signs of stress.
▪ Recognize how your own past experiences affect your way of thinking and feeling about this event, and think of how you handled your
thoughts, emotions, and behavior around
past events.
▪ Know that feeling stressed, depressed, guilty, or angry is common after an event like an infectious disease outbreak, even when it does not directly threaten you.
▪ Connect with others who may be experiencing stress about the outbreak. Talk about your feelings about the outbreak, share reliable health information, and enjoy conversation unrelated to the outbreak, to remind yourself of the many important and positive things in your lives.
▪ Take time to renew your spirit through meditation, prayer, or helping others in need.