Elsevier Coronavirus Toolkit - Evidence-based content and resources for healthcare professionals

Mindfulness During Self-isolation

The novel coronavirus is a pandemic that is continuing to prove its global impact in ways we have never fully experienced. During this time of fear and uncertainty, what was intended to initially activate a sense of social responsibility and proactive prevention resulted in just the opposite. The empty grocery store shelves and lack of toilet paper, physical fights in markets over supplies, and overall air of hysteria have clearly shown us this: we are ill-equipped as a society to mitigate the stress and anxiety that has been brought upon us by this pandemic.

The obvious psycho-social impact of COVID-19 has resurfaced the notion that many of us have never developed tools to respond to high-anxiety situations and rather respond with rash, illogical decisions such as panic buying, or by resorting to unhealthy habits including excessive time on social media. When we continue to sit with this anxiety and don’t take steps to quiet it, we further feed into the hysteria that initially ignited it.

It is likely that many of our thoughts and actions in recent days have been strongly influenced by a sympathetic drive—our physiological “fight or flight” response—rooted in innate survival mechanisms.

This is an opportune time to practice mindfulness and meditation, as getting a hold of our mental, physical, and emotional wellbeing is necessary during this prolonged period of uncertainty and isolation. Unfortunately, these concepts may be abstract and difficult to grasp, confusing, frustrating, intimidating, or even completely foreign to many of us. So how can we make this realm of wellness accessible? Eating healthy, exercising, getting adequate sleep, and social connection all fall under the umbrella of wellness. If you have made a commitment to do these things, you are already taking great steps towards a healthy way of life. But how do we truly tap in to achieve the inner peace and stillness that is crucial to carrying us through to the other side of this? Here are some principles that may help you attain a stress-free quarantine.


Visualize the entirety of your present life as two buckets: one filled with things you can control, and the other holding things you can’t control (for example, the natural course of a highly contagious novel strain of a virus). If it helps you to actually write these down, do this too. Place the bucket of things you can control right in front of you; the other in your periphery—it is there, you are aware of it, and you may need to make slight adjustments in your life based on its contents. But where your power truly lies is right in front of you.

When we begin to truly delineate these matters and accept that only a fraction of reality is in our control, our actions within what we can control become more purposeful, meaningful, and intentional. Relinquishing control of things that are out of our hands automatically invites a state of peace and stillness. It allows us to recover control of our own realities and be that much more intentional with what is in our hands. While we have little control over the natural course of this pandemic (aside from #flatteningthecurve), we can take ownership over every aspect of what goes on inside our homes and be purposeful with every move. Our productivity, daily schedule, the aesthetic of our spaces, our ability to create a meditative space, what we put inside our bodies, our hygiene, the kindness we demonstrate to ourselves and to others—these are things on which we can focus the entirety of our mental energies.

If we are able to continue with our work, we can take advantage of this time to immerse ourselves into it, rekindle a passion for our careers, increase creativity and productivity, or change direction. If not, recognize that we still have full control over our productivity. As stressful and disorienting as it may be to be out of work, we can consider picking up new skills that may benefit our careers, or mapping out the trajectory and meaning of our future careers once life returns to normalcy.


A common misconception is that meditation is solely practiced sitting criss-crossed in silence, with eyes closed, attempting to quiet down our loud and racing thoughts. We can actually practice mindfulness meditation throughout our daily activities. For those of us with normally fast-paced, goal-oriented day-to-day lives, we often mindlessly move through actions such as eating, drinking our morning coffee, walking, driving, talking with our roommates or loved ones, and experiencing nature. Self-isolation has forced many of us to drastically slow the pace of our daily lives.

Take this time, with each action, to bring your awareness to the present, existing fully in each moment. To the best of your ability, incorporate all five senses into each moment, using them to appreciate the subtleties of your immediate surroundings that often get overlooked. A focus on the present naturally combats anxiety or other negative feelings about the future or past. In recent weeks, we have seen how quickly things can change; this emphasizes the importance of focusing on and existing in the present.


We are built to move. Aside from the innumerable health benefits, exercise creates a sense of unity between mind and body. It is especially crucial during this time when we are confined indoors, and when our stress and worry may be manifesting physically and even dampening our immune responses. With all gyms shut down, many of our regular workout routines are no longer feasible, or we may not have a regular movement practice.

This is an ideal time for us to get creative and change the way we move. Rather than engaging in conventional fitness options that may be strictly goal-oriented, such as focusing on building muscle or changing one’s appearance, we should consider choosing movements that simply feel right for our bodies. We may opt to pick up a new form of exercise that has always been intriguing, and the vast amount of online resources and videos make this accessible. However, also consider that our movement practices do not necessarily have to conform to a label or follow instructions, but can simply involve dancing around your room or creating your own personal yoga flow—anything that unites your mind and body into a “flow state.” This is a time for us to reconnect with our bodies, and reframe our thinking of exercise as grounding and meditative versus laborious and chore-like.


Regulation of the breath has been practiced for thousands of years for its spiritual purposes and speculated health benefits. In more recent years, studies have repeatedly demonstrated that 5 minutes of mindful breathing a day can significantly reduce feelings of anxiety, depression, and negative thinking. It has also been shown to affect several physiologic parameters including blood pressure, heart rate, measurable brain activity, and many more. Slow, diaphragmatic breathing has been shown to shift our autonomic system to a parasympathetic, or “rest and digest” predominance, versus a sympathetic or “fight or flight” state.

If there is one quick and highly effective practice we can begin to implement immediately in our daily lives, it would be controlled, mindful breathing. During periods where our thoughts begin to race and we are met with feelings of stress, fear, anxiety, or disturbing thoughts, the breath serves as a still, quiet place built-in to our bodies; a natural escape mechanism from our own dangerous thinking. Drawing attention to the breath periodically throughout the day allows us to quiet these thoughts and return to a grounded and centered state of being. In addition, setting aside 5 minutes per day dedicated solely to controlled breathing makes us better equipped to handle episodes of anxiety as they arise. 4-7-8 breathing (4 seconds of inhale, hold for 7 seconds, 8 seconds of exhale) is a common breathing practice, although there are plentiful online resources to experiment with other methods and guide you to a practice that works for you. Use the breath as your anchor.


From a psycho-social standpoint, the danger of self-isolation is the possibility of it transcending its physical limitations, causing us to lose a sense of connectedness that can be powerfully grounding and calming. Without a sense of human connection, we may be more inclined to spiral into states of anxiety. In addition to looking inwards, we must harness the power of humanism to cultivate a social environment of calmness and unity. One analogy by a Vietnamese Zen master Thich Nhat Hanh demonstrates this concept beautifully: “When the crowded Vietnamese refugee boats were met with storms or pirates, if everyone panicked all would be lost. But if even one person on the boat remained calm and centered, it was enough. It showed the way for everyone to survive.”

Rather than allowing ourselves to disconnect, let us realize that no matter how different we are, we are now united by the same struggle. Knowing this can increase the vulnerability of our connections and conversations and foster a sense of support. Aside from the obvious of friends and family, seek connection with neighbors, mentors and mentees, coworkers and colleagues. The principles of mindfulness can be practiced during these conversations—being fully engaged and present, open in mind and heart, and willing to give and receive support, knowledge, and kindness. Our current circumstances can allow us to change the tone of our conversations to increase connectedness, which ultimately leads to a more peaceful and fulfilled self.