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A pandemic is an epidemic of disease that often 

spreads quickly across far-reaching areas, 

affecting many people. Few pandemics have 

affected as many communities around the world 

as the coronavirus disease 2019 (COVID-19) 

pandemic. 

Pandemics and other disasters involve physical 

danger and also stress that can overwhelm 

survivors’ usual coping strategies, both during 

and after the disaster. After a pandemic or other 

disaster, people often notice changes in how 

they feel, think, and act, and they may not realize 

that these changes are reactions to the disaster. 

Survivors may be at higher risk of intense 

reactions if they live in communities where many 

people got sick; they had the disease themselves; 

or they had health, mental health, or substance 

use conditions before and during the pandemic. 

Pandemics, unlike other types of disasters do not 

have a clear beginning and ending, sometimes 

leading to increased uncertainty and distress. 

This tip sheet describes common reactions after 

pandemics and other disasters and suggests 

ways to cope. It also covers financial stress 

and signs of the urgent need for mental health 

assistance and lists sources of help and support.

Tips for Survivors of a Pandemic:

MANAGING STRESS

Toll-free: 1–877–SAMHSA–7 (1–877–726–4727) | info@samhsa.hhs.gov | https://store.samhsa.gov

SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America's communities.
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TIPS FOR SURVIVORS OF A PANDEMIC: MANAGING STRESS

Toll-free: 1–877–SAMHSA–7 (1–877–726–4727) | info@samhsa.hhs.gov | https://store.samhsa.gov

Common Reactions to Disasters

Survivors often notice changes in their thinking, 

feelings, and behavior during and after a disaster, 

as well as physical signs and symptoms.

Changes related to thinking may include 

nightmares, confusion, trouble making decisions, 

trouble concentrating, difficulty with remembering 

things, and inability to listen to others.

Changes in feelings may include increased or 

overwhelming fear, anxiety, depression, irritability 

and anger, hopelessness, or guilt. Survivors may 

also experience a sense of disconnection, or not 

caring about things, as well as inability to feel joy 

or sadness.

Changes in behavior may include having an 

exaggerated startle response, trouble sleeping, or 

more arguments with others. Survivors may also 

notice that they are eating too much or too little, 

crying more often, having angry outbursts, or 

spending more time alone. Their substance use 

may increase.

Physical signs and symptoms may include 

headaches, stomachaches, or diarrhea; loss 

of appetite; sweating or having chills; tremors 

(shaking) or muscle twitches; higher or lower 

energy than usual; or being unable to relax.

Common Reactions in Children 

and Teenagers

Children and teenagers also experience reactions 

during and after pandemics and other disasters. 

In fact, because they have had fewer years to 

develop social, communication, and coping skills 

than adults, children may be at particular risk 

after disasters. Common reactions vary by age 

range. 

Children 5 years and younger may have persistent 

fear and worry; become clingy; cry or whimper; 

scream; have problems sleeping or have 

nightmares; or return to former behaviors or fears 

(e.g., bedwetting, thumb sucking, or fear of the 

dark).

Children 6 to 11 years may withdraw from others 

and activities; have sudden outbursts; have 

difficulty concentrating; have fears; become 

irritable; feel sad or anxious; blame themselves 

for aspects of the pandemic and related 

stressors; become emotionally numb; or start 

performing more poorly at school.

Children 12 to 17 years may have similar reactions 

to those of 6- to 11-year-olds. They may also 

have flashbacks, or sudden, upsetting memories 

of especially upsetting events associated with the 
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TIPS FOR SURVIVORS OF A PANDEMIC: MANAGING STRESS

Toll-free: 1–877–SAMHSA–7 (1–877–726–4727) | info@samhsa.hhs.gov | https://store.samhsa.gov

Engage in Practices To Relax. Try to meditate, 

or listen to music as a way to calm yourself. If 

you’re experiencing acute stress, you may want 

to try abdominal breathing (please refer to the 

Instructions—Abdominal Breathing text box). 

News Intake. Try not to overconsume news. Doing 

so has been shown to increase stress levels and 

anxiety. It may be helpful to identify a few sources 

you trust and plan to consult regularly; stick 

with those sources; and set a daily time limit for 

reading, watching, and listening to news.

Sense of Humor. Use humor to reduce stress. 

Watch a funny movie or podcast, read a good 

book, or tell a funny joke to someone you know.

Physical Care. Eat healthy meals and snacks, 

drink plenty of water, and get enough rest. Avoid 

excessive amounts of caffeine and alcohol. 

Model these behaviors for your family.

pandemic. They may engage in more risk-taking 

behavior, including misuse of drugs or alcohol.

If you are a parent or other caregiver, you can 

take steps to help your child or teenager cope 

with disaster reactions. Modeling effective coping 

skills that include a flexible routine with plenty of 

support, communication, and warmth will benefit 

the whole family.

Tips To Manage Distress After 

a Pandemic

Coping skills and strategies can help you deal 

with the distress that is common among disaster 

survivors. Modeling these strategies can also help 

your family through phases of disaster recovery.

Make and Use Your Connections. Build close 

relationships with others, especially with those 

who accept and understand your feelings, and 

take time to enjoy the close relationships you 

have. Socializing with others can reduce stress 

and create a sense of support and connection. 

Try volunteering, visiting family, calling a friend, or 

reaching out to a faith leader.

Find Purpose. After a disaster there may be time 

to reflect on what is important to you in life, and 

to make sure you’re spending the most time 

on things that matter most to you. Take part in 

activities you find enjoyable and meaningful, or 

create a plan to move in that direction.

Have a Flexible Routine. Create a routine or daily 

schedule. Have a plan to accomplish required 

tasks, and create a flexible routine to accomplish 

them. Routines provide a sense of control over 

your life and reduce stress and uncertainty. 

Flexible routines allow you to accommodate 

unexpected events or urgent needs that arise 

while also maintaining a degree of consistency.

Manage Thoughts. In challenging times, it is easy 

for your attention to focus more on the negative. 

To counter this tendency, remind yourself of 

transitions and challenges you have successfully 

navigated in the past. It may be helpful to 

remember coping methods that worked for you 

then, as they may also be effective now. 

Instructions—Abdominal Breathing

1. Lie on your back on a flat surface or in 

bed, with your knees bent.

2. Put one hand on your chest and the other

on your belly, just under your rib cage.

3. Inhale slowly through your nose toward

your lower belly. Your hand on your belly

should rise, and your hand on your chest

should stay still.

4. Tighten your abdominal muscles, and let 

them fall inward as you exhale through

pursed lips. Your hand on your belly should

move down, back to its original position.

5. Continue this process for 5 to 10 minutes.

From Harvard Health Publishing, https://www.

health.harvard.edu/lung-health-and-disease/

learning-diaphragmatic-breathing.
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TIPS FOR SURVIVORS OF A PANDEMIC: MANAGING STRESS

Toll-free: 1–877–SAMHSA–7 (1–877–726–4727) | info@samhsa.hhs.gov | https://store.samhsa.gov

Exercise. Set aside time for regular exercise or 

other physical activity, as research shows this 

reduces stress and anxiety while also boosting 

physical health. If your schedule doesn’t allow 

for long segments of activity, take a couple of 

5-minute walks instead. Try to make regular 

physical activity a part of your everyday routine.

Get Outside. Visit a local park or other beautiful 

space. Find time to step outside regularly and 

move around. The fresh air will decrease stress 

while providing a boost to physical and mental 

health.

Write in a Stress Journal. Take 15–20 minutes 

each day to reflect upon stress and write down 

your thoughts and feelings. If you take time 

during the day to address stress, it is less likely at 

night to interfere with sleep. 

Celebrate Successes, and Make Time for Activities 

You Enjoy. Know it is okay to experience joy in the 

disaster recovery process and have moments of 

success even after a pandemic or other disaster. 

Return to doing things you enjoy with your family 

and spending time with friends.

What To Expect in Your Financial Life

Pandemics may involve intense financial 

upheaval and stress linked to job loss and work 

disruption. The loss of a previous standard of 

living and professional identity, as well as the 

inability to pay monthly bills, may contribute to 

anger and prolonged stress and fear. 

Seeking financial assistance may help survivors 

regain a sense of control and create a plan for 

moving forward. Please refer to the text box for 

online resources about how to manage finances 

after a pandemic.

For survivors in immediate need of food 

assistance, the U.S. Department of Agriculture 

National Hunger Hotline (https://www.fns.usda.

gov/partnerships/national-hunger-clearinghouse) 

provides information on how to access local food 

resources such as meal sites, food banks, and 

other social services.

Personal Finance After a Pandemic

The Consumer Financial Protection Bureau 

has information on managing finances, 

finding assistance, and accessing support 

related to COVID-19: 

 Tools To Help When You Can’t Pay Your 

Bills: https://www.consumerfinance.gov/

about-us/blog/tools-to-help-pay-bills

 A Guide to COVID-19 Economic Stimulus 

Relief: https://www.consumerfinance.gov/

about-us/blog/guide-covid-19-economicstimulus-checks

 Protect Yourself Financially: https://www.

consumerfinance.gov/about-us/blog/

protect-yourself-financially-from-impact-ofcoronavirus

 Dealing With Debt: https://www.

consumerfinance.gov/about-us/blog/

coronavirus-and-dealing-debt-tips-helpease-impact

 Tips for Financial Caregivers: https://

www.consumerfinance.gov/about-us/

blog/tips-for-financial-caregivers-duringcoronavirus-pandemic

The Federal Trade Commission has 

provided information for consumers (https://

www.consumer.ftc.gov/blog/2020/04/

managing-your-bills-during-covid-19), 

as has the Federal Reserve (https://

www.federalreserveconsumerhelp.gov/

about/covid-19-resources), and the U.S. 

Department of the Treasury has highlighted 

resources for financial relief after COVID-19: 

https://home.treasury.gov/news/featuredstories/your-money-and-coronavirusresources-for-financial-relief.
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TIPS FOR SURVIVORS OF A PANDEMIC: MANAGING STRESS

Toll-free: 1–877–SAMHSA–7 (1–877–726–4727) | info@samhsa.hhs.gov | https://store.samhsa.gov

When To Seek Professional Support

Reactions to disasters dissipate in time for 

many survivors. However, some survivors may 

experience reactions that persist over time, cause 

them significant distress, and get in the way of 

their daily lives. Survivors with a recent history 

of intense stress or with health conditions before 

and during the pandemic may be at particular 

risk. Following are examples of more serious 

reactions after a disaster: 

 Disorientation or confusion, and difficulty

communicating thoughts

 Limited attention span and difficulty

concentrating

 Overwhelming guilt and self-doubt

 Feelings of hopelessness

 Frequent mood swings or continuous crying

 Reluctance to leave home

 Fear of crowds, strangers, or being alone

 Increased use of drugs, alcohol, or prescription

medication

If you or someone you care about is 

overwhelmed by stress and reactions to the 

pandemic, you may want to reach out for 

professional mental health and/or substance use 

services and treatment. Check out the Helpful 

Resources section for free, confidential help with 

crises and short- and long-term referrals to care 

and support. PEP20–01–01–020

Helpful Resources

Substance Abuse and Mental Health Services 

Administration (SAMHSA)

5600 Fishers Lane

Rockville, MD 20857

Toll-free: 1–877–SAMHSA–7 (1–877–726–4727)

TTY: 1–800–487–4889

Email: samhsainfo@samhsa.hhs.gov

SAMHSA Store: https://store.samhsa.gov

SAMHSA Disaster Technical Assistance Center

Toll-free: 1–800–308–3515

Email: dtac@samhsa.hhs.gov

Website: https://www.samhsa.gov/dtac

SAMHSA Disaster Mobile App

Website: https://store.samhsa.gov/product/samhsa-disaster

Helplines

SAMHSA Disaster Distress Helpline

Toll-free (English and español): 1–800–985–5990

TTY: 1–800–846–8517

SMS (English): text “TalkWithUs” to 66746

SMS (español): text “Hablanos” to 66746

Website: https://www.samhsa.gov/find-help/disaster-distresshelpline

Website (espanol): https://www.samhsa.gov/find-help/disasterdistress-helpline/espanol

National Suicide Prevention Lifeline

Toll-free (English): 1–800–273–TALK (1–800–273–8255)

Toll-free (español): 1–888–628–9454

TTY: 1–800–799–4TTY (1–800–799–4889)

Website (English): https://suicidepreventionlifeline.org

Website (español): https://suicidepreventionlifeline.org/helpyourself/en-espanol

Treatment Locator

SAMHSA’s National Helpline

Toll-free: 1–800–662–HELP (1–800–662–4357) (24/7/365 

Treatment Referral Information Service in English and español)

TTY: 1–800–487–4889

Website: https://www.samhsa.gov/find-help/national-helpline

*Note: The views, opinions, and content expressed in this publication 

do not necessarily reflect the views, opinions, or policies of the Center 

for Mental Health Services (CMHS), the Substance Abuse and Mental 

Health Services Administration (SAMHSA), or the U.S. Department of 

Health and Human Services (HHS).