Dealing With Uncertainty

The toll of the incredible levels of uncertainty in the world plagues our patients, our colleagues, and ourselves, explained Susan J. Noonan, MD, MPH.

Although some uncertainty is a natural and unavoidable part of life, recent years has seen an escalated level of uncertainty, she said. Events like the COVID-19 pandemic, global economic and political disruptions, natural disasters and extreme weather patterns, increased violence, and other issues have had resulted in a negative impact on emotional and physical well-being. So, how can we better support our patients, our colleagues, and ourselves?

As human beings, Noonan said we are programed to scan for potential threats, but without sufficient information, there can be cognitive distortions, especially if we are being overwhelmed with various forms of uncertainty over a long period of time. As a result, the “what ifs” and worst-case scenarios can paralyze individuals. Similarly, it may cause individuals to underestimate their ability to successfully cope and deal with adverse scenarios or to overestimate the danger and threats of the uncertainty.

The unprecedented level of chaos and uncertainty has led to excess worry and anxiety and a loss of emotional and physical energy, impacting the way we conduct work, carry on social interactions, etc, Noonan added.

The good news, she said, is that there is an opportunity in facing the unexpected: overcoming challenges helps increase resiliency. All past experiences can help build resiliency.

Noonan recommended several strategies to support patients, colleagues, and even oneself in facing uncertainty. For instance, she emphasized the importance of remaining calm, focusing on what really matters, as well as what individuals can realistically do to address uncertainty. Similarly, it is important to avoid seeking perfection, as perfection is not possible, and the goal will add undue stress.

Acknowledge what is uncertain and what it means, she said. As part of that exploration, do not assume bad things will happen; have your patients challenge the likelihood that bad things are inevitable, Noonan said. She elaborated on a few strategies.

Acceptance: It is important for individuals to accept those things that are out of their control. Instead, focus on solvable worries/concerns, or the issues you have control over. As part of this, Noonan suggested people seek good quality information (and to always assess the quality of information received). It is also important to limit the amount of time spent looking for information to avoid being overwhelmed. Start with small smart goals and focus on them. She suggested recognizing when filters (like a person’s opinions) may impact your assumptions. Make a contingency plan for those things you can anticipate.

Prioritize well-being. Noonan reminds patients of the importance of basic self-care as part of daily routine: maintaining normal activity, structure, daily rituals and routines, exercise, and healthy eating. She also suggests that individuals increase their social connections, particularly with supportive and positive individuals.

Leverage coping skills. Noonan stressed the importance of enjoying hobbies and engaging in pleasurable activities that enhance life and distract from the issues and uncertainties that cause stress. She also suggested employing relaxation techniques like meditation, deep breathing, and unplugging from technology, especially social media.

Foster resilience: Resilience is adapting well in the face of diversity, like stress and uncertainty. Help patients learn new ways of responding to stress, by learning and adopting new behaviors and regulating emotions. Remind them they lived through hard times before, of their previous successes and inner strength, and that they can do it again, she said. Help them build and good skills and control impulses. Provide nonjudgemental mental support, maintain a positive outlook, and share realistic perspectives.

Dr Noonan is a physician, mental health and wellness coach; author of 5 books on managing mental health and mood disorders with a print and video blog; consultant; group facilitator; and certified peer specialist. Dr Noonan is the inaugural recipient of the National Depression and Bipolar Support Alliance Peer Support Specialist of the Year 2022. Her most recent book, published by Johns Hopkins University Press, is Reconnecting After Isolation: Coping With Anxiety, Depression, Grief, PTSD, and More.