Coping with Uncertainty and Transition

The last few years have been challenging for many people and the COVID-19 pandemic has exacerbated stressors for graduate students in the health care professions. For example, you may be navigating your own experiences of stress and grief while working with patients and clients affected by similar experiences. Additionally, the scale and unpredictability of traumatic global events may bring up various feelings including uncertainty, danger, shock, confusion, frustration, disillusionment, and worry. You may face some, many, or none of these emotions over time as you work to process your experience. It is important to remember these emotional responses are valid.

The information shared below may offer some guidance as you identify strategies to support your mental health.

Start with Your Stress Response

Stress responses are different ways that we’ve learned to adapt to threatening circumstances. Knowing your stress response can help you figure out the best coping strategies that align with your needs.

Which of the following patterns resonate with your current stress response?

I feel out of control.

Response: I feel out of control and confused about what to do.

Coping Strategy: There is no way to prepare for the unexpected. When feeling out of control, take a break to care for yourself and focus on the things that are within your control.

I feel immobilized.

Response: I feel immobilized. I don’t feel like doing anything and can’t motivate myself.

Coping Strategy: Try to identify the cause of these feelings through reflection: take a break, try meditation, keep a journaling practice, and/or speak with a trained mental health clinician. Support your mood by increasing rest and practicing self-compassion.

I feel disconnected.

Response: I feel disconnected. I compartmentalize negative feelings and avoid addressing them.

Coping Strategy: Make time to reflect and connect with distressing feelings in small doses. Journal or talk with friends. Move on to something lighter when you begin to feel overwhelmed.

I feel overwhelmed.

Response: I feel overwhelmed.

Coping Strategy: Make time to reflect and connect with distressing feelings in small doses. Journal or talk with friends. Move on to something lighter when you begin to feel overwhelmed.

Develop a mental health plan that fits your current stress response and needs. Remember that your response and needs may fluctuate over time depending on a variety of factors. Be sure to remember that most people—yourself included—are doing their best with the knowledge, uncertainty, and stressors that they have. Be gentle with yourself on particularly hard days.

Structure Your Day

At times, your schedule can have an impact on your mood and functioning. Review your schedule to identify potential challenges especially when you are feeling overwhelmed. Are there tasks that you can reschedule, cancel, or adjust? Even finding one event to reschedule can be helpful when feeling overwhelmed. Another alternative is blocking some time in your calendar just for you. You can use this time to relax, connect with others, or engage in self-care.

Tips for Structuring Your Day

Keep your schedule as consistent as possible when it comes to class, meals, and bedtime. Use familiar apps and programs for scheduling and reminders. Gently re-evaluate your expectations and focus on what you can realistically accomplish.

  • Create boundaried spaces to work and rest to help you shift mind states. For example, have a designated study/workspace. If you live with housemates, consider having or revisiting conversations about guests in your home.
  • Stay active and exercise. Explore virtual workouts if going to the gym isn’t a feasible option—many workout plans do not require equipment and are free or low cost. 50 Haven Athletic Center may have options that are accessible to CUIMC students.

Schedule time to do things that lighten your mood: take breaks, read, watch movies, make music, dance, play games, and revisit past hobbies or start a new one. Consider checking out programming offered through Well-Being and Health Promotion.

Connect with Others

It can be helpful to maintain a sense of belonging by structuring opportunities to engage with friends, family, colleagues, or community.

Tips for Staying Connected

  • Schedule time to communicate with friends, classmates, coworkers, as well as biological and chosen family. Video chat, telephone calls, text, and email are ways to stay connected with others if in-person contact doesn’t feel possible. Connect with family members at your comfort level. If you find yourself in situations where you need to interact with people with whom you do not have a good relationship, identify and communicate boundaries as a compassionate way to preserve your energy and emotional health.
  • Seek additional support and resources from people you trust. For example, connect with your therapist, doctor, spiritual leader, or friends and family for support.
  • Revisit a hobby, interest, or a new creative endeavor. Share this with your support network. It’s important to allow space for creativity and okay and helpful to experience some pleasure and levity.

Set Boundaries with E-mail and Social Media

It’s okay not to be “on” all the time. Identify the most important communication channels and manage how often you engage with them.

Tips for Setting Boundaries with E-mail and Social Media

  • Set a schedule for interacting with social media and email. For example, limiting screen-time before bed can decrease anxiety and improve sleep quality.
  • Reconfigure your notification settings and consider which emails or messages should be reviewed immediately and which can wait (e.g., updates from your school or program vs. shopping deals).
  • Uninstall social media apps from some of your digital devices to decrease usage, or even move them away from your home screen to limit their accessibility. Block social media for a few hours a day on your browser.

Set Boundaries for Media Consumption

Information is rapidly changing and news outlets supply constant coverage. Consider what level of media consumption is right for you. Aim to be informed and updated without feeling overwhelmed. Remember that you are not responsible for being aware of everything that’s happening.

Tips for Setting Boundaries for Media Consumption

  • Be intentional about which issues or events are most important to you and focus your attention and energy on those.
  • Obtain information from credible media outlets, public health websites (e.g., CDC), local public health authorities (NYC Public Health Department), and CUIMC. Consider signing up for automated texting or email alerts so you have peace of mind that relevant updates will be promptly communicated with you.
  • Maintain distance from sensational media coverage that may be exaggerated or not grounded in scientific evidence.
  • Consider setting concrete limits on the number of minutes or hours per day that you spend obtaining news updates. If structure is helpful for you, schedule this into your day.

Manage Negative Thoughts and Feelings

Uncertainty can bring up many different thoughts and feelings related to change and uncertainty. Take time to reflect on your mood and what emotions are coming up for you.

Tips for Managing Negative Thoughts and Feelings

  • Identify and label your feelings. Are you feeling disappointed, bored, excited? Soothe big feelings by meditating, journaling, shifting environments, or doing something until the feeling passes (e.g., cook a tasty meal or take a hot shower for 15 minutes).
  • Build a tolerance for uncomfortable and challenging feelings—while recognizing there are multiple ways to cope with and tolerate these feelings. It is okay to seek comfort and distractions from time to time as you continue to process. Reach out for help from Counseling Services and explore individual therapy or group support so you don’t have to do this challenging work alone.
  • Let go of what “should” work—sometimes you can’t meditate or journal away a feeling and that is both valid and human. Coping is a complex process; give yourself some space to explore what works for you, even if it may not align with what helps other people.
  • Identify negative thinking patterns. Are you catastrophizing, fortune telling, or defining things in black and white terms? Take some time to reflect and reframe negative thought patterns.
  • If you use alcohol, cannabis, or other substances, also consider harm reduction techniques and/or setting up a confidential appointment with Addition Information and Management Strategies (AIMS). Additional resources about harm reduction and resources for people with substance use disorders are available under Resources.

Make Plans

Reduce the discomfort of uncertainty by choosing to focus on what you can control. Develop plans that balance your needs with the needs of other people in your life.

Tips for Making Plans

  • Develop a general plan for when you aren’t feeling well before you’re in a situation where you aren’t feeling well. Identify resources to access when feeling unwell and in need of more support. Student Health on Haven is here to support all CUIMC students.
  • Update emergency contacts and keep helpful phone numbers in an accessible place.
  • Make a simplified contingency plan with your support network for when you aren’t feeling well. Who can help you with daily activities like shopping and errands? How will you notify professors or supervisors?
  • Think through how you might want to support someone you know who becomes seriously ill or who experiences a loss or other significant life change; consider adapting similar strategies for yourself.

Connect with Resources

Student Health on Haven and Columbia University are committed to supporting our students’ mental health and well-being. Check out the following resources to learn more about what's available to CUIMC students. 

Connect with Counseling Services

  • Consider how you are going to take care of existing or emerging mental health needs. Both in-person and Zoom-based confidential appointments with Counseling Services are available to CUIMC students. Check the Appointments and Services page for updates and how to connect with our services.
    • Staying Connected to Care: People with existing mental health conditions may find that they need additional support beyond their routine care or treatment regimen. Reach out to established providers for support, medication refills, and update your treatment plan as needed. If you are already in treatment with a clinician at Counseling Services, you can contact your provider via secure message through the Student Health Portal.
    • Connecting to Care for the First Time: If you are not already connected to a mental health clinician, consider initiating contact with a provider. Most insurance carriers offer in-person or telehealth services, including psychiatry and psychotherapy. You can schedule an initial telephone appointment to talk through some of your options with Counseling Services through the Student Health Portal.
    • Group Support: Counseling Services also offers support groups for a range of topics (e.g., grief and loss, transitioning to graduate school, relationships with food/body image). Groups offer a safe space for reflection, grounding and support with a clinician and peers.
  • Add relevant 24/7 hotline numbers into your phone. These resources offer both phone and text options.
  • For life-threatening emergencies, call 911 and go directly to the nearest emergency room. View the Emergencies page for more information.

Connect with Well-Being and Health Promotion

  • The team at Well-Being and Health Promotion offers support with confidential problem solving and connecting to resources. We can help you prioritize self-care, problem-solve, and think through how to establish new routines or adapt/optimize existing ones. We can discuss coping techniques, give suggestions and tips for practicing mindfulness, provide ideas for communication strategies, offer a listening ear, and more.  Check the Appointments and Services page for updates and how to connect with us.
  • Get Involved: Students interested in participating in campus-wide conversations and action around CUIMC student mental health and well-being can find ways to support existing projects or share feedback and ideas. Check out the Student Well-Being Collective page and reach out to for more information

Connect with AIMS for Concerns about Substance Use or Pattern Behaviors

Additional Columbia University Resources

  • The Sexual Violence Response (SVR) Helpline is available 24 hours a day, seven days a week, 365 days a year and can be accessed confidentially at 212-854-4357(HELP). Our survivor advocates continue to provide students, faculty, and staff with information, referrals, reporting options, and telephonic support through crisis counseling and intervention. They are also able to conduct confidential appointments with survivors and co-survivors via phone or the secure Zoom platform.
  • Disability Services facilitates equal access for students with disabilities by coordinating accommodations and support services, including virtual drop-in hours.
  • The Ombuds Office serves as a confidential resource that provides a safe space for all Columbia affiliates to discuss work-related issues, academic concerns, clarification of policies, and many other concerns and issues. This can be a good place to start if you aren’t sure what resources you’re looking for.
  • The Office of the University Chaplain offers confidential spiritual and or religious individual, couples, family, and group pastoral care and counseling to CUIMC students. Appointments are available both in person and via Zoom.
  • The Food Pantry at Columbia is available for currently registered students within any of the 21 Schools of Columbia University, including CUIMC students. The Food Bank for NYC is also a resource available for people staying in the city.
  • Title IX is the non-confidential University office on policy for gender-based misconduct. Columbia University is committed to fostering an environment that is free from gender-based discrimination and harassment, including sexual assault and all other forms of gender-based misconduct.
  • CUIMC Public Safety

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