A Social, Activity, Nutritional, and Emotional (SANE) Approach to Coping with Alcohol and Mental Health Risks During COVID

Few things in life have effects that are as immediate, potent, and predictable as the effects from psychoactive drugs. Of all commonly used drugs, alcohol is the world’s favorite. This is because it is legal in most societies, socially accepted and less stigmatized than other drugs, and when the alcohol molecule reaches the human brain, it is generally perceived as good news. In addition to producing pleasant effects, it can also temporarily help dissolve distress, emotional pain and suffering, and produce sedation and relaxation. This is why it is such an attractive option for many people in times of stress such as those we are experiencing now during the COVID19 pandemic. The greater social isolation and monotony have contributed to increased alcohol use in the general population as a coping strategy to pharmacologically create pleasurable experience and psychological release that might have been previously obtained from greater social interaction and engagement with myriad recreational activities. 

“…greater social isolation and monotony have contributed to increased alcohol use in the general population as a coping strategy…”

For many suffering, or in recovery, from, an alcohol use disorder, however, the use of alcohol or other drugs is typically not a safe coping option. Also, the social isolation and more monotone existence has proven challenging and serious as the positive interpersonal therapeutic support that so many use successfully to cope and support their recovery through in-person mutual-help meetings, like AA and SMART Recovery, largely stopped. While many have been able to maintain recovery-specific social support via online meetings through platforms like Zoom, others without digital access or otherwise who are not “tech savvy,” have struggled, and distress and mental health symptoms have increased. 

Nevertheless, whether Zoom-savvy or not, or connected to mutual-help organizations or not, there are several survival activities that we can implement to create an adaptive structure to our daily lives and thereby help us manage feelings of loneliness and stress, shift negative thinking and renew hope each and every day, and protect against worsening symptoms and potential relapse. Together these form a Social, Activity, Nutritional, and Emotional (SANE) approach. (See Infographic A).

Infographic A. SANE Approach

“This too shall pass” is a commonly stated truth about many things in life, and with vaccines now being rolled out, the end of COVID seems in sight. Meantime, incorporating these four strategies each day, may be especially important particularly if you are struggling with addiction recovery or other mental health concerns. Make a point of it. Be an empiricist. Try it out and experience the positive difference these four SANE things will make.   

Here comes the hard part, picking one or more of these beliefs and applying them to your pandemic life. Reading alone will not do, although you may investigate Stoicism a bit more if you are intrigued (see Additional Materials below). 

Stoicism is one approach, but not meant to be used in isolation. For example, if you lose your job, you will also need to seek out concrete help in the form of financial assistance and finding a new job. Stoicism is also not a substitute for other forms of coping, like exercising regularly or seeking social support. Importantly, it is no substitute for political action when society needs to step up collectively to relieve hardship and correct injustices. Being passive in the face of injustice is not Stoicism! What Stoic resilience can do is this: give you the wisdom to make life a bit more tolerable and enjoyable – despite everything that goes wrong and is wrong in the world.


John F. Kelly, PhD, ABPP
Founder & Director,
MGH Recovery Research Institute


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