It can be tempting, as the pandemic wears on, to shut down — to escape into TV binging, social media and other inadequate ways of blocking out the stress and fears of illness or economic disaster.

Dr. Maryland Pao, the clinical director of the National Institutes of Mental Health Intramural Research Program and a psychiatrist who regularly sees children with life-threatening illnesses, says she's seen striking similarities between the ways her young patients deal with their diagnoses, and how lots of people are responding as we roll past month 5 of the pandemic.

We all tend to default to two styles of coping, Pao explains: "You can be an active coper or you can be a passive coper."

The active copers — the ones who pick up hobbies or take an interest in others and the world around them — generally have better mental health outcomes, Pao notes.

Taking on new activities "give[s] us internal control — when outside there is no control," Pao says. "People need to feel a sense of agency. Being able to accomplish something makes people feel competent."

Build on what you know

Arlene Zaffle and her husband recently retired and live on a quiet cul-de-sac in Aurora, Colo. Their sizable suburban garden is bursting with beans, asparagus, strawberries, cabbage and cucumbers. Arlene imagined she would spend much of her retirement casually tending it.

On a whim, the Zaffles bought a small worm-farming business from a friend in February — . The worms eat food waste and turn it into compost. Once COVID hit, more people stayed home and decided to work on their gardens — and they wanted those red wrigglers.

"For a while there, we were selling 10 to 12 pounds of worms a week," Arlene says. They often sold out. It was an unexpected boomlet for the couple's small business and it added structure to their days.

For a lot of younger people who spent the summer cooped up with parents and siblings instead of hanging out with friends, facing online learning this fall might seem pretty bleak. But it's important, Pao says, to find ways to stay connected with others and the world in these shifting times.

Early in the pandemic, baseball fan Zachary Johnson, 14, of Tunbridge, Vt., signed up for an online course to learn Korean so he could follow the Korean Baseball Organization — the only new baseball games airing in the U.S. up until late July. Korean baseball is like American baseball, but with a lot more bat flips, Johnson says.

So far, he's got "strike out" (삼진) (sam-jin) and "home run" (홈런) (hom-leon) down.

"I would like to go to Korea some time," Johnson says, once the world reopens broadly, "and possibly watch some baseball games there."

A focus on the positive

Of course not everyone has a lot of free time. Beyond those lucky enough to be able to work from home, many people still have to show up in person and/or juggle child care when daycare programs and schools are shuttered. People working outside the home are most at risk of contracting the disease. Many of these essential workers are Black or Hispanic, which also puts them at greater risk of a severe case of COVID-19.

Mamet Haile is a labor and delivery nurse and a young mother living in San Diego. She moved to the U.S. from Eritrea as a teenager. She works every weekend and is home with her two children on weekdays.

For the first few weeks of the stay-at-home orders in March, she was really scared. Her son has asthma and she worried about what would happen to him if he got sick. But now she tries to focus on the positive. "There's really no day off, per se, but the upside of it is that I get to be with the kids," she says.

Even though life is starting to get back to normal, she's still at home a lot more than she used to be. What's getting her through these times is helping students via her online mentoring business. Impromptu family dance parties help, too.

"We organized closets yesterday. We had music and snacks and we were dancing away," she tells NPR. Haile is donating her family's extra toys and clothes to a local shelter.

Finding herself at home most days is not as hard as it might be for other people, she says. "Life was just a lot more simple how I grew up [in Eritrea]," Haile says. "It was not so much about planning to go to the beach, going to the zoo. ... We played in the backyard."

Another nurse, Alexis Goudeau Philius from Inglewood, Calif., finds that helping others helps her cope with the stress and fear she feels, working on the front lines. She started an organization a few years ago to provide care packages to the homeless called. Now, in addition to toothbrushes and socks, she's handing out masks and hand sanitizer.

'No effort is too small'

"I'm trying to show the world that no effort is too small," Philius says.

She's also writing a children's book of life lessons which "literally started as me writing a letter to my 2-year-old daughter during this crisis to give her what she needed to know in case something happened to me."

Even if you are busy, you can find ways to manage stress and build resilience, says Pao. It's critical to stay connected to others — keep a journal, get a work buddy. Make masks or volunteer if you can. Most importantly, she says, ask for help when you need it. The National Institute of Mental Health has a variety of resources to help people cope with the mental health challenges of COVID-19. Harvard University does, too.

While the uncertain time frame of COVID-19 may be putting an extra strain on people, having to struggle through adversity for an indefinite period of time is not new. People have lived through other pandemics, wars, and natural disasters.

"Humans are incredibly adaptable. It takes a little while for the brain to adjust," Pao says, "but it does."

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