Psychiatric Annals

Editorial Free

On Resilience in the Time of the Coronavirus

Andrew A. Nierenberg, MD

With the world on lockdown to mitigate the spread of the novel coronavirus COVID-19, our lives have changed rapidly. At its worst, either we or someone we love or work with will get infected and some will die. At its best, we work from home, protect our families, practice physical distancing and meticulous hand hygiene, while continuing to see patients virtually along with trying to continue to do the research to which some of us have dedicated our lives.

No matter what, these are stressful and trying times, laced with uncertainty for the short and long term (financially and otherwise). In the face of these pervasive stressors, all of us will, at some point, experience anxiety, while some will sadly experience grief from the loss of loved ones, or more generally the loss of a world we thought we understood. We have tools available to cope and manage stress ( from Mass General Hospital) to mitigate the distress from this extraordinary time; this also provides an opportunity to look at what we know about resilience.

Resilience is “the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress.”1 Although the neurobiology of resilience is, not surprisingly, complex and multidetermined,2 during these specific challenging times, it is worthwhile to review aspects of our human neurobiology that are modifiable to build and reinforce resilience.

Cognitive control of emotion through cognitive reappraisal techniques can modify the distress of stress using the prefrontal cortex to damp down the hyperarousal with several paths to enhance resilience, including maintaining relationships, keeping physically active, eating healthy foods (to minimize inflammation and maintain a healthy microbiome), practicing mindfulness, finding purpose, accepting change, and putting events into perspective.1 Another technique is to find paths to optimism while still being realistic, especially when stressed.3 It is essential that as caretakers and healers we take good care of ourselves and find our paths to get through this worldwide pandemic.


  1. American Psychological Association. Building your resilience. Accessed April 9, 2020.
  2. Cathomas F, Murrough JW, Nestler EJ, Han MH, Russo SJ. Neurobiology of resilience: interface between mind and body. Biol Psychiatry. 2019;86(6):410–420. doi:10.1016/j.biopsych.2019.04.011 [CrossRef]. PMID:31178098
  3. Ozbay F, Fitterling H, Charney D, Southwick S. Social support and resilience to stress across the life span: a neurobiologic framework. Curr Psychiatry Rep. 2008;10(4):304–310. doi:10.1007/s11920-008-0049-7 [CrossRef]. PMID:18627668

Andrew A. Nierenberg, MD

Andrew A. Nierenberg, MD, is the Thomas P. Hackett, MD, Endowed Chair in Psychiatry, the Director, Bipolar Clinic and Research Program, and the Director, Training and Education, MGH Research Institute, Massachusetts General Hospital; and a Professor of Psychiatry, Harvard Medical School.

Address correspondence to Andrew A. Nierenberg, MD, via email:


Sign up to receive

Journal E-contents