Tag Archives: coronavirus

Mental health and Corona

Prior to the COVID-19 pandemic, nearly one in five of U.S. adults (47 million) reported having a mental illness in the past year, and over 11 million had a serious mental illness, which frequently results in functional impairment and limits life activities. Please remember that these are only the reported numbers, because many people do not seek help or endorse symptoms.

The COVID-19 pandemic and the resulting economic recession have negatively affected many people’s mental health and created new barriers for people already suffering from mental illness and substance use disorders, who were previously substantial in number. In polls conducted in mid-July, 53% of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the coronavirus. This is significantly higher than the 32% reported in March. Many adults are also reporting specific negative impacts on their mental health and wellbeing, such as difficulty sleeping (36%) or eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%), due to worry and stress over the coronavirus. As the pandemic wears on, ongoing and necessary public health measures expose many people to experiencing situations linked to poor mental health outcomes, such as isolation, health worries, evictions, and job loss.

Some takeaways:
A broad body of research links social isolation and loneliness to poor mental health, and data from late March shows that significantly higher shares of people who were sheltering in place (47%) reported negative mental health effects resulting from worry or stress related to coronavirus. In particular, isolation and loneliness during the pandemic may present specific mental health risks for households with adolescents and for older adults. The share of older adults (ages 65 and up) reporting negative mental health impacts has very significantly increased since March. Polling data shows that women with children under the age of 18 are more likely to report major negative mental health impacts than their male counterparts.

Research also shows that job loss is associated with increased depression, anxiety, distress, and low self-esteem and may lead to higher rates of substance use disorder and suicide. Recent polling data shows that more than half of the people who lost income or employment reported negative mental health impacts from worry or stress over coronavirus; and lower income people reported much higher rates of major negative mental health impacts compared to higher income people.

Poor mental health due to burnout among front-line workers and increased anxiety or mental illness among those with poor physical health are also concerns. Those with mental illness and substance use disorders pre-pandemic, and those newly affected, will likely require mental health and substance use services. The pandemic spotlights both existing and new barriers to accessing mental health and substance use disorder services.

In my practice, many people do not have access to consistent Wi-Fi or Internet service. During this unprecedented time of uncertainty and fear, it is likely that mental health issues and substance use disorders among people with these conditions will be exacerbated.

Embolden remains dedicated to providing access and services for medical professionals and front line personnel. The long-term effects that we are experiencing cannot be minimized.

Ten strategies to cope with anxiety about COVID-19

In my upcoming book, Fight/Flight/Flow, I discuss the importance of anxiety. Anxiety is a natural human reaction that involves mind and body. It serves an important basic survival function: Anxiety is an alarm system that is activated whenever a person perceives danger or threat. Anxiety is both in the mind, or cognitive; and in the body, in the form of physical symptoms.

When the body and mind react to danger or threat, a person feels physical sensations of anxiety — things like a faster heartbeat and breathing, insomnia, tense muscles, sweaty palms, a queasy stomach, and trembling hands or legs. These sensations are part of the body’s fight-flight response. The fight response can make us angry and irritable. The flight response can make us avoidant and isolated. These are caused by a rush of adrenaline, cortisol, and other chemicals that prepare the body to make a quick getaway from danger. They can be mild or extreme.

My psychotherapy for anxiety involves what I call the flow response. It’s hunkering in place, but not in a passive way. It’s observing, holding, and waiting. It’s like floating in water. You’re still in it, but you’re not thrashing about.

The fight-flight response happens instantly when a person senses a threat. It takes a few seconds longer for the thinking part of the brain (the prefrontal cortex) to process the situation and evaluate whether the threat is real, and if so, how to handle it. If the cortex sends the all-clear signal, the fight-flight response is deactivated and the nervous system can start to relax. If the mind reasons that a threat might last, feelings of anxiety might linger, keeping the person alert. Physical sensations such as rapid, shallow breathing; a pounding heart; tense muscles; insomnia; gastrointestinal problems; choking sensation; trembling; and sweaty palms might continue, too. Lastly, anxiety is curvilinear. A little bit of it can motivate us to problem solve and take action. A lot can immobilize and sicken us.

Tips to manage anxiety during these challenging times:

1. Sense of community.
Being there for and with others lessens our solitary load. From virtual exercise classes, virtual classrooms, volunteering, and zoom cocktail hours, feeling connected decreases anxiety. We are social creatures, and separating has been very difficult for many.

2. The spiritual life.
From meditation and yoga, to a peaceful walk in nature, a personal home altar, or faith based activities, these pastimes help reduce our panic and sense of fear.

3. The foundations of self-care.
Keeping to good sleep hygiene habits, nutritious meals, and daily exercise. All three of these are potent medicine.

4. Reflect don’t react.
There are many choices within our control even when we feel out of control. Dr. Victor Frankl, who was incarcerated in a concentration camp and wrote “Man’s Search for Meaning,” stated everything can be taken from a man but one thing, the last of the human freedoms, to choose one’s attitude in any given set of circumstances, to choose one’s own way of being.

5. Place stones across the river.
This is my method that I teach to patients, that consists of piecing together the small moments that make each day meaningful and significant. Speaking with a great friend, playing or cuddling with your companion animal, enjoying the beauty of the spring time, having the perfect cup of coffee, taking a moment to connect with others online, listening to your favorite music. These seemingly insignificant things become a powerful gestalt when they are pieced together, and help make our brains create hopeful pathways.

6. You are not your day.
If you have a day where nothing feels hopeful, or an even an hour of despair, it does not define you. It will pass. Remind yourself of the times that you persevered through catastrophic times. Reboot. You can even make self statement index cards and read them to yourself. Remind yourself that this too shall pass.

7. Disconnect.
Sleep, rest your body, turn off the screens, don’t read the news. We can stay in formed but we can also inundate our brain with information and misinformation.

8. Question.
Not everything you read in the news or the Internet is accurate. Similarly, when we are having anxiety or depression, our brain is a trickster that tells us misinformation. We can learn to refute it.

9. Schedule.
Keep to a routine as much as possible. This should include the aforementioned exercises, meal prep and planning, sleep, work, outdoor time, social media time, and downtime.

10. Breath-work and grounding.
Strategies that I teach individuals with anxiety disorders can be used by anyone, you can take them with you anywhere. Using the power of your breathing, close your eyes, take a deep breath in through your nose, and exhale slowly through your mouth. Repeat. And again. Similarly, you can ground your body by progressive muscle relaxation, this is a series of moments of tightening and releasing your muscles starting at your feet and working all the way up to the top of your head. For example, clench your feet hold for five seconds, and release. Continue to your legs, and so on. There are many guided strategies on the Calm App or HeadSpace, on Apple and android, that can help you practice these methods.

If you feel that anxiety is trying to take over your life, please seek professional support. Embolden offices are now offering free 30 minute sessions to first responders.

Parenting and homeschooling, during COVID-19

It’s been a frequent question, how to handle the current situation with regard to kids. In Washington DC, the school systems are closed for at least a month, and I’m thinking longer. This is what I’m telling my patients and families:

1. Establish a routine. This needs to include online schoolwork, chores, exercise, scheduled not random downtime with a preferred activity, and very regular bedtimes and morning routines. You do not get to sleep till 11.

2. This is not a snow day. We can’t live on Doritos, ice cream, and junk food. I am asking all kids nine and above, to help plan and prepare a meal at least once a week for the entire family. This can actually be fun. We all need to cook.

3. Developmentally appropriate information needs to be discussed. From social media to television, we hear bits and pieces that can be very scary. No kid needs to be terrified.

4. Get some outdoor time. It’s spring, and it’s beautiful. Just because we can’t interact, touch or hug, doesn’t mean we don’t get to embrace the sun.

5. Find one cool new hobby or interest to explore. You’ve never had time like this to do that.

6. Don’t forget to check on others. Lack of social contact is one thing, but we have neighbors, relatives, elders, who need our support.

6. Last time, probably most importantly, give each other space. We are used to being at school, the office, sports, activities. Now we are stuck with each other. Annoyance happens.
Find some alone time, for each family member.

Embolden Psychology
Embolden

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

Thank you for contacting us.