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COVID-19: Managing the Mental Mayhem

COVID-19: Managing the Mental Mayhem

Notes on Handling the Stress and Anxiety of the Pandemic
by Lori Kleinman, PhD

En Español

This Too Shall Pass — April 2

These are four simple words that can change the course of our lives right now. Let’s break it down:

This = The COVID-19 virus effects on our individual lives and society..

Too = There have been other large-scale difficulties in our individual lives and society. There will be again in varying ways. That is part of life and part of what brings us together to solve problems and build resilience.

Shall = We are designed to be resilient. Resilience means we can recover from difficulties and bounce back while becoming stronger through the process of recovery. Along with resilience, we have the capacity for stress hardiness. Stress hardiness means we utilize good coping skills during the difficult times to maximize our recovery and resilience. We, as individuals and as a society, can be realistically hopeful that we will survive and even grow stronger through this. In addition, we will cope with the sad and painful parts of this process by using our own strengths as well as reaching out for support and assistance with one another.

Pass = We will move through and beyond this. Stronger. More aware. Closer as individuals and as a society. There will be ease again, and in the meantime, we will actively look for and create moments of joy and relief as we soldier on toward solutions.

Managing Uncertainty

Now, on to the process of how we shall and will manage while times are uncertain:

  1. Schedule your time and include breaks
  2. Maintain healthy eating and limit sugar, saturated fats, empty calories
  3. Keep alcohol use to one or less drinks per day (yes, really!)
  4. Move your body and exercise at least an average of 30 minutes per day most days
  5. Practice relaxation exercises including deep belly breathing and releasing muscles, especially jaw, shoulders, back, hands
  6. Play and laugh, no matter your age, and schedule time for fun experiences into your day
  7. Maintain personal hygiene with an attitude of appreciation for your body
  8. Stay connected and reach out by voice to friends every day, even if only for a few minutes

Reach Out & Resources

These are challenging and uncertain times. Be gentle and compassionate with yourself and others. Sometimes the demands on us are greater than our existing resources to manage those demands. Please, if you need help, reach out. Below are some resources for you and your loved ones. Keep these numbers available, just in case.

  • Colorado State Crisis Hotline: 844-493-8255 (844-493-TALK) or text “TALK” to 38255
  • National Disaster Distress Hotline: 800-985-5990 (if emotional distress related to pandemic/disasters)
  • Veterans Crisis Line: 800-273-8255, ext 1
  • National Suicide Prevention Lifeline: 800-784-2433 (800-SUICIDE)
  • National Domestic Violence Helpline: 800-799-7233 (800-799-SAFE)
  • Safe 2 Tell: 877-542-7233 (877-542-SAFE) (anonymous reporting if someone in danger)
  • Youth Suicide Prevention Assistance: www.sourcesofstrength.org
  • Boulder County Public Health COVID-19 Information boco.org/COVID-19

Wishing you good health and comfort, Dr. Lori Kleinman

Lori Kleinman, PhD, is a licensed psychologist with over 30 years of experience providing mental health services and consultation. In addition to private clinical practice, she provides immediate disruptive event/critical incident response to organizations. Dr. Kleinman holds certifications and specialized training in the areas of stress management, trauma psychology, health psychology, compassion fatigue, grief, suicide prevention, relationships, communication, leadership development, performance enhancement, hostage negotiation, and combat stress mitigation. She assisted personnel and leadership before and after 911, led disaster mental health services, and has a written a suicide prevention training program.

Organizing Your Time — March 27

Have you ever said to yourself, “If I had more time I would…?” Or have your ever thought, “Someday, I’ll…?” Dreaming about the future and wishing for things in life is perfectly natural. In fact, our psychological research tells us that optimism and future-focusing are healthy traits. Optimism can be thought of as realistic hopefulness. It can also be viewed as having expectations of successful outcomes. Future-focusing means we can see beyond the past and this moment, and are able to create a vision of the future. I like to think of it as. “the past has passed, the present is me in this exact moment, and the future is filled with possibilities that await my choices.” The choices I make and the behaviors I do will give me a sense of control of my future. Even when things are difficult and uncertain, making choices about how we will manage can make the difference between feeling in control or out of control. Another way to think of this is to think of feeling powerful. You know, like a superhero!

Be Your Own Superhero

Superheroes have to deal with a lot of danger and uncertainty. They usually win. And that’s because they are powerful. They keep moving forward even though things are difficult. They use their strengths and resources to solve problems. We humans don’t need special powers to do this. We just need to realize that we have strengths and resources. We need to recognize that we’ve coped with difficulties before and will do so again. We need to trust in ourselves and our resiliency. We need to ask for help when we need it. We need to remember that there is a future and our healthy choices today will make us more powerful. And let’s face it, we all want to feel more powerful – in a good way, like a superhero!

We are in a difficult and uncertain time. However, we still have power over many of the hours in our day and how we use them. We may even be able to start to do some of the things that complete the statements “If I had more time I would…? and “Someday, I’ll…”. We all have 24 hours in a day. Even if we can’t control all of those hours, we can choose our attitude and sense of optimism. Even if we feel uncertain or fearful, we can make choices to do healthy behaviors and think healthy thoughts to reduce the intensity and severity of that uncertainty and fear.

Powerful Tip — Make a Schedule

One of the things we can do that will help us feel more powerful in each 24-hour day is to make a daily schedule. It sounds so very simple: Make A Schedule. Yet, many of us let the day go by without intentional behavior. This is more likely when things are uncertain. Our motivation lessens and we feel helpless. Then we give in to those feelings, and before we know it, hours have gone by without anything enjoyable or purposeful. That cycle continues, and we can begin to feel mildly depressed. We can do something to prevent and change this cycle. We have power to change this cycle! The power comes from our behavior. Behavior is what we do. We can feel unmotivated and depressed while we get up and go for a walk. We can feel uncertain and fearful as we make ourselves a healthy snack. As we do behaviors that are good for us, we begin to feel some relief. As we feel relief, we continue to do behaviors that are good for us, and our day begins to have purpose. Our mood begins to improve, and we feel motivated to do more. We have used our own power to feel more powerful.

So, how do we make a daily schedule?

First, make a list of the things you have to do in a day. For example, work hours, personal hygiene, sleep, meals. Next, make a list of the things that support your health and wellbeing. For example, exercise, relaxation, social contact, learning something new, hobbies/interests, time in nature/fresh air, cleaning your home or car, etc. Then, use a calendar with half-hour increments to fill-in these activities. Start with the “have-tos” and then add from the second list. Also include open time – 15-20 minutes that is unscheduled at various times. It’s important that we have time to rest and reset between some of our activities in the day.

Although we may have restrictions like a Stay-at-Home order or the closing of some our usual hangouts, we still have a lot of power over our day. Following are ideas to get you started with some of the categories listed above. Be creative in your pursuit of a schedule that supports your health and wellbeing. Each day may be different and altogether they add up to a healthy lifestyle. Optimistic, Future-Focused, Powerful!

Where You Can Focus

Work hours

Follow your employment schedule. If you need to work but don’t have a set schedule, make one. Create a space in your home where you will work without distractions. (when I work at home, I often wear 30db construction headphones so I am not interrupted by other noise in my household).

Personal hygiene

Even if you’re staying home, clean your body, brush and floss your teeth, comb your hair, trim your nails. This shows respect and caring for yourself

Sleep

Experts recommend at least 6 hours and preferably 8 hours each night. Keep your bedroom for sleep and sex only – no tech or tv! If you must work in your bedroom, cover your desk with a sheet before you go to bed and turn off the computer. Put your phone in another room, do quiet tech-free activities 30 minutes before you go to bed to help you relax before sleep.

Meals

Experts recommend mostly vegetables, lean proteins, fruit, whole grains as tolerated. It’s important to limit alcohol and other drug intake and limit sugar and saturated fat.

Exercise

Three areas of fitness: stretching, cardio, strength training. Move your body everyday: take walks, use an online fitness video (many are free online), play upbeat music and dance, do pushups or sit-ups or jump rope or jog in place or whatever you are safely capable of (in agreement with your doctor’s recommendations).

Relaxation

Take breaks through the day, take slow and deep breaths, visualize images of comfort and peace, take a nap if you are tired, take tech breaks and news breaks

Social contact

Use your voice to connect with friends and family, tech platforms that let us see each other are great as well, smile at others as you pass one another or checkout at the grocery. If you are more isolated, look at photo albums and hold pictures in your hands if possible while enjoying memories

Learn something new

There are all kinds of free educational options online and possibly on your bookshelf. This can be a formal subject like science or astronomy. This can also be something fun, like music or cooking or a foreign language.

Hobbies/Interests

Hobbies and interests support our creativity, elevate our mood, distract us from life’s difficulties, give us purpose and meaning. Choose something that really interests you. It’s wonderful to get lost in something that makes us feel interested and uplifted.

Time in nature/fresh air

We benefit physically, psychologically, spiritually by spending time in nature. It can be as simple as going outside and breathing or looking at trees. Even passively sitting in a natural setting has benefits for us. Interacting with nature makes it even better.

Clean your home or car

Even if we don’t want to do it — we will feel better if we are in a clean and neat environment. Select one area of your home and get it clean or organized. Clear out the junk in your car, vacuum the seats and floor, wipe down the dashboard.

Enjoy this process as part of your powerful approach to coping with the COVID-19 pandemic. Recognize your strengths and resources and feel your resilience!

Wishing you good health, Dr. Lori Kleinman

Welcome & Dealing with Uncertainty — March 26

Welcome to the Boulder County Public Health mental and behavioral health blog for coping with COVID-19. Our purpose is to help our community members best manage the stress, anxiety, and uncertainty that is a natural part of our experience during this pandemic. Please know that although the current situation is “abnormal” for all of us, it is “normal” to be experiencing thoughts and feelings that are more alarming than usual. The posts on this page will utilize our best knowledge in psychology, medicine, science and even the arts to help you and your loved ones through the coming days and weeks. You will be able to learn about sound psychological principles that keep us healthy and thriving day-to-day. You will also be given ideas and activities that can help make each day feel more meaningful and purposeful to you. We are living under difficult circumstances, and we have the ability to choose how we will respond to those circumstances. Psychology gives us tools to respond in ways that are good for us – good mentally, good emotionally, good physically, good spiritually, good relationally.

So, let’s get started!

First, accurate knowledge helps to lessen our fear and anxiety. It’s important that we focus on accurate knowledge from reliable sources, for example the Boulder County Public Health and Centers for Disease Control websites about the disease. One of the initial things first responders do in an emergency is take account of the facts of a situation using the most accurate knowledge available. It is essential to know what we’re dealing with without distraction, so our emotional responses don’t get in the way of our thinking and coping responses.

Fear is a natural emotional response when we perceive that we are in immediate danger. That fear response leads us to fight the danger or flee from it. In fact, it is called the “fight-flight” response. It helps us to survive when we are in immediate danger. There is much we can do now to reduce any chance of personal danger from this virus, such as self-quarantine to reduce possible exposure and spread. Anxiety is also an emotional response. However, anxiety can interfere with our ability to respond to danger or choose how we will solve problems. The anxiety response can get in the way of our ability to manage a situation. An example of anxiety getting in the way is when we start worrying about what might happen. Instead of being able to recognize a problem, access resources, think about possible solutions, and take purposeful action, we can become emotionally distracted and nervous. Then we have even more difficulty finding a solution, and our anxiety increases.

It’s not unusual to worry when we are faced with ongoing uncertainty. The key is that we need to recognize it and take action to change the anxiety and worry into something productive. Fortunately, what we can do is rather simple. We need to ask ourselves one question: “Is there anything I can do about this thing I’m worried about?” If our answer is “yes”, we can plan what we can do and get started doing it. If our answer is “no”, then we need to start accessing accurate knowledge and resources to help us change the answer to “yes”. Or, we need to recognize that sometimes we can’t do anything, so we need to focus on something else. This takes practice, and the worrying may seep in, but we are starting to learn to self-regulate our responses and use our mental and emotional strength to feel more in control of our life.

Let’s look at the idea of self-quarantine or stay-at-home orders. For most of us, these ideas are in stark contrast to the ways we usually live. We can begin to worry about what might happen, or even what is happening. But if we want to feel more in control of our life, we can use the worry question. “Is there anything I can do about self-quarantine or a stay-at-home order?” Or even better, “What can I do about self-quarantine or stay-at-home order?” Now we’re getting somewhere. Whether it’s voluntary or mandated stay at home, I can choose to comply so that I keep myself and others as safe as possible at this time. Whew…Next, I need to problem solve how I will comply without losing quality of life. I will tell myself, “This is a time for prevention. That means I will do the things that experts say will help us. It also means I won’t do the things that experts say may likely hurt us.” In addition, I will plan for my days at home, including meals, exercise, activities, checking-in with reliable news for accurate knowledge, and social contact by phone, text, email, social media.

Remember, COVID-19 is real and important and is having a huge effect. We may feel uncertain and even scared. Yet we have the best scientists and medical researchers searching for solutions. We are in a country that has been resilient throughout our history. We are also resilient, and these situations remind us of that. This too shall pass, and in the meantime, we will help and support each other through. You have knowledge, skills, abilities, talents that will help you through. Be gentle with yourself and others as we move through this one day at a time.

Wishing you good health, Dr. Lori Kleinman

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