The COVID-19 pandemic has affected millions of people in a variety of ways, some of which we are still discovering. Virtually everyone has suffered some form of a hardship over the past nine months. These include physical hardships, as many have fallen ill themselves and/or have lost loved ones to COVID-19. These include work-related hardships, like losing one’s job, or adapting to working from home while balancing a frenzied home life with children being educated online.   

But there are also the mental hardships, which can be more difficult to identify.  As the pandemic continues, many are missing the normalcy of social interactions and other activities outside the home.

Mental health professionals warn about the psychological effect the pandemic is having on people’s mental health and well-being.  Economic stress, anxiety and depression brought on by being home alone, and/or dealing with the loss of loved ones are all likely to have a significant impact on people. Mental health professionals also note that, as the pandemic rages on, the increase in mental health problems as a result of stress from social isolation and other COVID-19 related life changes is contributing to an increase in substance use and misuse. 

Although turning to alcohol and/or drugs may temporarily help you feel better, use of these substances, especially in higher frequency / amount, will ultimately make you feel worse and could lead to addiction and other mental health issues. Using drugs or alcohol to cope with life circumstances can become a habit that leads to substance abuse or addiction. Additionally, many people who were already experiencing mental health issues prior to the pandemic may be using drugs or alcohol more in an attempt to self-medicate and cope with symptoms of a mental health disorder.

Therefore, it is imperative that people focus on developing and maintaining healthy habits and activities to help alleviate stress/anxiety/depression instead.

Here are some suggestions:

• Set limits with work and school so they do not blend into other areas of your life.
• Limit exposure to social media and watching news. If you must watch the news, then set a specific time and only a specific channel. Don’t inundate yourself information from a variety of sources as it will only add to the stress.
• Get moving. Take a walk, go for a run or a bike ride, do an exercise video or yoga.
• Maintain healthy eating habits. Plan and cook healthy recipes and maintain normal meal times.
• Keep connected. Talk to friends and family via videoconferencing.
• Start a hobby. This is a great time for creativity. This will help with stress relief and positive thinking. 

Remember that everyone is going through some form of hardship right now as a result of the pandemic, so reaching out to loved ones and providing that much needed reminder that they aren’t alone and have support is also very helpful. 

If you or someone you care about is starting or increasing use of alcohol or other substances during the pandemic, please contact your healthcare provider to discuss various options for treatment and support.

In the midst of a worldwide pandemic, with cities and even entire countries shutting down, it may feel hard to escape the sense of panic around Covid-19. Stress and anxiety about a disease can be overwhelming and cause strong emotions. It can also have a profound effect on your immune system, so it’s important for both your physical and mental health that you prioritize your self-care. Coping with your own stress will make you, the people you care about, and your community stronger.

The CDC states that stress during an infectious disease outbreak can include:

• Fear and worry about your own health and the health of your loved ones
• Changes in sleep or eating patterns
• Difficulty sleeping or concentrating
• Worsening of chronic health problems
• Worsening of mental health conditions
• Increased use of alcohol, tobacco, or other drugs

Why am I feeling so stressed?

From a basic biological perspective, stress is a sign that our body is trying to keep us safe. Our sympathetic nervous system kicks into “fight or flight” mode when we feel like we may be in harm’s way or are experiencing a real or imagined threat. Physically, this can cause an increase in adrenaline, heart racing, sweating, etc, and mentally keep us hyper-aware, which can make it hard to sleep because of spiraling thoughts. While these symptoms can often be alarming, it is our body’s natural response to a perceived threat. Fortunately, we can reduce our stress and anxiety through some actions we talk about below.

How can I ease my anxiety?

1. Get enough rest.

While you may be tempted to stay up following the news, it’s more important to let your body rest. Getting adequate sleep will allow your body to perform at its very best and fend off potential viruses.

2. Keep exercising. High levels of cortisol, your body’s stress hormone, can cause your immune system to be less effective. Exercise can help reduce elevated cortisol levels, as well as trigger the release of endorphins, boosting your overall mood and happiness. Head outside for a run, bike ride, or another form of exercise that doesn’t require close contact with others.
3. Eat well. It’s easy when stressed to let your diet slide and turn to less nutritious comfort foods. When it comes to managing your anxiety, however, a balanced diet is vital for your health. Focus on eating fresh, unprocessed, whole foods in order to maintain a strong immune system.
4. Limiting alcohol and other substances. While having a glass or two of wine might feel like a good way to take the edge off of a stressful day, alcohol in any amount can make it difficult to get restful sleep. This can also be true with other substances, like CBD and marijuana. Alcohol is also a depressant, which might lead to increased anxiety and a poor mood. Additionally, nicotine not only has a negative effect on your lungs, but can also disrupt your sleep.
5. Spend time with friends and family. Research shows that quality time with people you care about can boost your happiness level. If you are self-quarantined or even just working remotely, try to still connect with your friends and family through video chat or phone calls. Try not to talk about Covid-19, talk about pleasant things! Find opportunities to laugh. Talk about books, podcasts, or even the last show you watched on Netflix.
6. Practice Mindfulness. When we get worried, stressed or anxious, we tend to breathe shallowly. If you find yourself feeling overwhelmed, take a few minutes to notice your breathing. Slow it down with a series of long deep breaths in through your nose, and out through your mouth. Stress can also cause us to tense up. When you recognize that you are worried, stressed or anxious, try a “body scan”. Start from the top of your head and take note of any stress or tension in your muscles. Is your face pinched? Are you clenching your jaw? Are your shoulders up at your ears? Are you hunched forward? Do you feel any tension in your belly, back, legs, or feet? Go through the body, notice where you are holding your stress, and try to let it go.
7. Implement a digital detox. While you will understandably want to keep up-to-date on the latest guidance from health authorities, it’s important to strike a balance between staying informed and consuming everything in your newsfeed. If endless scrolling leaves you feeling anxious and overwhelmed, it may be time to take a break and unplug. Set aside a certain part of the day specifically for news consumption and give yourself a time limit. Some social media platforms even allow you to create those boundaries within their apps.

Can medication help me cope?

Try the above techniques before considering medication, as most medications for anxiety disorders (usually SSRIs) often take 4-6 weeks to take effect, and may not be the best option for temporary stresses, like those caused by Covid-19. Additionally, more short-acting anti-anxiety medications like Xanax are not meant to be taken on a daily basis and can be addictive. Our hope is that by practicing self-care, engaging in activities that bring you joy, and taking a break from the news and social media, you will be able to manage your anxiety without medication. If you’re not finding these approaches to be effective, consider booking a telemedicine appointment with one of our providers for guidance on the best options to further address your mental health.

References:

https://www.onemedical.com/blog/live-well/coronavirus-anxiety

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

Even though it is often referred to as, “the most wonderful time of the year,” the holiday season can also be very challenging for many.

While the festivities and the advent of a new year are fun and exciting, the holidays also present an endless amount of demands — parties, shopping, baking, cleaning, and entertaining, to name just a few.  As a result, many people find that they are faced with an increase in stress, anxiety and depression throughout the holiday season.  In fact, according to a poll by the American Psychological Association, eight out of ten people anticipate increased stress over the holidays. In some cases, the increase in stress and anxiety may even lead to depression.

However, there are many ways to minimize stress, anxiety and depression so you can relax and enjoy this time of year.  Try out some (or all!) of these tips for a happy and healthy holiday season:

1. Be intentional with your actions and time. The first step toward discipline begins with you getting organized. Using a schedule is your best friend. But, each thing that fills a slot on your scheduling needs to be for a particular reason, not “just because.”
2. Be selfish … in prioritizing your well-being. You can’t take care of others if you aren’t taking care of yourself! One of the first things people let go around this time of the year are their healthy routines and behaviors.  You don’t need to be perfect with your routine, but strive for consistency.
3. Be health-conscious. Don’t let the holidays become a free-for-all. Overindulgence only adds to your stress and guilt.
4. Get plenty of sleep. Make sure you are getting at least 7-8 hours of sleep per night.
5. Get moving! Incorporate regular physical activity into each day. Even a 20 minute walk can help with fighting off anxiety and stress.
6. Make some time for yourself. Find something that reduces stress by clearing your mind, slowing your breathing and restoring your inner calm.
7. Be realistic about your expectations. The holidays don’t have to be perfect or just like last year. Life is messy, and beauty lies in the unexpected.
8. Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for a while, talk to your doctor or a mental health professional.

Many of us look forward to the summer: the warmer weather, the vacations, the longer days, the extra sunlight.

But for some, the summer months are not a relief from the seemingly endless winter months. For some, summertime brings on depression. Sometimes, summer depression has a biological cause, like a chemical imbalance, while other times, the particular stresses of summer can pile up and bring on feelings of sadness and depression.

It can be even more frustrating to feel like you are supposed to be happy and enjoying life because it’s the summer and instead, you are bogged down by depression.

Many are familiar with “seasonal affective disorder,” or SAD.  SAD typically causes depression as the days get shorter and colder.  What is less known is that people with SAD can actually get it in the reverse — the onset of summer triggers depression symptoms.

Specific symptoms of summer depression often include: loss of appetite, trouble sleeping, weight loss, and feelings of agitation or anxiety. Summertime depression can also create an increased feeling of isolation.

Here are some things that may cause an increase in summertime depression:

• Disrupted schedules in summer. Our schedules can get shifted during the summer time months and often times, that disruption can offset depression especially with people who need a reliable routine to keep balanced.
• Body image issues. Feeling unhappy and self-conscious about one’s looks in summer clothing can also increase depression.
• Financial worries. Summers can be expensive. With vacation, meeting up with friends for a night out, dinners out, etc. spending can increase and thus, results in increased worry and depression.
• The heat. It’s not enjoyable for everyone. It can be very oppressive physically and mentally.

So what do you do if you think you are suffering from summertime depression?

• Get help. If you think you’re getting depressed, no matter what time of year, get help. See a psychologist, talk to your PCP, share with family and friends about how you are feeling.
• Keep up with your exercise. Regular physical activity can help keep the risk and/or symptoms of depression down. But be careful not to overdo dieting and fitness.
• Protect yourself. Don’t overextend yourself. Don’t feel obligated to do anything and everything. Take time for yourself.
• Talk to your doctor about medication and/or adjusting current medications.

Happy 2019!  As we run, walk, or maybe even crawl into the New Year, we often begin with a desire, if not a definitive plan to make lifestyle improvements.  Once and for all, we’re going to tackle that cluttered home, lose those extra pounds, or find the career where we’ll truly find fulfillment.  Despite our good intentions, we may quickly find ourselves overwhelmed and frustrated as we set lofty and often unrealistic goals.  Without a thorough assessment of our needs, wants, and resources, we can often fail to achieve our intended lifestyle improvements.  The New Year offers an excellent opportunity for a fresh start and a reexamination of our goals and choices.  As we begin 2019, I encourage you to look at your life with a critical eye and decide what you need to, want to, and are willing to try to work to improve.  Here are 19 suggestions for 2019 that can help.  Through these, you can improve your chances of lifestyle balance, goal achievement and of living the life you want and deserve.

1) Spend some time alone.  Get to know yourself without the influence of others.  You might find you like your own company.

2) Learn and practice Mindfulness.  Work on being in the present rather than allowing yourself to dwell in the past or anticipate the future.

3) Set boundaries with others, be they family, friends or coworkers.  Do not accept disrespect.

4) Allow others to help you.  They’ll feel good and you may get some much needed relief.

5) Get up and move!  Take the stairs, go for a brisk walk, do some jumping jacks, practice yoga, ride your bike.  Find a way to move your body.  Simply moving briskly 20 minutes each day can help decrease anxiety, depression and relieve stress.

6) Don’t be so hard on yourself if you don’t accomplish everything you planned each day.  No one does.  Work on small, realistic, attainable daily goals.  Small achievements reinforce us, leading us to want to strive for more.

7) Help someone else.  You’ll feel good and they may get some much needed relief.

8) Surround yourself with supportive and loving people.  Make good choices about with whom you choose to share your world.

9) Work on clearing away physical clutter.  You’ll be amazed at how this can lead to increased productivity and decreased anxiety.

10) Decide what changes will make you the happiest in the coming year.  Prioritize those.

11) Give yourself a time out.  When you feel overwhelmed, take 10 minutes alone to regroup.  Close your eyes and breathe.

12) Stop comparing your life, body, career, children, house, relationship, etc., to others.  You are a unique individual and deserve to be treated as such.

13) Look for opportunities to enhance parts of your life you never considered.  Read more.  Learn an instrument.  Take a break from social media.  Volunteer.

14) Share your intentions to improve your life with someone.  You’re more likely to achieve goals when you tell someone else.

15) Take risks but don’t be careless.

16) Let go of regret and grudges.  These simply expend energy unnecessarily and increase stress.

17) Have high expectations of others, both personally and professionally.

18) Be honest about your present circumstances.  If you’re feeling anxious and depressed, seek help.

19) Finally, as the great Maya Angelou said, “My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor and some style.”  Let’s all seek to do the same in the New Year.

Best wishes for a wonderful 2019!

“Be moderate in order to taste the joys of life in abundance.”-Epicurus

As summer approaches, many of us are looking forward to vacation. We have spent months saving and planning – and we cannot wait to relax and de-stress!

However, when you’re enjoying the time off, your healthy living habits don’t need to “check out.” Vacations can provide a convenient excuse to overindulge. Overeating, consuming more alcohol, falling off an exercise routine … and before you know it, extra pounds have become your vacation souvenir.

You certainly don’t want to deprive yourself while you are on vacation, but thinking in moderation is critical. You can still enjoy your time away and do things in moderation. Here are some helpful tips for maintaining your healthy habits while vacation:

1. Downsize. If you are out to eat and the portions are bigger than you normally consume, take some home for leftovers, split an entree with someone, or even order an appetizer instead of a full meal.
2. Make healthy food choices. Ask for your entree to be served with fresh vegetables or a side salad. Instead of ordering something fried, see if it can be prepared in a healthier way like grilled, broiled or steamed.
3. Remember that calories from alcohol count! Who doesn’t dream of having a tropical drink with an umbrella in it while lounging by the pool? Alternate adult beverages with other healthier choices like water, tea, coffee, club soda or unsweetened tea.
4. Don’t overindulge with sweets. Have one scoop of ice cream instead of a sundae or share a dessert with the rest at the table.
5. Consider your exercise plans. Opt for locations that will allow you to engage in physical activities you enjoy. Keep in mind that being physically active is the ticket to enjoying extra calories without weight gain.
6. Plan fun fitness activities every day. Walk the golf course or take a jog on the beach, go sightseeing, or go on a nature hike. Remember that there are countless opportunities for you to work in a little exercise each day while on vacation.

In summary, vacation can still be a time to let loose, relax, and enjoy yourself. But it doesn’t have to be all-or-nothing. You can go on vacation, enjoy yourself, and still feel good when you get home, if you maintain a healthy balance.

“Educating the mind without educating the heart is no education at all.” – Aristotle

Generally, society discourages us from being in touch with our emotions. Social media seems to encourage us only to show a happy face to the world. Professional work environments appear to promote those who act dispassionately.

However, being in touch with your feelings–both positive and negative–will make you a better and more complete person. By understanding your emotions, you will feel better about yourself. You will improve your confidence, knowing that you are not hiding behind a false front.

What does it mean to get in touch with your emotions?

One interpretation is being able to communicate emotions to others. A large part of emotional security is validating your own feelings by expressing them to other people.

When we choose to not to express our feelings, we punish ourselves and others. We may no longer make ourselves available to others and may withdraw, or just not be fully engaged when we do spend time with other people. At other times, if we choose not to express our emotions, we may react inappropriately because our emotions are pulling us in a different direction from where we really want or need to go. When we can express how we truly feel in healthy ways, we can solve problems, improve relationships, and enjoy life. In addition, we end up viewing our lives more positively because we are not holding on to unhealed or confusing feelings.

There are many reasons why we might feel the need to hold in our true feelings. We may feel we can’t express them without causing embarrassment or harm to another. We may not want to unleash our feelings out of fear that once we start, we will not be able to stop. But by letting our feelings out, we are letting out what hurts, while making more room for positive thoughts and feelings. Expressing our negative emotions in a way that is considerate of others people’s feelings is actually a good way to free us from them.

We can get better at knowing what we are feeling and why. This skill is called emotional awareness. Understanding our emotions can help us relate to other people, know what we want, and make choices. Even emotions we consider “negative” (like anger or sadness) can give us insight into ourselves and others.

Although emotional awareness comes more easily to some people than others, it is a skill that anyone can work on. Here are a few ways to improve your emotional awareness:

1. Notice and name your emotions. Start by just noticing different emotions as you feel them. Name them to yourself.
2. Track one emotion. Pick a familiar emotion — like happiness — and track it throughout the day. Notice how often you feel it and when. Whenever that emotion shows up, you can simply make a mental note to yourself or jot it down in a journal. Notice where you are, who you’re with, and what you’re doing when that emotion is present. Note whether the emotion is mild, medium, or strong and if it has different intensities at different times.
3. Build your emotional vocabulary. Try going through the alphabet and thinking of one emotion for each letter.
4. Think of related emotions that vary in intensity. See how many you can come up with.
5. Keep a feelings journal. Take a few minutes each day to write about how you feel and why. Journaling about your experiences and feelings builds emotional awareness. You also can express an emotion creatively. Make art, write poetry, or compose music that captures a specific emotion you’re feeling.

We all have emotions every day, even when we do not realize it. When we are able to be in tune with our emotions, we remain true to ourselves, and we help ourselves receive the support we need. Ignoring our feelings may be the easy choice in the moment, but it can have serious repercussions for our relationships and our mental health. Being in touch with our emotions can help us be more empathetic, know our strengths and weaknesses, make better decisions, and ask for what we need.