Couplespeak™ Blog

CNN Health: “5 Signs Your Coronavirus Anxiety Has Turned Serious, Threatening Your Mental Health, and What to Do About It”

Here is an excellent CNN Health article which I’m reprinting, because it deals very thoroughly with the potential impact of the Coronavirus pandemic on our mental health. The writer discusses several tools we can all use to offset some of the negative effects of living in lockdown, “hiding from death,” as I think of it.

CNN Health:  by Sandee LaMotte

Enforced lockdowns. Isolation from friends and loved ones. Loss of job, income, economic stability.

Grief and loss on so many levels — from missing milestones such as birthdays and graduations to severe illness and death.

Difficult times made worse by the fear of an invisible, deadly enemy who strikes via the very air we breathe.

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Coronavirus symptoms: 10 key indicators and what to do

Such is the anxiety-ridden reality of living in the age of coronavirus for many people around the world. While some of us may be coping well right now, experts worry our emotional resilience will begin to fray as the threat of Covid-19 drags on.

“We’re living constantly with a level of fear, a heightened state of arousal, much like Vietnam vets and Iraqi vets live with every day,” said trauma counselor Jane Webber, a professor of counselor education at Kean University in New Jersey.

“And our sympathetic nervous system can only stay in that overwhelmed, almost frenetic state for so long before we crash,” said Webber, who counseled survivors and families during 9/11’s tragic aftermath.

“I call it ‘chronic threat response’ — the continued state of being in a hyper-aroused survival mode,” said trauma psychologist Shauna Springer, who has spent a decade working with military veterans suffering from post-traumatic stress disorder, also known as PTSD.

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Why soap, sanitizer and warm water work against Covid-19 and other viruses

“Chronic threat response is an escalation of many of the same symptoms associated with post-traumatic stress — sleep problems, floods of anxiety, irritability, difficulties concentrating and a hair-trigger startle response,” Springer said.

What are some of the signs that our coping skills are becoming threadbare and our anxieties may turn dark and more dangerous?

1. Poor sleep

“When nightmares become a regular thing and our sleep quality is consistently bad, that is often the first sign that we may need to take action to improve our mental health,” said Springer, author of a new book called “Warrior: How to Support Those Who Protect Us.”

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Craving carbs and sleeping badly while social distancing? Here’s how to cope

Poor sleep is a double-edged sword: Not only does anxiety create poor sleep, a lack of quality sleep can lead to anxiety, stress and depression, a sort of circular impact. The good news is that exercise and practicing good sleep hygiene can often help get us back on track.

2. A focus on bad news

As we shelter in place, a focus on watching alarming media reports on the growth of the virus and the devastation to the economy is another warning flag, according to Springer.

“If we are spending our days soaking in this general anxiety and dread about what may happen, in a sort of foxhole waiting for bad news, that’s another sign that things are getting into a more clinical range,” she said.

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Smoking weed and coronavirus: Even occasional use raises risk of Covid-19 complications

“And there’s the guilt of taking our feelings out on loved ones, which is likely to happen when you’re in close quarters with people for a long time and you haven’t adjusted to that.”

3. Loss of interest and pleasure

An even more serious sign, Springer said, is when we lose the taste for connection to others and stop reaching out to friends and family.

“When we can’t find pleasure in anything and we begin to feel numb rather than connecting with others and doing things we value or want to do with our lives, that’s a sign that we may need help and support, she said.

4. Helplessness or crippling anxiety

If the current threat of Covid-19 has reawakened feelings of helplessness, such as in the face of violence at home, or from a loss of identity and purpose after being fired or furloughed from a job, that can also be a key sign of risk, experts said.

“An overwhelming feeling of helplessness is what often leads to trauma symptoms,” Springer said. “Those of us who’ve been let go from a job can feel as if we’ve lost our identity, due to the absence of the roles and relationships that give our lives meaning, and therefore we feel helpless. We can be at risk.”

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Coronavirus: What to do if you or a loved one has symptoms

Helplessness can turn to a dark and crippling anxiety, which is another sign that we need help.

“Crippling anxiety is where you feel constantly flooded with feelings of panic and this nameless dread about what may unfold,” Springer said. “You don’t have a sense of a hopeful future. Anxiety creates tunnel vision and it really puts us in a state of fight or flight.

“And when we are in that survival mode for a prolonged period of time, that’s when anxiety goes into a darker phase and it really warrants clinical support,” she said.

5. Thoughts of suicide

Being so hopeless and anxious that we begin to think of ending our life is, of course, a sign that immediate professional help is needed, experts said.

“Military veterans say this is when ‘whispers of our demons’ begin to take over,” Springer said. “When we start to script out a story in our heads of how others won’t miss us or that we’re a burden to those that we love, that is a critical sign that we need to get help immediately.”

What to do to help yourself

Reach out and connect, just not physically. The first thing to do is stay socially connected with friends and loved ones even though you’re physically apart. Technology is a great way for many of us to do that, but some in the family, such as grandparents, may be as adept at using Facebook, Facetime and Zoom, for example.

“Instead of just relying on social media, we can make a list of the 10 or 20 people that we care the most about and put them in our phone on a rotating basis,” Springer said. “We’re going to call one of those people every day.”

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You can’t hide your stress from your kids, study says

Next, Springer suggested adding more people from our outer ring of friends and associates that we may not be as close to and put those people into that daily call rotation. That’s especially critical if you think those people may be especially isolated right now.

“Reaching out and connecting with people, especially those who are especially isolated, and giving them space to talk about their experience and anxiety during this unprecedented time of anxiety and then sharing our own experience is how we will get through this,” she said. “When we connect, we survive.”

Breathe deeply. In therapy sessions, Webber said, “the thing we teach most is deep breathing. It’s free, it doesn’t cost anything and it really works.”

Here’s how to do it properly, she says: Breathe through the nose, hold it and then exhale very slowly out through your mouth like you’re breathing through a straw.

“And when you breathe slowly out, you improve your whole picture of life and you reduce your nervousness,” Webber said.

Practice gratitude. Science has shown that people who practice gratitude are happier and more optimistic — and you can easily teach yourself how to do it.

“One thing I recommend to everyone in scary times is to write two or three things each day of what you’re grateful for. It shifts your view of the world,” Webber said.

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Five ways to improve your mental health in 2020

“I’m grateful for my daughter because she is home with me right now. I’m grateful for my son, the nurse. I’m grateful for my other son who has figured out every possible way of getting food online that there is in the entire county,” she added with a chuckle.

Take control of your mental state. Fight back against anxiety turning darker, experts suggested, by taking control of how you think.

“One of the ways to do that is to take out a sheet of paper, put a line down the middle and on one side write down the things we can’t control right now, and on the other write what we can control,” Springer said. “And then we form a plan of action that allows us to move on those things that we can control.’

This stops us from “soaking in that feeling of helplessness or if you will just be sitting in our foxhole and waiting for more bad news to come,” she said. “We’re actually moving on things that we want to be doing with our lives, even if there are some very challenging circumstances right now.”

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The meaning behind your strange coronavirus dreams

For some people that may not feel possible, especially if they lost a job or were furloughed when the economy came to a screeching halt.

“Losing a job is a seismic stressor, one of the most stressful things that can happen to you,” Springer said. “But you can sit and ponder on your negative situation or you can use the time to learn something new or deepen yourself or gain some skills.”

She points to the many high quality, inexpensive or free training programs on the internet today that can add skills to your profession or even help you transition to something new.

“So people can use this time to build skills and become smarter and stronger and more prepared for when the workforce really kicks back in and full force,” Springer said.

Establish a schedule. Our days and nights are blending together, and many people find themselves working more hours, or if they can’t work, fretting about finances. One way to fight back to is establish a schedule that separates work or job search from family and play time, especially exercise, which is critical for boosting our mental mood. Meditation or mindfulness are also excellent options to schedule into our day, experts said.

“We have to create routines in order to get through this absolutely surrealistic world right now,” Webber said. “Focus on the little things, such as making a lunch in a special way, knitting, crocheting, meditation, mindfulness, yoga or walking or running to do something physical to help us reach a more calm mental state.”

Be careful with media, especially social media. Be sure to limit the amount of time you spend watching the news, especially if you feel it makes you anxious, experts said. That can also apply to social media, said Arthur Evans, the CEO of the American Psychological Association, in a recent interview for the Washington Journal section of CSPAN.

“There is a lot of misinformation on social media,” Evans said. “When you couple that with a lot of contradictory information, it creates more anxiety for people.”

For example, he said, social media is filled with conspiracy theories and other wrong information that “is contradicting what we are hearing from professionals who really know and understand these issues … so limiting the information to reliable sources, sources you can trust, goes a long way in helping manage that stress.”

Crack a smile. It’s long been said that “laughter is the best medicine,” and that applies to the anxiety of our times, experts said.

“Remember, you can’t be anxious and smile at the same time. That’s a physiological thing,” Webber said.

So watch funny movies, listen to comedy routines, ask everyone you talk to on the phone to tell you a joke. Give back to them by doing the same.

Stay optimistic. There are so many unknowns when it comes to this new disease that is terrorizing the world. Will it ease over the warmer summer months? Get better or worse as the world begins to open back up? Even worse, will it return with a vengeance in the fall and winter?

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Don’t let those unknowns shake you or take away your optimism, Webber said.

“I consider optimism both healthy and an Achilles heel, because of course, being too optimistic might let you down,” she said. “But if I had the choice, optimism is always better than pessimism. And optimism is always better than realism. If we have hope that the best will come, we might be disappointed, but that hope, I always believe, will get to the person that you love.”

“If You’re Hitting a Wall You’re Not Alone”

(This CNN article was just forwarded to me by my cousin who is an avid reader, staying afloat in quarantine as a single person through her endless curiosity for information and ideas. I thought the article perfectly captured the dilemmas we all face now in this pandemic, and I couldn’t have covered it any better, so I’m sharing it with you here).

Opinion by Jill Filipovic

Updated 11:11 AM ET, Wed April 29, 2020

(CNN) 

Are you losing your mind in quarantine? Because I am losing my mind in quarantine.

It can feel trite, even crude, to talk about our own discomforts, frustrations and longings in the midst of a pandemic that has infected more than three million people worldwide and killed more than 200,000 including nearly 60,000 in the United States, with numbers climbing. 

Across the globe, families are grieving friends, family and community members. Husbands, wives, children, parents and partners are saying goodbye via iPad, unable to hold a loved one’s hand in their final moments. It’s a grim, ghastly time.

Those of us who are just stuck in self-isolation, and not hooked up to a respirator or the next-of-kin of someone who is, are the lucky ones. And no, what’s being asked of us is not excessive: We just need to stay home.

So why does this feel so hard?

Around the world, people report feeling stressed, anxious and generally discombobulated by this whole mess. Parents and other caregivers for young children are particularly stretched thin. People have canceled trips, concerts, weddings; new babies are being brought up without the help of extended family or community members; big life milestones like graduations go publicly uncelebrated. We miss the friends and family we can’t see. We miss dinners out, parties in, museums, live music, theater, even the gym. 

I miss being able to walk through my neighborhood without the stress of staying six feet away from bikers, joggers, cooped-up children gone wild on scooters, and other pedestrians.

It’s not just working from home. I’ve worked from home for close to a decade, in many different cities and multiple countries. But the general rules of work-from-home life no longer apply. For example: Do something social, or at least that forces you to interact with other human beings, every day, even if that’s just going to the grocery store or the gym. Or: Create a separate dedicated workspace, even if it’s only a particular cushion on your couch; reserve your bed for sleeping (and other recreational activities). Or: Get outside at least once a day.

That’s all harder when your whole family is stuck inside on top of each other; when there are no gyms to go to; when, at least in dense cities, even going for a walk outside is a stressful (and masked) experience.

No, we are not being asked to go to war or survive one. But what we are being asked to do is profoundly antithetical to our natures as human beings; it is profoundly destabilizing and difficult. There is little more human than the desire for connection, touch, stimulation and novelty. This is all so hard because in going without those things, it’s not hyperbole to say we have to find new ways of being — or at least feeling — human.

Esther Perel, a psychotherapist and best-selling author, tells viewers in a brief but compelling video for The New York Times that it’s no wonder we are feeling a sense of grief and anxiety. It’s not just that we’re missing out on travel, dates, or dinners. It’s that we’re also losing the meaning behind all of those things. A date isn’t just a date; it’s the possibility of a romantic future. A trip isn’t just a trip; it’s a new and stimulating experience, a chance to understand oneself in a different context, an opportunity to see things that before you could have only observed through a screen. A dinner out isn’t just a dinner out; it’s a moment of indulgence, pleasure and connection with the person across the table. A longing to hug a friend, a loved one, a far-away child, your mom is more than just “I want a hug” — it’s a primal and fundamental longing for the way touch is so often short-hand for everything we don’t find the words to say.

Even in the midst of catastrophe — war, natural disaster, destruction — human beings continue to forge connections; we perhaps especially forge connections in the most trying of times so we can survive. In the most dire of circumstances — in war zones and refugee camps, in towns leveled by earthquakes and communities pocked by violence — people create art, paint in bright colors, plant seeds. They play music. They feed their beloveds. They tell stories. They fall in love.

The isolation that this pandemic has forced upon us doesn’t prevent all of those things, but it certainly hinders them. In the days after September 11, 2001, New Yorkers defied stay-at-home suggestions to congregate in bars and restaurants; the city teemed with life and energy (and, for once, not with car horns — a little bit of softness in the aftermath of such brutality). That collective gathering was very much a collective middle finger to those who attacked us: No, we are not scared. Yes, we are still here, and guess what? We’re going to live.

What is being asked of us now is not quite so satisfying; it does not meet our need, in a time of anxiety and grief, to come together and seek comfort. To touch each other. To even smile at a stranger — you can’t see a person’s expression behind a mask.

Compared to illness and death, these are small things. Being alive matters more, and so of course we have to continue to live this way for as long as is necessary to keep ourselves and others safe and healthy.

But it’s also OK to grieve the pieces of life that we’re missing, to express the feeling so many of us have that we can’t take it anymore. It’s necessary to understand that missing the fullness of life, including pleasure and connection, doesn’t make us selfish. Feeling destabilized and disoriented or pushed to a breaking point doesn’t make us flaky or weak. It makes us human.

And perverse as it may sound, those of us who are anxious, frustrated and disoriented can be grateful for that exact experience — in disorienting and disconnected times, this reaction is a rational one. It means we’re warm. We love. We’re curious. We seek pleasure, and we revel in it when we experience it. It means we live.

Life in Coronaland

Most everyone in the world, for some time now, has been experiencing the anxiety, losses, uncertainty, and constraints of social distancing related to Coronavirus. We know we’re living in an apocalyptic scenario, we hear all the gory details on the news and from each other every day. The people who seem to be surviving best in this new “normal” are the hard-core introverts, and even they are weirded out. I am not a cryer, but have done my share in the last few weeks, so I get the trauma in all this.

However, there are also some pretty bizarre and funny things going on which I think it would be therapeutic to notice and share. We’ve gotta find some humor amidst this crisis, so I will be doing my part here to spread the word about what’s laughable and inspiring in our current reality.

First installment:

“Big Night Out – Suicidal Grocery Shopping at BJ’s”

 

After a few weeks of this self quarantining my husband and I noticed a serious lack of freezer paper, cheese and Half and Half. We could deal with staying at home 24/7, being online 24/7 for all work and social contacts, the losses, the ongoing experience of Russian Roulette about who would die next, but no freezer paper? No cheese? No Half and Half for the gallons of coffee we’ve been drinking? No way!                 Besides, it was Friday night, and time to go out!

I’d heard from a few clients who are high up on the medical chain that yes, we should be wearing face masks to protect each other, but my idea to strap a huge towel around my head wasn’t so great – too much possible absorption of respiratory droplets for me while being socially altruistic. They both were adamant that glass or plastic face shields are what docs use in certain surgeries and risky situations. And yes, a motorcycle helmet would be fine. So, here I am above, following medical wisdom, preparing for our Friday night foray to get “desperately needed” supplies at BJ’s Wholesale Club.

Imagine Darth Vader walking around in front of you in a store. It was the perfect setup for social distancing! People around me probably thought I was either a psycho or someone about to rob the place, so nobody came near, even the customer service people who ordinarily assist when you’re useless at the Self Check Out line, as I generally am. It didn’t help that I was also wearing a giant scarf to seal the bottom opening of the helmet, so my hair was plastered down with sweat and the plastic shield was all fogged up from the heat condensation. Then at BJ’s you have to look for half boxes to pack your groceries in – uh oh, cardboard! More Coronavirus droplets about to pounce! My solution was to get this Big Night Out over and done with at top speed so my immune- compromised husband who was waiting in the car, wouldn’t worry that I’d succumbed to evil Covid-19. Of course it was pouring outside, and he’d parked right in front of the store, way too close to other people who were loading up their cars. He was less than 6 feet away from them, ready to help me! Of course I starting shrieking warnings at him from inside my Darth Vader getup, now soaked from the rain as well, so those people also backed off. (Handy)……….

I think the “insanity posture” may be very effective for our Covid-19 existence.  It certainly worked when I lived in Manhattan, would be coming home from work on the deserted subway late at night, and approached by some menacing creep. I’ve never carried any weapon except the ability to appear totally crazy, loudly shouting out psychotic rants, which I’d witnessed at Bronx State Hospital where I’d worked on the ward with folks who were in a different state of reality. Nobody wants to screw with an insane person, so in my later middle-of-the-night homeward bound subway rides I never got mugged or attacked. Shady characters would always back off. It was my perfect New York defense. If you’re not too self conscious I’d highly recommend it when clueless people get within 6 feet of you nowadays, especially the friendly ones.

The good news is that we had our Big Night Out and now have lots of freezer paper, cheese and Half and Half.                 Hallelujah!

 

 

 

Moving forward with therapy amidst Covid -19

To all current and prospective clients,
 
I hope you and your family are all well and managing this crisis reasonably well.
 
In the interest of safety and social responsibility I’m no longer seeing clients at the office, but instead via either
phone or video conferencing through Doxy.me, an easy to use, HIPAA compliant setup. 
All you’ll need to do is to wait for an email from Doxy.me/SusanLager telling you I’m ready to begin
your session, click on the link enclosed and you’ll be in my virtual “waiting room” until I let you into your session.
There’s no need for you to download any software or join anything. A Chrome or Firefox connection is best, but
Safari works as well. A laptop or iPad provides much better reception than an iPhone.
 
If you prefer, we can do a phone session if you don’t have access to a computer or would be more comfortable
with that. Just let me know what number you’d like me to call. 
 
*You will just need to call my VM at 603-431-7131 ahead of time to let me know your preference,
so we don’t take up your session time with these logistics.
 
I’m recommending that all clients who would be coming in for sessions under normal circumstances continue
their therapy this way, especially in these times of uncertainty, fear, anxiety, loss and isolation. All you’ll need
will be a private space and a laptop, iPad or phone for 50 minutes. This will allow you to continue our work in
the safety and comfort of your own home or private space.
 
If your are a current client I would expect us to maintain all sessions moving forward, especially in light of the
possibility that this crisis will persist for the next several months, according to infectious disease experts. Waiting
until this pandemic recedes to schedule a next session at the office may just be too ambiguous, creating a prolonged
limbo state for your relationship work. The same is true if you are a prospective client.
 
It’s of paramount importance to me that my clients have tools for support and continued growth during this highly
stressful time which challenges everyone’s fanciest coping skills, especially for couples who have already been
wrestling with relationship or family issues.
I hope you’ll avail yourself of this “new normal” way of working. 
 
Stay healthy and safe,
Susan

Some insight about managing your anxiety amidst Covid-19

(Here’s an article my cousin sent me I’m reprinting so all of you can benefit from the honesty and wisdom in it):

I have clinical anxiety. If the coronavirus scares you, this might help

I’m not a doctor, but what I’ve come to learn over 20 years is that you really can master your anxiety.

By Kara Baskin Globe Correspondent,Updated March 25, 2020, 2:08 p.m.
 
ADOBE STOCK IMAGE; GLOBE STAFF ILLUSTRATION

Editor’s Note: This story is part of a Globe Magazine special report, appearing in print on Sunday, March 29.

You might think that this is a terrible moment for someone with a clinical anxiety disorder. But here’s the thing: It’s like the rest of you have finally caught up with me. Hyper-vigilance? Insomnia? Catastrophizing? Extreme fear of uncertainty? Welcome to my Isle of Dread. Care for a cocktail?

I’m kidding, sort of. Panic disorder and extreme health anxiety have alternatively propelled and paralyzed me for two decades. For the most part, I exist as a fully functional human being thanks to 10 milligrams of Lexapro, an insightful therapist (now available on video chat), and long-practiced behaviors that keep me even-keeled.


But many friends, thankfully never touched by the cold paws of anxiety, are now asking me how to deal. They don’t know what it’s like to awaken each morning wondering what kind of mood they’ll be in, or to contemplate whether today will be the day that mortality — in the form of a rash, a lump, a tremor — descends. They have never gasped for breath, ridden the acidic wave of heart palpitations and clammy sweats, and clawed for reassurance like a feral cat only to retreat into a mind that offers no solace, only more questions.

Most people move through the world assuming it has a veneer of predictability, or what psychologist Luana Marques calls a “thin veil of certainty.” We are not wired to deal with open-endedness; under normal circumstances, for example, we can feel fairly certain when we go to the grocery store that we’re not going to contract a virus. That has changed.

“But uncertainty is there all the time, and we just don’t feel it,” says Marques, an associate professor of psychiatry at Harvard Medical School and president of the Anxiety and Depression Association of America. Anxiety sufferers know this intimately. You might be realizing it for the first time.


Please know that it will be OK. What I’ve come to learn over the course of 20 years is that you really can master your anxiety. I’m not a New Age guru or a doctor; I’m just a person who’s ridden it out. Here’s the trick: Don’t deny it. Accept that you are absolutely, 100 percent going to feel awful sometimes. I know, I know — the world is rife with mindfulness apps, breathing strategies, glamping retreats, and drugs aplenty to keep your unease at bay. These have their place. We cannot live in a state of heightened vigilance at all times.

But engaging with discomfort is its own therapy, too. It’s the most un-American thing ever, yet: You must sometimes feel bad. So accept the anxiety. Don’t blunt it; summon it. This sounds counterintuitive, I know, but anxiety isn’t a mark of shame to hide from people whom you assume are far more resilient than you. (They’re not.) It will continue to bounce on your shoulders like a thorny goblin until you grab it, stare it in the face, and have a firm chat.

“The first thing I’ve been making people understand is that anxiety is a normal response to a threat,” Marques says. “We want to run away from discomfort, but pushing anxiety away makes it worse. We’re living in times when most of us are comfortably uncomfortable at a minimum. Understand that by embracing our emotions and labeling them, we can ride the wave a little more smoothly.” It’s like surfing. You’ll be jostled by the ocean, tossed around, and eventually tumbled back onto the shore.


Of course, this is all academic until you’re hiding under a weighted blanket scrolling Twitter, wondering about that tickle in your throat. A behavioral way to cope is by doing something action-oriented, Marques says: cooking dinner with your kids, going for a walk. You’re forcing your brain to deal with what’s right in front of you.

Yet those of us with anxiety disorders also know that the only way out is by sitting with the discomfort until it dissipates. It’s like stepping into a hot tub and staying there until the water grows lukewarm. Acknowledge that you’re scared, and then tell yourself that you’ll sit, and you’ll breathe, and you’ll exist — yes, you will exist, minute by minute — until the feeling goes away. And, of course, reach out for professional help if you feel you need it.

Frame it as what we’re being asked to do in quarantine, on a smaller scale. Your mind is your own private bunker. You can’t just get up to leave, but when the door finally opens, think how much stronger you’ll be.

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Susan Lager

I am a licensed, board certified pyschotherapist and relationship coach in Portsmouth, New Hampshire. Through my psychotherapy or coaching services, I can provide you with skills and tools to transform your life.

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