Tracy Ross and four regional health experts take a closer look at what it means to maintain physical, mental, and emotional health amidst the coronavirus pandemic in a new Sounds Good special.
"It's clear that the psychological impact of COVID-19 is real and likely worsening," Dr. Michael Bordieri, Murray State professor of psychology, says. "We're really going to be contending with a mental health crisis on top of what we already have as a public health crisis."
"In terms of specific individuals or types of individuals who might be at risk, the big ones that come to mind are depression and anxiety," Bordieri continues. "The core of social distancing, which is so important from a public health perspective, also comes with a psychological cost. I think that's one of the challenges we're seeing now."
Rebranding 'social distancing' as 'physical distancing' is one way to overcome that challenge. By using video chats, phone calls, social media platforms, and other virtual places, "[we] maintain social connection, belonging, and community," Bordieri says. "One of our core theories of depression is behavioral action. People tend to do better when they're moving around lots in their world and contacting lots of things. Social distancing closes our world down, which is something we see in depression."
"We know that anxiety feeds on uncertainty. This crisis is marked by uncertainty. For people who struggle with that and whose minds really struggle and try to take charge of making sense of anxiety, this really presents a challenging time. I think all of us are going to have to take our psychological health into consideration as we work our way through this process."
Bordieri recommends maintaining social contact "often, early, and as frequently and meaningfully as possible." Maintaining a routine and sense of normalcy by regularly bathing, getting dressed, and preparing for the day. Exercise, adequate sleep, and a nutritious diet all help to maintain mental health.
"Humans are remarkably resilient. That isn't to disparage or any way minimize the amount of suffering that's present right now. We know this is a difficult time. On one hand, I think it's important that we acknowledge and make space for that and to honor our experiences and the experiences of others. But humans are quite resilient. We look at the areas of psychological strengths, and we see that humans have huge coping reserves and unique ways of coping with the crisis. I think that's going to be one of the most exciting areas to look at as we move forward with this -- [learning] all of the innovative ways that we're coping with this."
"Right now, one of the best things we can do is treat this as an opportunity. Not an opportunity any of us wanted or signed up for. But as an opportunity as our world is getting smaller to find meaning and purpose in small things in our life...to look for kindness as opposed to stigma, isolation, or prejudice."
"One final note...help is available for folks who need it. I think there really is a mental health crisis that's right alongside this public health crisis. It's not visible yet. I think it will increasingly become so. There are services available. We've seen a huge increase in telehealth. It's important to know that help is available. It really is a sign of strength to reach out for health, especially at a time like this, because you're doing that for yourself, your family, and really making sure you're going to be in the best position to navigate the difficult but manageable road ahead," Bordieri concludes.
"When clients first think of telehealth, there's a hesitation there. Especially current clients because they have certain ways of doing things," Katie Englert, LPC-S, BC-THM, president of Compass Counseling, says. "We've been offering this as a supplemental service or convenience for people for a couple years now, but this situation made it important for people to decide, 'am I going to stay on track? Am I going to fight for something that's a little different? Or am I just going to stop completely until I know what's going on?' We're a month in, and we still don't really know what's going to happen."
Englert compares the transition to telehealth to a change in your airport gate. "You're ready for your trip, you show up with your luggage, and if they change the gate, would you say, 'nope. I'm going home. I'm not going to get on my flight because I have to change the gate.' We're changing how people are connecting with their therapists or doctors. We're still going on a trip."
Online telehealth services like Compass Counseling can see anywhere from 40 to 70 patients per week. Englert says that while these services were experiencing a recent shortage in patients, more people seem to be reconnecting this week.
"The likelihood that [a counselor] is going to be able to figure out a way to work with you right now is very high," Englert says. "We use a HIPAA compliant program. It's just like if you're going to start an appointment anywhere else for the first time. When you go back to the doctor after filling out that first little bit of information, you just pop [online]. A lot of people like it. I'll be interested to see who wants to stick with this even when we can meet in person again."
"There are people available to connect with even if you live alone, even if you are not sure of how to connect or you're feeling lonely. There are different things out there that you can connect with in the community. If you need help with that, reach out to a neighbor. We're here. There are a lot of other professionals that are also available in a lot of different ways -- whether that's to take care of your physical...spiritual...emotional or mental health."
"I know if you don't know where to get started, there are a lot of resources that are open and available. Just call one of them and say, 'I don't know where to get started, can someone help me?' Just reach out," Englert concludes.
"The big concern that comes to my mind is the idea that exercise is self-induced stress," says Eric Romanak, fitness coach, martial arts instructor, owner of Paducah, KY's SEVA Fitness Academy, and author of Live Better, Die Slower. "When we're trying to have a real strong immune system response, the way we handle exercise needs to be very, very careful. You have to think of it more like a drip than a dump."
"When we exercise too hard, we kind of become a pathogen window until we recover," Romanak explains. "For a lot of people who maybe haven't exercised a lot in their lives, or it's been a long time, their heart rate can spike really, really quick. They can deplete some resources very quickly. If we can't replenish them, they become immunocompromised, which is a great concern right now. We want to start building the immune system as opposed to breaking it down. Exercise right now is a really great thing, but it just needs to be done intelligently. For those who haven't done exercise before, a little bit goes a long way. I think walking with an elevated heart rate is one of the best things that we can be doing."
As a practical at-home exercise tip, Romanak encourages individuals to "make sure that your breath is dictating your effort. We have this primal response to hold our breath in grip under a stressful situation. The thing about that is it's a great survival mechanism short term. But when you're talking about health, we have to look a little bit down the road. Make sure you're exhaling very deliberately. If they're exhaling deliberately, they're controlling their nervous system a little more positively. They're keeping their brain involved."
Romanak also suggests that on top of getting plenty of sleep and regularly drinking water, individuals avoid simple sugars, carbohydrates, and vegetable oils. "That's about the worst thing you can put in your body when you're trying to fight off illness because it creates inflammation. All disease kind of breeds in inflammation. The exercise component is definitely up there, but it's not as definitively important as sleep and what you're putting in your body."
"We, as a culture, need to...adjust some of our behaviors. Preparing for the worst and hoping for the best in our lives. Disruption will happen in our lives, but it's not such a big kick in the face -- especially when it comes to health. An ounce of prevention is worth a pound of cure," Romanak concludes.
"Of course, one of the things that seems to be at the top of everyone's mind is 'when is this going to be over?' How much longer are we going to have to be in like this?' Another thing that people are saying is they're 'running out of things to do.' I try to help people reach into themselves and use their own creativity," Dr. Laurie Ballew, certified holistic psychiatrist and president of Paducah's Temple Isreal, begins.
"People aren't aware of how creative they can really be. Now is a time that we can be our most creative. There aren't people around to scrutinize us or find faults in our ideas that we're coming up with. So some of those ideas that people are coming up with, I tell people to go ahead and see what you can do in your own home or your own backyard to bring these ideas to fruition. I'm encouraging people to dig deep into themselves and use their own creativity as a means of comfort and a way to keep them busy and give them something to do. A project."
Ballew encourages using nature as a means of connecting to one's own spirituality and sticking to a healthy diet rich in omega-3 fatty acids (a quick, healthy snack with these mood-boosting nutrients: pecans, walnuts, almonds, and dark chocolate chips). She also recommends moving to boost endorphins. While many people associate endorphins with running, Ballew suggests something a little more wiggly.
"Get out there in the yard and turn on the radio to some music you like, even in your living room. If you have kids, get the kids out there with you. Your wife or your husband or your partner and dance! Do this for 15-20 minutes 3-4 times a week. You increase your endorphins in your brain. You've also improved muscle tone. There are so many things that we as humans can do to pass the time that are healthy and that will help our mood, body, and spirit."
The coronavirus required followers of all faiths to stay inside during a busy religious season. While this separation has been difficult for church families across the country, Ballew implores people to remain strong.
"[Not meeting] is a little bit of loss," Ballew says, "But what we've gained? We've stayed healthy. We've not gotten this horrible illness. It's helped us realize that we can have a togetherness in a different way and that God will still protect us and get us through it. God is also allowing us to use our intelligence and ingenuity and creativity to make a way for us to still be together. Twenty years ago, we wouldn't have been able to do this."
"I've had people say to me, they're so tired of being cooped up, and you know what comes to mind for me? April the 21st is Holocaust Remembrance Day in the United States. Usually, in Temple Israel, we have an interfaith service to remember the victims of the Holocaust. One thing that this brings to my mind is Anne Frank. She lived in 450 square feet for 762 days. She was not able to go outside...to see other people other than her immediate family...and she survived that time before she was turned in by a neighbor, taken to a concentration camp, and killed. But she and her family survived for 762 days in 450 square feet. If she can do that, surely we can do this."
"My recommendation for people is to live each day one day at a time. We, as humans, want to plan ahead. It's human nature. But all we have is today. So let's enjoy today. Let's not worry the day away because then we've lost it. Sure there may be hardships, but reach down into yourself for that little bit of sustenance that you can give yourself and make it through today. And then, you can make it through tomorrow," Ballew concludes.