By: Kurt LaRose, MSW LCSW LICSW
A bit of research first …
COVID is affecting the globe. And while there are not allot of studies yet on the impact, recently the folks from “sleep cycle” completed some research that is worth repeating. The company, along with post doctoral Brigham and Harvard University researcher(s), gathered data from an app that was used by nearly 70,000 participants, covering over 30 million nights of “sleep.” The study, besides being a data aggregate from a digital application, looked at sleep and how COVID is a player, plus the connections to mental health. Sleep disturbance was determined, in part through latency tracking. The app generated data included survey responses from study participants (meaning both digital data and human input were a part of the collected data). This research revealed COVID is/was affecting a good number of people (particularly younger folks) in surprising ways. Depression, stress, isolation, loneliness and sleep disruptions were apparent. The article is easy to read, includes nice graphics, and highlights some solutions to feel better – with practical steps that are relatively easy to implement. Technology, connected to people, digitally harvested data with survey responses, a private company and researchers in unison, with ideas to improve – during unprecedented times – makes this research worth a read!
My take in behavioral health…
To give you some ideas from a behavioral health perspective (that’s my business) about what can be done to deal with COVID limiting factors in day to day living — I’ve put together a “treatment plan” to give you some pointers. I also include information about when other professionals* should be involved … so read on!
Interventions and a plan to feel better
Relieve the stress, improve the mood, decrease the anxiety and tackle the loneliness …
- Increase trust and care events and decrease doubt and fear events
- Activate/alter testosterone (confidence)
- Decrease/alter cortisol (doubt)
- Activate/alter oxytocin (trust/care)
- Stress Alterations: healthy vs unhealthy stress
- How inflammation impacts mood and anxiety
- Long-term stress and how it can show up
- Healthy stress?
- Rest and exertion
- Elective stress: good news, bad news, “drama”
- Sleep Hygiene
- When it works – duplicate.
- When it doesn’t – alter it.
- If everything fails consider MD* (additional testing possibly)
- Activate/alter tryptophan
- Activate/alter melatonin
- Nutrition Hygiene
- Consult the MD*
- Slower changes allow enzymes to re-align
- Rapid changes in short term vs long term outcomes
- The “healthiest diet” on the planet look like
- Bio/Body Hygiene
- Consult the MD*
- Sunlight (part of sleep hygiene as well)
- Exertion (“sedentary” vs. “extreme”)
- Activate/alter serotonin
- Mind (thinking) Hygiene (see exercises below as a part of this)
- “Do” thinking vs “Don’t” thinking: practice
- Elective stress: good news, bad news, drama
- Mindfulness / Meditation / Prayer
- Prospecting: negative, positive and compare
- Look for thoughts you can change and look for processes you cannot change.
- Change THOUGHTS you CAN change and include PROCESSES you CANNOT change
- Brain (organ care) Hygiene
- Digital Technology
- Blue Light Exposure
- Telomeres and humor
- Fats that help the brain vs fats that don’t
- Self care and Others care
- Self care first
- Other care second (and repeat)
- Scheduled vs fitting it in
- Preexisting health conditions
- Physical conditions* = MD consultation and coordination
- Mental health conditions* = MD / other consultation and coordination
- Stress impact and what to expect.
- When trauma interferes
- How trauma “interference” might be identified
- How/when to counter trauma interference vs. “just going with it”
- When trauma (PTSD) treatment becomes primary
- The simple things
- Good ole’ fashioned rules that have been around for years:
- Cover your mouth, wash your hands, stay home if sick, let others know
- Do not “share everything” – do not share anything – while sick
- And … do what you can in play, work, sleep, family, love, nutrition (kind of like this video suggests)
*Before you engage in a physical activity and/or nutritional changes you should consult with your medical doctor first. Over the counter medicines, prescription medications, nutritional supplements and vitamins are all factors that should be considered before you elect to alter exercise and diet. Because your medical doctor is most suited to be aware of your overall health, medications, supplements and the like, s/he can talk with you about what (or if) needs to / can be changed.
This “treatment plan” is provided for information only. It is not a treatment plan for you as these should be developed between you and your provider. Treatment planning should be done with a licensed provider, using clinical assessments, interviews and in many cases, coordination of care, tailored to your particular situation and your particular needs. It is not recommended to begin a treatment plan on your own, especially one posted on a commercially driven website (like this one). It is recommended that you first consult the appropriately trained and licensed provider (beginning with your MD).
Can I do something without scheduling?
Sure … here are few tricks to try and to get you started. If you have some trouble with these, just let me know. Here are a few things to consider, and then something you can practice now. Here, you’ll be using thoughts while considering processes, and likely walk away with a useful little tool to feel a little better (even a little might help).
One of my podcasts about preparing for a pandemic …
First, it will help to understand the stress response …
The ACE effect: Adrenaline, cortisol and epinephrine. These guys, stress response hormones, are the biological displays for actual fight and flight. Fight and flight responses make sense in life threatening scenarios. However, perceptions can also activate the ACE safety related hormones. And this is exactly one of the problems facing many people, during pandemics. Because of the many “what if’s, as one example, where matters of life are in flux and a bit difficult to predict – people are generally afraid of what they do not know, and what they cannot control. Here, it is helpful to consider that thoughts can activate the ACE effect – and therefore – thoughts can help deactivate it too! Thinking is powerful.
What cannot be changed ….
In actual safety thinking is not too significant. Why? When imminent and immediate threats exist, it is then that the brain wonderfully takes over and ACE goes about making you safe! In fact in actual safety risks, ACE can literally interrupt logical thinking processes so that the body is ready for what it needs to do to live (there’s little time for logical processes in getting safe – now). So the fight/flight response is a function of literal safety – and as such that process cannot be changed. Not all is lost however; when safety is NOT imminently at risk it is possible to reduce the impact of ACE (and maybe even interrupt it entirely).
What can be changed …
If a person is thinking about worse case scenarios (mild, moderate or severe) and imminent safety risks are not present, it is possible that a milder form of ACE will occur. Here you might consider that there could be a heightened stress response, greater than the immediate situation warrants. This stress response can cause havoc on the body, especially if it is an elongated one, such as what can happen with a person who is trying to avoid a pandemic-like virus (and who might be ordered by some mandates to stay home, wear a mask, quarantine, “get tested”, etc. etc. etc.). Thinking differently is one part of what can be changed!
So, what about those perceptions that might be activating stress hormones? Read on ….
First understand how it works. Many times people think about why it is that something should or should not be happening – as a way of finding a way to stop it or prevent it. The challenge is, when a troubling event is happening to look at why will not alter it (and it might add to the stress response). While this way of thinking (why this / that occurs) makes sense, it creates internal escalation. Why helps most in future prevention. How is most helpful in past and current intervention.
Should and shouldn’t thinking can create a bind. “It shouldn’t be” becomes wedged by “it actually is, however.” Thinking about what is wrong and why something is working incorrectly (or even by thinking whose fault it is that you/I/we are in this predicament) may serve to unintentionally activate a stress response. If that stress response is channeled into something productive, then it’s possible that it can be converted to “healthy stress.” I’m asking the reader to consider the impact of looking more at how something works, instead of why it is wrong or messed up. This is a small shift in focus….to move from the why to the how.
Most people struggle with “healthy stress” and healthy stress responses. Particularly when the body escalates and this is not wanted, liked, or preferred (or if it cannot be channeled to some healthy actions). Some people are actively in a stress response state, and have been for operating that way for so long they are (or can be) unaware of it! They’re tired; they’re anxious; they cannot sleep, etc. etc.
So, looking at HOW the stress system works is helpful in improving your thoughts about it. No longer is it a bad thing (or a good thing even), but the thought about how is a way of seeing that – a response to a situation is what the brain and body do – as a process. It is like understanding that the gears of an engine or the mechanism of a clock work as they do; cogs and clicks and clacks are understandable in the way they go about (and if something is amiss, it is still helpful to look at how – to find what can be changed). Again, it helps to understand how the clicks and clacks and cogs work to some outcome (and to see what can be changed or improved otherwise).
So, now let’s look at how stress works in the brain and the body…
How stress works in the brain and the body
Here’s a short video that looks at stress and anxiety in the body. It is from an article I wrote a number of years ago. Give it a watch while staying on this page.
A hit to the immune system …
ACE impacts the immune system negatively. The immune system needs all the gas it can possibly muster, particularly when a virus is floating around. The immune system is ‘less necessary’ in actual fight/flight however. Again, that ACE impact is going to need to get reduced a bit – in the way it can – just for the boost to immunity! The immune system is weakened during ACE so that all energies and forces of the body are engaged in staying alive. So if death is imminent that’s a good thing. Staying in this ACE effect state otherwise, has to be changed – even if only a bit. ACE is not needed right now (for most people) – even in a pandemic.
A podcast … about wearing masks as a political statement….really? It could be about – well – masks.
Creating care for brain and body is a start
Next, let’s look at how CARE works. Care is about finding a way of judging yourself and your body in an evolutionary and beneficial way. What is an evolutionary and beneficial way?
Your brain (as an organ that operates automatically) and your body (doing what it does too) are simply doing what they do, no matter what is happening around you. And this automatic process occurs, whether you want it to or not – for benefit. Why else would the brain and body be doing automatic stuff? You see, here in this way of thinking, that scientifically the process of brain and body can ONLY do so for benefit – period. It would be a consideration that evolution is about future propensity and longevity!
Evolutionary benefit is true if you were going for a jog and your body told you somehow “hey, that’s enough for now” in all of the painful ways it might say so (leg aches, muscle weakness, breathing challenges, etc). Body is saying “hey, take break already!” Like it or not, that’s probably a good thing. Besides, how many times have you heard your doctor say: “listen to your body and don’t push it. You’ll get there.”
What about dealing with illnesses or risks of illnesses?
Evolutionary benefit is true even if you are/were dealing with a severe illness. The brain and the body are going about the business of making things work as good as possible. Maybe in the case of illness, evolutionary benefit could be like this: “Hey you! We’re going to get this going really really really fast here so it will end soon or so it will work as good as it can!”
The point is your brain (the organ) and your body both automatically do what they do for your evolutionary benefit. You can see that, and value it (care) or you can see that and put it down (not care or care negatively). If you think (using your mind – this is not the organ – it is the thoughts as one small part of what the organ does) that your body is messing up by doing what it is doing, denying its processes as helpful (even if disliked) you will inadvertently increase the ACE response. So caring about the body’s automatic processes as helpful – can help you! As in, if you think of your body as trying to always do what it does for some kind of help – you can CARE about what all of your body processes are telling you, and this thinking then will reduce likely reduce the ACE response.
Let’s practice negative thoughts about body vs. caring thoughts about body ….
Try it. Let’s try telling ourselves two different narratives – judgments about self – and see what happens as the body goes about its business. So, let’s get started. Tell yourself these things and then pay attention for a moment. When the first scenario is done, then we’ll do another.
- Think about the bad things happening around you. Think about your job, your money, being home more, not eating out or seeing friends, wearing masks (or arguing over wearing masks), possibly getting the virus or having it again. As you think this way (re-read that list) notice your body. It is jumpier or tighter (it COULD be almost numb here; if so then you may need to talk with a professional as there may be some traumatic influences that inhibit this exercise. You can look it up online too though – it’s basically a part of what is called the PolyVagal theory and it is often born out of past trauma). So, unless you are numbing out as you do this exercise, you should be experiencing increases in jumpy or tight. Now as you do experience this, let’s start thinking that it is bad, that it should not be happening, that something is wrong. And that jumpy or tight thing will get even worse.
Okay, now stop. Stop? Yes. Just like a person driving a car puts on the brakes at a stop light, put your foot on the brakes of the earlier thoughts and feelings. We’re going to go somewhere else in just a second (right after the light changes). You see, even here “stop” is not quitting something, it is actions that hold something in place … the foot on the brake is metaphoric then for taking action to pause the earlier activated thoughts.
Now, let’s get onto sequence number two.
- Think about the bad things happening around you. Think about your job, your money, being home more, not eating our or seeing friends, wearing masks (or arguing about wearing masks), possibly getting the virus or having it again. As you think this way (re-read that list) notice your body. It is jumpier or tighter. If not, see the polyvagal information above and consider reaching out to someone to move through this part so that the exercise works better (nothing is wrong really, it’s just that brain is kind of stuck in a trauma mode and it might need a bit of nudge to get back on with the exercise is all). Now, as you experience this jumpier or tighter stuff in your body, while thinking about all the COVID relate stuff happening, let’s start thinking that everything going on in your body is working just as it is supposed to do. The jumpy and tight is about a message in the body that is helpful. It’s working exactly! How do I know? Well, I’m feeling it in my body. Now let’s think that body does all of this stuff to help me, so that I can do well. Then let’s think how cool it is (because it is cool actually, this is not a reframe – it’s an understanding of science and appreciation for how the brain and body work) that brain and body do this automatically all of the time, whether we want it to or not! Now let’s just appreciate, for a moment, how body and brain do this for benefit. And here a bit of care will appear — and guess what – that jumpy and tight will have softened just a bit.
Looking over what just happened…
Vignette one is about how people might think and feel. If people judge thoughts and the feelings as bad – the ACE effect increases. In vignette two, looking at the SAME situation, the brain and body were judged differently – as if they work for good in benefit. From here, this different way of thinking activated bit of appreciation for automated help and then a calmer sense begins, and a person feels a bit better!
Was that a re-frame?
No, it was not. You don’t need someone to come up to you and say “hey, just think positive and everything will be alright.” That’s well intention-ed, but the fact is some pretty difficult stuff is going on. We’re not looking at the situation as having a silver lining. We’re not finding the parts of the yucky stuff in the air and then finding the good in it (what’s good about COVID?). In fact, we’re not re-framing the view of the situation at all. What you and I just practiced (which can work better with verbal coaching) was a way of seeing the brain and the body working (during a difficult situation) for our own good. We took a more scientific view of what our systems do (and/or can do differently). And when we did, assuming this exercise worked (and if not, there is a reason it didn’t) by seeing our brain and body as helpers, care appears – and a more calm state of being does too (ACE is reduced).
Besides, there is nothing here meaning to imply that changing thoughts about processes is all that you or I need to do. This thinking exercise is/was one part of a plan to deal with pandemic impacts. And it is offered as a way to ease things, just a bit!
The simple things…
If you haven’t already seen this video, one I created for a social media post early on when COVID-19 started to his the US in big ways … it might be worth watching. Sometimes the simplest of things can have the biggest effect!
A few small things that will make a big difference …
Wanna learn about the ways you can deal with the impact of the pandemic on your mental health? Reach out to me and we can over the ways the plan above might work for you.
Page Hx: 9/1/20, 9/2/20, 9/21/20; 9/29/20