Transcription:
Mental Health Check-in: One Year Into The Coronavirus Pandemic

Prakash Chandran (Host): On March 11th, 2020, the World Health Organization declared the novel coronavirus, COVID-19, a global pandemic. For more than a year now, we have endured the strains of this highly transmittable virus, from social distancing to virtual learning, to working from home to zoom family holidays. There is no fraction of our life that hasn't been changed forever.

We're going to discuss it today with Dr. Charles Luther, Chair and Medical Director of Psychiatry at Southwest General Health Center. This is Southwest General Health Talk. My name is Prakash Chandran. So Dr. Luther, it's great to have you here today. You know, I just wanted to start with a high-level question around what are some of the mental health challenges that you've seen occur during this past year, during the pandemic?

Charles Luther, MD (Guest): Oh, great. Thanks. Thanks for having me on the talk today. It's been year that's required a lot of flexibility and digging deep for everyone in our nation and worldwide. The pandemic I think has affected different groups differently. Some individuals have found new connections and new resilience and ways of rising up to meet the demands, whether those people are healthcare providers or patients meeting the needs of their neighbors or loved ones.

Others have faced much greater challenges in terms of the isolation, the quarantining and seeing loved ones impacted by the virus and even the morbidity and mortality has led to an impact on depression and anxiety. I've seen anecdotally an increased reliance on alcohol and other drugs, and there's some evidence in the literature that our rates of alcohol use are on the rise.

And I've seen that in patient population. What I've seen amongst healthcare providers, whether they're people working in intensive care units or mental health counselors is that, you know, we continue to meet the needs of our patients in the hospital. We're a hospital setting. So, we're open 24/7, 365. So, we can't move everything to Telehealth. But for some patients, they really benefited from Telehealth interventions delivered by mental health professionals. And we sped up the rate at which we adopted that technology and we had great success with that for a select group of our patients.

The other thing I would say is that the pandemic increased the impact of some of the social determinants of health. So, people that had difficulty accessing healthcare prior, or more isolation from family and friends, or those people in institutional settings or communities of color; some of the adverse consequences of the pandemic effected their mental health more adversely than other groups. And it's something we've seen clinically.

Host: Absolutely. And just anecdotally in my own life, I have so many friends that just have suffered through this pandemic, you know, just being isolated, not going or really breaking out of the routines that they were used to. And especially the people that were already suffering with some mental health or depression, this has really taken a toll on them. So, you know, just thinking about this, you can see that this pandemic has just taken this overwhelming toll on our society. So, how do we even begin to start to address this?

Dr. Luther: Well, I think from a mental health perspective, it's afforded an opportunity for some, not all, to take stock of what was important in their life before and during the pandemic and then going forward. So, things like relationships, hobbies, just healthy living. So, the importance of sleep or avoiding excessive alcohol intake or just focusing on things such as meditation or whatever that may be; it's given people an opportunity to revisit that, and restructure how their life is. For others who have more difficulty accessing some of those things, their outcomes can be worse. Especially if they're isolated or their relationships are strained or they're in an area of the country that's, may have difficulty accessing healthy foods or the work schedules changed to such a degree that they're working excessive hours or they're not working enough and they're too isolated. The pandemic has affected this broad swath in, in widely different ways, depending on your functioning prior to the pandemic, and also some of the social determinants of health that I described earlier.

Host: Yeah. And another thing to take note of is that this pandemic, and to some degree, the mental health issues that come along with it has been in the media and the media cycles quite a bit over the past year. And I'm sure that has contributed to a lot of people just feeling a little bit stressed out.

Dr. Luther: There's been a lot of media coverage of how the pandemic affects mental health. And some of it, frankly, from my perspective, seems a little bit like the sky is falling. There are some reasons for hope. Interestingly, in the year 2020, suicides fell in the United States by roughly 5.6%, according to national statistics from the National Center for Health Statistics and the Centers for Disease Control and Prevention.

So, that's contrary to what we might've mentioned dissipated, that the stress would have led to an increased suicide rate. It actually fell in 2020. There is reason for hope and it's something to monitor because the after effects of the pandemic can persist for a long time.

Host: So, speaking about some of those after effects, you know, for the people that have been struggling with mental health issues over the past year, what does the post pandemic world look like for them as things slowly start to open up?

Dr. Luther: Well, that, that's a huge question. I think, and this is my opinion, having gone through it myself and other people I've spoken to, but I think hopefully best case scenario, the pandemic has allowed some increased resilience as we come together as a community and hopefully will allow us to think of how we're all interconnected and we need to rely upon each other and account for one another and bring us just closer. That sort of cohesiveness will help us all move through this difficult time. I think that new found resilience will help us make better choices as a society and as human beings living together. And I think that would be the best possible outcome, or one of the best possible outcomes.

I think popular press notions that people have anxiety about reopening, that some of the isolation and some of the staying closer to home so to speak, less travel, less work travel. Some people got really comfortable with that, and enjoyed it. And the notion of reopening and going back to life as it was pre 2020 is anxiety provoking. And I think, you know, as we see what tomorrow brings and what next month brings and what next year brings, to sort of focus on, you mentioned the word gratitude or being grateful for what we have and focusing on those more positive emotions, that can help a lot and actually making a conscious choice to focus on positive emotions can help us maintain our mental health along with things that I'm sure everyone hears.

You know, things like healthy living, like regular sleep schedules you know, some modicum of exercise in your life and a healthy diet that goes a long way to maintaining mental health along with close connections with other people.

Host: Yeah. You know, I think you touched on maybe a demographic of people I wanted to narrow in on a little bit more. There are people that might have some anxiety around things opening up again, and they've lived a largely siloed life for the past year. So, as things start to open up, what recommendations might you have for them to reintegrate themselves and return to some semblance of normalcy?

Dr. Luther: Anxiety, is part of life. And I don't say that to minimize the experience of it. It can be very debilitating for some people. But some degrees of anxiety help us motivate and organize on how to deal with a stressful upcoming moment. And some of the things I already mentioned can help minimize that anxiety. But preparing for it and embracing the feeling and thinking positively about it, whether it's gratitude or humility or things like abdominal breathing you know, that can help move forward through that difficult challenge.

But for others, the anxiety is severe and can be debilitating. And that may necessitate seeking some professional help, whether it's through a counselor or a therapist or even some medication help for that, you know, depending on, I imagine there's a large area that this podcast might cover, but you might want to go to the SAMHSA website, S-A-M-H-S-A.gov. And there's a treatment locator there that can help people locate professional help in their area.

Host: Yeah, that's a great resource. And I'll also make sure to include it at the end of the show. I wanted to move on to how people can take care of themselves. You mentioned a healthy diet and a consistent sleep schedule. Are there any other self-care tips that you would recommend for people as they move into this post pandemic world?

Dr. Luther: So, I think for everyone it can be unique and individual. Some people really enjoy writing down their thoughts and feelings. You know, we'd call it journaling. You know, walks in nature, everything from yoga to running and you know, maintaining a healthy diet, avoiding processed food. Those things can all help, but also just taking time to reward yourself in I guess, a healthy way would be good to be positive and actively focus on positive emotions. I think that can go a long way. And I don't mean to say that these things are easy for everyone. You know, some of these things require access and the opportunity to be able to take the time to do some of these things.

And that's why we see the pandemic and stress impacting different groups of the population differently. I think because of the evidence that alcohol use is on the rise, I think it's really important to monitor your alcohol use and make sure that's within safe guidelines. And again if you think that's getting out of hand there's a venue to seek help for that. And not just alcohol, but other drugs as well. We are seeing that particularly people with problems with substance use prior to the pandemic may have had increasing difficulties during the pandemic either because of the stress of the pandemic triggered a relapse or increasing use, or because accessing mutual self-help groups to maintain recovery was more difficult during the pandemic.

So those are all important things. I really can't emphasize sleep enough. Sleep is a way for your brain to make sense of your day, lay down memories, maintain brain health and you know, maintaining some people need seven hours. Some people need nine hours, we'll just call it eight. You know, maintaining that regular schedule can go a long way to maintaining mental health.

Host: Yeah, that definitely makes a lot of sense. So, just before we close here today, Dr. Luther, is there anything else that you'd like to share with our audience just regarding taking care of themselves from a mental health perspective?

Dr. Luther: I think I'm echoing what I said previously. The virus has reminded us that we're all humans on this planet together and we count on one another and we're in this together. And we're all we've got. So it's, really important to think of our, our fellow human being in terms of our daily actions and not just in terms of, did I get a vaccine or not, but also am I looking out for my neighbor and my loved ones and even other people that might be more farther afield. I think that's one hope I have that comes out of this pandemic and that even with the stress of the pandemic, stress can bring resilience. And I don't mean to say that's easy for that to happen, but the stress of this pandemic can hopefully help us find strengths we didn't know that we had. So that's a hope that I have.

Host: Well, Dr. Luther, I really appreciate your time today. Thank you so much for talking with us today.

Dr. Luther: Oh, it's my pleasure. And thanks for having me on.

Host: That's Dr. Charles Luther, Chair and Medical Director of Psychiatry at Southwest General Health Center. To learn more about Southwest General's Oak View Behavioral Health Services, call 440-816-8200. Or visit swgeneral.com. You can also visit S-A-M-H-S-A.gov for additional mental health resources, as Dr. Luther mentioned. We hope that you found this podcast to be helpful. Please share it on your social channels and check out our full podcast library for topics of interest to you. Thanks so much again, and we'll talk next time.