Transcription:
Maintaining Mental Health During a Crisis

Prakash Chandran (Host):  Fear and stress may be increasing in the lives of many as the global pandemic continues through the season. It’s important during this time, to take action to reduce your stress and anxiety levels to prevent mental or chronic health problems. We’re going to talk about it today with Dr. Puru Thapa, Director of Student, Resident and Faculty Wellness and Professor of Psychiatry at the University of Arkansas for Medical Sciences.

This is UAMS Health Talk, the podcast from the University of Arkansas for Medical Sciences. I’m Prakash Chandran. So, Dr. Thapa, really good to have you here today. I want to start with what are the most common cases of mental health during a crisis like the one we’re in right now?

Purushottam Thapa, MD (Guest):  The most common mental health issues are primarily feeling of overwhelming stress but also severe anxiety as well as depression.

Host:  Yeah, that completely makes sense because we are living in this world that is kind of isolating. We can’t do the same things that we used to do. So, I imagine, that a lot of pre-existing conditions that you’d seen before have just been exacerbated. Is that true?

Dr. Thapa:  Yes. It has. The challenge has been that we are faced with an unprecedented situation, a pandemic for which we don’t have a clear ending how it is going to end if you will. And it has raised an incredible amount of uncertainty. Most of us want to have a good sense of control over what’s going to happen tomorrow, how we can plan and like in our institution, with all our students, residents, because of the disruption of classes and board exams, it’s really thrown everybody into a state of disequilibrium if you will. And what compounds that is we’re not quite sure how it’s going to end if you will right now.

And so, in the face of uncertainty, what happens is we react to it with a lot of stress and our brain is programed that way. A lot of stress and the stress results in us being overactivated and that will result into more anxiety, feeling overwhelmed, more depressive symptoms and because part of dealing with the pandemic has been to be socially distant which is not the same as being socially isolated. But what that has resulted in is people feeling like they’ve lost their normal way of life if you will and needless to say, this has generated all kinds of mental health issues.

Host:  Absolutely. You mentioned some of the symptoms as you just gave your explanation; for some one that might not necessarily know that they are feeling anxiety or some of the things that you mentioned, what are some of the symptoms that they might experience when they are going through this?

Dr. Thapa:  If they find that they are feeling like they’re constantly on edge, in a sense, tenseness, feeling restless, they find unable to focus or concentrate on things, noticing that they are a little more irritable than usual and at times when they are trying to sleep, they find that they’re having difficulty initiating sleep, falling asleep. So these are some signs and symptoms when you are feeling anxious.

Host:  So, if someone is feeling this way, what are for example, three things that you might tell someone that could improve their mood or their state to decrease anxiety?

Dr. Thapa:  The first thing is to – what I’ve been doing actually is reassuring them that what they are experiencing in this unprecedented time is normal. The fact that we’re feeling anxious, we’re worried, we don’t know what’s going to happen, is normal because that’s how our brain is programmed from an evolutionary perspective. And so, what I tend to do is try to normalize that look this is normal. However, if you dwell on it too much, if you focus on it too much it’s not really helpful.

So, then the next thing that I encourage them to do is to say look, this is how you are feeling so instead of focusing on things that you cannot control, which is we cannot control our mind and thoughts so I would encourage them to focus on the things that they can control. We can control our activity. We can control our – we control our actions and our behavior. So, when you find yourself feeling anxious or restless, then do something physical. Come into your body. There are different techniques like mindfulness techniques where you focus on your breathing, awareness of your breathing for it to be here and now. Or go for a run or do something physically so that you’re not focusing on what your mind is trying to do.

Another thing that I encourage them to do is focusing on self-care. Which means making sure they get adequate rest, adequate movement. When I say movement, physical activity, exercise can be yoga, if it’s too hot to go outside or watching a show, something that relaxes them or listening to music. Because these little things all add up together to take away that sense of anxiety and restlessness.

Host:  Yeah, that’s really good advice. I am curious about some of the other symptoms that one might experience if they are suffering from anxiety or depression. I’m actually interested in the physical symptoms that one might experience. Can you talk a little bit about this?

Dr. Thapa:  Sure. For depression, you find that your mood is down, you feel more depressed, you feel more hopeless about the future, you feel tired. You feel unmotivated. You don’t want to do anything and if that gets really bad, you may actually reach a point where you don’t want to live anymore. And that can be very, very scary. Now, when anxiety gets bad, what happens is you find yourself in a sense of vague kind of intense fear, your heart is pounding, and you can feel like your mind is zoning out. There is a sense of doom and kind of feeling sweaty. And it’s an incredibly scary kind of a feeling when you get pretty severe anxiety attacks. If that is really severe, we call them panic attacks so you can have that too.

Host:  And how do you point patients to the fact that that feeling might be caused by their stress?

Dr. Thapa:  Usually when we sit down and talk with them, we talk about what’s going on in their life, what are the stressors, what do you think is happening. And usually again, given the unprecedented nature of this – of the times, the pandemic, the impact it has had on their schooling for our students, or for their families who have lost their jobs. So, we know that stress, right, when you have stress at these levels then our bodies, our system, our coping abilities cannot handle that and that’s where we end up with a full manifestation of depressive disorder or an anxiety disorder.

Host:  Yeah and one of the things I want to note is that there are people out there that struggle with depression and anxiety under normal times and normal conditions. So, I imagine one of the things that you’re seeing is that those people this affects in a much stronger way wouldn’t you say?

Dr. Thapa:  Absolutely. And in fact, I can tell you from personal experience that many of our existing clients, students, residents and faculty were already dealing with depressive disorders or anxiety disorders with all this added stress again, especially the uncertainty of what has exacerbated some of their symptoms. Now with many of them, just being able to talk and process and then being able to refocus on taking care of themselves; it’s sufficient. But for some, we have to adjust their medications to help them. In addition to of course, encouraging them to continuing to maintain self-care.

Host:  So, just in closing here, we’ve talked about a number of things that people can do. We talked about self-care, making sure to control the things that are in your scope of control, potentially reaching out to talk to someone; what’s some final advice that you might give to a distressed individual or their loved ones just as we wrap up here?

Dr. Thapa:  Basically follow the points that I mentioned before. But what I would really, really emphasize is if you feel yourself or loved ones are at a state where you are just overwhelmed and can’t cope with it, then please seek help. Seek out – reach out to a therapist to be able to process and develop better coping skills to deal with this or reach out to a psychiatrist who can help with some medications. The key is to reach out for professional help.

Host:  Well Dr. Thapa, I truly appreciate it. One of the things that really resonated with me is that this, the feelings that you might be feeling are normal especially during a time like this. So, it’s very important to reach out to those that care about you or those that might help you to get through this hump. Because there’s no reason why you have to go through it alone. So, thank you so much for your time. That’s Dr. Puru Thapa, Director of Student, Resident and Faculty Wellness and Professor of Psychiatry at the University of Arkansas for Medical Sciences. Thanks for checking out this episode of UAMS Health Talk. For more information on this topic and to access the resources mentioned visit www.uamshealth.com. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.