Transcription:
Dealing with Stress During a Pandemic

This UAMS Health Talk COVID-19 podcast was recorded on September 17^th, 2020.

Prakash Chandran (Host):  In the midst of a global pandemic, added stress is something many people are struggling with. Learning to cope with this additional stress, is important for both a healthy life and mind before it leads to some more longer term problems. We’re going to talk about it today with Dr. Sacha McBain, an Associate Director for the Center for Trauma Prevention, Recovery and Innovation and Assistant Professor in the Departments of Psychiatry and Surgery 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, first of all, it’s great to have you here Dr. McBain. Who exactly are the people suffering the most as a result of the COVID-19 pandemic?

Sacha McBain, PhD (Guest):  I think when we think about who is suffering the most, we have to really think intersectionally about the impact of COVID.  Because even though we are all exposed to this same stressor, our collection of identities like our age, our gender, our race, ethnicity, economic background or our health status really influences how we are impacted by COVID and its consequences. So, I think we’ve seen a lot in the media and public awareness about how COVID has disproportionally impacted people of color especially Black Americans and how that’s been compounded with other collective experiences of racial trauma as a result of the deaths of George Floyd and Breonna Taylor and many more and the protests that have come as a result of that.

So, I think that there has definitely been a compounded stress for Black Americans and other people of color. I think especially relevant in this last month is thinking about teachers and students as we think about schools reopening and, in some cases, closing again. So, there’s this kind of uncertainty about what it means to go back to school and teachers and school personnel and kids are trying to navigate all of this. And then we think about our healthcare workers who are still experiencing significant stress. So, I don’t know if there’s a most, but these different groups are experiencing COVID through these factions and lenses that are making it difficult and are compounded by other parts of their experience.

Host:  Absolutely. And I really appreciate that you just mentioned so many different groups that are going through this because especially me as a father, it feels like my wife is going through her own challenges as she normally had the schedule with mom groups and play dates that’s been taken away from her, my child not being able to do the same things that she was once able to do with her friends and that’s such an important part to her life and then compounded on top of all of that, it just seemed like anything that was there before, in terms of behavioral health potentially, has now been exacerbated and amplified, wouldn’t you say?

Dr. McBain:  Yes. Absolutely and I think you bring up a really good point that even within the same family, people are experiencing COVID very differently. So, how do we come together and support each other in our own home, let alone in our communities or in our country or society?

Host:  Yeah, that’s a great question. I’m curious if you have any best practices or tips that we can use not only at home but just with our friends and family or loved ones. Like how can we start helping those that are struggling with problems related to COVID-19?

Dr. McBain:  Yeah, I think what we know from the literature, so my expertise is in early intervention for post traumatic stress disorder and thinking about how we recover from stress or trauma. And so one of the things that we see in the literature over and over again is one of the strongest protective factors against negative both psychological and physical health outcomes is social support. And so being present with someone who is struggling first and foremost we know is really protective against negative health outcomes.

Obviously how we access social support has really changed. We have to be much more intentional about how we do that. We’re not running into people like out and then scheduling something to do. We have to be really intentional about like a text or a phone call or a Zoom call. And so I think starting with social support first and being present is a way to help people who are struggling.

Host:  Absolutely. I love that you mentioned that and in regards to providing that social support, one of the things that I have found in doing Zoom meetings is sometimes you get this I guess what’s called Zoom fatigue. It’s hard to connect with people in that same authentic way over a screen and so for those people that might be experiencing that, do you have any tips around how they can continue to offer that social support?

Dr. McBain:  Yeah, I think Zoom fatigue is real. And I think we have to get creative about how we reach out to each other. One of the things that I’m appreciating more than ever is a really good friend of mine always send me postcards. And even from home, and so obviously we are not traveling and social distance and like a funny postcard or I had friends who have just dropped food off at the door and they come in, they just kind of drop something off as like a heh, I’m thinking about you. So, I think we can get creative and I think that in times of stress, we sometimes focus on all the detriments of that and of crisis and of these kind of collective traumatic experiences. But people also get really innovative and creative and find other ways to connect and so I think highlighting those pieces of this experience as well is important.

Host:  Absolutely. And I think it’s interesting that we kind of revert back to the way that things were, like dropping food off and sending postcards and even picking up the phone and calling someone for a real conversation. Those are the types of things that feel very authentic in this time and it’s so funny, that’s what we used to do to connect and it’s a good reminder that we can still do those things and try to provide the social support that you’re talking about. I wanted to shift topics here to what people are doing at home to potentially cope with some of this stress. We’ve heard about people potentially consuming more food, alcohol, and drugs to help cope with all of this. What can be done to help them overcome these problems?

Dr. McBain:  I think you’re right that we have seen this general increase in excessive intake or even restrictive behaviors. People not eating, not doing the things that they do, kind of shutting themselves off. And I think that part of that is our general kind of difficulty as a society to sit with ourselves and to kind of know ourselves. Like we really build our lives around being busy or being hyper-productive and we’re generally very external. And so I think in a time like now, when our routines and our world have been so drastically changed, and we don’t have those same stimuli in our life that we’re used to, that keep us busy, keep us distracted; it can feel hard to slow down and to feel all the things that are catching up to us when we have been so busy distracting or avoiding our emotions.

And so think with especially when we’re thinking about alcohol and drug use, it’s really important to think about it on a continuum. Because we know that it can be having a couple more glasses of wine a night or it can be more significant and severe impairing alcohol or drug use. So, when we think about the first way to address that if you notice yourself reaching for more alcohol or a drug or something like that in a way that you haven’t before, you noticed increased use; I think getting used to and learning to sit with that emotional discomfort and trusting yourself that you can handle difficult emotions. I think sometimes with these kind of numbing or distracting behaviors, it’s kind of like a lack of self-trust like I cant handle it, so substances help to numb or avoid those difficult emotions or memories.

And first, being able to tolerate that discomfort in yourself in a safe way, reaching out for that support and then thinking about what purpose are these substances or overeating, what purpose is it serving, and I think sometimes where we get stuck is we say we’ll stop doing that and we don’t acknowledge the use of that like how it’s serving us. It’s distracting us. It’s giving us something to do when we’re bored. And so really looking at the function of your use. What purpose is this serving for me? And then looking and kind of zooming out of what else can I do to serve that same purpose to kind of help make that less of a primary coping strategy and you’re able to bring other things into your life to serve that need.

Host:  I love that framework of thinking about it, definitely acknowledging the why you’re using it in the first place because there is a reason whether that be routine, whether that be to just relieve that stress from a day that you might be having. Being able to acknowledge that and then really think about okay how can I sit with this a little bit more and what it an alternative that I might be able to turn to in order to relieve that stress. I really appreciate thinking about it in that way. There’s going to be people listening to this who are already struggling with a psychiatric condition and we talked earlier about things being magnified. What additional advice might you give to those people that are struggling with something already and they’re having a hard time during COVID?

Dr. McBain:  I think first that I would say that it’s understandable to experience an increase in stress or symptoms during time. And to be realistic with your expectations and to be kind to yourself. To celebrate those small wins. To kind of detach your worth from your productivity or your self-sacrifice. I think that we’re so used to like gritting through things to focusing on the next thing, the better thing and really pushing ourselves and so I think for anybody and especially those who are already experiencing mental health concerns before the pandemic; being able to pace yourself through this is going to be really important for your long term health and wellness. And to continue using the coping skills that you have and also maybe trying some new skills or adapting your usual strategies.

Another thing that we know really helps with our overall mental wellbeing is maintaining or establishing a routine. We know that structure really supports wellness. And this is time where we don’t have routines. We’ve lost a job; you might not even be waking up at the same time every day. And so really building in pieces of structure into your day will be really important to help you feel like you have things to look forward to that you have some structure that you’re moving where you want to go can be a really nice way to do that.

I also want to plug some resources related to if you feel like your coping strategies aren’t working or you need some help to figure out how to cope; UAMS has a lot of resources. So, there’s AR Connect which is a new Tele video service that actually provides free brief mental health services to anyone in the state of Arkansas. This is a really valuable resource and so you can access AR Connect and have free services for a brief amount of time and then if you need more, they can connect you with other resources in your area. And somebody is available 24/7 to answer those calls.

Host:  That’s a fantastic resource. As we close here, I always like to ask if there’s one thing that you could leave our audience with, a piece of advice or just something that you really want our audience to take away from this conversation; what might that be?

Dr. McBain:  I think of Aesop’s fable “The Oak and the Reed” where if you are not familiar with that story, it’s this idea that in a really bad storm, the oak tree that’s really rigid, it can be destroyed in the storm. It can be toppled over with the wind or the water whatever it is. Whereas the reed is flexible, and it moves with the wind and it can survive the storm. And so I think right now, being adaptable in terms of your mental flexibility but also how you are navigating the world can really make a difference and kind of softening your thinking around I’m not doing the best that I need to be doing, I should be doing this, I need to push myself further. That might work in some instances but because we’re surrounded with so many stressors right now, it can actually have more of a harmful impact. So, being a little bit more gentle and flexible with yourself, the people in your life, and how you are navigating this time I think is really the most important thing that we can do and then add all these other skills and resources on top of that.

Host:  Well Dr. McBain, I truly think that is a perfect place to end. Thank you so much for your time and your informative advice today. I truly appreciate it. That’s Dr. Sacha McBain, an Associate Director for the Center For Trauma Prevention Recovery and Innovation and Assistant Professor in the Departments of Psychiatry and Surgery at the University of Arkansas for Medical Sciences. Thanks for checking out this episode of UAMS Health Talk. For more information about this topic visit www.uamshealth.com and to access the AR Connect Service, that’s A-R CONNECT, mentioned by Dr. McBain, please call 800-482-9921. 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.