Transcription:
Maintaining Mental Health in Uncertainty

Caitlin Whyte (Host): Many people are finding themselves mentally exhausted with the current surge in COVID-19 cases and hospitals at capacity. Therapist, Isis Pettway joins us today with some tips on how to stay grounded in the midst of chaos. This is UAMS Health Talk, the podcast by the University of Arkansas for Medical Sciences.

I'm Caitlin Whyte. Now, Isis, a lot of people saw the light at the end of the tunnel as vaccines rolled out and cases went down. But now we're seeing another surge and mental health is being impacted once again. Can you talk about what you're seeing with patients and your community these days?

Isis Pettway, MS, LAC (Guest): Gladly. So absolutely. We, you know, saw the light, we saw the vaccines rolling out, and then we got news of variants and even more of an uptick, even more information, as far as it being more serious than what we had learned and were dealing with a year ago. And so what I am seeing in my patients is frustration. I'm seeing burnout. I'm seeing anxiousness, exhaustion from hopelessness. A lot of worry this time around due to the fact that it's impacting kids. A year ago, we got word that the older community, and then about, I'll say 40, 40, and up, you know, it was looking out for us, but now it's impacting a much younger population and so you have a different level of worry.

I'm also seeing information overload, you know, where do I look? Who do I trust? And so I'm seeing definitely the information overload and then just fear of the unknown. A lot of patients are to an extent, fearful because it's, you know, we don't know what to expect and every day there's news of a, you know, a new variant.

And so those are just some of the symptoms that we are seeing because for a while, you know, we saw them with hope and people were clinging to the want of getting back to what they know is their normal. And what a lot of us are finding out is that we are having to form new normals. And so that means that at times we may be inconveniened. At times we, you know, we have to come to terms with the fact that what we knew as normal has been disrupted. And a lot of times we, we don't, a lot of us don't like change, you know, some of us do, you know, it's like, okay, hey, I have a chance to carve a new path and you know, for a lot of us it's we're navigating uncharted territory, like never before. And so it's scary. It's frustrating, for some it's, you know, it's presenting almost like Star Wars, a New Hope, but you know, those are just some of the things that are continuing, that we're continuing to see rise up.

Host: Some say we were already in a mental health crisis even before this pandemic and especially in the earlier days. And now it seems like it's getting worse. Would you agree with that? Can you tell us more about that side of things?

Isis: Oh, absolutely completely agree that it's getting worse. You know, then in the beginning of where we were a year ago. What I, you know, what we've seen happen is of course, with you know, the announcement of the vaccine, we were like, okay. It was almost like this big communal exhale. Like we, we have some breathing room, we can start actually holding on and maybe putting some things that were normal back into place. It was like, okay, I can take this breather and I can reduce some of this anxiousness and I can be in my present and not feel like I have to be in survival mode and maybe go back to some of the thriving I was doing ahead of time.

So, what is happening is with the announcement of the variant, we are in an extended mental state of living in what is known as hyper arousal, this is what is called kind of the fight or flight. And what happens is it's almost known as you feel like you're walking on eggshells, like. Okay, what's going to happen today. I have to be prepared for anything. So, it's almost like we, we've had to armor up again because we don't know from day-to-day what is what. You know, we get the information, we get comfortable in what is out there and then something new pops up and it's like, okay, here we go again.

And so what you're seeing, this is a state of mind that a lot of times you see with people who have experienced trauma and in a way this pandemic can be categorized as traumatic because it's disrupted normal, it's disrupted ways of life. It has taken lives of people who are continuing to deal with grief, not only what the physical loss of a loved one, but even a loss of a way of life and having to figure out what their new normal looks like.

And so living in that state of hyper arousal is very exhausting. It's a very exhausting mental state to live in because you're consistently on alert with no break. You are consistently looking for, you know, you're consistently on the lookout, you're consistently on for 24/7. And that is not only mentally exhausting, but it is physically exhausting.

People are used to what you're used to doing to help cope with your stress, your anxiousness, you may not have those options anymore. And so it's even navigating, what do I do to calm down when, what I used to do isn't there anymore? And so having to navigate new ways of doing activities on top of all other new ventures, and then again, this time around as parents, you know, it's one level watching out is just you as the adult. But now as the parent and with the news coming out about how kids are impacted, you've got a new level of hyper arousal, you know, just trying to make sure that the kids are okay. And so that is what is definitely a mental health crisis, as the kids say in Anime, it's super and level. And so we are definitely there and I think we're all just trying to do the best that we can, but again, we're burnt out.

We are, we're burnt out and it's getting, and it's starting to get even worse.

Host: You know, so much about this virus has become pretty polarized, whether you're pro or anti vaccine, pro or anti mask. I mean, how can we go about just our daily lives when we run into people who are on the opposite side of whatever opinion we have on those things?

Isis: I think like before, because this isn't the first time that we have, you know, heard news around, you know, being Pro vax versus anti-vax, you know, you had it in a, you had it a while ago, and even there's still some rumblings there, but you know, back when there was, you know, the big debate about what causes autism and things like that, you had, you know, the community of I'm not going to vaccinate versus I am going to get vaccinated.

And so, it's actually interesting. You mentioned that because I was asking my mom, like, you know, hey, when you were coming up, what was it like trying to get people to get the polio vaccine and you know, all these other things that were happening. And she was like, you know, it was, it was interesting because we didn't have the necessary communication that we do now.

You know, we had TV, we had radio, but then I saw a clip where I think it was the polio vaccine, but I know Elvis went on TV to get a particular vaccine. And they said that after he did that, numbers went up. And so my suggestion, when this conversation comes up in the workplace, or even with relatives, whoever, number one, know your boundaries and your bit, and what I mean by that is know your bandwidth, know what you are capable of discussing without it becoming personal, because this topic can be very personal because it's about safety.

I will say, like my Chancellor says lean into the science, what we are watching. And I saw this tweet, or it was on TV. We are basically, and I thought this was genius. They were like, we are in the midst of basically science fair 101. We are dealing with, we know what the problem is. There's hypotheses out there. We are gathering the materials. We are gathering all of the information and it's almost like we're in the procedure mode, you know? Okay. We, we knew this, we knew that this was working. Now we've got a new variant. Now we've got to go back to, you know, now we've got to go back to the hypothesis mode. And so this it's science and it's like watching the, the, the science fair in real time.

You know, your sources like CDC, our resources here at UAMS, our researchers are doing their best to get the information out. Our College of Public Health puts out reports for the community to look into. And so I will say, you know, lean into the science and that's any suggestions that I have for anyone that just wants to keep a neutral conversation, lean into the science, because our people are doing the best they can to get out what they can get out with the resources that they have.

Host: Absolutely. And, you know, looking into the fall, what are some ways that people can stay positive during this time?

Isis: Okay. Yes. Fall is coming, winter and Game of Thrones, but I keep hearing people say, winter is coming. So, naturally I have to watch it. What I will say is we're getting ready to go into that season, where we all kind of hibernate.

We all kind of close in and it's definitely the season. Whereas in the mental health community, we talk about seasonal affective disorder, depression it's called SAD. And so this is already something that comes because we're in hibernation mode. We're not really connecting in person. And now even more so with word out again, hey, mask up.

Be careful with gathering in large groups, you know, with the encouragement once again, to social distance, as we deal with all of the new information coming out with COVID and the different variants. One thing I will say is, the first thing I will say is, acknowledge the losses that have occurred. A lot of times in our society, we can mask and we, you know, tell everyone that everything's okay. And that's a form of masking because things are not okay. And you're really putting on a face to try to encourage everyone else around you. But behind that mask, you're really not. And so what I would say is acknowledge the truths and the feelings that you're having about this pandemic, about all the information, everything that's happening, acknowledge the grief.

Be honest about how it's impacting you and those around you. Have a mourning period, give yourself permission to grieve the losses. A lot of times when we think about grief, we only think about physical death, but a lot, again, a lot of people have lost a way of life that they've known. A lot of people, even in going home to work, a lot of people have lost that office community, you know, for some that was really great for them and the isolation, they're having a hard time adjusting too. And so, you know, that's the loss of that community, even social gathering, being able to go to my favorite restaurant, you know, I get takeout, but it's not the same as that experience and ambience of sitting down and things like that because you're just wanting to do what it takes to be safe.

Even then the loss of being able to go into a store and not feel like you're on consistent alertness. You know, I think nowadays we're all looking for, okay, who's wearing their mask. Who's not. You know, if somebody gets too close to me, I need to move away. And so even enjoying, just going into a store and not feeling like you're on consistent alert.

You know, it's okay to even grieve that. And so, so that's the first thing I'll say is acknowledge the truth about how you're feeling about this pandemic. So that's one thing. The second thing I'll say is lean into those healthy coping skills. And so whether it's listening to music. Even taking time out to watch a favorite TV show. Sometimes it may be taking a walk and play time. We forget, especially as adults that it's okay to have play time. And so if it's pulling out the game board, if it's pulling out UNO cards, if you like to game online, you know, don't forget to have some, some sort of play time. It's okay to still play. Yes, adults, I'm saying that out loud, it is still okay to play.

It's a great coping skill. I would say also, we in the pandemic, we have focused on a lot of the losses. I will go against the grain and say, practice gratitude by making a list of what you're currently grateful for. Take constant focus on what you still do have. And let that some days be a guide for you, even if it's, you still have the same place that you're living in.

If it's that you've been able to maybe switch careers and do something that you've always wanted to do, this pandemic has given you that opportunity. If it's even the ability to have clarity that you didn't have before, because we were so busy. And at times we were busy and avoidance are so busy, we didn't have time to really tap into those things that we still desired and want it for ourselves.

So, I will say practice that gratitude, make a list of maybe one to five things that you're grateful for and I'll even plug this. It doesn't have to be anything big. Again, it could be in my computer worked today. It can be my internet, go out. It can be, hey, I, you know, I had the energy to go to the grocery store because again anxiety and depression is real. And so, you know, celebrate the small things I got out of bed this morning. I'm grateful that I got out of bed this morning. And so a gratitude list. I'll definitely encourage. Another thing I'll say is practice being in the present. This is through mindfulness techniques and I, I go over with my patients, my clients, grounding.

And so what that, what that does is a lot of times mentally we create narratives. We'll go from zero to 60. We'll be stuck in the past, or we'll go 10 seconds to the future. And we forget to consistently be in our now, consistently be in our present. And so one of the things I use with my clients who are, have a very, very serious case, or are just dealing with anxiety period, is when you start to feel yourself having you know those feelings, either tightening of the chest. And that's sort of a symbol for panic attack as well. Grounding means you put your both of your feet on the floor, make sure you're at a 90 degree angle. You close your eyes. You picture a place of calm. You picture a place of peace or happy for you.

And for about maybe five minutes. You stay in that place. You take three, very, very deep breaths, exhale through your nose and you release whatever has got you feeling uptight and anxious so, if you need to release self-doubt, if you need to release worry about something, you let that go through your breath.

And it also allows you to connect and be in tune with your body. And it's a very, very powerful method. And so I encourage grounding, grounding techniques to help you practice being in your now. Also to help you clear your head space, you know, and to again, yeah, be in your present and then take time to disconnect.

We live in a digital age now where more than ever, the psychology of it is amazing how social media and internet, you know, has really become a part of our lives. But it is okay to disconnect. If you feel yourself having information overload, take a break. You know, even if you are used to picking up a newspaper, it's okay to take a break from whatever it is you need to take a break from and so if it's not watching the news for the day, do that. If it is taking a week off of social media, do that. It is okay to disconnect and to settle and to just regroup and recenter because information overload is real and it can subconsciously do a lot more to you than you think it's doing.

Even, you know, the psychology of scrolling and feeling like you have to post and share. It's okay to keep some things to yourself. And if you don't want to do social media for a week, for a month, you don't have to. Now, if it's part of your job, that's something you'll probably want to talk with your bosses about, but advocate for yourself, if you need those breaks, because mentally it is, it's exhausting.

Digital overload is exhausting. And last but not least, take time to stay connected to family, friends and more. If it's a text message to just say, hey, thinking about you, if you don't have the bandwidth to have an actual conversation. If you, and I know a lot of people did like virtual Zoom meetings where they would have like, you know, friendship check-ins and things like that.

Group chat, you know, it's still just, you know, make sure that you're staying connected to your loved ones, to your friends. And even for coworkers who have become friends for you. So, I will say, you know, definitely lean into those support systems. The other thing I will add and staying positive, you know, acknowledge that we are in very uncharted waters right now. Daily, we're getting news about surges and variants. And so I will encourage everyone to be gracious and compassionate with yourself. Give yourself permission to not get everything done that needs to be done. Also pay attention to your body and how you're reacting to certain conversations and or news. And don't forget that your boundaries still matter.

Remember that we are not operating in the same space as we were before. And that it is okay to not be okay. And to seek help.

Host: Absolutely. And on that note, wrapping up here, what are some resources that people can reach out to during this time, if they need that extra help?

Isis: Well, I'm going to definitely plug the program that I work with. AR Connect is a, the UAMS virtual mental health platform. We are 24 hours a day, seven days a week. But let me clarify that. We have a triage that is open 24 hours a day, seven days a week. And what they do is they take the calls. We then schedule you, we do the intake process where our screener gets some information.

And then from there you are set up with a therapist who does an assessment, to set up therapy appointments. And even if you need to see a psychiatrist, we screen for that as well. It is a free program. And so for those who don't have health insurance, or for those who are just seeking help, you know, for some people they're getting help for the very first time for mental health needs.

And so it's a great program. And so we are here, you can find us on the UAMS PRI website and you can also reach us at 1-800, right. 9921. And so again, that is AR Connect UAMS's virtual mental health platform. The second thing is there is the suicide prevention hotline. And so if you are not feeling well, or if you're having thoughts of harm, the suicide prevention hotline is available.

They have texts as well. So, if you are afraid to call and you just feel like you need someone to talk to or talk you off the ledge. Also, I always encourage my patients, if you are having thoughts of self-harm to get to the nearest ER for help. And that number for the suicide hotline is 1-800-273- 8255.

And then also research your local NAMI chapters, the National Alliance for Mental Health. They have chapters in each state and sometimes they have support groups and all different resources as well. So, NAMI is a good one to look up too, and then any local agency. Psychology Today is a good one to help find a therapist and many, many more resources, but those are the three that I'll give out of now.

Host: Well, just some incredible essential information in this ever-changing time. Isis, words really can't describe all the good work that you're doing. Thank you for joining us. For more information, you can visit us online at uamshealth.com. And thank you for listening today. This has been UAMS Health Talk, the podcast by the University of Arkansas for Medical Sciences.

I'm Caitlin Whyte. Stay well.