Managing Stress and Anxiety with COVID-19

With the recent outbreak of the coronavirus, or COVID-19, stress and anxiety can be difficult to manage. Coping with stress during these times is essential for you and your loved ones. While stress can appear differently in everyone. According to the CDC on their website to help with anxiety and stress during the coronavirus, common signs of stress can include;

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs

Common changes to watch for in children include;

  • Excessive crying or irritation in younger children
  • Returning to behaviors they have outgrown (for example, toileting accidents or bedwetting)
  • Excessive worry or sadness
  • Unhealthy eating or sleeping habits
  • Irritability and “acting out” behaviors in teens
  • Poor school performance or avoiding school
  • Difficulty with attention and concentration
  • Avoidance of activities enjoyed in the past
  • Unexplained headaches or body pain
  • Use of alcohol, tobacco, or other drugs

As important it is to know the signs, it is just as important to know the resources to help with stress and anxiety. Taking care of yourself during these times can seem difficult with orders to “Stay at Home” or “Shelter in Place”. We are fortunate to have resources online to help us through this unique time.

Health.com recently published an article “10 Virtual Therapy and Mental Health Apps to Cope With Coronavirus Stress” that has great options to explore while at home, https://www.health.com/condition/infectious-diseases/coronavirus/virtual-therapy-mental-health-apps. All apps suggested in the article are free to download, with some having in-app purchase options. If you currently have a behavior health physician that you work with, ask them if you can schedule an appointment via online video conference.

If you are having these feelings, please feel free to reach out by calling 509.444.8200 or learn more about our behavioral health services.

Additionally please keep in mind how to deal with stress and anxiety on a daily basis. Below is a graphic from the Anxiety and Depression Association of America. You can also access more resources by visiting www.adaa.org.

by Mike Cardenas, Marketing Specialist

Post Holiday Blues

Presents have been unwrapped, cookies cooked and consumed, and memories of joy on faces remain in your phone. Now that the festivities are over and it’s time to start taking down the lights, are you feeling down? It’s no surprise that the decrease in celebration and excitement can certainly affect moods, causing disappointment or even sadness. “It’s not an uncommon phenomenon, so if you are feeling that way, you are not alone,” says Martha Nelson, CHAS Health Behavioral Health Provider.

Causes:

  • Busyness – It’s a really hectic time of year. You just finished finding the perfect present for so many people, prepared the perfect meals, and attended too many functions. It’s such a wonderful time, but also, exhausting. Coming down from the busyness and hype is tough.
  • Memories – Holidays can bring up past memories, and often a sense of nostalgia for good times that have passed and loved ones that may be gone.
  • Fatigue – Fatigue is a common contributing factor for holiday depression. It can be a packed time of year, with normal routines and exercise out the window. Additionally, it’s cold outside (and so warm under the blankets). No wonder you can feel fatigued. It’s the time of year I personally put off a lot of things in exchange for sleeping in or going to sleep early.
  • Sugar and food – So many good treats! So many good foods! During this time of year, there is so much to eat, drink, and be merry with. It’s easy to go overboard, throw your routine out the window, and over eat (or under eat if you swap eating something good in order to splurge on a dessert). The amounts of blood sugar spikes can leave you feeling crabby, hungry and a little bit sad.

Ideas to help cope with post-holiday depression:

  • Take what you enjoyed during the holidays and continue it throughout the year. If you enjoyed spending time with friends and family, invite them over soon for a meal, to play some games, or watch a movie.
  • Have fun! Go to a movie, see a play, visit the Museum of Arts and Culture, ski or do some sledding.
  • Start or continue your exercise routine. Sometimes exercise goes out the window during the holidays (sometimes it goes out the window well before the holidays too). But, now is a perfect time to re-start or get into a new routine. Include a buddy so you have company and someone you look forward to hanging out with, plus it’s a great way to hold each other accountable.
  • If you’ve gained weight, don’t worry about it. There were a lot of good treats around. No regrets. It doesn’t mean you are weak, , it just means there were some awesome cookies around… and you’ve got to live a little. Right? However, it’s never too late to get back on track with a healthy eating plan.
  • Plan something each week to look forward to.
  • Take care of yourself, including eating well (don’t confuse this with not eating), exercising and getting enough sleep. Have a good attitude as well; it’s easily to slip into negative notions.
  • If the post-holiday blues hang on for too long, consider reaching out to a Behavioral Health specialist. Seasonal affective disorder is a real issue that many people deal with. As we roll into 2018, remember to make the resolution to highlight health and happiness.

 

By Matt Grebe and Martha Nelson, LICSW

Post-Holiday Depression

Presents have been unwrapped; cookies cooked and consumed, memories of joy on faces remain in your phone. But now that the festivities are over and it’s time to start taking down the lights, are you feeling down? It’s no surprise that the decrease in celebration and excitement can certainly affect moods, causing disappointment or even sadness. “It’s not an uncommon phenomenon, so if you are feeling that way, you are not alone,” says Martha Nelson, CHAS Health Behavioral Health Provider.

 

Causes:

  • Busyness – It’s a crazy hectic time of year. You just finished having so many people to get the perfect present for, the perfect meals, and attended too many functions. It’s such a wonderful time, but also, exhausting. Coming down from the busyness and hype is tough.
  • Family – Family is the best! Family is the worst! All kinds of feelings come up during the holiday season and it can certainly take an emotional toll. Do you have family members that are stressful to be around? “Hope for the best, prepare for the worst,” most definitely applies here. Even the most incredible families can cause some levels of exhaustion.
  • Memories – Holidays bring past memories, and often a sense of nostalgia for good times that have passed and loved ones that may be gone.
  • Fatigue – Fatigue is a common contributing factor for holiday depression. It can be a packed time of year, with normal routines and exercise out the window. Additionally, it’s cold outside (and so warm under the blankets). No wonder you can feel fatigued. It’s the time of year I personally put off a lot of things in exchange for sleeping in or going to sleep early.
  • Sugar and food – So many good treats! So many good foods! During this time of year, there is so much to eat, drink, and be merry with. It’s easy to go overboard, throw your routine out the window, and over eat (or under eat if you swap eating something good in order to splurge on a dessert). The amounts of blood sugar spikes can lead you feeling crabby, hungry and a little bit sad.

 

Ideas to help cope with post-holiday depression:

  • Take what you enjoyed during the holidays and continue it throughout the year. If you enjoyed spending time with friends and family, invite them over soon for a meal, play some games, or watch a movie.
  • Have fun! Go to a movie, see a play, go to the Museum of Arts and Culture, ski or do some tubing at Mt. Spokane.
  • Start or continue your exercise routine. Sometimes exercise goes out the window during the holidays (sometimes it goes out the window well before the holidays too). But, now is a perfect time to re-start or get in to a new routine. Include a buddy so you have company and someone you look forward to hanging out with and to hold each other accountable.
  • If you’ve gained weight, don’t worry about it. There were a lot of good treats around. No regrets. It doesn’t mean you are weak, worthless, or irresponsible, it means there were some awesome cookies around…gotta live a little. Right? However, it’s never too late to get back on track with a healthy eating plan.
  • Plan something each week to look forward to.
  • Take care of yourself, including eating well (don’t confuse this with not eating), exercising and getting enough sleep. Have a good attitude as well; it’s easily to slip in to negative notions.
  • If the post-holiday blues hang on for too long, consider reaching out to a behavioral health specialist. Seasonal affective disorder is a legit issue that many people deal with. As we roll in to 2017, remember to make the resolution to highlight health and happiness.

By Matt Grebe and Martha Nelson

Holiday Blues

Many people can experience feelings of anxiety or depression during the holiday season. People who already live with a mental health condition should take extra care to tend to their overall health and wellness during this time.  Extra stress, unrealistic expectations or even sentimental memories that accompany the season can be a catalyst for the holiday blues. Some can be at risk for feelings of loneliness, sadness, fatigue, tension and a sense of loss.  A lot of seasonal factors can trigger the holiday blues such as, less sunlight, changes in your diet or routine, alcohol at parties, over-commercialization or the inability to be with friends or family. These are all factors that can seriously affect your mood.

Via nami.org

Pokémon Go, For Your Health?

If you’ve seen an increased number of people walking and biking around town with their phones glued to their faces, there’s a strong chance they are searching for a Charmander, Snorlax, or one of the other 151 Pokémon varieties. Of course we’re talking about Pokémon Go, the latest interactive app to blow up your Facebook and Twitter feed. The coolest part of the app (aside from finding a Squirtle in your backyard), is it’s actually helping people to get outside and exercise more.

Released last week, Pokémon Go is an interactive game that uses your phone’s GPS, camera,  and clock to detect where and when you are in the game and make Pokémon “appear” around using augmented reality. The Pokemon that the players catch can be powered up and used to take over or train at local gyms (usually monuments, churches, other public spaces). Different types of creatures appear as you move around your city, with the variety changing as you move from block to block. You’re literally chasing Pokémon around your city, which is making this game a huge hit and an excellent addition to your exercise regimen.

Many people using the app have seen significant increases in their steps since they began playing.

In addition, some Pokémon Go players are seeing mental health benefits. Simply by getting outside and taking a short walk (sometimes with friends) players are helping themselves to battle anxiety and depression. The game can be played solo or with a group of friends/strangers.

Tumblr user Ari is one of them. She has anxiety and depression and for the past three years has avoided leaving the house unless absolutely necessary.

“I have struggled with motivation and energy since I was 9, when I developed severe depression. After that, when I was 15, I developed CPTSD [complex post-traumatic stress disorder] from an abusive relationship that left me completely socially phobic, and starting then I was barely able to leave my house for fear of seeing people.

“But as soon as I got Pokemon Go I was able to leave the house, and I walked outside for hours and suddenly found myself enjoying it. I had the instant rush of dopamine whenever I caught a Pokémon, and I wanted to keep going. Then today and yesterday I purposely put myself in social situations, going to the mall, just to play. And best of all I enjoyed it.

“I think it’s partially because it gives an instant reward. It’s not like going out, having an awful experience, and getting praise after. It’s going out and getting that instant positive affirmation that makes going outside a good experience. I guess most people get that with being social or doing other activities.”

 

Of course the exercise is a side effect of playing Pokémon Go, which is at its core an incredibly fun way  to try and see if you can “catch ‘em all”. It brings back a sense of nostalgia, childhood wonder, and lets players explore their environment.

Now, if someone can help me find a Pikachu in Spokane, that would be amazing.

-Matt Grebe & Rachael Chambers, CHAS Health Communications Team

Adolescent Suicide on the Rise in Spokane

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A recent article in the Spokesman Review states, “Five teen suicides this school year – including three in the past month – have jolted the community. It’s the highest number in the history of Spokane Public Schools, prompting parents, students and community members to ask what they can do to help.”

As a Pediatrician here at CHAS I have noticed since mid –March an increased number of teenagers coming into my office for significant suicidal concerns with several reporting that they don’t feel safe going home from the clinic. This is very alarming and hard to manage if our Mental Health Staff has a full schedule. Periodically, the only option we may have available is to ask the family to go to the Sacred Heart Children’s Hospital Emergency Room for safety and to get prompt access to a mental health professional or other services.

Another article from the Inlander just three years ago, covers this local topic as well. They report, “experts say the region needs to start talking about the problem. Spokane has a rate of suicide higher than the state average. It’s the city’s second-leading cause of death for people ages 10-24.” Suicide isn’t just an issue for Spokane, but the entire Inland Northwest. Coeur d’Alene has the highest suicide rate in Idaho, and Idaho consistently has one of the highest rates in the nation, according to a report by Suicide Prevention Action Network of Idaho.

Both articles go on to discuss the need to work on being open and frank with all adolescents. As a medical care team we need to remember to do annual mental health screenings for all teenagers and the PHQ (Patient Health Questionnaire) is a validated test and a reasonable way to open the conversation with any teenagers in your office. The biggest obstacle is getting over the awkwardness of discussing this topic which is hard for many individuals to do. Teenagers tend to be more open and honest when they feel you are open with them and showing them that you actually care about their personal story.

Scientifically we know the adolescent brain works differently than the adult brain as teenagers seem to be pre-programmed to take greater risks and have less inhibition of impulse behaviors. This makes them appear to live more in their current emotions and less in their analytical/reasoning brain where adults tend to spend more of their time. This can lead to behavior that seems uncharacteristic and reckless to others but does not seem strange or out of the ordinary to teens in my office when they bring up the topic.

To try and keep this commentary to a minimum, I have provided links to both of the recent articles which I feel are informative for our community. They do go on to provide resources which I have attached below.

What Causes Suicide?

According to the National Alliance on Mental Illness (NAMI), “90 percent of youth suicide victims have at least one major psychiatric disorder, although younger adolescent suicide victims have lower rates of psychopathology.” Overall, NAMI asserts that 90 percent of people who complete suicide could have been treated for a mental or substance-abuse disorder.

Suicide Prevention Meetings

Prevent Suicide Spokane is hosting a meeting about what can be done in the community to help. The event is 1 to 3 p.m. Friday at Spokane Regional Health District, 1101 W College Ave. For more information contact Sabrina Votava at (509)475-7334 or sabrina@yspp.org.

Prevention Resources

First Call for Help Crisis Hotline: 509-838-4428

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

suicidepreventionlifeline.org

LGBTQ Crisis Hotline: 1-866-4-U-TREVOR

American Foundation for Suicide Prevention: afsp.org

QPR Institute: qprinstitute.com

Youth Suicide Prevention Program: yspp.org

Some Warning Signs

  • Talking or writing about death, dying or suicide when these actions are out of the ordinary for the person
  • Acting reckless or engaging in risky activities — seemingly without thinking
  • Increasing alcohol or drug use
  • Withdrawing from friends, family and society
  • Feeling anxious or agitated, being unable to sleep, or sleeping all the time
  • Experiencing dramatic mood changes
  • Changes in eating and sleeping habits
  • Unusual neglect of personal appearance
  • Marked personality changes
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • SOURCES: National Suicide Prevention Lifeline (suicidepreventionlifeline.org); National Alliance on Mental Illness (nami.org)

By Dan Moorman, Physician