Peter White, M.A., LPCC
Lindner Center of HOPE, Addictions Counselor

Due to the COVID-19 pandemic, this is a period of unprecedented changes marked by great uncertainty shared by literally everyone. One of the complex realities of dealing with this much uncertainty is that we should feel a wide variety of difficult emotions – confusion, fear, disorientation, sadness, and anger to name a few. In a way, it is healthy to not feel okay at this time. But at the same time, it is important for us to acknowledge that we want to manage these difficult emotions in a healthy way. One common vulnerability in managing difficult emotions is depression. Although challenging, we can get good at identifying and countering the presence of depression during difficult times. We can effectively treat and manage depression so that it does not make our coping less effective.

Depression is a condition involving thoughts, emotions and physical reactions. It is opportunistic in periods of uncertainty expanding its ability to disempower and disquiet ourselves and our relationships. Depression’s biggest advantage is its negative judgement – hopelessness, helplessness, worthlessness and guilt are all hallmarks of depressive thought process. “It’s not going to get better. There is nothing I can do to make it better. I don’t deserve to have it be better,” are all examples of depressive distortions that can plague the mind and divorce us from our natural capacities to endure and thrive. In a way, depression fills the mind with judgements that are fundamentally untrue. There is always hope. Things can always improve. We always have some options to improve our situations, or at least find how to endure with as much forbearance and gratitude as possible. And of course, we all deserve to have our suffering relieved. They may seem like simple reframes, but they are the fundamental effort of successfully countering depression so that we can move forward with all our strengths and resources. Fear is appropriate and understandable in times like this with major uncertainties and potential pending losses of security and predictability. I always encourage clients to honor their fear, comfort themselves with the many blessings of their lives that help them endure and rebound from loss, and resist the power of depression to convince them that they are alone and without options

As noted, depression infects both the mind and the body. Depression disrupts our metabolism, so we might experience fatigue, sleep disruption, changes in our appetites, difficulty in concentrating and decision making. Given that depression has a corrosive effect on body, mind and spirit, it is most effective to counter it with body, mind and spirit. Keep moving, maintain a wholesome routine mixing both work and pleasure. An easy acronym to remember is GRAPES. G. stands for gentleness and gratitude in thought. R. stands for relaxation, even for brief moments. A. stands for the recognition of our accomplishments, especially the simple ones-caring for ourselves and our loved ones is always an accomplishment. P. stands for pleasure, again especially the simple ones- food, music, reading, nature, or whatever there is that reminds you that life has its joys. E. stand for exercise, or if not rigorous physical activity, any movement that brings the reward of the body moving through space. And S. stands for remaining social. All of the above are anti-depressive activities – effective reminders that hopelessness, helplessness and especially worthlessness are untruths to be dispelled during our moments of fear and doubt.

Let me end just highlighting the social. All humans, especially so right now, share the experience of fear and doubt related to uncertainty. Near invariably, we are all comforted when these fears are shared amongst our loved ones and our fellows in a spirit of honor and trust. Nearly all of us have experienced a darkness of spirit that is quickly dispelled by kind words from friends. If nothing else, resist the power of depression to convince you that you are alone and do not deserve the fellowship of loved ones and peers. Clearly now, our experience of uncertainty is a deeply shared experience. I encourage you to become robustly social, so that within the shared uncertainty, we can all experience the power of ourselves and others to endure and overcome this frightening time strengthened in our spirit of togetherness.

Chris Tuell Ed.D., LPCC-S, LICDC-CS, Clinical Director of Addiction Services

As feelings of anxiety, depression, or sheer boredom mount due to the growing pandemic of the coronavirus, the desire to turn to drugs and alcohol as a coping mechanism could become more problematic. Experts warn against self-medicating during these stressful times for a multitude of reasons. For many people who struggle with mental illness and/or substance use disorders, there is an unfortunate tendency to withdraw or isolate from others. So when we are told to practice social distancing, remain in our homes, isolate from one another, this can feed into a further deepening of an individual’s struggles and isolation with depression, anxiety, trauma or loss.

According to SAMHSA, (Substance Abuse Mental Health Services Administration), 84% of individuals who experience a substance use disorder, also experience a co-occurring mental health issue as well. During times of stress, many of us seek relief, in any way we can find it. The use of substances is not a healthy way of coping. Substance use is frequently used as a means to escape or numb-out from life’s problems. Substance use will often exacerbate a previous existing problem, making it worse.

In cities across the country, people are increasingly living under “shelter-in-place” or lockdown mandates that have closed businesses, limited social gatherings, and urged self-quarantine. These added stressors have resulted in increased levels of alcohol consumption. According to the Republic National Distributing Company, a wine and spirits distribution company, sales of spirits jumped by 50% for the week ending March 21, 2020. Nationally, the overall increase for the week according to Nielsen data, saw a 55% spike in alcohol sales.

Each of us experiences stress from time to time. However, recent events of the past few months have been unprecedented. Stress can feel overwhelming. There are different types of stress – all of which carry physical and mental health risks. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time. Some people may cope with stress more effectively and recover from stressful events more quickly than others. Unfortunately for some, substance use becomes an unhealthy way to self-medicate one’s stress, mood and/or anxiety.

Coping with the impact of chronic stress can be challenging. Because the source of long-term stress is more constant than acute stress, the body never receives a clear signal to return to normal functioning. With chronic stress, those same lifesaving reactions in the body can disturb the immune, digestive, cardiovascular, sleep, and reproductive systems. Some people may experience mainly digestive symptoms, while others may have headaches, sleeplessness, sadness, anger, or irritability. Over time, continued strain on the body from stress may contribute to serious health problems, such as heart disease, high blood pressure, diabetes, and other illnesses, including mental health issues such as depression or anxiety. For some, substance abuse only adds insult to injury.

When does one’s consumption of a substance (i.e., alcohol, drugs, gambling, Internet, gaming) become
problematic? Addictive behaviors consists of the following three behavioral questions (The Three C’s).
• Is there a loss of Control? (I am unable to manage the behavior.)
• Is the behavior Compulsive? (I cannot stop doing the behavior.)
• Do I continue to engage in the behavior, despite the negative Consequences?

Coping with life stressors by the use of alcohol or any other substance, is a bad idea. If you take practical
steps to manage your stress, you may reduce the risk of negative mental and physical health effects. Rather
than reaching for that adult beverage, below are tips that may be helpful in coping with stress:

Be observant. Recognize the signs of your body’s response to stress, such as increased alcohol and other
substance use, difficulty sleeping, , being easily angered, feeling depressed, and having low energy.

Talk to a health professional. Don’t wait for your health care provider to ask about your stress. Start the
conversation and get proper health care for existing or new health problems. Effective treatments can help
if your stress is affecting your relationships or ability to work.

Get regular exercise. Just 30 minutes per day of walking can help boost your mood and improve your
health.

Pursue calming activities. Explore relaxation or wellness programs which may incorporate meditation,
imagery, muscle relaxation, or breathing exercises. Schedule regular times for these and other healthy and
relaxing activities.

Set goals and priorities. Decide what must get done now and what can wait. Learn to say “no” to new
tasks if you start to feel like you are taking on too much. Try to be mindful of what you have accomplished at
the end of the day, not what you have been unable to do.

Stay connected. Even though this may be a challenge, given our current social distancing, we need to remain
connected with one another. You are not alone. Keep in touch with people who can provide emotional
support and practical help. To reduce stress, ask for help from friends, family, and community or religious
organizations. Many community support groups (AA, NA, GA, SMART Recovery) are available online. Stay
healthy, stay connected.

En esta oportunidad quiero compartir con ustedes el articulo que escribimos en mi Grupo de estudio Psicoanalisis de Cara a lo Social integrado por Manuel Llorens, Alicia Leisse, Carmen Elena Dos Reis, Claudia Alvarez, Yone Alvarez y esta servidora.  Nos reunimos de forma “virtual” cada 15 dias para discutir trabajos y temas de corte psicoanalitico y tambien social. Somos todos venezolanos conectados desde el exilio o desde la emigracion elegida.  Espero que les resulte de utilidad en estos tiempos de incertidumbre…

UNA CONVERSACION CON LA INCERTIDUMBRE

Una de las anécdotas que ha circulado ampliamente en medio de la pandemia es de la antropóloga Margaret Mead cuando un estudiante le preguntó que cuál era, a su juicio, el hallazgo que evidenciaba el comienzo de la cultura. Esperando escuchar algo como potes de arcilla o cabezas de flechas, el estudiante se sorprendió al escuchar “un fémur roto que fue curado”.

La pandemia ha servido para subrayar la íntima conexión de la humanidad entera. La manera en que los hábitos alimenticios, los sistemas de gobierno, los medios cada vez más veloces de transporte, y hasta nuestra manera de saludarnos, influyen en el curso de un virus que ha detenido todo el planeta. El coronavirus ha puesto de rodillas el poderío humano: paralizó el comercio, las olimpiadas, los aeropuertos, las protestas públicas y más.

Sumado a las consecuencias de la salud de los contagiados, los sistemas sanitarios, la economía mundial y las adaptaciones a la vida cotidiana que ha exigido la pandemia, ha habido un repunte a nivel mundial de trastornos de ansiedad. Por ende se les pregunta a los profesionales de la salud mental: ¿cómo se lidia con las angustias que todo esto despierta?

Circulan muchas recomendaciones, ideas, gestos salvadores, actos creativos que dan cuenta de que, en lugares geográficos con mayor piso de respuesta social, los daños ciertamente están, pero el músculo creativo se reinventa al servicio del otro y de uno con el otro y del sí mismo. Muchas de las recomendaciones, útiles  sin duda, se anclan en el terreno de las acciones concretas y conscientes que podemos incluir en nuestras rutinas para sobrellevar la angustia, el tedio, la pérdida o el conflicto que desata las medidas de protección que han alterado nuestras vidas.

Creemos, sin embargo, que puede ser útil tomar un paso al costado y escucharnos desde otro lugar. Hay por lo menos dos elementos fuera de las prescripciones más concretas que valen la pena considerar. El primero, es que la pandemia nos ha colocado de manera dramática frente a la vulnerabilidad humana. Ante esto, algunos han querido continuar como si nada, como los presidentes de Brasil y México, besucones desafiantes, que parecerían estar en negación de los riesgos que implica el COVID-19. Lo cierto, es que desde el Príncipe Carlos hasta los plebeyos estamos expuestos. La omnipotencia no está resultando buena consejera.

A la vulnerabilidad se le suma una gran cuota de incertidumbre. Nuestros parámetros de control han sido trastocados. Hay recomendaciones que nos pueden ayudar a sobrellevar el día a día, pero inevitablemente necesitamos escuchar y articular el temor que surge. El miedo, lo sabemos, pero se nos olvida, es una alerta que necesita ser atendida, para poder prepararnos para lidiar con una amenaza. Lidiar con el miedo sin negarlo, pero sin quedar sobrepasado por el desespero, es parte de la tarea.

La escucha y el esfuerzo por darle palabra a nuestro mundo interno, es parte de una solución que lidia con la incertidumbre sin pretender tener las respuestas de antemano. Una de las maneras en que la psicoterapia psicoanalítica ha sido descrita es como una “conversación con la incertidumbre”. La gran verdad, es que ni los expertos tienen la respuesta completa de las dimensiones del problema ni de su solución. Lo más probable es que tengamos que hablar y escucharnos para descifrarlo en conjunto.

Lo que estamos diciendo, y que lleva al segundo elemento, es que el problema tiene que ver con la interdependencia humana, y su solución, probablemente también. Una de las medidas preventivas curiosamente se ha llamado “distanciamiento social”, cuando lo que necesitamos es distanciamiento físico, pero no social. Tanto por el proceso de concebir soluciones a un problema de dimensión sistémica, como por el funcionamiento biológico individual: la conexión humana es esencial. Sabemos que el sistema de defensa inmunológico está íntimamente relacionado con la vinculación interpersonal, la soledad nos hace más propensos a enfermar.

Nos estamos quedando en casa, aunque parezca paradójico, como gesto de profundo reconocimiento del otro. Nos quedamos en casa, para cuidar a los demás tanto como a nosotros mismos. Nos quedamos en casa, porque el bienestar del otro es indispensable para el bienestar nuestro. Visto así, nuestro encierro no es aislamiento. Las redes de solidaridad, para estar atentos a las personas de nuestro vecindario que no se pueden valer por sí mismas, el comunicar nuestra preocupación por el otro, el pedir ayuda, la música en los balcones o los aplausos a los operarios de salud, son gestos indispensables de conexión humana, necesarios para mantenernos sanos y cuerdos.

No olvidemos finalmente que los riesgos y las desventajas tienden a multiplicarse, por lo que, aquellos que vienen arrastrando desventajas, están ahora en una situación multiplicada de riesgo. Los que tienen alguna situación previa de vulnerabilidad, por edad, por salud, por pobreza, por red de apoyo limitada, están mucho más expuestos y haremos bien en pensar en el problema priorizando las necesidades de aquéllos que la van a sufrir más.

La cuarentena es un alto obligatorio que puede ayudar a hacer un parado en una vida que no deja de exigir apresuramiento, un llamado a abrir espacios para la reflexión, para recalibrar nuestras prioridades y para hacernos más conscientes de nuestra interdependencia, nuestra necesidad del otro, fomentar nuestra capacidad de construir la cultura en los términos que propuso Margaret Mead.

 

 

Margot Brandi, MD,
Sibcy House, Medical Director

Tracy S. Cummings, MD Psychiatrist, Lindner Center of HOPE Chief of Child and Adolescent Psychiatry Medical Director of CCHMC Services at LCOH

On a large scale, our world continues to adjust to the new normal enacted for our safety in the wake of COVID19. And while we may be interested in global responses and big picture outcomes, this tends to pale in comparison to the level of concern a family holds for its members and home. Our definitions of “family” may vary, and our abilities to handle stress can be wide-ranging, but we all likely share our desire to see the system succeed. Having tangible options to put into action in our households right now can give us a sense of purpose and accomplishment while keeping those that mean the most to us moving forward in positive directions through this uncertain time. Consider the following acronym, HELP, to help keep your family functional:

H– Heed the advice of our trusted medical and community leaders.

  • Staying up to date on current safety recommendations from the CDC, WHO and governmental leaders is important.
  • Understanding what local resources may be needed and taking the time to consider your home’s personal emergency plan is worthwhile.
  • Creating a sense of control over those things that are within your grasp will feel rewarding, even if there is some anxiety around the situation.
  • Once you have the general information you need to proceed with helping your family, limit exposure to crisis-related media.

E– Enact the recommendations of the leaders and your personal plan.

  • In order for this to be successful for families, there will need to be good communication about its importance. Talking about the virus in a way everyone can understand (particularly if there are young children in the home) will pose a worthwhile challenge. Consider this as an opportunity to demonstrate empathy and compassion for each other when our particular ways of acknowledging, responding to, and addressing stress becomes apparent.
  • Take the universal precautions immediately: good hand hygiene, covering coughs/sneezes, frequently clean/disinfect, maintain social distancing, wear a mask if in a public setting, stay home as much as possible and absolutely if sick.
  • Remember that younger members in the home will be watching those around them for cues on how to handle this situation, so reinforce the recommendations through modeling the appropriate behaviors as much as possible. If the adults in the home are struggling with how they are personally managing the stress of today, seeking assistance for mental health strength should not be delayed.

L– Listen to the needs of your individual household and make room for those in the necessary changes.

  • Label priorities for your family: academics, virtual lessons, family meals, general chores, and what needs to be done on a given day.
  • The use of a broad-strokes calendar may be helpful here, so as to set some daily standards and routines. With so much changing around us (ie. schools closed, remote working requirements, conveniences disrupted), having some predictability to the day can provide security to adults and children alike. Do you have to set up a strict schedule for every hour of the day and follow it militantly?  No, but knowing there is some allotted time for a few essential activities a day is reasonable, and IT CAN CHANGE as needed.
  • Emphasize flexibility over perfection these days.

P– Protect your unity.

  • Emotions can run high during this time of collective crisis. Accepting how difficult these changes are for us all can be freeing.
  • It is ok to grieve the loss of all the special moments and events that have been postponed or canceled due to COVID19. Whenever possible, consider ways to creatively experience those moments in an alternative fashion. Can’t go to Disney?  How about making a Disney movie night and riding some virtual rides that are posted for the park?
  • Keep in contact with those who are important to your family as much as possible. Use the technology available to your advantage. Virtual birthday parties and gatherings, like many current classrooms, are being readily utilized with success. Phone calls with or without video, texts, and even sending letters/cards are simple ways to avoid isolation while maintaining social distancing.
  • Staying connected doesn’t mean you have to spend every moment together, though. It might be nice, and likely necessary, for family members in the same home to have some time to themselves. Use these moments to recharge and encourage young ones in the home to appreciate this personal time as well.

These are uncharted waters for our families, our communities, our planet. We cannot expect to know how to handle our current circumstances flawlessly, but we can keep trying.  All we need is a little HELP.

Megan Schrantz, Ed.D., LPCC

Students everywhere are struggling to engage in their studies meaningfully during the coronavirus crisis. For now, gone are the comfortable routines, activities, and structured in-person expectations of the school week.

Children, teenagers, and college students need adequate sleep, healthy meals, and regular exercise.   Healthy habits are particularly important for young people who may be struggling with anxiety or depression. Losing reliable routines can be a big source of stress.  Many students feel unfocused and unproductive. It’s ok to dial down expectations of oneself and others.

It’s important to simply acknowledge your feelings. It is normal to feel worried, lonely, and frustrated. Here are some strategies for students of all ages to thrive during this unusual time:

Stick to your pre-coronavirus routine.  Although students are likely sleeping in a bit later, it is helpful to wake up and go to bed at about the same time as on a regular school night.

Move your body. The recommendation to hunker down does not prevent going for a walk, bike ride, run, or just playing outside (assuming you’re not in complete quarantine). Movement is a great way to relieve stress, notice the big wide world, and get fresh air.

Sleep. Sleep restores us like nothing else. Create a sleep schedule to wake up about the same time every day, which can add some structure to your day and help regulate your circadian rhythm. Keeping a consistent sleep schedule, with predictable times to wake up and go to bed, is especially important in maintaining a positive mood and the ability to fulfill academic expectations.

Limit video game time.  Enough said.

Take care of your mental health.  Practice mindfulness. Being mindful helps us to slow down and reduces anxiety. A few deep breaths can reduce stress. Play outside and notice the magical changes of spring.  Being mindful for one minute can be a welcome change from worries, and it can help us to focus on what’s truly important.

Maintain social connections. Those connections can mean the world. Check in on others, including family members, friends, and classmates.  Ask how they’re doing. Let them know you care. Imagine what you can do virtually, in pairs, in small groups, or in larger gatherings!  Dance, sing, read, play games, create.

Mix it up. If you’re staring at a screen too long, take a break, move around, and shift your gaze.  Limit news-watching to reduce anxiety.  If you crave a change of scenery, take a walk, or if you can’t get outside, escape into a book or creative activity. Make up a game.  Try a wacky science project.  Plan for an optimistic future- think of what you can look forward to.

 

It can be a challenge to structure your day when all classes are from home.  These ideas can help establish a more comfortable and efficient routine.

Make a plan.  Consider unplugging from time to time to supplement digital apps and online learning portals with a paper planner or notebook.  Recording assignments and projects in a paper planner can help you learn and remember your schedule.

Create a cozy and ideal learning environment.    Make a “classroom” free of unwanted distractions.  Keep all needed materials organized in one place.

Hide or put down the phone!!  Close all unnecessary tabs when in learning mode.  Quiet all notifications.

After studying, practice explaining what you’ve learned.  If you can explain the lesson to someone else, then your studying has paid off. A simple but effective study tip is to describe what you studied. There are several ways you can do this while still observing social distancing:

  • Practice explaining what you’ve learned to family members.
  • Practice virtually with friends online.
  • Practice in front of a mirror.
  • Record yourself explaining what you’ve learned.

Study with friends … online.  We all crave social interaction in learning environments. Consider organizing virtual study groups with your friends to get your dose of socializing while staying at home,  and to hold each other accountable to academic goals.

Limit social media.  Too much social media wastes time and can be a source of stress or uncertainty.

Break up learning into chunks of time.  Try to finish your work when school would be over for the day.  After “school hours”, do something fun and relaxing.

Ask for help.  Teachers are available online.  It’s ok to ask parents for help, too.

Paul R. Crosby, MD

Lindner Center of HOPE, Chief Clinical and Operating Officer, Psychiatrist

4075 Old Western Row Rd.

Mason, OH 45040

513-536-HOPE

Most of us are weeks into the significant life changes caused by the novel coronavirus.  Even as we work to adjust to our new normal, there continues to be changing instructions and sometimes confusing and frightening information to process.  Daily, we are being asked to make sacrifices and critically important decisions for the safety and welfare of our family and our communities.  It is important during this crisis to remember to monitor and maintain our own mental wellness.

Some tips to manage the stress of today’s circumstances include avoiding excess exposure to media, including social media, taking care of yourself through exercise, eating healthy foods, getting enough sleep, and talking to friends and family.  Cultivating a practice of mindfulness and gratitude is another evidence-based way of improving wellness and alleviating stress-related mental health symptoms.  For people new to the idea of meditation and to those with more experience, there are many apps, such as Headspace www.headspace.com, to guide the process.  Also, even though social distancing is necessary during these times, seek out safe ways to stay connected with others.  The American Psychological Association, The National Alliance on Mental Illness, and Mental Health America are advocacy organizations that have a wealth of information about supporting your mental wellbeing during this crisis. www.apa.org  www.nami.org www.mhanational.org

With most students out of school and engaged in some combination of home-based and online learning, the situation is understandably stressful for both children and parents.  It can be hard to know where to start; but, try and establish a regular routine.  Children (and most adults) are reassured by structure and predictability.  Try to keep in mind that children learn from watching and listening to the adults around them.  They will be very interested in how you respond to news about the coronavirus outbreak.  Let children know that there are lots of people helping the people affected by the coronavirus outbreak.  This is a good opportunity to show children that when something scary or bad happens, there are people to help. Try to create an open and supportive environment where children know they can ask questions.  It is also important to remember that most children may be more interested in playing games, reading books, and other physical and recreational activities than discussing current events or following the news about what is happening across the country or elsewhere in the world.  The American Academy of Child and Adolescent Psychiatry’s website is an excellent resource with advice to help families help the children in their lives through the pandemic.  www.aacap.org

When there are many changes and uncertainties that are beyond our control, heightened stress and anxiety are normal feelings.  A time of crisis can also be a trigger for the onset or reoccurrence of mental health symptoms.  If anxiety and/or stress related feelings are causing you significant discomfort or are interfering with relationships, work, or other areas of your life, it may be time to seek help from a mental health professional.  Other symptoms to look for include:

  • Behaving, thinking, or feeling in ways that are out of character
  • Withdrawing from social contacts
  • Lack of interest in things that would normally bring joy
  • Becoming consistently irritable
  • A change in sleep patterns
  • Changes in eating habits and/or weight
  • Increased use of intoxicating substances

It is essential to remember that mental health services are still available during the COVID-19 crisis.  For individuals already receiving mental health and/or substance use disorder treatment services, it is important to continue with these services during this difficult time.  To follow social distancing guidelines, outpatient services for mental health assessment and treatment are being offered virtually via a simple phone call or one of several easy-to-use, secure video conferencing apps.  When needed, in-person services are still being offered with added health and safety measures to keep patients and staff safe throughout their treatment.

Similar to adults, children who become overly preoccupied with concerns about the coronavirus outbreak should be evaluated by a trained and qualified mental health professional.  Other signs that a child is struggling and may need additional help include ongoing sleep disturbances, intrusive thoughts or worries, recurring fears about illness or death.  If you notice similar symptoms or other behaviors, thoughts, or feelings that seem out of character for your child, seek a consultation with a pediatric mental health professional.  For help finding such a provider, your child’s pediatrician, family physician, or school counselor are good places to seek a referral.

Unfortunately, stigma about mental illness remains the key reason that people do not access care.  It is important to know that more than 50 percent of the population will suffer from a diagnosable mental illness at some point in their life and about 20 percent every year.  Only a small fraction of these individuals ever seek treatment.  One way to start breaking the stigma is to start talking about mental illnesses as a part of normal conversation, similar to how we may discuss illnesses like diabetes or high blood pressure.  Mental illnesses are common, biological illnesses that tend to respond very well to treatments that are typically very safe.  The goal of mental health treatment is to get back to feeling completely like yourself again.  In most cases, treatment is highly effective and allows individuals to function to their full potential.

When it comes to mental health, we need to start treating ourselves more gently.  We also need to extend that compassion to those around us.  We may be social-distancing but we are all in this together.  As, together, we work to fight off this pandemic and take up the challenge of recovering from it, kindness to ourselves and others has never been more important.

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others call:

  • 911
  • Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)
  • The National Suicide Prevention Line: 800-273-8255

 

 

 

You can’t affect the cards that are dealt, but you can determine how you play them.

Milton Erickson, MD
Psychiatrist
The father of modern hypnotherapy

When we think of hypnosis, we typically think of a stage performance in which the subject is crowing like a rooster or engaged in some outlandish behavior designed to entertain. Many view hypnosis as a “party trick” or an “act” for amusement. However, the practice of medical hypnosis can be traced back thousands of years in cultures around the world. It was once used for pain management during surgery until doctors started using ether. Today, physicians, licensed psychotherapists and psychologists commonly use it as a tool for change. Hypnosis or hypnotherapy, has been known to help patients with everything from depression, anxiety and phobias to smoking cessation, weight loss, stress management and irritable bowel syndrome. Some hospitals even use it as a tool to reduce pain in individuals before, during and after surgery, as well as in patients with chronic conditions or diseases. Hypnosis is a human condition involving focused attention, reduced peripheral awareness, and an enhanced capacity to respond to suggestion.

One major myth regarding hypnosis is that the individual is unconscious – and powerless. Most people have a clear memory of what happens during hypnosis, while another’s recollection might be not as clear. Some might be able to move their head or lift a finger if they’re prompted, whereas others will remain impassive. Everyone’s experience with hypnosis can differ. While “under” hypnosis, you are not rendered unconscious; you are simply in a deeply relaxed state. In fact, we enter “trance” states all the time. Most of us are familiar with highway hypnosis, the phenomenon in which the person can drive a vehicle great distances, responding to external events in the expected, safe and correct manner with no recollection of having consciously done so. Another example of a common trance state is watching a movie. When we watch a movie, we know actors are up on the screen. We know that this story is not happening in real life. But for those few hours, we can experience emotions and a connection to the story. A movie can create an experience of happiness, sadness, suspense, fear or joy.

Hypnosis is a deeply relaxed state in which suggestions can be given to assist the individual in changing a maladaptive behavior. Do you remember when you were playing as a child and fell down, and your parent kissed your “boo boo,” and you instantly went back to play? Suggestion can change our behaviors.

One of the major problems within the field of research is when clinical trials are conducted and a medication or placebo is given to a subject, the placebo (a sugar pill) turns out to work too well. Researchers don’t like this. Unaware subjects who receive the placebo should not report a difference from the sugar pill, but sometimes they do. The subject’s belief or the “suggestion” that the “pill” is going to improve how one feels, in fact, improves how he or she feels. Recent studies have also found that even a physician’s own presentation of the effectiveness of a new medication to the patient, can result in a patient’s higher perception that the medication is going to be effective, resulting in a more positive result for the patient.

Even though hypnosis has faced many misconceptions through the years, it remains an effective technique in making behavioral changes and improving the lives of many individuals. Not everyone may respond to hypnotherapy in the same way, but this can also be said about other treatment approaches. In searching for a hypnotherapist, find a licensed professional within the mental health or medical fields, and who has been certified to conduct this clinical hypnosis. The American Society of Clinical Hypnosis is a resource, which can assist in locating a certified hypnotherapist in your area. Like meditation, guided imagery, acupuncture, and music therapy, Hypnotherapy can be a valuable tool in providing a healing science to facilitate the body’s innate healing response.

by: Lindner Center of HOPE’s Spiritual Care Team

Research has shown that laughter has tremendous benefit to your emotional and physical health. One study in Norway even concluded that people who laugh a lot live longer! It is good medicine for the soul and the mind. Consider:

  • Laughter stops distressing emotions. You can’t feel anxious, angry, or sad when you’re laughing.
  • Laughter helps you relax and recharge. It reduces stress and increases energy, enabling you to stay focused and accomplish more.
  • Laughter shifts perspective, allowing you to see situations in a more realistic, less threatening light. A humorous perspective creates psychological distance, which can help you avoid feeling overwhelmed and diffuse conflict.
  • Laughter draws you closer to others, and we all need people we can count on.[1]

Having a sense of humor is not necessarily natural to everyone. But finding the funny can be developed.

  • Smile, it is the start of laughter
  • Consider your blessings, it will make you more open to humor.
  • Pull it into your life. Ask others for their funniest stories.
  • Schedule time to look for the funny. Today’s tech makes this so very easy!

All of us could use more laughter. Find people who are playful and play. Listen for laughter and go find out what is so funny. Watching a baby laugh seems to work magic on our own funny bone. And laughing at ourselves is always a good practice.

by: Elizabeth Mariutto, PsyD, Lindner Center of HOPE, Psychologist and Clinical Director of Partial Hospitalization/Intensive Outpatient Adult Eating Disorder Services

With all of the news and changing regulations in our current times, it can be very hard to manage anxiety and mood related to coronavirus. Below are 10 tips on how to manage your mental health.

1. Limit your access to the news and social media. With everything changing minute by minute, it is easy to find yourself constantly scrolling various sources. Possibly set a certain number of times per day or a set amount of time that you are “allowed” to check one news source that you trust. Some find it helpful to set an appointment with themselves to do so and limit their checking to this appointment. Some phones allow to you track or limit your screen time, which can be a beneficial tool. It can also be helpful to physically put your phone or computer in a separate place, or to go in a separate room from your TV.

2. Practice mindfulness. Try to take it day by day and remember that all of this is temporary. Use of apps such as Headspace and Calm can help promote mindfulness.

3. Use gratitude. Identify 1-3 things each day that you are grateful for. Don’t neglect things that we take for granted, such as our physical health, the ability to use technology to keep us connected, and all of those working at those grocery stores to keep the shelves stocked as much as possible.

4. Focus on what matters in the big picture. Taking steps to practice social distancing is to help our healthcare system avoid being overwhelmed and to help healthcare workers save lives. These could be those that you love, or loved ones of your loved ones.

5. Stay active. Exercise releases endorphins and can help us stay both physically and emotionally happy when done in moderation.

6. Go outside. Vitamin D can positively impact our mood and energy level, and a great source is from the sun.

7. Stay connected with others. This is key when practicing social distancing. Facetime is a great way to be present with those you love without increasing anyone’s risk.

8. Perform acts of service. Volunteering can lead to improvements in mental health, so offering to bring groceries to an elderly neighbor or donating to a local food pantry can both help others as well as boost our mood.

9. Engage in hobbies. One of the best ways to fight depression is to engage in behavioral activation, or do things that are fun for you. This may be a great time to try a new recipe if you enjoy cooking, or to take that online course on photography.

10. Get connected with resources if needed. Many therapists are switching to use of different technologies for therapy to help with social distancing, and you can find self-help resources online to help cope with stress

“Cada persona debe vivir su vida como un modelo para otros.”

Rosa Park

Tenia muchas ideas para esta columna de marzo, fundamentalmente dedicarla al tema de la Mujer (a razón del día internacional de la mujer) y a las mujeres de mi vida y sus grandes hazañas pero para ello ya habra tiempo…

Creo que desde hace unas semanas todos estamos tratando de entender y explicar esta experiencia global sin precedentes que es la pandemia del coronavirus COVID-19 y por sobretodos las cosas intentado mantener la calma y la cordura.

Por norma, toda  situación de incertidumbre produce un desbordamiento de la angustia y debilita nuestras defensas habituales para manejarla.  Sin darnos cuenta, nuestros horarios, hábitos, rutinas y en general el orden del mundo exterior juegan un papel importante en nuestra propia organización interior y en nuestra identidad. Así, la incertidumbre y este quiebre en nuestra cotidianidad pueden dar origen a un cuadro emocional de confusión. Nosotros como inmigrantes estamos en una posición aún más vulnerable pues en nuestra identidad ya puesta a prueba, esta confusión puede reactivar la experiencia traumática vivida alrededor del proceso migratorio y enfrentarnos a fenómenos de “Deja Vu” y des-realizacion como manifestaciones de una angustia desbordada.

A continuación, algunos cambios a los que debemos estar atentos:

  • Dificultad para distinguir nuestras emociones  (impotencia, rabia, tristeza, frustración, euforia, angustia)
  • Distorsión de la realidad, bien sea minimizando o negando los hechos reales  o magnificándolos de una forma desproporcionada. (“No pasa nada vs el mundo se va a acabar”)
  • Cambios bruscos en nuestro estado de animo (cansancio e indiferencia  o hiperactividad )
  • Problemas para enfocarnos y concentrarnos en el trabajo o en el estudio.
  • Diversas y múltiples manifestaciones de la angustia: problemas para dormir o mantener el sueno, trastornos de la alimentación o de la vida sexual, malestares físicos, ataques de pánico, fobias o ansiedad generalizada.
  • Tendencia a la auto-medicacion  a través del incremento en el uso de tranquilizantes, alcohol, cigarrillos o drogas

Qué hacer ?

  • No intentar escapar de la realidad. No es posible. Mantenernos desinformados nos debilita aun mas.  Debemos mantener canales de percepción para estar informados de lo que acontece y acatar todas las medidas sanitarias recomendadas por el CDC (center for disease control ) mientras  también preservamos canales que nos protegen de la sobre-exposicion a la “noticia del día”. Con más razón aun, Mantengamonos nuestra mente y nuestro cuerpo activo a través del ejercicio y la meditación en cualquiera de sus formas.
  • Dale espacio a la creatividad. Muchos tendrán mas tiempo libre en sus manos si les corresponde quedarse en casa. Utilicen ese tiempo para darse permiso y hacer algo que siempre hubieran querido hacer y nunca encuentran el tiempo. Escriban esa canción que siempre sonaron con escribir.  Hagan música como los italianos en cuarentena desde sus balcones en Sicilia y otras ciudades. Comiencen por fin ese proyecto que tienen pendiente comenzar “algún día”. No permitan que el aburrimiento les gane esta partida.
  • Mantener la capacidad de disfrute-  lNo permitas que a rabia y la tristeza por lo que perdemos (planes de viaje de trabajo o vacaciones , carreras cortas, maratones para los que nos hemos estado entrenando, la visita tan esperada de familiares o amigos que nos impulsa a diario a no sentirnos tan lejos de nuestra tierra de origen) te impida disfrutar de lo que si conservamos.
  • Pensar en que nuestras acciones individuales afectan el colectivo – Mientras escribo este articulo, me tope con mensaje en twitter que decía lo siguiente: Han visto a muchísima gente correr a los mercados a comprar todo lo posible al mismo tiempo y en el mismo momento en lugar de limitarse a comprar lo que verdaderamente necesitan para la semana o la quincena. Ahora imagínense la misma dinámica en los hospitales. En lugar de papel higiénico serian camas y ventiladores en la terapia intensiva que no serian suficientes para cubrir la demanda.
  • Cuida tus relaciones familiares y de amistad más allá de la necesidad de “distanciamiento social”. Se nos ha pedido evitar el contacto social y sobretodo físico en todas las areas de nuestra vida para prevenir el contagio viral. Cuando estes en casa o en tu lugar de trabajo No uses a tus seres queridos como “basureros” de tu angustia. Más importante que nunca es importante conservar y no poner en riesgo nuestras relaciones mas significativas.   Usa el teléfono para textos y llamadas de video conferencia para mantenerte juntos “cercanamente lejos”.
  • Busca ayuda psicológica lo antes posible – Mientras más temprano busques ayuda especifica mas fácil sera poder empezar a sentirte mejor. El uso excesivo de tranquilizantes sin prescripción medica puede disminuir nuestra capacidad para pensar y reaccionar frente a las crisis.

La invitación este mes es a ser un modelo para otros, a cuidarnos todos, tanto del virus como de la “locura” que puede producir.

by: Margot Brandi, MD,Sibcy House, Medical Director