Self-care during COVID and beyond
During my career as an individual therapist in Dallas, TX, I have noticed that many of my clients have something in common: they are kind, caring people, but they are not always very good at caring for themselves. Part of the reason for this is because they believe they are not as deserving of care as others, a topic I touched on in my previous post, “Your Relationship With Yourself.” Another reason is that, very often, people simply aren’t used to thinking about taking care of themselves. Many of us learned to believe that care is something you only do for others. But whatever the reason, most of us are likely to agree that basic self-care is probably a good idea. I’ve never heard a compelling argument for why it wouldn’t be.
As important as self-care is, we are living through a time when it is more important than it has ever been. A global pandemic has turned our world upside-down, figuratively speaking. As of this writing, new infections, hospitalizations, and deaths due to COVID-19 continue to soar, and now there is news of a new, more contagious strain of the coronavirus.
This pandemic has created stress and suffering on a global scale. According to the Centers for Disease Control and Prevention (cdc.gov), which conducted a study at the end of June of last year, adults in the U.S. reported significantly elevated adverse mental health conditions associated with COVID-19. Younger adults, racial and ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation.
Among those people who participated in the study, 31% reported symptoms of anxiety and/or depression; 26% reported trauma/stressor-related disorder symptoms; 13% reported starting or increasing substance use; and an alarming 11% stated they had considered suicide. Overall, the prevalence of symptoms of anxiety disorder was three times higher than during the second quarter of 2019, and the prevalence of depressive disorder was four times higher. In short, the pandemic has created a mental health crisis with no end in sight, and we are in the thick of it.
In my practice, I’ve seen a huge spike in anxiety symptoms over the past several months, mostly related to COVID. Throw in the recent election and the events at the Capitol on January 6th, and there is no wonder that people are experiencing an increase in feelings of anxiety, anger, sadness, and helplessness.
All of this raises a question that many are asking at this moment: Do I need help? In order to answer that question, the National Institute of Mental Health (nimh.nih.gov) provides the following guidelines:
If you decide to seek the help of a therapist, another good resource is the “Find a Therapist” tab on the website, psychologytoday.com. (I get about half of my referrals from this site.)
Regardless of whether or not you decide to seek professional help, self-care is critical. So let’s take a closer look at the recommendations provided by the National Institute of Health:
1. Exercise. It would be difficult to over-state the benefits of regular exercise. Most of us know intuitively that exercise does something good for our mental health, but recent controlled experiments have proven it beyond all doubt. Yet in spite of this, there is a lot of resistance to exercising. Many of my clients have said to me, “I know, I know, I really should start working out,” but not many actually follow up on this. Which is a shame, because it helps. As a general rule, anything that is good for your physical health is good for your mental health, as well. That’s why I have a sign in my office that says, “Ask your doctor if getting off your ass is right for you.”
2. Engaging in social contact. As the saying goes, social distancing doesn’t mean social isolation. While it’s understandable that many of us are sick of Zoom meetings, they are a lot more fun when it’s with family and friends. Making the time to socialize with others is part of how we take care of ourselves.
3. Adequate sleep. It’s a cruel irony that for many people, heightened anxiety leads to insomnia, which in turn creates more anxiety, creating a vicious cycle. Sometimes, so-called “sleep hygiene” simply isn’t enough to overcome this. At some point, medication may be called for, whether it’s over-the-counter or prescription. A lot of people don’t like the idea of having to take something to help them sleep, but lack of sleep is not good for our mental health. I’ve had quite a few clients who were resistant to the idea of sleep meds, but they reached a point where something had to give. Most of them have expressed immense relief and positive benefits from being able to get a good night’s rest. And taking a medication doesn’t necessarily mean you have to take it for the rest of your life – sometimes, insomnia is a phase.
4. Eating healthy. Again: if it’s good for your physical health, it’s good for your mental health. ‘Nuff said.
5. Talking to a trusted friend or family member. The essence of therapy is simply giving voice to your feelings. Ideally, this is done in a caring, non-judgmental environment with someone who has a degree of empathy. Not everyone we know will fit the bill. Some people are better listeners than others, so we must choose wisely.
6. Practicing meditation, relaxation, and mindfulness. Easier said than done. But part of being mindful is a little practice I call the “emotional check-in.” It’s pretty easy. Here’s how: Sit with yourself in a quiet, distraction-free environment. Take a few moments to simply breathe and relax, and then ask yourself, “What feelings am I having right now?” To help answer the question, consider this list of common emotions: happiness, sadness, anger, fear, powerlessness, guilt, and shame. (Did you notice only one of those isn’t a form of emotional pain?) Keep in mind, you can feel more than one thing at a time, and some emotions might contradict others, which is normal. Spend some time with yourself, and go deep into your feelings. It’s important to maintain an attitude of complete non-judgment, which is the essence of mindfulness. Acknowledge and allow the feelings. The purpose isn’t to change what you are feeling, it’s to identify and understand your feelings. You may think about what is causing you to feel what you do, but again, remain judgment-free. Some of the feelings (like guilt) might suggest a course of action, while others (like sadness) must simply be allowed to run their course. If everyone practiced this emotional check-in twice a day, the world would be a much calmer place.
Remember, we are living through an extraordinary time in human history. Most of us have heard what is purported to be an ancient Chinese curse: “May you live in interesting times.” We are certainly living in interesting times. Part of how we will get through it is the practice of self-care.