Speaker 1: Hi.
Speaker 2: I'm Aaron Welsh and I'm Aaron Allmont Updike, and.
Speaker 3: This is this podcast will kill you?
Speaker 1: Sure is.
Speaker 3: This is an episode that is chapter six of our
Speaker 3: series called Anatomy of a Pandemic, which covers COVID nineteen
Speaker 3: and all the different aspects of disease. It's been about
Speaker 3: a week and a half since COVID nineteen was declared
Speaker 3: a pandemic by the WHO, and since that time, our lives,
Speaker 3: everyone's lives have changed dramatically, some more than others. And
Speaker 3: you know, I think it's our tendency. I can speak
Speaker 3: for both of us, Aaron right for sure when I
Speaker 3: say that we like to fight fear with facts. But
Speaker 3: there is still so much about this virus and this
Speaker 3: pandemic that we don't know about, and we don't know
Speaker 3: how it's going to go. We don't have a roadmap
Speaker 3: for this. And thinking about our personal risk, or our
Speaker 3: risk to others, or the risk to our families or
Speaker 3: our friends, or the economic outcomes, I mean, all of
Speaker 3: this can send us swirling down the rabbit hole of
Speaker 3: stress and anxiety and bad dreams and or lack of sleep.
Speaker 3: That's not exactly a helpful thing. No, and so we
Speaker 3: wanted to bring on a couple of amazing people who
Speaker 3: can share with us coping strategies or good practices to
Speaker 3: try to get a handle on our stress and anxiety
Speaker 3: and to help us think about where it's coming from.
Speaker 2: So for this episode, we were really fortunate to speak
Speaker 2: to Rosemary Walker and Pete Rosenkranz, two graduate students at
Speaker 2: the University of Washington in psychology, to talk to us
Speaker 2: about all of kind of the mental health issues about
Speaker 2: this pandemic. They were really incredible to talk to and
Speaker 2: so we hope that you really enjoyed this episode. I
Speaker 2: think it was one of our favorites to record because
Speaker 2: this is stuff that we don't know anything about. We
Speaker 2: go into anxiety spirals just like everyone else very easily.
Speaker 2: So this was really really personally useful and hopefully it'll
Speaker 2: be useful for listeners as well.
Speaker 3: Yeah. So, but first we do indeed, speaking of coping strategies,
Speaker 3: this is we do not recommend alcohol in any way
Speaker 3: as a coping strategy. No, but because you know branding
Speaker 3: and symmetry, we have to have a quarantini recipe.
Speaker 2: So if you want to make the place sipa rita
Speaker 2: version that'd be a good coping strategy.
Speaker 3: Yeah, it's pretty delicious. Okay, So what is in Quarantiny six?
Speaker 2: Quarantine six is a wine spritzer with pineapple juice and
Speaker 2: some kind of like a nice fruity white wine, like
Speaker 2: a Pinot Grease or something, I don't know, whatever you
Speaker 2: have in your cupboard.
Speaker 3: Yeah, honestly, that's kind of the theme of these quarantinies
Speaker 3: so far, is that, like, you know, this.
Speaker 2: Is what we had. A can of pineapple juice and
Speaker 2: a twist top bottle of wine. Don't knock the twist top, No,
Speaker 2: I love Twisttop. I was actually disappointed in myself that
Speaker 2: I bought multiple bottles and one of them had a cork,
Speaker 2: and I was like, dang, should have gone all twisted.
Speaker 3: I shred about forty percent of the cork works that
Speaker 3: I try to do.
Speaker 2: You really remove learned something new about you today. Let's
Speaker 2: take a quick break and then dive into this episode.
Speaker 4: My name's Rosemary Walker. So I'm a sixth year doctoral
Speaker 4: student at the University of Washington and my lab focuses
Speaker 4: on or Our lab is called the Center for Anxiety
Speaker 4: and Traumatic Stress, and a lot of our work focuses
Speaker 4: on providing psychotherapy to individuals with anxiety disorders and post
Speaker 4: traumatic stress disorder, and I work in various clinics throughout
Speaker 4: the Seattle area, mainly our University clinic, where we provide
Speaker 4: psychotherapy to individuals with kind of a broad spectrum of
Speaker 4: mental health needs.
Speaker 1: My name is Pete Rosencranz. I'm a fourth year doctoral
Speaker 1: student at the University of Washington, also working in the
Speaker 1: Center for Anxiety and Dramatic Stress, which is doctor Lori's
Speaker 1: owner's lab that you dub Similar to Rosie, my research
Speaker 1: interests primarily focused on anxiety and PTSD, particularly on I
Speaker 1: was doing some of the treatment mechanisms and therapeutic change
Speaker 1: processes that are going on in our treatments for these issues,
Speaker 1: and also, similarly to Rosie, kind of do a range
Speaker 1: of clinical experiences ranging from clients I see through our
Speaker 1: University Psychology graduate clinic, our training clinic, as well as
Speaker 1: external practice sites around the Seattle area.
Speaker 3: Awesome, thank you, So, I mean, first, I would love
Speaker 3: to hear how you guys are doing. So you're in
Speaker 3: wah Ohington State, which is one of the states that's
Speaker 3: been hit the hardest by COVID nineteen and so you know,
Speaker 3: you've been experiencing these things and probably thinking about these
Speaker 3: things on a day to day basis much earlier than
Speaker 3: some of the rest of us in the US have.
Speaker 3: So can you just kin, don't know, how are you
Speaker 3: guys doing.
Speaker 4: Yeah, yeah, it's a good question. And I've been getting
Speaker 4: that a lot, you know, I think because it really
Speaker 4: it hit here first, and so it has been i
Speaker 4: think a little bit more present for us for a
Speaker 4: bit longer than other parts of the country.
Speaker 1: And yeah, I.
Speaker 4: Would say I would say it's been a it's been
Speaker 4: a challenging time. Life as we have known it has
Speaker 4: really changed, which is now probably starting to be true
Speaker 4: for most people across the country, across the world really,
Speaker 4: and I think one of the hardest parts has really
Speaker 4: been the uncertainty of it all and a lot of
Speaker 4: adjusting to changes in you know, lifestyle and work and
Speaker 4: things like that, and the social distancing aspect has been
Speaker 4: difficult as well.
Speaker 1: I think.
Speaker 4: On the other hand, we've heard this a lot this
Speaker 4: week across patients and friends in Seattle, but the sun
Speaker 4: came out this past week, which I think we have
Speaker 4: been especially thankful for. I also would say there's been
Speaker 4: a feeling of you know, shared humanity and community and
Speaker 4: a lot of creativity being sparked too.
Speaker 1: In the past few weeks.
Speaker 4: That I've really seen from you know, breweries and restaurants
Speaker 4: offering kind of curbside deliveries that they you know, hand
Speaker 4: to on a pole into your car, to you know,
Speaker 4: organizations gathering people to babysit for medical professionals, or writing
Speaker 4: letters to individuals who are quarantined, or organizing dance parties
Speaker 4: in the street, things like that. So it's been it's
Speaker 4: a difficult time. The uncertainty is hard, and I also
Speaker 4: think there's been it's been uplifting to see the community
Speaker 4: coming together.
Speaker 1: Yeah, I would, I would really echo pretty much everything
Speaker 1: that Rosie is saying. The uncertainty has definitely been a
Speaker 1: major challenge. I also think it's especially early on when
Speaker 1: we were seeing some of those first cases emerge here,
Speaker 1: it really wasn't clear what we should be expecting and
Speaker 1: exactly what we needed to be doing, and kind of
Speaker 1: just what the future in the near term was going
Speaker 1: to look like, and that was just kind of really
Speaker 1: hard to navigate and prepare for. Now, there does seem
Speaker 1: to be a bit of a new normal that's being
Speaker 1: established here with you know, pretty much everybody is working
Speaker 1: remotely at this point except for kind of those essential
Speaker 1: businesses and services. There's a lot of social distancing going on,
Speaker 1: self quarantining going on, and I think becoming increasingly clear,
Speaker 1: at least to me, My general assumption is that we're
Speaker 1: in this for a longer hold than I initially expected,
Speaker 1: on the scale of months as opposed to days or weeks,
Speaker 1: And so I think at this point the main challenge
Speaker 1: for me is just trying to kind of embrace this
Speaker 1: new normal and figure out, you know, how do I
Speaker 1: want to structure my day so that I can retain
Speaker 1: some semblance of normalcy and build some new routines into
Speaker 1: my life, and how can I kind of make the
Speaker 1: changes that I need to be making to ensure that
Speaker 1: I can keep up my work, my personal wellbeing, social connections,
Speaker 1: all those sorts of things.
Speaker 2: Yeah, So the impacts of this disease we're seeing is
Speaker 2: they're super diverse, of course, and much broader than just
Speaker 2: the impact on people's health. And none of us have
Speaker 2: really ever experienced something like this before, especially not on
Speaker 2: this scale. So what are we seeing in terms of
Speaker 2: some of the mental health outcomes.
Speaker 1: Yeah, So I can start out talking just kind of
Speaker 1: generally about what we're seeing broadly speaking in terms of
Speaker 1: mental health outcomes. And I think you're really you're hitting
Speaker 1: the nail on the head there when you say that
Speaker 1: this is an unprecedented situation, because I think in a
Speaker 1: lot of ways that defines are action right now. It's
Speaker 1: just that inherent uncertainty that's going on. So broadly speaking,
Speaker 1: I think we're seeing kind of an increase in some
Speaker 1: negative mental health outcomes and as well as a decrease
Speaker 1: in some positive aspects of mental health. So what I
Speaker 1: mean by that is, on the negative side, we're seeing
Speaker 1: increases in stress and anxiety on a pretty broad scale
Speaker 1: that are being driven by actual health and socioeconomic threats
Speaker 1: to ourselves, our loved ones, in our communities that COVID
Speaker 1: nineteen presents. I think that stress and anxiety has really
Speaker 1: been compounded by that sense of uncertainty and that sense
Speaker 1: of helplessness that often comes along with this. We know
Speaker 1: from a long history of research in animals and mammals
Speaker 1: and humans that uncertainty and unpredictability and uncontrollability really tend
Speaker 1: to drive these fear and anxiety reactions and kind of
Speaker 1: exacerbate them. So I think we're seeing those reactions really
Speaker 1: amp up. I think we're also just seeing difficulties that
Speaker 1: come along with balancing competing demands from work, family, personal responsibilities,
Speaker 1: your social needs. You know, there are families who have
Speaker 1: kids who are home from school because the school systems
Speaker 1: are closed, while the parents are trying to work remotely
Speaker 1: at the same time. Probably have households where some parents
Speaker 1: are maybe getting sick and also trying to care for
Speaker 1: their children at the same time, and that just really
Speaker 1: increases the overall stress and level of demand across the board.
Speaker 1: Some other key things I think we're seeing are kind
Speaker 1: of the sense of detachment from our social connections, from
Speaker 1: our social lives in general. That comes along with this
Speaker 1: effort to practice social distancing and self quarantining. So we're
Speaker 1: spending more time in isolation or maybe solely with members
Speaker 1: of our household, or maybe seeing some disruptions and social
Speaker 1: activities and social connections. We're seeing kind of big life
Speaker 1: events be disrupted, so weddings having to be canceled, their mood,
Speaker 1: vacation's rescheduled, you know, maybe visits that we're skilled to
Speaker 1: family members who live in a different area, those are
Speaker 1: being put on hold, and so I think what comes
Speaker 1: along with that. In addition to the kind of increase
Speaker 1: in anxiety and stress that I've talked about, there's also
Speaker 1: we're kind of losing access to some of these sources
Speaker 1: of positivity and reward that we ordinarily have that make
Speaker 1: our lives enjoyable. We're seeing our hobbies be interrupted. We're
Speaker 1: seeing disruption to the things that we find fun and
Speaker 1: that we like to do, and some of the reactions
Speaker 1: we can see from this can be you know, sadness
Speaker 1: and response to some of those losses. Might even see
Speaker 1: some depressed mood as some of those activities have to
Speaker 1: be canceled or postponed indefinitely. And as we kind of
Speaker 1: decrease our activity overall and lose access to some of
Speaker 1: those positive things in our lives, we might be seeing
Speaker 1: some decreased motivation in general, as well as antiedonia or
Speaker 1: kind of a loss of an ability to experience positive feelings.
Speaker 4: I was just going to add a little bit more,
Speaker 4: you know, I echo, I would echo everything Pize says,
Speaker 4: but I would also add a couple unique considerations for
Speaker 4: the clinical populations we work with. So we work particularly
Speaker 4: a lot with individuals with experiencing mood and anxiety disorders,
Speaker 4: and you know, for individuals with anxiety in particular, one
Speaker 4: thing we know is that uncertainty tends to be most
Speaker 4: people don't love uncertainty, but for individuals with anxiety disorders,
Speaker 4: uncertainty is particularly challenging to tolerate. So you know, we
Speaker 4: can see, we can imagine that this might be impacting
Speaker 4: them kind of even more. And another piece of it
Speaker 4: also is that a lot of our work with individuals
Speaker 4: with anxiety disorders focuses on challenging sort of overly negative
Speaker 4: or catastrophic thoughts. So these thoughts might be that we
Speaker 4: focus a lot on might be things like the world
Speaker 4: is completely dangerous, or something terrible is going to happen
Speaker 4: to me or my family if I don't take extreme precautions,
Speaker 4: for example. And so a lot of our work, like
Speaker 4: I said, in psychotherapy, we focus on challenging these beliefs
Speaker 4: through various evidence based techniques to help individuals develop more
Speaker 4: balanced or realistic thoughts. And so you can imagine that
Speaker 4: the current COVID nineteen situation is making some of those
Speaker 4: catastrophic beliefs a little bit harder or more difficult to
Speaker 4: challenge for some of our patients. So, you know, having
Speaker 4: the reality is that risks right now of becoming sick
Speaker 4: or loved ones becoming sick are higher, and so again
Speaker 4: we're sort of aware of the fact that for many
Speaker 4: of our patients they're experiencing kind of even finding it
Speaker 4: even more difficult to kind of work to challenge those
Speaker 4: overly kind of catastrophic beliefs. And then also the kind
Speaker 4: of there are some specific considerations for individuals experiencing or
Speaker 4: in psychotherapy for depression because sort of Pete hit on
Speaker 4: this a little bit, but a lot of the work
Speaker 4: that we do with our patients with depression is around
Speaker 4: scheduling activities because there's a real link. We've seen this
Speaker 4: kind of consistently, and a lot of our therapies are
Speaker 4: based on the kind of connection between your activity level
Speaker 4: and your mood, and so when we're working with individuals
Speaker 4: experiencing depression, we might spend a lot of time making
Speaker 4: kind of an activity schedule to boost their mood. And
Speaker 4: we know that kind of engaging in activities that our
Speaker 4: values based tends to have a positive effect on our mood,
Speaker 4: and it's one of our main ways for targeting depressed mood.
Speaker 4: So again, sort of like we were all just talking about,
Speaker 4: you can imagine there might be some particular implications for
Speaker 4: individuals already experiencing depression to then have it harder to
Speaker 4: access these activities or to be active because of social distancing.
Speaker 4: So we're really working to be proactive and creative to
Speaker 4: address that with our patients who we're working with to
Speaker 4: who are experiencing depression.
Speaker 3: Yeah, that is you know, additional challenges. It's very important.
Speaker 3: So you know, you two have unique perspectives in the
Speaker 3: mental health profession. Can you talk about some of the
Speaker 3: challenges that you have faced so far and some of
Speaker 3: the challenges that you think are going to appear in
Speaker 3: the future as this COVID nineteen situation progresses.
Speaker 4: Yeah, yeah, I think, you know, like everybody else right now,
Speaker 4: this is all very novel. We're navigating new water, and
Speaker 4: I think over the past month, flexibility has been incredibly
Speaker 4: important for us and also for our patients. So you know,
Speaker 4: for example, one day, the University of Washington clinic was
Speaker 4: seeing patients in person, and then we changed the next
Speaker 4: day to kind of having it optional in person, and
Speaker 4: then an option to do what we call telehealth or
Speaker 4: sort of therapy virtually, and then the very next day
Speaker 4: we changed it to they it had all sessions had
Speaker 4: to be moved to telehealth. So I think just you know,
Speaker 4: being really flexible and creative and in terms of kind
Speaker 4: of rolling with the updates and sort of the new restrictions,
Speaker 4: and also balancing kind of the needs of our patients
Speaker 4: with the need for social distancing and working with our
Speaker 4: patients to find something that works for them. If we
Speaker 4: can't meet in person person, not all the clinics in
Speaker 4: Seattle have the ability to move to telehealth or even
Speaker 4: walk to you know. Again, it's sort of a balance
Speaker 4: between what's best for our patients and also the need
Speaker 4: to distance ourselves right now. So for example, if patients
Speaker 4: are particularly at high risk for suicide, a provider might
Speaker 4: decide that meeting in person is still important or necessary.
Speaker 4: Patients with social anxiety, it might be a real barrier
Speaker 4: to get them to meet via telehealth. On the other hand,
Speaker 4: telehealth has been around for a long time. Not everybody's
Speaker 4: trained in it, so some people have had to kind
Speaker 4: of go through really quick training to be able to
Speaker 4: provide telehealth. But you know, there's a lot of evidence
Speaker 4: to suggest that it can be very effective, and yeah,
Speaker 4: I think that's been a big piece of it is
Speaker 4: also just getting that all set up for everybody. And
Speaker 4: then there's more specific things again to our psychotherapies as
Speaker 4: we deliver them that need to be adapted if you're
Speaker 4: going to be doing them via telehealth, So things like,
Speaker 4: you know, when we're treating patients with anxiety disorders, a
Speaker 4: lot of the time we actually leave the clinic and
Speaker 4: go out and do what we call exposure exercises, so
Speaker 4: things like having our patients approach things that they're afraid
Speaker 4: of in order to learn that it's not actually dangerous
Speaker 4: or that they can tolerate the distress that comes up
Speaker 4: as they approach that feared situation. And so sometimes we
Speaker 4: do that in our sessions, and clearly that's more challenging
Speaker 4: when you're meeting via telehealth, but again there are resources
Speaker 4: to turn to because telehealth has been rolled out, you know,
Speaker 4: and becoming used more and more, especially for rural populations
Speaker 4: and things like that, over the past few years. So yeah,
Speaker 4: I would say again, I would just say that flexibility
Speaker 4: has been really important and sort of trying to meet
Speaker 4: the needs of our patients as best we can, despite
Speaker 4: the current events and the limitations that are being put
Speaker 4: on us, and maybe some of the reasons why it's
Speaker 4: maybe not best to meet in person.
Speaker 2: Yeah, so we've heard a lot from our listeners, our
Speaker 2: friends and family. You guys brought up a lot of
Speaker 2: the different stressors and anxieties that people have been feeling.
Speaker 2: Aaron and I I can speak for us both right
Speaker 2: erin Oh, Yeah, we've both we've both been really feeling
Speaker 2: this as well too. A lot of the fear, the apprehension,
Speaker 2: the anxiety about all of this uncertainty. Even us even
Speaker 2: though we kind of, you know, know about the fact
Speaker 2: that these sorts of pandemics could potentially happen, it's still
Speaker 2: so unknown is what is going to happen. So could
Speaker 2: you talk a little bit about some of the coping
Speaker 2: strategies that we could all use to try and deal
Speaker 2: with some of the issues that we're facing, like the
Speaker 2: social isolation, the empathy, fatigue, and all of this anxiety
Speaker 2: about the future.
Speaker 1: Yeah, absolutely, I think there's a there's a lot we
Speaker 1: could cover here. So I'm gonna I'm gonna cover some
Speaker 1: things up front, and then Rosie's gonna take over from there.
Speaker 1: So the first place I would start out is just
Speaker 1: to really emphasize the importance of normalizing and validating some
Speaker 1: of these negative emotional responses and feelings that are coming up,
Speaker 1: as you're saying, with the levels of uncertainty that we have,
Speaker 1: how little we know about how this is going to
Speaker 1: progress and what kind of what the actual level of
Speaker 1: threat is, as well as those kind of socioeconomic stressors
Speaker 1: that come along with the health risks. You know, stress
Speaker 1: and anxiety are certainly to be expected here, and it's
Speaker 1: not a sign, you know, if you're experiencing elevated stress
Speaker 1: and anxiety right now, it's not a sign that something
Speaker 1: is kind of fundamentally wrong with you. Those feelings are
Speaker 1: are normal given this context, and there might be some
Speaker 1: comfort in just kind of reminding yourself of that when
Speaker 1: you notice these feelings coming up in a more intense
Speaker 1: way than maybe you've been used to in the past,
Speaker 1: and then to really kind of validate them, like the
Speaker 1: feelings aren't coming out of nowhere right like there is
Speaker 1: an actual threat out there. There is actual kind of
Speaker 1: bona fide uncertainty and unpredictability out there, and that's what
Speaker 1: these emotions are really responding to and that's the way
Speaker 1: they're supposed to function. And so these emotional responses, even
Speaker 1: though they can be unpleasant, oftentimes they actually have real
Speaker 1: value to us. Anxiety and worry, again certainly can be unpleasant,
Speaker 1: but it can also help motivate us to prepare and
Speaker 1: protect ourselves and our families. Key thing I would also
Speaker 1: mention here is while it's important to validate and normalize
Speaker 1: these feelings and kind of accept them that they're kind
Speaker 1: of part of our experience for now, given the situation
Speaker 1: that we're in, I think it's also important to be
Speaker 1: on the lookout for unhelpful thoughts and unhelpful behaviors. So
Speaker 1: you can ask yourself, is what I'm going to do
Speaker 1: or what I'm doing, is this actually useful or helpful
Speaker 1: or affect for me right now? One of the key
Speaker 1: things that we talk about is distinguishing between helpful and
Speaker 1: unhelpful worry. So most people are probably worrying a lot
Speaker 1: right now, to the extent that that worry and anxiety
Speaker 1: actually leads to active problem solving and adaptive coping strategies.
Speaker 1: That worry is actually useful and it can be helpful
Speaker 1: to kind of lean into that and act on the
Speaker 1: urges that come along with it. However, worry can also
Speaker 1: be taken to an extreme, and worry can kind of
Speaker 1: it can go beyond actually helping us take constructive action,
Speaker 1: and it can start to become more just self perpetuating.
Speaker 1: So I would say that worry that leads to rumination
Speaker 1: or the sense of spinning, or generally just to more
Speaker 1: anxiety and more worry without producing concrete helpful behaviors, that's
Speaker 1: not going to be so helpful. So when we notice
Speaker 1: that kind of worry coming up, it can be helpful
Speaker 1: to engage in some strategies to limit it. That might be,
Speaker 1: you know, limiting your new user media consumption so you
Speaker 1: don't necessarily want to be spending all day kind of
Speaker 1: scanning the news, especially if you're not actually gaining any
Speaker 1: new or more useful information than you had before. You
Speaker 1: might just be perpetuating that anxiety or making it worse. Similarly,
Speaker 1: I think when you are seeing out information, you want
Speaker 1: to make sure that you're actually seeking out reputable, trust
Speaker 1: trustworthy information so that you can actually act in the
Speaker 1: appropriate way. Might be just kind of distracting yourself if
Speaker 1: need be, uh, you know, preferably with something enjoyable like
Speaker 1: a book or a show or a movie, or maybe
Speaker 1: you know, video chatting with a friend. But certainly distraction
Speaker 1: can be a useful tool when we find ourselves hooked
Speaker 1: in this kind of cycle of unhelpful worry. And also
Speaker 1: mentioned it's probably helpful to be aware of some of
Speaker 1: the psychological effects that increased stress, fear, and anxiety have
Speaker 1: on our psychological system, so we know that when we're
Speaker 1: when we have elevated fear and anxiety, it changes how
Speaker 1: our attention functions can develop an increased attentional bias to threat,
Speaker 1: where we are kind of quicker to pick out all
Speaker 1: the things that appear scary and threatening in our environment,
Speaker 1: and we may be gloss over or dismiss things in
Speaker 1: our environment that maybe would be run counter to that fear,
Speaker 1: and that can lead to an escalation of fear and
Speaker 1: anxiety as well. The last thing I would say is
Speaker 1: fear has a tendency to overgeneralize, meaning that if there's
Speaker 1: something in particular that we're afraid of, like a virus
Speaker 1: or coming into contact with the virus, oftentimes that fear
Speaker 1: kind of spreads out to things that seem related to it.
Speaker 1: But that actually are something completely different. And as an
Speaker 1: example of this, I might think of, you know, fear
Speaker 1: and anxiety motivated people to go out and buy, say
Speaker 1: like enough food to have for a couple of weeks
Speaker 1: in case we can't go to the grocery store. I
Speaker 1: also saw some people going out and you know, maybe
Speaker 1: getting some things that didn't necessarily make logical sense and
Speaker 1: connection to this particular outbreak. So for instance, like going
Speaker 1: and buying up down the gawlln of the gallons of
Speaker 1: drinking a bottled water when you know our tap water
Speaker 1: is perfectly safe to drink here, and you know that
Speaker 1: maybe how we prepare for like an earthquake or another
Speaker 1: type of natural disaster where where that type of infrastructure
Speaker 1: might be threatened but isn't necessarily something that's going to
Speaker 1: be disrupted from this type of outbreak. Yet that fear
Speaker 1: can kind of push us to engage in kind of
Speaker 1: those more general actions. So I think just kind of
Speaker 1: being aware of that can be helpful to see when
Speaker 1: those tendencies are getting kicked in by the fear. Yeah.
Speaker 4: Great, that covered a lot of really good things, and
Speaker 4: I'll just add a couple more that sort of tie
Speaker 4: back a little bit to some of the things we've
Speaker 4: hit on, the first being uncertainty. We've kind of been
Speaker 4: that's come up a lot so far, and I think,
Speaker 4: like we've mentioned, uncertainty is a really is really challenging
Speaker 4: for a lot of people. People vary. There's a lot
Speaker 4: of variability and how well people tolerate uncertainty, and like
Speaker 4: I mentioned before, individuals with anxiety disorders tend to find
Speaker 4: it even more challenging usually, And so I think in
Speaker 4: this time, an important first step can be to simply
Speaker 4: acknowledge how this is a time where there is quite
Speaker 4: a bit of uncertainty, uncertainty about how long this is
Speaker 4: going to last, about what this will mean for work
Speaker 4: and our financial situations, and uncertainty about you know, potential
Speaker 4: infection of us or our families. And instead of kind
Speaker 4: of trying to spin on spin and spin and spin
Speaker 4: and look for certainty, there can be some relief in
Speaker 4: trying to sort of just accept the uncertainty for now
Speaker 4: and tolerate it. Think about other times that you've tolerated
Speaker 4: uncertainty and how you did that, and with that acceptance,
Speaker 4: like I said, there can be some relief. And it's
Speaker 4: also okay to accept the discomfort that comes with the uncertainty,
Speaker 4: and to notice that it's you know, you don't like it,
Speaker 4: or that you know what makes you feel anxious in
Speaker 4: your body, And so that I think can be a
Speaker 4: really helpful first step is to sort of give up
Speaker 4: problem solving, give up trying to find answers, and really
Speaker 4: kind of notice and acknowledge and accept the uncertainty of
Speaker 4: the moment right now. Another helpful piece here can be
Speaker 4: that there's significant evidence to show that people overestimate how
Speaker 4: badly they will be affected by future negative events and
Speaker 4: underestimate how well they will cope with and adjust to
Speaker 4: difficult situations. So along with the acceptance of the uncertainty,
Speaker 4: it also can be sort of helpful to remind yourself
Speaker 4: of that and remind yourself that it's very likely that
Speaker 4: whatever comes your way in the next few months, getting sick,
Speaker 4: losing a job, any of those things, it's very likely
Speaker 4: that you will find a way to get through it,
Speaker 4: even if right now you can't imagine that you possibly
Speaker 4: would be able to. I think another really helpful thing
Speaker 4: in these moments is I hear a lot from friends, patients,
Speaker 4: family that kind of thought of I can't imagine how
Speaker 4: I would possibly get through this, another few weeks of this,
Speaker 4: another few months of this, and sort of one of
Speaker 4: the things that makes it the most difficult is the
Speaker 4: idea that it might last for a while, kind of
Speaker 4: this disruption to our life as we know it. And
Speaker 4: I think this is where we can bring in some
Speaker 4: of our mindfulness techniques and staying in the present moment
Speaker 4: can really help. So focusing on what can you do
Speaker 4: in this exact moment and kind of acknowledging that really
Speaker 4: all you have to do is get through this moment,
Speaker 4: and that can really feel a lot easier than thinking
Speaker 4: about getting through months of this and we really don't
Speaker 4: know right again, there's that uncertainty. We don't know. We
Speaker 4: could see change tomorrow or it could be a few months,
Speaker 4: and so really all you have to do is stay
Speaker 4: tied to the present moment and get through the present moment.
Speaker 4: And then I think a last piece that kind of
Speaker 4: ties back to some of the challenges people are facing
Speaker 4: is a lot of us have lost access to things
Speaker 4: that give us meaning in life, and so how are
Speaker 4: we not going to fall into hopelessness and helplessness if
Speaker 4: we've lost contact with those things that give us meaning
Speaker 4: and how can we make meaning out of our life
Speaker 4: still given the current circumstances, one thing that we really
Speaker 4: encourage people to do is try to spend some time
Speaker 4: thinking about what your values are. So values are personally important,
Speaker 4: principles that are kind of you as an individual, find
Speaker 4: intrinsically rewarding, and these vary across individuals. Can be things
Speaker 4: like creativity, learning, compassion, gratitude, social justice. All of those
Speaker 4: are our values. And in this time it's a really
Speaker 4: good time to get in contact with those values and
Speaker 4: think about what can bring these into your life despite
Speaker 4: the fact that maybe your homebound, or you aren't able
Speaker 4: to go to work, or you aren't able to spend
Speaker 4: time with friends, if that's your value, and people have
Speaker 4: gotten really creative with this, you know, and I think
Speaker 4: that there's lots of ideas online you can look up,
Speaker 4: but first it takes figuring out what your values are
Speaker 4: and then finding ways to get creative to bring them
Speaker 4: into your life. Right, So, for example, if compassion is
Speaker 4: a value of yours, can you find a way to
Speaker 4: bring in four different ways that you get in touch
Speaker 4: with that value each day? So maybe that's you know,
Speaker 4: asking a neighbor who you know if you can grocery
Speaker 4: shop for them, or write letters to people who are quarantined,
Speaker 4: or make drawings if you have kids at home, your
Speaker 4: help your have your kids make drawings and send them
Speaker 4: to family members or loved ones. Lots of different creative ideas,
Speaker 4: and one thing, it can be kind of difficult to
Speaker 4: actually think of these things when you are when you
Speaker 4: are feeling low or you are feeling anxious, because we
Speaker 4: know that sort of our mood impacts how we think.
Speaker 4: So a really good idea is to actually have you
Speaker 4: think about these ideas for this and generate a list,
Speaker 4: and so that in times when you are maybe your
Speaker 4: mood has kind of tanked a little bit, you can
Speaker 4: kind of access this list and force yourself to kind
Speaker 4: of engage in one of these activities which then we
Speaker 4: know can have a positive impact in your mood, and
Speaker 4: schedule them ahead of time, so even if in the
Speaker 4: moment you don't feel like doing them, it's a part
Speaker 4: of your kind of planning, a part of your day
Speaker 4: that you've planned, and kind of do what you can
Speaker 4: to force yourself to go through with these activities or
Speaker 4: these ideas that you've had because again, we know that
Speaker 4: that can have a positive impact on your mood.
Speaker 3: Those are wonderful. Thank you, that's good advice. Yeah. So,
Speaker 3: you know, for people who normally see a therapist in person,
Speaker 3: I know that you mentioned teletherapy, but what are some
Speaker 3: other resources or that they could use during this time
Speaker 3: or if someone has never maybe gone to see a
Speaker 3: therapist in person, what are some resources that they could
Speaker 3: use as well.
Speaker 4: Yeah, so again I think a lot of people are
Speaker 4: uncomfortable with telehealth, so I'll just put in another plug
Speaker 4: for that, and that it can be really effective and
Speaker 4: I think even patients who are sort of resistant at
Speaker 4: first find that it's actually really nice to connect and
Speaker 4: easy to connect over through the computer, through the screen,
Speaker 4: you know. I think there's various platforms for it. Our
Speaker 4: clinic actually uses the hip a compliant Zoom, which means
Speaker 4: that it's all you know, all of it is protected
Speaker 4: and you know, not accessible, so it's very private. And
Speaker 4: then a lot of the time, again there might be
Speaker 4: little adaptations, but the therapy sessions look largely like therapy
Speaker 4: sessions look in person. You can you can see the
Speaker 4: person through the screen, you know. The therapy sessions usually
Speaker 4: actually end up feeling I think, very very familiar and
Speaker 4: similar to when they're in person. You know, there's things
Speaker 4: we help people set up, you know, a private place
Speaker 4: so that they feel like they are have privacy. I
Speaker 4: think that can be a really key component of it.
Speaker 4: If there's family members or kids around, we might ask
Speaker 4: that they step outside or something like that. But it
Speaker 4: largely looks very similar to therapy in person, but you're
Speaker 4: just communicating through the computer.
Speaker 1: Yeah, I would, I would really echo what Rosie's saying.
Speaker 1: I mean, I've actually been I was pretty skeptical about
Speaker 1: how telehealth would go doing therapy over it. I've been
Speaker 1: surprised at how well it's worked out. I really do
Speaker 1: think there's a lot of value to it, and it's
Speaker 1: going to be a major tool that we lean on
Speaker 1: throughout these events that are ongoing. So I would kind
Speaker 1: of just I would reiterate that plug for at least
Speaker 1: giving telehealth a try if it's an option to you,
Speaker 1: and you know, even if it's let's say you're already
Speaker 1: in therapy but for one reason or another, telehealth is
Speaker 1: not an option for you, you might consider still just
Speaker 1: reaching out to your therapist and seeing if you can
Speaker 1: kind of actively make a proactive coping plan together with
Speaker 1: your therapist for how to navigate that term period until
Speaker 1: you're able to resume treatment, and that's probably something that's
Speaker 1: best done in consultation with someone's individual therapist. Similarly, if
Speaker 1: you've been in treatment, just kind of remembering what you
Speaker 1: have learned so far, and you know, rather than approaching
Speaker 1: this as taking a hiatus from your treatment, to approach
Speaker 1: it as maybe an opportunity to practice and live with
Speaker 1: the skills that you've been learning so far, so not
Speaker 1: to give up on those efforts, so you can practice
Speaker 1: that self compassion even if you know you might struggle
Speaker 1: to use the skills that you've learned effectively when you're
Speaker 1: outside of therapy at context, and that's okay, And so
Speaker 1: being compassionate with yourself if you know as you're trying
Speaker 1: to do that, but really trying to keep up practicing
Speaker 1: those things that you've been learning. And then more broadly,
Speaker 1: I think if you haven't been in treatment, it's probably
Speaker 1: worth just being on the lookout for really some longer
Speaker 1: term patterns of mood or emotional behavioral sturbances, particularly when
Speaker 1: they get to the point where they're really starting to
Speaker 1: interfere with your daily activities or your general well being.
Speaker 1: In that case, it might be a sign that it
Speaker 1: might be worth reaching out for some professional help. And
Speaker 1: I think that kind of resources are being developed on
Speaker 1: an ongoing basis in terms of where to find telehealth opportunities.
Speaker 1: But in general, individuals, insurance companies definitely generally have kind
Speaker 1: of a directory of providers that are who are in
Speaker 1: network psychology today. You can also have several find of
Speaker 1: therapist tools. I'm not sure if you know telehealth option
Speaker 1: has been built into that search tool he yet, And
Speaker 1: there's some other resources out there where you can kind
Speaker 1: of search for therapists to explore if telehealth is an option.
Speaker 4: I would add also just you know, and this goes
Speaker 4: back to some of the things Pete was saying about
Speaker 4: validating that this is a stressful time and it seems
Speaker 4: like it's a really good time to just for everybody
Speaker 4: to be practicing self care. So thinking about the things
Speaker 4: that make you feel relaxed, the things that are comforting
Speaker 4: to you, and try to build these into your life
Speaker 4: as well. And simple things too, like good sleep hygiene.
Speaker 4: There's lots of information on the internet about you know,
Speaker 4: good sleep hygiene, and sleep is so important. You know,
Speaker 4: it has a cascading effect on mood and anxiety definitely,
Speaker 4: and anything we can do to kind of buffer against
Speaker 4: those right now is going to be important. And so
Speaker 4: you know, doing things like going to bed at the
Speaker 4: same time and waking up at the same time, and
Speaker 4: you know, limiting screen time before going to bed, things
Speaker 4: like that can make a really huge difference. Right now,
Speaker 4: taking a bubble bath, if you find that relaxing, Anything
Speaker 4: that you can think of to build into your life
Speaker 4: right now that can just boost up your resilience and
Speaker 4: buffer against issues with mood and anxiety is going to
Speaker 4: be really important for everybody.
Speaker 2: Yeah, that makes a lot of sense. And we've kind
Speaker 2: of talked a little bit and touched on how wide
Speaker 2: ranging the kind of effects of this are in terms
Speaker 2: of mental health, socioeconomics, everything. So how can we as
Speaker 2: individuals help other people during this time? How can we
Speaker 2: be good neighbors, community members, good leaders while still protecting
Speaker 2: our own mental health.
Speaker 1: Yeah, so I think this ties into a lot of
Speaker 1: what we've been talking about. So I think on the
Speaker 1: most basic level, the advice of being like follow those
Speaker 1: guidelines that we're getting from the CDC or from your
Speaker 1: state or county or city public health departments or departments
Speaker 1: of health actually adhere to those guidelines that we know
Speaker 1: we need to be doing to, you know, keep people
Speaker 1: healthy and protect those of us are at higher risk.
Speaker 1: More on the kind of psychological or mental health side,
Speaker 1: the themes that we've seen emerging in terms of how
Speaker 1: to kind of best go through this process in terms
Speaker 1: of outlook for our own and our community members' mental health,
Speaker 1: is to really embrace this attitude of flexibility, kindness, and creativity.
Speaker 1: So you know, again, we're all navigating an unprecedented situation
Speaker 1: and they're bound to be missteps along the way, trying
Speaker 1: to take kind of a gracious and flexible attitude to that,
Speaker 1: maybe watching out for negative assumptions about people's behavior and
Speaker 1: instead kind of considering that, okay, maybe we're all kind
Speaker 1: of trying to do our best here navigating an inherently
Speaker 1: very difficult situation. We're all kind of trying to figure
Speaker 1: this out together, and that involves extending kindness and graciousness
Speaker 1: to yourself and others and kind of just accepting that,
Speaker 1: you know, we're not going to be perfect through this,
Speaker 1: and that's okay, We're still going to do our best.
Speaker 1: I think intentionally practicing empathy can be helpful in those situations.
Speaker 1: Really just embracing those creative ways that we can stay
Speaker 1: connected to the people we care about, and to get
Speaker 1: creative about how we build in those sources of positivity
Speaker 1: and reward and things that fulfill our values into our life.
Speaker 1: I think this is going to entail having to take
Speaker 1: a pretty open mind approach to this and being open
Speaker 1: to some trial and error as we go along, So
Speaker 1: being willing to maybe try out new, potentially unconventional ways
Speaker 1: of connecting with other people, whether it's you know, virtual
Speaker 1: happy hours, or watching a movie together over video chat,
Speaker 1: maybe playing a board game together or virtually as well
Speaker 1: as you know, maybe finding new ways to exercise if
Speaker 1: you can't go to your normal gym, or of having
Speaker 1: trouble kind of getting access to the normal ways of
Speaker 1: the exercise. Maybe it's finding new things that you try
Speaker 1: out at home or walking around your neighborhood, and maybe
Speaker 1: those wouldn't have been your first choices up until this point,
Speaker 1: but it might be worth just taking open minded approach
Speaker 1: to them and giving them a try to see if
Speaker 1: they work for you. I think this emotional support aspect
Speaker 1: is pretty key, So offering emotional support to others when
Speaker 1: it's needed or when it's sought out by people you
Speaker 1: care about, kind of you know, validating those feelings that
Speaker 1: are coming up, and also seeking out that kind of
Speaker 1: support when you need it yourself. So if you're you know,
Speaker 1: seeking someone to kind of process your emotional reactions to
Speaker 1: things with or to problem solve with, you know, be
Speaker 1: proactive about that. Seek someone out who you trust and
Speaker 1: have that conversation that can be really beneficial for everyone involved.
Speaker 1: And then I think you know to the extent that
Speaker 1: we can offer concrete or physical support when it's appropriate
Speaker 1: to help our communities. So there are some communities who
Speaker 1: are asking if anybody has you know, extra and ninety
Speaker 1: five masks at home that they could donate for healthcare workers.
Speaker 1: Maybe there's philanthropic means in which you can have a
Speaker 1: positive impact in your community, those types of things. So
Speaker 1: being on the lookout for really what is called for
Speaker 1: by trust, trustworthy, reputable sources, participating in those efforts when
Speaker 1: you are able to, and you're just kind of doing
Speaker 1: your part to engage in these new practices that are
Speaker 1: being encouraged and to kind of kindly encourage others to
Speaker 1: do so as well, and just acknowledging that, you know,
Speaker 1: we're finding a new way to live our lives for
Speaker 1: this time being, and that's a real challenge for all
Speaker 1: of us.
Speaker 3: Yeah. Thanks, those are very helpful. So are there some
Speaker 3: specific resources that you can recommend for some of our
Speaker 3: listeners who may be struggling during this time some specific
Speaker 3: resources they could seek out.
Speaker 1: Yes, So I think the two big ones are probably
Speaker 1: once that everybody's heard, which are, if you want, you know,
Speaker 1: reputable information about coronavirus or the COVID nineteen itself. CDC
Speaker 1: website and the World Health Organization website are two go
Speaker 1: to sources that are reputable and generally up to date.
Speaker 1: More on the mental health side, there's actually a lot
Speaker 1: out there. So in general, we'd probably recommend making sure
Speaker 1: that you're consulting trustworthy sources, government websites, professional organizations, as
Speaker 1: opposed to maybe taking mental health advice from social media
Speaker 1: or from memes that you see hosted or from non
Speaker 1: mental health professionals. So there are a lot of those
Speaker 1: professional organizations out there, some of them that we have
Speaker 1: come across that have COVID nineteen specific information on there
Speaker 1: that we liked. One was a DAA dot org. That's
Speaker 1: the Anxiety and Depression Association of America. On their if
Speaker 1: you go to their front page of their website, they
Speaker 1: have an entire section devoted to helpful advice for dealing
Speaker 1: with coronavirus anxiety and it's a great resource to consult.
Speaker 1: Another one would be SAMSA or the Substance Abuse and
Speaker 1: Mental Health Services Administration, So that's SAMHSA dot gov. Similarly,
Speaker 1: they have a wealth of COVID nineteen related mental health
Speaker 1: information right on their front page. There a good place
Speaker 1: to consult as well.
Speaker 3: Thank you again, so so much to Rosie and Pete.
Speaker 3: We appreciate you taking the time and honestly, like it's
Speaker 3: I can't tell you how much better I think we
Speaker 3: both felt, both during the recording and then when I
Speaker 3: was editing it, Like I almost cried several times because
Speaker 3: I was just like, oh, I feel validated. I feel
Speaker 3: like I understand more about why I'm feeling this way
Speaker 3: and the importance of you know, practicing these coping strategies.
Speaker 2: Aaron I almost cried during the interview.
Speaker 3: Yeah, that's a good thing. I mean, I think it's
Speaker 3: a good thing. I think we've been, you know, just
Speaker 3: like barreling Head, thinking about this, that this constantly and
Speaker 3: recognizing that it may not be a helpful thing to
Speaker 3: do was very important, and so hopefully you will find
Speaker 3: what they have said very interesting or relevant or helpful
Speaker 3: as well.
Speaker 2: Absolutely, and one of the things that they mentioned was
Speaker 2: for for some people who feel like you want to
Speaker 2: be doing something to help. If you are one of
Speaker 2: those people, Ologies is putting out a great episode where
Speaker 2: Ali interviewed doctor Michael Wells, who put together a kind
Speaker 2: of database of scientists who want to volunteer to help.
Speaker 2: So check out that episode of Ologies if you want
Speaker 2: more detail on that and where to find the links
Speaker 2: to actually kind of sign up for that if you're
Speaker 2: a person who's interested in helping in that way.
Speaker 3: So yeah, awesome, Well this isn't going to be.
Speaker 2: The last I'm sure episode.
Speaker 3: No, this will definitely not be the last episode. And
Speaker 3: we you know, I think that one of the things
Speaker 3: that has really been illustrated by this pandemic, by the
Speaker 3: coverage of it, by by doing this research on it,
Speaker 3: is that pandemics, public health, these are so multifaceted. It's
Speaker 3: hard to comprehend and it's hard to cover in a
Speaker 3: very efficient or effective way. And so what we're trying
Speaker 3: to do is kind of reach each one of these
Speaker 3: different aspects of the disease. And so as we learn more,
Speaker 3: we may revisit aspects of the clinical disease, or the
Speaker 3: vaccine development, or the epidemiological patterns, but we also want
Speaker 3: to bring in some other things too, So hopefully we'll
Speaker 3: bring you episodes on the economic impacts of this, on
Speaker 3: how this disease or outbreaks like this work in countries
Speaker 3: that do not have the resources like the United States
Speaker 3: and other more wealthy countries have. So keep an ear
Speaker 3: out for those subscribe to our social medias tpwkise our Twitter,
Speaker 3: This Podcast will Kill You, Instagram, and we're also on
Speaker 3: Facebook under this Podcast will Kill You. And we also
Speaker 3: have a website where we're going to post FAQs and
Speaker 3: we're going to post updates, and we're going to post
Speaker 3: new episodes as we have them.
Speaker 2: As well as transcripts for all of these coronavirus episodes.
Speaker 2: We're working on transcripts for the past episodes as well.
Speaker 2: And yeah, if you're not subscribed to our feed already
Speaker 2: on whatever podcaster you use, make sure you are, because
Speaker 2: I don't know when these new updates are coming, but
Speaker 2: they're coming.
Speaker 3: They're coming. Yeah, We're just going to do them as
Speaker 3: a as they get ready kind of a basis. So anyway, well,
Speaker 3: thanks again to Rosie and Pete for the amazing discussion
Speaker 3: that we had with them.
Speaker 2: Absolutely, and thank you to Bloodmobile for providing the music
Speaker 2: for this and all of our episodes.
Speaker 3: And thank you to you listeners. We hope that you
Speaker 3: enjoyed this episode and this series so far as much
Speaker 3: as we have enjoyed putting them together.
Speaker 2: And if you have more topics that you want for
Speaker 2: us to cover, shoot us an email. This podcast will
Speaker 2: kill you at gmail dot com.
Speaker 3: Absolutely, okay, Well, until next time, wash your hands.
Speaker 2: You filthy animals.
Speaker 1: Oh bu bu bumbumbo oh