Anxiety, Depression, and COVID-19

Instances of anxiety and depression are rampant, as people grapple with COVID-19. Every last one of us has been touched in some way by the pandemic. Naturally, a new disease can spark fear and stress, and social distancing can increase feelings of loneliness. Men, women and children are suffering as a result of this uncertainty, fear, and isolation. Despite all this, there are ways to cope. While we are mired in uncertainty for what the future holds, I assure you we will ultimately prevail. 

It is normal to have feelings of anxiety during times like these. If you are diagnosed with COVID-19, you may feel particularly anxious. One way to manage is to trust in medical professionals’ advice. Personally, I have enjoyed watching Dr. Sanjay Gupta’s advice on breathing techniques for COVID patients. He recommends doing breathing exercises sitting up first, then continuing the exercises in a prone position on your stomach. This is to discourage mucus settling in the bottom of the lungs. Dr. Gupta’s recommendations can be easily found online if you’d like to see his demonstration. 

People experiencing anxiety tend to feel restless, wound up, or irritable. They may also be easily fatigued, sleeping too much or too little. Some describe having difficulty concentrating, and their minds go blank at inopportune times.  Others describe muscle tension. Most tell me they have difficulty controlling their feelings of worry. 

 Situational anxiety, that comes about as a result of specific circumstances, is one thing, but anxiety with a genetic component will not usually resolve on its own. I have seen that medication in conjunction with counseling can help people feel less anxious and more in control of their lives. I know first-hand that COVID-19 makes anxiety worse. I have an elderly, disabled brother who lives in a care home in Boston. In March, a  staff member told me her coworker had gone to the beach for spring break. She became infected and spread it to the youngest resident. As older people and those with underlying conditions are the most vulnerable to COVID-19, I felt anxious about my brother’s health. I knew that he would likely die if he contracted the virus. To regain a sense of control, I found myself calling seven different agencies seeking information. Thankfully, the infected resident, who recovered, was able to self-isolate in his room, and everyone else was tested, so it was unable to spread further.  I have been there with you, and am deeply understanding of your anxiety. There is always hope. 

Men and women experience depression differently. Men who are depressed may appear angry and aggressive. They may feel tired and lose interest in work, family, and hobbies. Some suffer insomnia, or sleep too much. Men often feel restless or “on the edge.” They may be unable to concentrate or remember details.  They may overeat or lose their appetites completely. Frequently, men experience physical symptoms, like aches and pains, headaches, and digestive problems which prompt them to go to their doctors. Some men turn to drugs and alcohol to self-medicate.

Depression in women can be genetic, biological, environmental, or may have physical factors. Some feel persistently sad or anxious, while others find themselves feeling empty and numb. They may feel helpless and hopeless. Many women experience decreased energy and increased fatigue. They may suddenly discover they’ve lost interest in hobbies or other activities. Women can talk more slowly and feel restless or have trouble sitting still. Their appetites may change, and their weights may fluctuate (e.g. “the COVID 15”). Some women even experience aches and pains, headaches, stomach cramps, or digestive problems without a clear physical cause.

Children who may be experiencing depression can have similar symptoms. Generally, they will have stomachaches and headaches. They may be more clingy than usual and follow you around, or not want to play with their usual toys. 

I have many recommendations to help you get through the pandemic. I always recommend people limit their time watching the news to five minutes or so. The news is often negative, and can remind you of the things you’re anxious about, like COVID-19 and the upcoming November elections. I would suggest limiting your news consumption at least until stage 3 of vaccine trials have come to an end.

If you find yourself feeling alone, call or video chat with a friend.  Additionally, go outside in the sun for 30 minutes a day, with sunblock if you choose, for Vitamin D. I myself take a daily 4000 IU supplement as well. Exercise is another simple way to manage stress.  You should exercise for at least 30 minutes a day to get the benefits of the serotonin, dopamine, and endorphins that are released during exercise. Of course, right now I can’t recommend going to a gym, as they tend not to be clean in even the best of times. In fact, I picked up MRSA at a gym several years ago, which I had to take bleach baths for three months to clear up!  As a high-risk person, I especially cannot take the risk of going to an in-person gym. However, you can find myriad free exercise videos on YouTube, to do from the comfort of your own home.

Good sleep is paramount for depression management. If you are having trouble getting to sleep, staying asleep, or waking up feeling rested, see your doctor and don’t be shy about explaining your problems. In addition to pharmaceuticals, there are also over the counter supplements that can support good sleep. I like Twinlab’s l-Triptophan. It is pricier than some other supplements, but can help you sleep. Melatonin is another popular supplement used for sleep, even by many psychiatrists. I always recommend GNC Melatonin 3mg timed release, as it helps you not only fall asleep, but stay asleep. 

Depression is painful. 7.1% of adults have had at least one major depressive episode, and due to the pandemic, that percentage is increasing. If you believe you may be suffering from depression, please seek help from a professional. Counseling and medication work best when they are used together. If you reach out, you can see a world of difference. 

We can learn to be resilient. One way to get through challenging times is to think to the future and make preparations. For example, I am getting a flu shot for the first time this year. 

Try to stay connected with other people in safe ways. Social connections are important for your mental health.  If you believe in God, you can turn to religion for support. Many churches are hosting virtual meetings to congregate, without risking anyone’s health. I have even been to virtual funerals, which have helped me gain closure after the loss of a loved one.

If you’re experiencing a mental health crisis as a result of the COVID-19 pandemic, you can call the Disaster Distress Helpline at 1-800-985-5990. They provide crisis counseling over the phone, 24/7. You can also call me if you need to talk to someone. I am currently available most of the time, due to both the pandemic and an injury keeping me at home. I would love to speak to you.

Depression and Social Isolation

Depression and social isolation is the topic of this post. Right now, I am in there with you. I am at home or in my office doing teletherapy alone.

Depression is normal for the weird times you are going through right now. Along with Depression there is fear of the unknown. The COVID 19 virus is very different than what we have ever experienced before. As a result, there is nothing "normal" about being stuck in the house or apartment alone.

It is easy to pretend this is not real or it cannot happen to you. We have to wake up and see what is real.

My first recommendation is to watch the news sparingly. It is important for us to know what is happening in the world but too much can drag you down a rabbit hole.

I believe in structuring a day so that you wont't get so depressed that you can feel non functional. Get up at a regular time and go to bed at a regular time.

Exercise, exercise, exercise since it helps release endorphins in your brain that make you feel less depressed. Eat regular meals at regular times. Do not take naps since they can interfere with sleep at night.

Stay groomed. Shower or bathe every day. Those of you who are home with children have to structure their days. I am recommending and hour of chores in the morning and an hour or more of schoolwork in the morning. I recommend the same for the afternoon. Schoolwork followed by an hour of chores. This is how children can develop positive self esteem.

You are not alone in this, it just feels that way. Spend some time on the phone talking to friends or to loved ones about what you will do in the future together because it really will happen. Yes, you will be able to get together with friends, just not now.

Sunlight helps with depression so going outside in the backyard is fine in sunny weather. Make sure you are taking happy vitamins such as B12 and B6. Take things to boost your immune systems such as Vitamin C and Vitamin D3. No more than 2-4 thousand units of Vitamin D3.

Online therapy is absolutely fantastic. I am using Doxy.Me, Zoom, Face Time and the regular phone. It actually works. For some reason the screen or the phone lets people say what they might not say in a face-to-face session in my office. So I am thinking that Teletherapy is a great thing right now.

If you need a consult or a session for depression or anxiety, call me at 277-1366 or text me at (334)223-4917. I am very available since I am self isolating like you are. Frankly, I am always here. So stay inside and be well. I would love to help if you need me. We are going to make it just fine with some adjustments.

The Treatment of Anxiety

When your chest feels tight, when you fee dizzy and lightheaded, when you feel closed in, when you want to scream out loud, when you are sweating for no reason and you feel you want to run away, to anywhere, it is called ANXIETY.

Anxiety can have many causes. It can be inherited, it can be caused by trauma, childhood identification with an anxious parent, we learn much a home, or it can come on from an event experienced as an adult. There are multiple types of anxiety such as social anxiety, panic disorder and generalized anxiety.

No one has to live like this anymore, afraid to leave the house, afraid to be with friends yet afraid to be alone. We have multiple treatments for anxiety now. You don’t have to go it alone anymore.

One of the techniques I use is to be with the client so that he or she never feels alone with the anxiety. There are many types of breathing techniques that we use to help a person stop and the panic. There is even Yoga breathing now. Everyone has different breathing techniques that we use with different clients. Breathing techniques are the first line of attack with anxiety.

Medications such as antidepressants are used to help with anxiety. Not everyone wants to take antidepressants because of unwanted side effects such as weight gain and loss of sex drive. Progressive relaxation techniques are another type of technique that helps people quiet the panic within. Everyone has a different way of learning to handle anxiety which works for only that person. Many therapists use touch to stop anxiety. I tend to help people find a place on their bodies to touch, such as an arm, a leg or a chest. During that period of time I ask patients to say out loud what anxiety they are having. It is quite effective.

I also use safe place in therapy. For example, I ask people to visualize the place where they feel safest. I then have them close their eyes and go there. It usually takes people away from the moment of terror. I am there every step of the way.

Nature tends to help people a great deal. Right now I have my lemon and lime Trees in the garage because the the bad weather we have been having. My lemon tree is blooming right now. I hope it survives. What I normally do is touch a leaf as I pass by. Since it is still winter, I ask my patients to buy a plant that cannot be killed. I then ask that they touch it everyday and water and fertilize it as needed.

I ask everyone who comes to my office to exercise. It can be simple walking or it can be weight lifting, my favorite, or high intensity aerobics. Exercise releases serotonin in the brain which is good for all of us. It can be used instead of medication. I ask everyone to do something everyday for a minimum of thirty minutes, good for your heart and your anxiety as well..

For women, I recommend exercise no later than 7PM as it can cause insomnia. Men can exercise anytime they want. We are just made differently. It is no different than men wanting to sleep after an intimate moment while women want to have a long loving conversation. Men and women are just different.

One thing I want to go into depth about is the root cause of anxiety. It is critical that we understand what is the root cause of anxiety. Without dealing with the root cause of anxiety, you will never be truly free of anxiety. We have to go back to your family of origin to understand what caused the anxiety to begin with. There is always a reason for anxiety. Always!

Above all, do not suffer alone. Being alone with anxiety can be almost crippling. I believe in finding what calms you the most. It can be touching your dog or cat. It can be going to Church if you are religious. If not, find something that you can do to nourish yourself. Eating is fine but too much can harm your physical health.

Holiday Blues and Seasonal Affective Disorder

 The Holiday Blues generally start at the beginning of November.  No one can live up to what the Holidays are supposed to mean. The holidays have become more commercialized for many years now. Holidays are supposed to mean happiness and peace and harmony. It is not usually the case in most families. Holidays can remind us of things in the past, both positive and negative.

For example, just a few days ago, my husband mentioned that his mother would have been 99 years old on November 2nd had she lived. I replied that my mother died on November 15th.  Death, divorce, stressful job situations can make the holidays very tough to live through. There is something calledAnniversary Reactions when we remember a lost loved one not just on their birthday or the anniversary of their death but also during the holidays.

Divorce can make for difficult Holidays. Splitting children up during the holidays can cause so much stress. Children get confused about when they are going where. Co-parenting just doesn’t always work. Thinking of holidays past with when the family was united can cause a sense of loss and depression. Who can give the children the most  gifts can be a competition.

I believe divorced couples should make a list of things the children want and divide it according to what is affordable. I do not believe that the newest video game is going to make children happy. They occupy children but can create obsessions so that valuable time playing, talking, and reading can be lost. Physical activity is gone. Recent research has shown that too much cartoon watching can create depression in children.

I have remedies for the Holiday Blues. Never try to equal holidays you had before with loved ones who have passed. I believe in doing different things every year to help you manage the Holiday Blues. I believe in leaving town for brief or periods of time. I recommend cruises, short ones out of Mobile take you to where there is sunlight.  If you are religious, attend services. Antidepressants help but they take 14 days to begin to be effective. Change what you usually do. Mourning is normal during the Holiday seasons.

Seasonal Affective Disorder (SAD) is a form of depression that lasts from the time that days become shorter and darkness lasts longer from November until April. The causes of SAD can be a lack of serotonin, a lack of melatonin, calcium and magnesium. The lack of light is generally the root cause of SAD. Serotonin can be helped with exercise, even simple walking. Aerobic exercise can make a huge difference since it releases serotonin in the brain. Melatonin can be purchased at many health stores. It can be also bought at grocery stores. I prefer health stores.

 Light therapy is an excellent way to help with SAD. These are supposed to be the best SAD lights:  Verilux HappyLight Liberty. amazon.com; Verilux HappyLight Touch; Aura Daylight; Circadian Optics Lumos 2.0; Alaska Northern Lights Northstar 10,000; Carex Day-Light Classic Plus Bright Light Therapy Lamp; Circadian Optics Lampu Light Therapy Lamp.

SAD can also be managed by antidepressants, the SSRI’s. Therapy is effective as well. Making just one to two appointments with me can make all the difference in how you handle the Holidays and Seasonal Affective Disorder.