Mental and emotional health is just as important as physical health. Overall, your mental and emotional health can ultimately impact your physical health if not cared for properly. Taking care of your physical body by eating right, working out, and taking proper medications to treat a disease correlates closely with taking care of your mental and emotional health by practicing mindfulness and not allowing certain thoughts to take over your daily life and spiral into a string of questions, uncertainty, and anxiety/depression.
It has become more apparent to me during this time of self isolation, distancing, and out of my normal routine that anxiety and depression are more apparent. We, as humans, desire companionship and interaction and when we are taken out of those elements (especially extroverts), we feel lost and begin to question ourselves. Many have been laid off from work due to the lack of necessity for their jobs during these COVID-19 circumstances, and many have been overworked due to the demand in patient care and loss of other healthcare workers to illness or quarantine. Both of these contribute to anxiety/depression whether it is worrying about how the next bills will be paid, if another job can be obtained, whether there will be enough PPE for that work day, whether a patient will survive, etc., etc. Family members and friends are hospitalized and can't be visited. Intubated not knowing if the tube will ever be removed. There are those that are isolated in nursing homes and can't be visited, in other states in their homes where you are only able to communicate via FaceTime, not knowing when will be the next time you will see them, hold their hand, give them a hug, or pay a social visit. Many are out of their routine. Assigned to their homes to work—waking up alone or with multiple children running around doing e-learning, trying to get their jobs done. Some are left with not much work to do based on their usual routine of business at work. Healthcare workers on the frontlines are overworked—emotionally, mentally, and physically drained (especially those in the hotspot areas). Day in and day out—working as quickly as possible to provide care for those that are over-saturating the hospitals with this virus and hoping there is enough PPE to protect them while providing care to those critically ill.
For me, my job encompasses a great portion of my life. I work long hours and have been working hard ever since college to achieve the dream of being a physician. I picked a fast paced job because I like staying busy and that has been my routine. When I am off, I am usually good for about 2-3 days but then get bored when I don't have routine or tasks to complete (even when on vacation). I like a plan, a routine, something to keep me busy. My new routine: 1 week of work, 1 week off, 1 week of telehealth at home. I'm not used to this. I'm not used to waking up with no routine. What is wrong with me? Why can't I just relax and enjoy “this time off?” My routine has been taken away from me. My job, which I have come to find that I use to identify myself , has been changed to where I rarely spend time face to face with others, doing surgeries, delivering babies, seeing those in office—and it has definitely made a difference in my life.
I was watching 60 minutes last night and discovered that anxiety/depression tend to spiral when there is lack of routine in one's life, when there is a huge surge in social media, and when jobs are decreased (whether that is losing a job or a massive change in a role) because if affects one's identity. Many find their purpose for life in their job; so when it lost, what do you do? Increase in social media use is associated with increase in anxiety—is that because it is overflowing with articles about coronavirus, outcomes, politics, etc? Yes, I do believe part of that is true; but I also believe it plays a role in allowing people to identify their self worth and purpose based on likes and comments from others and “how popular I am.” I didn't realize how much social media played a role in my life until I had enough time to dive in on facebook, instagram, snapchat, and now TikTok. It is easy to get lost in all of it. It has taken me a couple of weeks and a lot of soul searching; and I'm aware I am being transparent here; but I have come to find that I have to find happiness within myself—not my job, my social media, my husband/family/friends/co-workers/patients. If I depend on others opinions to place value in what I think of myself, I will always be disappointed. Even though I don't wake up and go to my job everyday at this point, I have found a new routine—wake up, have my coffee, read a devotional, work on tasks around the house, occasionally the Peloton (I'm trying to get better at this), check my work basket and keep up to date on recent requests, etc.--my routine changes at times but having a list of things to complete during a day has helped me stay grounded. I started again doing hobbies I like and things I have needed to focus on—working on house projects, painting, blogging, lying in my hammock (when it is sunny outside) for self reflection as my husband grills and allowing the sun to hit my face—realizing I am blessed.
Many of my patients ask about anxiety/depression and want to discuss it. It has become more apparent during this time as well. I always explain the importance of anxiety and depression—it is a disease. Like hypertension, diabetes, etc, anxiety and depression is a physiological manifestation of a chemical imbalance in the brain and those cannot be helped without appropriate treatment. It can be exacerbated by certain events, inherited, and worsened by certain factors (caffeine, immobilization, lack of light, alcohol, drugs, etc). People should not be ashamed if they have this diagnosis. Some are concerned of the social stigma of what others would think it is was made known they were on an anti-depressant or were seeing a therapist. Like I said previously, if you do not take care of your mental/emotional health, it will impact your physical health. Some need behavioral health and counseling/therapy to develop coping mechanisms to help deal with an anxiety provoking situations or to re-route a negative thought process. Some need an extra step with medication to help correct that chemical imbalance so they can cope with difficult circumstances, handle stress, and find happiness once again.
Anxiety disorders are the most common mental illness in the United States and are highly treatable. However, those suffering need to make sure to reach out for help. Many of my pregnant patients want to “wean” off their anti-depressant during pregnancy for fear of how it will impact their pregnancy. Sure, there are anti-depressant medications that are better in pregnancy than others; but I strongly advise my patients to consider the benefits vs risks. Pregnancy is one of the most hormonally and life changing events; and if someone was previously on a medication for anxiety and depression prior to this, I would strongly discourage discontinuing a medication during that time in one's life. Anti-depressants have a small risk for withdrawal symptoms in an infant if taken during pregnancy and some (like Paxil) increase risks for fetal cardiac defects; but I discuss with my patients to strongly consider the benefits the medication provides to their mental health and weigh that against the small risk—I ultimately allow patients to make their own decisions in regards to the final decision, but feel counseling is a HUGE factor in coming to that decision. Always discuss with your physician if you are planning to discontinue a medication and never abruptly stop it.
Our current circumstances are like no other the United States have faced, especially in my lifetime. Along with COVID-19 cases, mental health disorders are rising and I do not believe have reached their peak. Once this pandemic is over, I believe the aftermath in regards to mental health will be a battle we will face.
I challenge your to create a routine for yourself. Make a list of things to do and stick with that. Don't allow anxiety of these most recent circumstances to overtake your daily life. Find things you enjoy doing for yourself. Reach out to those your love and tell them their importance in your life and to you—tell yourself this will pass. Cook that new dish you've wanted to try. Read that book you haven't had time to read. Journal your thoughts, allowing all your negative thoughts and worries to spill on the page rather than continue to continue to run in your mind. Allow self reflection, mindfullness. Do yoga. Meditate. Pray. Don't define yourself in social media, your job, and other's opinions of you. Re-define yourself during this time. Find yourself again. This is the only time in my life I have had the chance to be this alone this long with my thoughts—it has been the most challenging yet also the most beneficial time in self reflection. I still have a ways to go to find COMPLETE contentment but I have been made well aware of the steps to take and can see the finish line on achieving that.
Below are some links you may find beneficial with the last being screening for depression. Do not be afraid to ever reach out and ask for help.
"What you thought before has led to every choice you have made, and this adds up to you at this moment. If you want to change who you are physically, mentally, and spiritually, you will have to change what you think."Dr. Patrick Gentempo
-Dr. Riley
