Just As Well, The Women's Health Podcast - Talking Coronavirus: How To Protect Your Mental Health During A Pandemic

Episode Date: March 22, 2020

As the country comes to terms with the new normal of social distancing, self-isolating and staying home, managing your mental health has become more difficult - and vital. In light of this, we’re breaking with our usual format to bring you a bonus episode of expert-backed advice on how to cope in these dramatically-altered times. Here, Clinical Psychologist Dr Jessamy Hibberd, who has partnered with other mental health professionals to deliver evidence-based advice via Instagram, explains why uncertainty feels so alarming, the small things you can do every day to feel well and how to manage an existing mental health condition during this difficult time. For more expert-backed advice follow @from_the_other_chair @mumologist @thepsychologymum @the_thomas_connection Join Women’s Health on Instagram: @womenshealthuk Join Roisín Dervish-O’Kane on Instagram: @roisin.dervishokane Join Dr Jessamy Hibberd on Instagram: @drjessamy Topics:  How can you follow the news while protecting your mental health? What’s a negative bias and how can you avoid it? How can you manage disappointment over cancelled plans? How can you manage an existing mental health condition?  What’s behavioural activation and how can it help you right now? NOTE: While we are attempting to keep our content as up to date as possible, the situation surrounding the coronavirus pandemic continues to develop rapidly, so it’s possible than some information and recommendations may have changed. For any concerns or for the latest advice, you can visit the following sites:  https://www.nhs.uk/conditions/coronavirus-covid-19/ https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen https://www.cdc.gov/coronavirus/2019-ncov/index.html Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

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expert-backed advice on how you could reduce anxiety in these strange and pretty dramatically altered times. I'm recording this just as the government has announced that we're going into the suppression phase. So there's going to be a lot of time at home, a lot of time alone, and that's hard. So someone who has put out some great information about this on Instagram already is Dr. Jessica Hibbard. She's a clinical psychologist and author of The Imposter Cure. Jessamy, welcome. Thanks for having me today. Thank you so much for coming on and bearing with us. So you You posted a brilliant graphic on your Instagram, which is at Dr. Jessamy, earlier this week, about how to cope with anxiety within these kind of altered times and within this pandemic. And there was some other psychologists that you worked with.

Why did you guys all decide to work together? I think you felt that it was really important for it to be a team effort and that there's so much information out there. We wanted to create a really well-thought-out, helpful, practical and calming response, pulling together all our. expertise and working together we can put it together more quickly but also we know that we're stronger together and I think we felt there was also a broader message in that in terms of that we do need to work collectively at the moment and to support one another so I was really fortunate to work with Emma Hepburn, Emma Sponbergh, Michelle Cottle and Michaela Thomas and I need you'll put their handles in their show notes as well and it just felt really important

to put something out there because people are feeling so. and to have some evidence-based information that will be really useful to people. So big question, but what about this moment, this very specific moment, is so anxiety-inducing? I think the biggest thing is the uncertainty at the moment and knowing exactly what all this means. And I suppose that how it affects people will, you know, vary with the individual. So for some people they're going to be worried about getting the virus themselves, for some people they'd be worried about people in their family or loved ones. For others, with the latest advice, they'd be worried about their work and what can happen.

With that, for many people, they're worried about wider society. So there is a very real reason to fear anxiety right now. And coupled with the uncertainty of not knowing what lies ahead, that really adds to it. Because our brains don't manage uncertainty well. We're wired to respond to the unknown with experience. extreme caution and our brain, you know, has evolved to keep with trying to help us survive. So when we were a caveman, if there was something hidden behind a bush, we exercised extreme caution and didn't go near that and flipped into our limbic system, which is where the emotions are.

And it raises our anxiety so that we're protected from whatever the threat might be. Whereas, of course, in our modern day, you know, we don't need that in the same way, but we still have that strong response, which is why people are feeling that anxiety. Does this send us into maybe a slightly... ...to think in a more rational or more generous way, and thinking of there's lots of stuff around panic buying, and everyone seeming to go a little bit inward? I think the thing about uncertainty is that most people move

to try and be more certain as a way to manage it. And because we don't have to manage uncertainty that much in the way we live now, for example, you know, you don't have to wait for the next episode, you can watch a full box set. If you're driving somewhere, put your Google Maps on and you can avoid all the traffic. You know, we don't have to manage the uncertainty of everyday decisions because of all the things that we've got in place now to make modern life run more smoothly. And the trouble with reaching to become more certain and taking kind of more extreme action to do so is that actually it's impossible to be 100% certain in anything in our lives. with what's going on at the moment we've shown that more than ever. And the better move is to try and increase our tolerance of that uncertainty

and to think about a more day-by-day approach rather than these kind of extreme responses and to think about facts rather than fear. And whilst we can't control that automatic reaction of anxiety, we can recognise it and understand that it's a really human and understandable response and that these are scary times. And we can give ourselves space a process that, you know, it's really new information, we're still making sense of it ourselves, and having a chance to feel the emotions connected to it, to talk about it with people you trust and who can talk to you

about it in a sensible or understanding way, then that's really helpful because we need to process what's going on and we need to work out what it means for us and our families. But I suppose it's being careful of shifting over into those fear-based responses which are less helpful and which increase anxiety further. I think that's a great point about tolerance. and increasing tolerance, and we're going to come to that in a little bit. I guess I want to know how you're pretty plugged into the psychological well-being community. What is the message that you're getting from people at the moment? What are people coming to you asking about?

What are people concerned about? I'd say over 50 cent of the people that I normally see at the clinic did Skype calls or video called in. And then within the topic of my sessions, then it is focusing on, you know, what it means to people individually and also what it means more widely. And I think it's important to manage how it affects you personally, but also not to get so caught in looking inwards that you forget to look out and think about others too. So top line, it's kind of if people are feeling weird and tense right now, that is completely normal and to be expected.

I suppose I was going to say, well, in part what's linked to that as well as this idea that, In our daily lives, we have an illusion of control over what goes on and that we believe we're in control of our lives. And again, that's a way for our brain to make sense of things and to continue kind of living in a normal way each day and to concentrate on the things that are important. And again, with something like this, it shows you that really you can't be completely in control of your life.

And I suppose it's easy to switch then into feeling powerless. And again, then it's coming back to this idea of, well, what can we do and trying to think about ways to let go of what you can't control, but also to focus on what you can do. And so when you think ahead, that's really anxiety for it because you can't think how the thing's going to be really even in a month right now, let alone three, six, you know, a year. But do you know what you can do today? And rather than thinking about all the potential possibilities, I think as a starting point,

it's almost thinking about this as putting one foot in front of the other, that seems more doable and it reminds you, you know, that if I think about it for myself, well, I know what I need to do today, and that will get me to tomorrow. So you're saying that it's about taking a daily approach, about zooming in on what we can manage and control and realistically get done.

So let's move to those things then. Obviously we are in a strange situation, many of us, So there's a real chance that people could be feeling quite lonely. There's the social interaction that people might have normally going to work with their colleagues. There might be seen grandparents where lots of these little interactions and chances for human connection are limited or curtailed. Why can that be psychologically difficult? And what can people do to rectify it?

It's a difficult situation because, again, as humans, we're hardwired for connection. And lots of us get that connection. without really even realising it in the ways that you've described. We rely on that to feel part of things and linked to other people. And so I think with the changes coming in, it's going to be almost kind of thinking a new way about how you can find that connection. So when we are talking about loneliness,

and I think it can be quite an actual reaction to think to almost go online, to seek that reassurance and find answers for what you don't have at the moment, whether that's on social media, that's monitoring the news constantly. Why would you advise against this? I think that, again, you know, our brains are trying to make sense of this, but we jump to the threat option. And so when we're checking, it can feel we're assuring in the short term to go online

and seek as much news as possible, but actually then we're focusing on the threat. So it's about doing it in a moderate way that's helpful to you. You're going to catch up with what's going on. There's no way to avoid that right now. So being careful about checking trusted these websites when you do that, you know, following evidence-based guidelines and being wary of the things that can spring up in times of crisis that might not be so helpful into people who you trust and who will be reassuring rather than, you know, make you feel more anxious.

And again, watching out from the negative thinking patterns your own brain is going to try and, you know, start springing on you and the tricks that our own brains can play on us. like catastrophizing, where you're imagining far worse case scenarios than there are right now, fortune-telling and trying to predict the future, finding yourself dwelling on things and just going over and over it, and also operating a negative bias to collect all the information that flips your fears. And I suppose in terms of that, reduce social context, then it gives you more time to think. So it's easy to fall into the trap of worrying about these things and going over them and ruminating or predicting the way. And it can feel like we don't have any choice in terms of how we direct our attention.

But actually we do have a choice. We have to almost be quite strict with ourselves for that so that we have a proportionate response to what's going on right now. And we don't get stuck in really unhelpful thinking and behavioural patterns. I've seen lots going around on social media about the importance of routine. What are some ways that you could maybe interrupt these unhelpful thinking patterns? Is there anything else that you can suggest? there is a lot of practical things you can do. And I think that it's thinking about the small things that you can still incorporate into your day.

So whilst you might not be able to go and see friends or family members, you know, most of us have got a mobile or tablet that you can FaceTime and do video calls and thinking about all the things that you can do within your own home. And again, it's going to be quite individual. So whether it, you know, whether you're someone who really enjoys reading or, you know, you like jigsaws or you've had a list of things that you need to do, like sorting, this is my personal one, sorting out my photos from about the last eight years, things like exercise or virtual book clubs. And I think it's being a bit inventive in terms of the things that you can still

do and that it is really important to focus on these things, even though they might feel frivolous in the wake of everything that's going on. We need to have some distraction. We need to keep our mood buffered from everything that's going on. And whether it's exercise, it's got an amazing evidence base, whether it's social contact in virtual ways, you know, whether it's hobbies that you really enjoy. It's really important to make time for those things alongside ensuring you look after yourself and that you say you keep a routine that brings structure and security. And I think other things to include time outside is going to be slightly different, but still it's important to get outside if you can and to keep those

social distancing rules in place. It's still possible to do that. And if it's hard to get outside, making sure you sit by your window and look out the window and get plenty of daylight. So you're thinking in slightly more clever ways about what you can do to lift your mood and manage your mood. I should say here as well. Anything we say on here that specifically pertains to the government's advice might be out of date by the time this goes out. So to the latest advice, check the NHS website and the NHS-111 website. Definitely, I just want to come back to something you said there about the importance of buffering and the importance of things that we might ordinarily have thought of as frivolous.

You're almost doing some sort of civic or personal duty by constantly keeping tabs on everything that's going to happen. Is this something that you've come across with some of your patients? I think it's all so fresh. It's almost like a grief response. It's the shock and the sadness and the worry that everybody's feeling and in times like that it can feel hard to do other things. So again, it's about this human response to the current situation.

and it can almost feel like, well, I shouldn't be focusing on this right now. But the reality is that whilst there are some things we can do, there's a lot that we can't do right now. And we know that sitting and worrying and panicking is definitely going to leave you feeling worse. I'm going to leave you in a worse place to manage over the coming months. So it's almost like taking care of yourself in every way from, you know, the basics of eating, sleeping, resting, hydrating to the making time for these kind of more pleasurable activities or relaxation activities that are going to give you a break from thinking

about it and a chance to, you know, keep going and keep well. At the moment, we've got to be particularly compassionate and kind to ourselves and to others. Do you think there is an argument then that actually letting yourself rest and do some hobbies and things that might feel a bit silly and fluffy, that could actually help you be stronger to kind of show up for others in your community down the line? Yeah, absolutely. feeling of having a collective response and being part of a community is key to our connection at the moment as well. And that, you know, it's important to keep looking outwards and remember that we're all just doing our best to get through this difficult periods.

Absolutely. And I know there's community WhatsApp groups. You've got Sally Hughes, brilliant beauty banks service. They're accepting donations to provide basic hygiene and washing products. I know the Truss or Trust are really calling on people to donate food to food. banks. So there's all sorts of things that you can do on that you can actually make a difference from behind your laptop. And I think even things like when we reach out, we're kind and we support each other, actually that helps to manage anxiety. It lets you feel again that you are doing something and even things like, you know, it's massively affecting businesses, how you can continue to support small businesses like you say with the food banks as well. And I think when you're doing

something positive that that is a way to make you feel a little karma. We know that giving back is actually key to wellbeing as well as a broader thing it's thinking about it in terms of okay is this a problem that I can do something about now you know if it's worrying about a vulnerable person in your family what can you do to protect them now there is actions that you can take to ensure that they're protected and following government guidelines and adapting to your own family and your own needs as well but then there are also the what if which aren't in existence yet we don't know if they ever will be and they aren't helpful because there's nothing that you can do about them right now because it's not a problem that's practically solvable right now and with those things it's about

trying to distract yourself from it or do things that take your mind off it or finding ways to put them on hold until a time when when you can take action and I think the other thing that's important to remember is that worry tells us we won't cope with things whereas all of the research and the evidence shows that when faced with difficulties, people tend to cope better than they expected to, and that generally we do cope well with difficult circumstances. That, again, as humans really are adaptable, we do adjust to really difficult situations. So I think having trusting in your ability to cope and for others to cope around you can also be quite reassuring. To going back then to people who are struggling

with an anxiety disorder or something like OCD, which could be really triggered in these times, or, you know, another mental health condition, what can people do in terms of ensuring that their treatment plan or that their processes that they have in place are able to continue? Should people be getting in touch with their therapists? What would you advise as a professional? I think that for those that are already affected by anxiety, you know, hopefully they are linked in with their GP or a therapist, and if they're not, then it's important to do so. but again how people react to this varies so for some people it would increase their anxiety

further and it's really important that they get support with that and that they share that with somebody else and you know as I said at the beginning session for me are moving over to video calls which are really effective on that really well so it's a way to still be in touch with people and get that advice that you need and the support that you need and the practical advice that you need too but being really really sure that you are getting help where you need it. Ontario, the wait is over. The gold standard of online casinos has arrived.

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Golden Nuggetcassino.com for details. Please play responsibly. So it's being aware of how it's affecting you and where the anxiety is for you or where the problem is alive for you. And again, ensuring that you get the support that you need, all of your feelings are valid. And as much as it's important to focus on what you can do

and to incorporate these small things into each day to keep the connection and reach out to other people, it's also important to allow your feelings that give them space. Because when you're denying them, I think often they almost inflame more words when you allow them and accept them and acknowledge them, it means you can process what's going on and make sense of things. And particularly if you're hooked into good support in terms of a therapist or your GP or your psychiatrist, then you've got that support to manage it. Okay. And then something else that we've, because I should say, we didn't ask me anything on our Instagram and it was all the questions that people wanted to know about coronavirus.

So a big question. And loads of the ones that came up were stuff about kind of keeping positive and keeping motivated because people have had weddings cancelled. People have had birthdays, holidays. And I think it's the time of year that it's happening as well. This is just, it's spring. It's everyone comes out to hiding. We're all ready for summer.

We've got all these plans. And then it's just a bit anticlimactic. What would you say to people who are struggling to find, to kind of, to find their why with all of this at this time. I think that again it's completely understandable if you've had these things planned and you've been looking forward to them and that they've had to be cancelled because that's another way that we manage in terms of our well-being, you know, having things to look forward to, having events that are special to us and meaningful to us and lots of those have had to go. And I think as well in terms of particularly with yesterday,

days advice the way that that's going to affect people working as well so again these are not you know silly worries or frivolous fears or it's not it's again acknowledging that this is a really understandable response that you feel down and upset and that you're just in a point of being able to get it back together in your head to then be able to move forward so it's not denying those feelings or saying you know well it's much worse for everybody else or putting yourself down in any way seeing course I'm upset by that, you know, I was really looking forward to that. And now I don't know when it will happen or how things are going to go. So again, it's all right to feel a bit demotivated and not be straight into doing your home

workouts and, you know, watching out for your online videos for all the things that you need. Give yourself time to work through it, but also knowing that it is almost like taking medication, you know, this kind of structure and routine and having to have. having small daily activities is key to maintaining your mental health and seeing it within those parameters. You might not feel like doing it, but do it anyway and give yourself a chance to catch up with feeling like that when you do it, it has a positive knock-on effect,

and it can get you back into feeling a bit more motivated. And actually, for people that I treat with depression, who feel very low in motivation, very low in energy, find it really difficult to do things, the first course of action would be what's called behavioral activation, which is exactly what we're talking about today in terms of finding a structure and routine and adding in those things. And they feel like it's easy in your mind to feel like, well, what is the point of this?

Because, you know, what's the point of anything and where are we going right now? But having those things will boost your mood and has proven to do so. And keeping them in place is a better alternative than sitting and constantly do or constantly taking the news. And it's thinking about what's best for you right now rather than what you feel like doing because the two will be very different. A bit like going to exercise.

I never really feel like going to exercise. There's never a time when I'm not glad I've done it. And it's just remembering that in terms of the coming weeks. It's almost about having this executive function, this slight intervention within what your mind automatically wants to do. If someone, because again, coming back to the point about loneliness, lots of people do live alone or they might be with a housemate or family member, but they might need to be self-isolating within the home that they share.

If someone does feel a little bit concerned that they could maybe slip back, that their mental health could slip and they could fall back into some unhealthy habits and get to a pretty low place, is it a good idea to have some form of like a check-in system? I'm thinking for people that maybe aren't married or people that don't have. have, don't have a partner or close to family. What's your thoughts on that? I think it's exactly right. And I suppose, again, it makes me think about what does connection mean.

So connection often means being with people, and that's an easy-reach connection. But at the moment, we can't do that in the same way. So how can you feel connected to other people still? Because essentially it is a feeling. And as we've already talked about, there's ways that you can do that all virtually. But I suppose also it makes me think with all these. different groups that are springing up. Maybe it's thinking about how you can become part of a WhatsApp group with people that do check in

and, you know, kind of an easy route to reaching out to somebody should you need to and setting that up now so that you're setting up these kind of things before it gets to a point where it's actually really hard to reach out to people. So if you know that you are going to be on your own during this period or that you, you know, will find it harder to have the usual support in place that you would have from other people, in those natural ways that we get contact like at work or like on our commute or whatever it might be in the groups that we attend or, you know, exercise efforts, then finding ways to set up smaller groups yourself and doing it now while you're still feeling all right and say to people, you know, I know I'm going to be on my own, can we set up a time to chat each, you know, each day? And so maybe I think it's setting that up in advance rather than getting to a point where you're feeling really lonely and then it's actually really hard to reach out. So again, it's kind of be proactive and thinking about what you can do.

So, Dr. Jessamy, thank you so much. There's so much information in there, and I do genuinely feel like it's been very useful and calming. What would be your one tip for people who are listening to this and feeling uncertain and feeling anxious? So I'm going to cheat and do two, but I would think about what is fact and follow fact rather than fear, and think about what's sensible rather than scaremongry. but also I think what's really important is this day by day approach and thinking what can I do today and what are the things that will make today better and how can I think about myself and others within this day so that you have controlled over the day ahead of yourself.

So take day by day and be nice to yourself and others. Yeah. Wonderful. Okay, thank you so much Dr. Jessamy for coming on again. Thanks for having me. thinking of everybody who's going through so many different things at the moment. Yeah, we would definitely echo that. And thank you, everyone, for listening.

Now, it's worth saying, again, that this information is changing all the time. While we are attempting to keep our content as up to date as possible, the situation surrounding the coronavirus pandemic continues to develop rapidly, so it's possible that some information and recommendations may have changed. For any concerns and the latest advice, you can visit the World Health Organization. If you're in the UK, the NHS website can provide useful information and support or the NHS-111 website, because we do have some US listeners, you can contact the Centre for Disease and Control Prevention.

The final thing to say is that if we do go on a break over the next few weeks, don't panic, as going to goal is a weekly show. There's a good chance that we might need to pause recording during disruption caused by the coronavirus. So, yeah, I guess all that's left to say is to take care, everyone. And I'll catch you soon. Bye.