This Is Woman's Work with Nicole Kalil - 018 / Your Mental Health - Staying Aware During COVID With Alex Kenna

Episode Date: May 20, 2020

In this episode, I welcome guest Alex Kenna - Licensed Psychologist and Certified CPT Provider. Alex shares her expertise and personal experience on how to maneuver through these social distancing days, with an emphasis on the importance of meeting YOUR needs. She walks us through how to know if what we may be feeling is a normal reaction to the current crisis, or when we may need to seek help. And there is no shame in asking for help. In fact, it’s the incredibly brave thing to do. Life in general has ups and downs that we all struggle with from time to time, but adding in the stress and uncertainty of COVID makes it EXTRA challenging. We are treading through uncharted territory and juggling more than humanly possible. By giving ourselves permission to refill the tank, charge our battery and take the time we need, we come out the other side better and stronger. This is Woman’s Work To learn more about what we are up to outside of this podcast, visit us at NicoleKalil.com

I am Nicole Khalil, and in today's episode of This is Woman's Work, we're going to talk about mental health. And since I'm not a doctor or an expert on the subject, but I have had moments during this pandemic where I think my own mental health is questionable at best, I've asked Alex Kenna, licensed psychologist and certified cognitive processing therapy provider, research psychologist at the VA Healthcare, who's worked with veterans suffering from PTSD, as well as people dealing with anxiety, stress, sadness, depression, and also women struggling with family work balance and career transitions, which is actually what led me to her a couple years ago. Alex is not only qualified to talk about mental health, but I also trust her because she helped me immensely as my

therapist when I was going through a dark time myself. So Alex, thank you so much for joining us today. Absolutely. I'm happy to be here. Me too. I feel like this is going to be a little bit of a therapy session for me as well as everybody else. Yeah, there you go. Yeah. Kill two birds with one stone. Yeah, there we go.

So my first question is almost everybody I've talked to, myself included, has had sort of this feeling of things are okay. Things are good. Things might be good and happy one day, but then there's this day where you just sort of feel like you hit a wall and it's like so bad all of a sudden. Is this normal? And can you share any tips or thoughts about how to maybe move through these moments when they happen? Yes. I think we've all hit those moments. And I think you're right that sometimes it hits us unexpectedly. We can be having a pretty good day and then all of a sudden

things sort of go for a dive. To me, it feels like, and from what I've been hearing from patients, is that this combination of getting through the day, dealing with all of the added layers of responsibility and stress of homeschooling and working or just dealing with everything around the house. And so there's this sort of micro daily activities going on that require a lot of attention and focus. And then all of a sudden, the larger picture of the pandemic and this kind of like, holy shit. I don't know if I'm allowed to. Yeah, you're allowed. I cursed on my very first podcast. Oh, good, good, good. Okay. And that sort of moment of like, oh my God, like, what is this going to look like? This is awful. This is way too overwhelming. And that,

that sort of crash of the macro situation and how long this is going to last and the multiple sort of layers out of how this is going to impact, you know, the summer and, and dealing with camps and vacations. And then like around the dark corner is, is the fall and schools in the fall and what that's going to look like. And so to me, it feels like this, these moments of those two things crashing together, whoever just pushing you too far, too many different people in your lives attending to their needs. And then maybe work sort of gets to be too much. We're all juggling so many things right now that it's bound to happen that sometimes these different issues and stressors all collide in funky ways. And then it's like, okay, time for a glass of wine. Or a bottle. Or a bottle. Yeah. Regardless of the time of day. Yeah. Right. So when we hit those moments, are there any things that we can do? I remember when we worked together,

taking a few deep breaths, that was something that we had talked about. And it seems so simple, but it is actually very helpful. Anything on those days or in those moments where we're hitting that wall that we can do to help ourselves and the people around us, because I don't know about anybody else, but when I hit those moments, I have a tendency to get mean and like say, you know, snip at my husband. We're not our best self. Exactly. Yeah. So this is tricky because I feel like for me up until recently, I would try to go for

a walk. And now I'm really irritated with the fact that there's people who are going to yell at me if I don't have the mask up. So I've either just sucked it up and worn the mask and tried to feel calm in the moment with this thing wrapped around my face, which is inherently not very soothing or calming. I've also started because when there's better weather, trying to go outside, just sit there and try to appreciate some nature, reading a book for 10 minutes, or just sitting and trying to take a break. But I do think whatever way people, what feels right in terms of for you, if it's taking a few deep breaths, if it's getting outside, I know a lot of people garden. I guess I could probably start gardening more.

Baking. I've seen a lot of baking, lots of bread going on out there. Yeah. I mean, I think that's been tough for certain people. It's that's a, that's a tricky one because all these, you know, comfort foods and, and cookies and all that stuff then is all around and everybody's at home and then eating more of it. So I feel like that can be a loaded, a loaded one, but yes, you know, if that, if that's what makes you that relaxes you, But I guess the point would be more

figuring out for you what feels like an enjoyable half an hour and just allowing yourself to do that. And if you need, if that requires saying to the people in your household, like, I'm taking a break and I will see you in an hour or a half an hour or whatever, the world will go on without you for that period of time. And it's, it's absolutely necessary because otherwise I feel like we end up being either nasty or resentful or bitter or, or just getting more down. Yeah. So what I'm hearing is we at, in those moments, the best choice is really to fill our tanks. I mean, Jay drives an electric car and so, you know, he doesn't have to go to the gas station, but he has to plug that thing in, you know, every once in a while to recharge the battery. And I've definitely done the,

when I've hit a wall, tried to push through it. Didn't work out so well. So, you know, my experience aligns with what you're saying, which is to give ourselves permission to recharge the battery, fill the tank, take the time that we need so that we can come out a little bit better. Yep. Yeah, great. Yeah, exactly. And that knowing yourself enough to recognize that you need that, but also just it's okay. And nobody is a robot. Like we are all people dealing with this and it's a lot to deal with. And it just is going to overwhelm us at different times. And just to recognize that need in the moment, do what you need to do. And then, you know,

most likely you'll feel better later on. Yep. So you brought up an interesting point, which was going to be one of my questions. How are you seeing or guiding people or just what are your thoughts around balancing, you know, being strict and cautious and following the rules and being mindful of protecting both ourselves, but also our communities and loved ones, but also balancing that with what's right for you and your family and your own mental health. Like there's, you use the mask shaming thing. I went to the transfer station to drop off my trash a couple of weeks ago and I didn't have a mask on. And somebody was like, you should really be wearing a mask. And I said, yes, I know we've ordered them.

We just haven't gotten them yet. And she was like, no, you should really be wearing a mask. And I said, yes, I know we've ordered them. We just haven't gotten them yet. And she was like, no, you should really be wearing a mask. And I'm like, I heard you the first time. And again, I'm sure she was coming from a very good place and she pressed a button, which was, you know, the, I don't like to be told to do things over and over again, but yeah. How are we navigating through that? Yeah. So I guess what I've been, and this is, I feel like it's been an evolving process. So, you know, what worked for people in week one, two or three, now, you know, it seems like there is understandably more need and pressure to wear masks, which makes sense. And I think that, you know, obviously, the long term play to getting, you know, our society back to whatever the new normal is going

to look like, is going to be sort of all of us getting our heads around the fact that that's, that's what it's going to look like a lot of a lot of masks. That being said, I feel like, what is like troublesome to me, from both kind of a mental health standpoint, but also just for all of us working together as a community is that shaming or judging other people for making decisions that might be different from what you're making in your own family doesn't help anybody and is really harmful. And I think what's important to remember is that different families and different setups have different priorities. And there are people who, for instance, there's a huge income disparity in terms of who has the luxury to sit at home and quarantine and not go out, right? There are a lot of people in Massachusetts that don't have that luxury that have to go work. And those jobs require putting themselves at risk.

And it's not just all the nurses. It's like the people that are doing all the grunt work that a lot of us have the luxury of not doing. And I think it's really important to, first of all, appreciate those people, obviously. But second of all, to recognize that there's a wide spectrum of needs. And some people need to have somebody else take care of their kids. And that's not going to be socially distant, because they don't have that luxury. Or, you know, I've, I've talked to people who have said that their kids are so extroverted that if they don't have other children to play

with, they're going to get really sad and then withdrawn. So it's that balance of what, what does your child need? And, you know, and they're not, I personally feel like there are no right answers. You know, if this is going to, this is lingering a long time. And if it's balancing your own mental health or your child's mental health or someone else in your family's mental health and them getting depressed because they're isolated, that's something to consider. It requires a lot of creativity. I mean, we've all done our Zoom meetings or chats with our friends or family. And that's good. That's fine. I think we're all getting a little bit of Zoom fatigue at this point. But I guess my point is that I think it's really important not to judge others and that we are all doing the best we can.

And most of us are very good people and good hearted people, but that nobody knows what's going on behind closed doors with that person's family. And I think it's important to sort of give people some credit that they will make the choice that's best for them. It might not be what you choose, but at the end of the day, you know, people have a lot going on in their lives and the situation sucks. Yeah. Well, and the thing that you said that I think, you know, bears repeating is judging and shaming other people isn't good for anyone. And I think we know in our mind, it's not good for the people who are being judged and shamed, but I would also reiterate that it's not good for the person

judging or shaming. And I don't know about this on the mental health side. I just know about it in all of my work and research and reading and everything about confidence building. When you as a person judge or shame someone else, you actually chip away at your own confidence when you do it. And so, you know, I try to catch myself. It's harder sometimes than others, but it's just, I think reiterating that this judging and shaming that we're doing is not helpful to anybody. Yeah. And so if we can catch ourselves. Can I just add one more thing? Yeah, please. I think the other part of it is to helpful to anybody. Yeah. And so if we can catch ourselves, can I just add one more thing? Yeah, please. I think the other part of it is to try to pull back the lens and recognize that a lot

of, a lot of the reactions to this, it's subjective, right? So, you know, I have a good friend down in Florida and people in Florida aren't taking this very seriously. You know, whether or not that comes back to bite them in the ass, I don't know, but the point would be that different States have different ways that they're handling it. Different countries have different ways that they're handling it the same dynamic as all of us. And there is no right answer. And so therefore judging is sort of closed minded. Yeah. Yeah. It's an interesting pattern that I observe both in myself and in other people is when faced with uncertainty, when we deal with the unknown, we as humans have a tendency a lot of time to go into believing that the way we see it is right. Like it's fact, it's true with a capital T and there, this is just the only way. And everybody

else around us is idiots. And I'm not like, I do that too. So, and I definitely have my moments and have to talk myself out of it, but it's just an important thing is the only thing that's true with a capital T and the only thing that's fact is that this whole situation is an unknown. It is uncertain. Nobody has all of the right answers or knows exactly what's going to happen, right? Yep. Humans don't like an uncertainty. No, no, no. And I don't think it brings out the best in us. No, exactly. Yeah. So let's talk about two people that I am a little bit worried about right now, or two sets of people, I should say. First, you mentioned already extroverts. I am a diehard, hardcore introvert. You know this. Yes. So,

you know, I actually, the beginning of this was like, I'm going to totally win at social distancing. This is like, you know, you're going to nail it. Yeah. And not so because I've had my very hard moments too, but I just have to imagine from a place of empathy that this has got to be very hard in a different way for those people who are much more extroverted. So talk us through maybe some things that extroverted people might want to be mindful about or paying attention to as it relates to their mental health right now? Yes. So I am the opposite. I'm very extroverted and I could tell the first week that I was going to have to be very cognizant of this dynamic for me because I don't like working from home. I am not someone who wants to be working from home. I like the social dynamic of being in a more interactive setting, which is

when I'm at the VA. I love the researchers that I work with, and that offers both the intellectual stimulation, but also the socialization. And Zoom meetings just don't cut it in terms of that more kind of personal connection. So I think for extroverts, it's really knowing yourself and knowing when you are getting down. You know, introverted, being introverted or being extroverted is sort of about where you gather your energy from. And so if you're introverted, you need time and space to have time to yourself to recharge. And if you you're introverted, you need time and space to have time to yourself to recharge. And if you're extroverted, you look to others to help you recharge. So to me, socializing is relaxing, whereas for a lot of introverts, it's not relaxing, it's work.

So without being able to do that, I've had to, and I think a lot of people are struggling with this, there's a balance and that that sort of gets back to this, the shaming thing. one of those people that's going to be out there talking to a friend or going for a walk with a mask on because I won't do well. I will wilt without having that. And I don't think there's anything wrong with that. And I also don't think there's anything wrong with people who are doing fine with this because they don't really like socializing. It's again, sort of stepping back and recognizing that there's a spectrum of human sort of emotion and human behavior and that different people have different needs. either trying to get super creative with how you do it, or at least recognizing that this is going to be extra hard for you. And that maybe because of that, you're going to need to do some other nice things for yourself. A lot of those nice things that we do for ourselves aren't available right now, but maybe planning them, thinking about, you know, the minute the salon opens up

that you will be booking something or, you know, getting a pedicure or whatever it is, just being okay with that need, I guess. Yeah. I have a client who I think is a genius, but she and her husband rented an Airbnb and of course they cleaned it, but then they paid for like the extra, like, you know, crazy. And they ended up going just to get a new environment just to be, you know, outdoors a little bit more and same people. But I think it was just, I don't know. I think we just are all feeling a little bit bored with our, the sameness of everything that's going on. Yeah. And I think boredom, I think that's a big one. And I think that that boredom is the newer sort of twist on this because I don't know, I think

we're at like week eight of, you know, staying home and the longer the weeks have gone on, I think that boredom has increased. In the beginning, it was sort of crazy and anxiety provoking. And when people are anxious and worried and trying to figure out all the logistics, they are more jacked up. And then when now that we've all sort of, for the most part, adjusted to this new kind of shitty normal, then there's the boredom can sort of start to creep in. Yeah. Yeah. I mean, again, diehard introvert over here and I miss my people. Like the number one thing I want to do when we're on the other side of this is a girl's trip or, you know, even just go grab a drink with a friend. You know, I just, yeah, I don't get it because I'm not in an extrovert's shoes, but like if I'm feeling it, it's got to be times 1000, right? Right, right. So the second group of people I'm particularly concerned about is just women in general during all of this. I've said this on a previous podcast. I'm a little bit worried that we're sort of falling back into old historical patterns of, you know, taking care of

everything as it relates to the kids and the household. But now a lot of us are working, you know, full-time jobs, 40% of households, the woman is the primary income earner as it stands today. And then that stat is changing dramatically over time. If you look at, you know, all the leading indicators, like women are graduating from college at a higher level and getting their master's degrees at a higher level and so forth and so on. So we are providing for our household in the monetary and sort of traditional masculine way, but we're still providing for our household in the more traditional feminine way of handling all of the stuff. And I think we're going to break if we keep at it, if we keep

holding ourselves to these unreasonable expectations. And then the flip side is I think maybe there's an opportunity in this for us to break the pattern. So, okay, now I'm just sort of ranting, but what are your thoughts, again, as it relates to mental health for women as we deal with this pandemic? Yeah. So, I mean, I think it's a really interesting question. It's definitely one I've been thinking about a lot. I've had a I had, you know, like a few patients in my practice before the pandemic that were finally at this place where either they were going to go back to work after having kids and have not been able to do that now, which is really rough because, you know, you get to a place where you're like, okay, I'm going to, I've, they had figured out kind of the

next, the next step of re-entry into the work world, you know, rejiggering kind of their career path. And it had finally felt inspiring to sort of get back out there. And now they're back doing laundry and feeding their kids. And like that sort of 1950s role that it's almost like it's, it's worse now because because it's like we are more aware of, I think the way you were describing it, like when you work full time and then have your kids and normally without the pandemic, hopefully there's a bit more balance between spouses

about who carries what duties and whatever. But you're right that the pandemic has in a a lot of ways, put women back into those traditional roles. Yes, there are a lot of women that are the higher earner in the household, who's making more money, who can work and who can afford to stay home with the kids. And more often than not, that's, that's the woman still. And I think, I think you are, I know, you know, more people that are the exception, but I think bigger picture, it's still, it's still that way. And, you know, for instance, food, like I am so sick of thinking about food. I feel like it is the, the, the ever, the never ending dilemma of it's just, it's not just getting to the store and getting the stuff, but then what are we going to have for the next meal? And I've heard a lot of women who just have fallen into that role of being the person

who's planning it and just planning it and having it on your radar all the time. It's not something that I prefer to do. And it feels like a burden. And I think it represents this larger sort of issue of falling back into those sort of more traditional patterns. So you're wondering what to do about it? Well, I mean, I don't think that's a simple answer, obviously. No. To me, it feels like just recognizing it and almost seeing, it's not just that it's unfair,

but seeing kind of how alarming it is that a situation like this can so easily put us back into those roles. And to me, it just sort of highlights that when, again, things sort of start emerging out of this, that we recognize that, you know, going forward, we need to keep a better eye on that so that the next time something happens, it doesn't, it's not automatic that the woman in the house would then do all these things. Yeah. It just feels, it feels very automatic that like those things just fall on women still. You have two thoughts. Number one on that automatic thing, I actually bit Jay's head off and I felt awful about it. Like he, I don't remember what he asked a question about, but I was like, in the, you're just going to assume that I'm going to do this and did it. And he looked at me and he's like, I wasn't thinking any of that. And I, you know, I'm grateful that he does it, but there

is an assumption even within ourselves that it's going to be us. right? Yeah, absolutely. So I think there's that opportunity. The second thought is two questions I've been asking myself on a regular basis that has been helpful when something comes up as the first question is, does this actually need to be done? Because, you know, it is a new normal. And I was very particular about the house being very clean pre this. And like, there's just some things where I look at it. I'm like, does this need to be done? And the answer, if I'm being honest with myself in a lot of cases is no. Does the toilet need to be cleaned on occasion?

Yes. But does, you know, that toy need to be cleaned up and put back in its spot right now, right away? Right. Maybe not. No. And then the second question, which has been really empowering for me, is there somebody else who can do it? So yes, you know, Jay, but also JJ, like really engaging her.

Also, like there's so much leverage now, whether it's Uber Eats or groceries being delivered to the house or, you know, I actually have my in-laws watching JJ for a couple of days and they haven't seen anybody for two months and we haven't seen anybody for two months and we just finally broke and said, we, we got to do this. Yeah. So yeah. I mean, I think it's, there's no answer immediate, but I agree with you that we should be thinking, um, and also just be questioning and asking ourselves, because again, there's an opportunity, I think, here to break some patterns. The other thing, can I just add in one thing, just that I think the other really big area that to me feels like it's just been automatic is the homeschooling piece. And again, this is different for different families, but more often than not, it feels as though, so for the first, I don't know, six weeks, I was feeling just this tremendous pressure for my youngest daughter.

There was just so many different moving parts for her in terms of Zoom calls during the day and different assignments that were coming in at different times during the week. And until schools kind of got their act together and had more of sort of an organized plan, it was very chaotic. And I was feeling very stressed about not doing a good enough job at helping her and keeping on her about it. And I had many, many moments where I was just unable because of my own work to do both. It just like, it was impossible. I can't have, I can't be helping her get on a Zoom call at 10 if I'm in the middle of a therapy session. And so it sort of pointed out pretty early on for me that it's impossible and I will not be able to do both well. And at the end of the day, if she misses one of these check-ins with the librarian, it is not the end of the world, sort of the same sort of, you know, dynamic I ask my husband to do this, he's willing to do it

if he can, which is a different issue. But it's about that, like, who has these things on their radar? And more often than not, it's the mom and the family. And that just having it on your radar and thinking about it takes up a lot of mental energy. Yeah, I've heard it called the mental load. And yeah, that resonates with me. Okay. Alex, my last and hopefully quick question is I've heard people say like, I'm feeling more depressed or I had a friend say, you know, I think I had a panic attack for the first time. What is the difference between like, okay, we're having a tough moment and we can get through this versus we should actually seek help. So I'll do, I'll talk about anxiety first and then about depression. So with anxiety,

we all are feeling anxious because these are anxious times and there's a lot of uncertainty and anxiety is usually about kind of uncertainty and fear. So at the end, at the very sort of base of anxiety, it's fear. And so we all have some fear right now, right? And there are going to be moments where, as we were talking earlier, you hit your wall and everything kind of collides and you're like, oh my God. And that's all, I think, very normal and to be expected and not particularly worrisome. But the difference would be if people are feeling so anxious so much of their day that they're not able to feel other moments of peace or relative peace and that it's preventing you from doing other things. So in order for anxiety to sort of get to a point where it might make sense to reach out and get some help with it is when it starts running your life. And it's sort of taking a front seat kind of role in your life and that

other things are being impacted by your anxiety. Does that make sense? Yes. And sort of the same thing for depression. So again, we all feel depressed at times about this whole scenario. It is depressing. So that's important to remember, you know, feeling anxious and feeling depressed in a depressing and anxious time is a completely normal reaction. But if you're beginning to feel as though you're depressed more often than not, more days than not, that's sort of the red flag of, all right, maybe I need some help. And I think the tricky thing is that as this thing has lasted longer, that potential for people getting depressed is increasing. And so, you know, I don't think we know yet, you know, how much mental health impact this is going to have, obviously

going to have a lot, but with depression specifically, and especially with people being isolated, you know, in general, people are social creatures and need some social interaction. And so there's, you know, long term negative effects to being isolated. And depression is one of those things that kicks in when people are isolated for too long. So I think getting back to some of the stuff we were talking about earlier, I think, you know, that would be a time to either get some help or recognize that you need, you need some social interaction because it isn't healthy to be isolated this long. So if it starts being, being that you are getting up every morning, feeling depressed, going to bed, feeling depressed,

and that that feels like the majority of your time, that's then the red flag. Yep. Okay. Thank you. And thank you for your time and for talking through this with me. I hope, you know, people listening are feeling comforted, but also feeling like supported and, and, and to reach out to somebody if they in fact do need additional support or help outside. Yep. If you're listening and you live in the Massachusetts area, actually, Alex, I think you were saying you were doing some things across the nation as well right now. Yeah, I have a patient in California right now,

which I would not have been able to do before coronavirus. So if you want to learn more about Alex and her work, you can visit her website, alexandrakenna.com. It's A-L-E-X-A-N-D-R-A, kenna, K-E-N-N-A.com. And again, Alex, thank you so much for your time today. Of course, of course. We're all in this together, so I appreciate you doing this. It's a really important topic. My pleasure. There is no shame in getting help. Seeking the support of a professional when you're going through a tough time, or if you're recovering from trauma, or if you're one of the, I don't know, 970-ish million people in the world who have a mental illness, this is nothing to be

embarrassed about. It takes strength and courage. It is incredibly brave to face your discomfort, your fear and your pain head on. It's incredibly smart to do it with the guidance and support of somebody who's equipped and prepared to help. Ladies, there's nothing more important than our health, mental, emotional, and physical. And I believe all of us have been tested and affected

in many different ways over the last couple of months. So take care of yourselves. Put your health at the top of the priority list. Get the support you need if you need it. Because you have so much to offer this world. Because we are all inherently worthy. Because you are enough.

And because you are loved. And because bringing your best self, your best you to the world is the only thing necessary for all of us to be doing woman's work.