This Podcast Will Kill You - COVID-19 Chapter 6: Mental Health

Episode Date: March 23, 2020

Welcome to Chapter 6 of our Anatomy of a Pandemic series exploring the world of COVID-19. If you have made it this far in the series, you might be feeling a bit overwhelmed by all of the information we’re throwing your way. You’re not alone. We were feeling a bit too deep down the rabbit hole as well. So we reached out to Rosemary Walker and Peter Rosencrans, two psychology doctoral students at the University of Washington to talk to us about the mental health impacts this pandemic has had and walk us through some coping strategies (interview recorded March 20, 2020). Hang in there, everyone. To help you get a better idea of the topics covered in this episode, we have listed the questions below: You are both in Seattle, which has been impacted longer than much of the US, so, how are you? (05:55) This is a brand new situation for all of us that's affecting so much more than our physical health.So what are we seeing in terms of some of the mental health outcomes? (09:21) What are some of the challenges that you, as mental health professionals, have faced so far and that you expect to appear in the future related to COVID-19? (15:59) What are some coping strategies that we could use to deal with some of these issues? (19:15) What are some resources for people who normally see a therapist, but who cannot now because of COVID-19? (31:43) How can we as individuals be good neighbors, community members, in this stressful time while still protecting our mental health? (36:50) Do you have any specific resources that our listeners could seek out? (41:09) See omnystudio.com/listener for privacy information.

This is exactly right. There are already enough things charging your card every month. Dinner should not be one of them, which is exactly why Blue Apron is now subscription-free. You heard that right, Blue Apron no longer requires a subscription. You can order meals when you want them and skip when you don't without adding another recurring charge. Blue Apron meals are designed by chefs and arrive with pre-portioned ingredients, so there's no meal planning and no extra grocery trip. Order now at Blue Apron.com. Get 50% off your first two orders plus free shipping with code this podcast 50.

Terms and Conditions Apply. Visit blueapron.com slash terms for more information. This is Bethany Frankel from Just Be with Bethany Frankel. Listen, I have a bone to pick with these dog food brands calling themselves fresh, natural, healthy. Sounds great, but a lot of these quote-unquote fresh dog foods in your fridge are not even 100% human grade, which is why feed your babies just food for dogs. It's good enough for big and smalls, my precious babies, so it's good enough for your babies. 100% human grade, real ingredients, beef, sweet potatoes, green beans, delicious.

These are foods that you would want to eat. Not that the babies would ever share. Just Food for Dogs is the number one bet recommended fresh dog food back by over a decade of research. No marketing fluff. My dogs lose their minds at dinner. They run to the bowl, tags wagging, paws tapping, full Broadway performance every single night. So I do care about the food I feed big and smalls. So go to just food for dogs.com for 50% off your first box, no code, no gimmicks, just real fresh food.

There's a difference between liking a house and actually getting it. Redfin is built to make up that difference and close the gap between finding and owning the home for you. Redfin agents close twice as many deals as other agents. So when you find a home you love, you're not a step behind when it comes to making an offer. That means less watching great homes disappear and more focus on the one you'll call home. Redfin helps turn saved listings into real addresses. Get started at Redfin.com. Own the dream.

Hi, I'm Aaron Welsh. And I'm Aaron Almond Updike. And this is, this podcast will kill you. Sure is. This is an episode that is chapter six of our series called Anatomy of a Pandemic, which covers COVID-19 and all the different aspects of disease. It's been about a week and a half since COVID-19 was declared a pandemic by the WHO. And since that time, our lives, everyone's lives, have changed dramatically, some more than others. And, you know, I think it's our tendency, I can speak for both of us, Aaron, right? For sure.

When I say that we like to fight fear with facts, but there is still so much about this virus and this pandemic that we don't know about and we don't know how it's going to go. We don't have a roadmap for this. And thinking about our personal risk or our risk to others or the risk to our families or our friends or the economic outcomes, I mean, all of this can send a swirling down the rabbit hole of stress and anxiety and bad dreams and or lack of sleep. That's not exactly a helpful thing. No. And so we wanted to bring on a couple of amazing people who can share with us some coping strategies or good practices to try to get a handle on our stress and anxiety and to help us think about where it's coming from.

So for this episode, we were really fortunate to speak to Rosemary Walker and Pete Rosencran's two graduate students at the University of Washington in psychology to talk to us about all of kind of the mental health issues about this pandemic. They were really incredible to talk to you. And so we hope that you really enjoy this episode. I think it was one of our favorites to record because this is stuff that we don't know anything about. We go into anxiety spirals just like everyone else very easily. So this was really, really personally useful and hopefully it'll be useful for listeners as well. Yeah. So. But first, we do indeed. Speaking of coping strategies, Aaron.

This is, we do not recommend alcohol in any way as a coping strategy. No, no, uh-uh. But because, you know, branding and symmetry, we have to have a quarantini recipe. So if you want to make the Placebara version, that'd be a good coping strategy. Yeah, it's pretty delicious. Okay, so what is in Quarantini 6? Quarantine 6 is a wine spritzer with pineapple juice and some kind of like a nice fruity white wine, like a pino gruge or something. I don't know, whatever you have in your cupboard.

Yeah, honestly. That's kind of the theme of these quarantini so far. Is that like, you know. This is what we had. A can of pineapple juice and a twist top bottle of wine. Don't knock the twist top. No, I love twist top. I was actually disappointed to myself that I bought multiple bottles.

one of them had a cork, and I was like, dang, should have gone all twist. I shred about 40% of the corks that I try to remove. Do you really? I do. Learn something new about you today. Let's take a quick break and then dive in to this episode. Dinner shows up every night, whether you're prepared for it or not. And with Blue Apron, you won't need to panic order takeout again. Blue Apron meals are designed by chefs and arrive with pre-portioned ingredients so there's no meal planning and no extra grocery trip. There, assemble and bake meals, take about five minutes of hands-on prep. Just spread the pre-chopped

ingredients on a sheet pan, put it in the oven, and that's it. And if there's truly no time to cook, dish by Blue Apron meals are fully prepared. Just heat them in the oven or microwave, and dinner is ready. And here's the exciting news. Blue Apron no longer requires a subscription. You can order meals when you want them and skip when you don't without adding another recurring charge. Order now at Blue Apron.com. Get 50% off your first two orders plus free shipping with code this podcast 50. Terms and conditions apply. Visit blue apron.com slash terms for more information. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keefe's working hands hand cream

is such a relief. It's a concentrated hand cream that is specifically designed to relieve extremely dry, cracked hands caused by constant hand washing and harsh conditions. Working hands creates a protective layer on the skin that locks in moisture. It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours. It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments. It's been relied on for decades by people who wash their hands constantly or work in harsh conditions because it actually works. O'Keefs is my hand cream of choice in these dry Colorado winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth,

no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keefs. Just visit O'Keef's company.com slash this podcast and code this podcast at checkout. A timeless wardrobe starts with pieces that are built well from the beginning. From the fabrics to the fit, everything needs to last beyond one season. And that's how Quince approaches design. Quince has all the staples covered, from 100% organic cotton sweaters to premium denim made with stretch for all-day comfort and luxe cotton cashmere blends, perfect for the changing seasons. The quality shows in every detail, the stitching, the fit, the fabrics. Every piece is thoughtfully designed to be your new wardrobe essential. And each piece is made with premium materials in ethical

trusted factories and priced far below what other luxury brands charge. I recently got a pair of Quince's Bella stretch wide-leg jeans, and they are now in constant rotation. They are so comfortable. The fit is amazing, and they come in a bunch of different washes, so I'm about to go order some more. Refresh your wardrobe with Quince. Go to quince.com slash this podcast to get free shipping on your order and 365-day returns, now available in Canada, too. That's Q-U-I-N-C-E-D-com.com. slash this podcast to get free shipping and 365-day returns. Quince.com slash this podcast. My name's Rosemary Walker.

So I'm a sixth-year doctoral student at the University of Washington. And my lab focuses on, or our lab is called the Center for Anxiety and Traumatic Stress. And a lot of our work focuses on providing psychotherapy to individuals with anxiety disorders and post-traumatic stress disorder. And I work in various clinics throughout the Seattle area, mainly our university clinic, where we provide psychotherapy to individuals with kind of a broad spectrum of mental health needs.

My name is Pete Rosencranz. I'm a fourth-year doctoral student at the University of Washington, also working in the Center for Anxiety and Traumatic Stress, which is Dr. Lori Zolter's Lab and UW. Similar to Rosie, my research interests, primarily focused on anxiety and PTSD, particularly on elucidating some of the treatment mechanisms and therapeutic change processes that are going on in our treatments for these issues. And also similarly to Rosie, kind of do a range of clinical experiences ranging from clients I see through our university

psychology graduate clinic, our training clinic, as well as external practica sites around the Seattle area. Awesome. Thank you. So, I mean, first, I would love to hear how you guys are doing. So you're in Washington State, which is one of the states that's been hit the hardest by COVID-19. And so, you know, you've been experiencing these things and probably thinking about these things on a day-to-day basis much earlier than some of the rest of us in the U.S. have. So can you just, I don't know, how are you guys doing? Yeah. Yeah, it's a good question. And I've been getting that a lot, you know, I think, because it really, it hit here first. So it has been, I think, a little bit more present for us for a bit longer than other parts of the country.

And, yeah, I would say, I would say it's been a challenging time. Life as we have known it has really changed, which is now probably starting to be true for most people across the country, across the world, really. And I think one of the hardest parts has really been the uncertainty of it all and a lot of adjusting to changes in, you know, lifestyle and work. and things like that, and the social distancing aspect has been difficult as well. I think on the other hand, we've heard this a lot this week across patients and friends in Seattle, but the sun came out this past week, which I think we have been especially thankful for. I also would say there's been a feeling of shared humanity and community and a lot of creativity being sparked to in the past few weeks that I've really seen from, you know,

breweries and restaurants offering kind of curbside deliveries that they, you know, hand you on a pole into your car to, you know, organizations gathering people to babysit for medical professionals or writing letters to individuals who are quarantined or organizing dance parties in the street, things like that. So it's been, it's a difficult time. The uncertainty is hard, and I also think it's been uplifting to see the community coming together. Yeah, I would really echo pretty much everything that Rosie is saying. The uncertainty has definitely been a major challenge. I also think it's, especially early on when we were seeing some of those first cases emerge here,

it really wasn't clear what we should be expecting and exactly what we needed to be doing and kind of just what the future and the near term was going to look like. And that was just kind of really hard to navigate and prepare for. Now there does seem to be a bit of a new normal that's being established here with, you know, pretty much everybody is working remotely at this point except for kind of those essential businesses and services. There's a lot of social distancing going on, self-quarantining going on. And I think becoming increasingly clear, at least to me, my general assumption is that we're in this for a longer haul than I initially expected. on the scale of months as opposed to days or weeks.

And so I think at this point, the main challenge for me is just trying to kind of embrace this new normal and figure out, you know, how do I want to structure my day so that I can, you know, retain some semblance of normalcy and build some new routines into my life. And how can I kind of make the changes that I need to be making to ensure that I can keep up my work, my personal well-being, social connections, all those sorts of things. Yeah.

So the impacts of this disease we're seeing is they're super diverse, of course, and much broader than just the impact on people's health. And none of us have really ever experienced something like this before, especially not on this scale. So what are we seeing in terms of some of the mental health outcomes? Yeah, so I can start out talking just kind of generally about what we're seeing, broadly speaking, in terms of mental health outcomes. outcomes. And I think you're really, you're hitting the nail on the head there when you say that this is an unprecedented situation. I think in a lot of ways that defines our reaction right now. It's just that inherent uncertainty that's going on. So broadly speaking, I think we're seeing kind of an increase in some negative mental health outcomes and as well as a decrease in some positive aspects of mental health. So what I mean by that is on the negative side, we're seeing increases in stress and anxiety on a pretty broad scale that are being. driven by, you know, actual health and socioeconomic threats to ourselves, our loved ones, and our communities that COVID-19 presents. And I think that stress and anxiety has really been compounded by that sense of uncertainty and that sense of helplessness that often comes along

with this. We know from a long history of research in animals and mammals and humans that uncertainty and unpredictability and uncontrollability really tend to drive these fear and anxiety reactions and kind of exacerbate them. So I think we're seeing those reactions really amp up. I think we're also just seeing difficulties that come along with balancing competing demands from work, family, personal responsibilities, your social needs. You know, there are families who have kids who are home from school because the school systems are closed while the parents are trying to work remotely at the same time. Probably have households where some parents are maybe getting sick and also trying to care for their children at the same time.

And that just really increases the overall stress and level of demand across the board. Some other key things I think we're seeing are kind of a sense of detachment from our social connections and from our social lives in general that comes along with this effort to practice social distancing and self-quarantating. So we're spending more time in isolation or maybe solely with members of our household. we're maybe seeing some disruptions and social activities and social connections. We're seeing kind of big life events be disrupted. So weddings having to be canceled, their mood, vacations rescheduled, maybe visits that were scheduled to family members who live in a different area,

those are being put on hold. And so I think what comes along with that, in addition to the kind of increase in anxiety and stress that I talked about, there's also we're kind of losing access to some of these sources of positivity and reward that we ordinarily have that make our lives enjoyable. We're seeing our hobbies be interrupted. We're seeing disruption to the things that we find fun and that we like to do. And some of the reactions we can see from this can be, you know,

sadness and response to some of those losses. Might even see some depressed mood as some of those activities have to be canceled or postponed indefinitely. And as we kind of decrease our activity overall and lose access to some of those positive things in our lives, we might be seeing some decreased motivation in general as well as Anedonia or kind of a loss. of an ability to experience positive feelings. I was just going to add a little bit more, you know, I would echo everything Pete says, but I would also add a couple unique considerations for the clinical populations we work with. So we work particularly a lot with individuals with experiencing mood and anxiety disorders.

And, you know, for individuals with anxiety in particular, one thing we know is that uncertainty tends to be, most people don't love uncertainty, but for individuals with anxiety disorders, uncertainty is particularly challenging to tolerate. So, you know, we can see, we can imagine that this might be impacting them kind of even more. And another piece of it also is that a lot of our work with individuals with anxiety disorders focuses on challenging, sort of overly negative or catastrophic thoughts. So these thoughts that we focus a lot on might be, that we focus a lot on, might be things like the world is completely dangerous or something terrible is going to happen to me or my family if I don't take extreme precautions, for example. And so a lot of our work,

like I said in psychotherapy, we focus on challenging these beliefs through various evidence-based techniques to help individuals develop more balanced or realistic thoughts. And so you can imagine that the current COVID-19 situation is making some of those catastrophic beliefs a little bit harder or more difficult to challenge for some of our patients. So, you know, having the reality is that risks right now of becoming sick or loved ones becoming sick are higher. And so, again, we're sort of aware of the fact that for many of our patients, they're experiencing kind of even, finding it even more difficult to kind of work to challenge those overly kind of catastrophic beliefs.

And then also there are some specific considerations for individuals experiencing or in psychotherapy for depression because sort of Pete hit on this little bit. But a lot of the work that we do with our patients with depression is around scheduling activities because there's a real link. We've seen this consistently and a lot of our therapies are based on the kind of connection between your activity level and your mood. And so when we're working with individuals experiencing depression, we might spend a lot of time making kind of an activity schedule to boost their mood.

And we know that kind of engaging in activities that are values-based tends to have a positive effect on our mood. And it's one of our main ways for targeting depressed mood. So again, sort of like we were all just talking about, you can imagine there might be some particular implications for, individuals already experiencing depression to then have it harder to access these activities or to be active because of social distancing. So we're really working to be proactive and creative to address that with our patients who we're working with who are experiencing depression.

Yeah, that is additional challenges. It's that's very important. So, you know, you to have unique perspectives in the mental health profession, can you talk about some of the challenges that you have faced so far and some of the challenges that you think are going to appear in the future as this COVID-19 situation progresses. Yeah, yeah, I think, you know, like everybody else right now, this is all very novel. We're navigating new water. And I think over the past month, flexibility has been incredibly important for us and also for our patients. So, you know, for example, day, the University of Washington Clinic was seeing patients in person, and then we changed the next day to kind of having it optional in person, and then an option that do what we call

telehealth or sort of therapy virtually. And then the very next day, we changed it to, all sessions had to be moved to telehealth. So I think just, you know, being really flexible and creative in terms of kind of rolling with the updates and sort of the new restrictions and also balancing kind of the needs of our patients with the need for social distancing and working with our patients to find something that works for them if we can't meet in person. Not all the clinics in Seattle have the ability to move to telehealth or even walk to. You know, again, it's sort of a balance between what's best for our patients and also the need to distance ourselves right now.

So, for example, if patients are particularly at high risk for suicide, a provider might decide that meeting in person is still important or necessary. Patients with social anxiety, it might be a real barrier to get them to meet via telehealth. On the other hand, telehealth has been around for a long time. Not everybody's trained in it. So some people have had to kind of go through really quick training to be able to provide telehealth. But, you know, there's a lot of evidence to suggest that it can be very effective.

And yeah, I think that's been a big piece of it is also just getting that all set up for everybody. And then there's more specific things, again, to our psychotherapies as we deliver them that need to be adapted if you're going to be doing them via telehealth. So things like, you know, when we're treating patients with anxiety disorders, a lot of the time we actually leave the clinic and go out and do what we call exposure exercises. So things like having our patients approach things that they're afraid of in order to learn that it's not actually dangerous or that they can tolerate the distress that comes up as they approach that feared situation. And so sometimes we do that in our sessions, and clearly that's more challenging when you're

meeting via telehealth. But again, there are resources to turn to because telehealth has been rolled out, you know, and becoming used more and more, especially for rural populations and things like that over the past few years. So, yeah, I would say, again, I would just say that flexibility has been really important and sort of trying to meet the needs of our patients as best we can, despite the current events and the limitations that are being put on us. And maybe some of the reasons why it's maybe not best to meet in person. Yeah. So we've heard a lot from our listeners, our friends and family. You guys brought up a lot of the different stressors and anxieties that people have been feeling. Aaron and I, I can speak for us both, right, Aaron? Oh, yeah.

We've both been really feeling this as well, too, a lot of the fear, the apprehension, the anxiety about all of this uncertainty. Even us, even though we kind of, you know, know about the fact that these sorts of pandemics could potentially happen, it's still so unknown what is going to happen. So could you talk a little bit about some of the coping strategies that we could all use to try and deal with some of the, issues that we're facing like the social isolation, the empathy fatigue, and all of this anxiety about the future. Yeah, absolutely. I think there's a, there's a lot we could cover here. So I'm going to, I'm going to cover some things up front and then Rosie's going to take over from there. So the first place I would start out is just to really emphasize the importance of normalizing and validating some of these negative emotional responses and feelings that are coming up. As you're saying,

With the levels of uncertainty that we have, how little we know about how this is going to progress and what kind of what the actual level of threat is, as well as those kind of socioeconomic stressors that come along with the health risks, you know, stress and anxiety are certainly to be expected here. And it's not a sign, you know, if you're experiencing elevated stress and anxiety right now, it's not a sign that something is kind of fundamentally wrong with you. Those feelings are normal given this context. And there might be some comfort in just kind of reminding yourself of that when you notice these feelings coming up in a more intense way than maybe you've been used to in the past. And then to really kind of validate them, like the feelings aren't

coming out of nowhere, right? Like there is an actual threat out there. There is actual kind of bona fide uncertainty and unpredictability out in there. And that's what these emotions are really responding to. And that's the way they're supposed to function. And so these emotional responses, even though they can be unpleasant, oftentimes they actually have real value to us. Anxiety, and lorry, again, certainly can be unpleasant, but it can also help motivate us to prepare and protect ourselves and our families. Key thing I would also mention here is, while it's important to validate and normalize these feelings and to kind of accept them, that they're kind of part of our experience for now,

given the situation that we're in, I think it's also important to be on the lookout for unhelpful thoughts and unhelpful behaviors. So you can ask yourself, is what I'm going to do or what I'm doing, is this actually useful or helpful or effective for me right now. One of the key things that we talk about is distinguishing between helpful and unhelpful worry. So most people are probably worrying a lot right now. To the extent that that worry and anxiety actually leads to active problem solving and adaptive coping strategies, that worry is actually useful and it can be helpful to kind of lean into that and act on the urges that come along with it. However, worry can also be taken.

into an extreme. And worry can kind of, it can go beyond actually helping us take constructive action, and it can start to become more just self-perpetuating. So I'd say that worry that leads to rumination or the sense of spinning, or generally just to more anxiety and more worry without producing concrete helpful behaviors, that's not going to be so helpful.

So when you notice that kind of worry coming up, it can be helpful to engage in some strategies to limit it. That might be, you know, limiting your news or media consumption. So you don't necessarily want to be spending all day kind of scanning the news, especially if you're not actually gaining any new or more useful information in any hand before. You might just be perpetuating that anxiety or making it worse. Similarly, I think when you are seeking out information, you want to make sure that you're actually seeking out, you know,

reputable, trustworthy information that you can actually act in the appropriate way. might be just kind of distracting yourself if need be. I know preferably with something enjoyable like a book or a show or a movie or maybe, you know, video chatting with a friend. But certainly distraction can be a useful tool when we find ourselves hooked in this kind of cycle of unhelpful worry. I also mention it's probably helpful to be aware of some of the psychological effects that increased stress, fear, and anxiety have on our psychological system. So we know that when we have elevated fear and anxiety, it changes how our attention functions. So we can develop an increased attentional bias to threat where we are kind of quicker to pick out all the things that appear scary and threatening in our environment. And we maybe gloss over or dismiss things in our environment that maybe would be run counter to that fear.

And that can lead to an escalation of fear and anxiety as well. The last thing I would say is fear has a tendency to overgeneral. meaning that if there's something in particular that we're afraid of, like a virus or coming into contact with the virus, oftentimes that fear kind of spreads out to things that seem related to it, but that actually are something completely different. And as an example of this, I might think of, you know, fear and anxiety motivated people to go out and buy, say, like enough food to have for a couple weeks in case we can't go to the grocery store. I also saw some people going out and, you know, maybe getting some things that didn't necessarily make logical sense

and connection to this particular outbreak. So, for instance, like going and buying up gallon a gallon of gallons of drinking a bottled water when, you know, our tap water is perfectly safe to drink here. And that may be how we prepare for like an earthquake or another type of natural disaster where our, where that type of infrastructure might be threatened. But isn't necessarily something that's going to be disrupted from this type of outbreak. Yet that fear can kind of push us to engage in kind of those more general actions. I think just kind of being aware of that can be helpful to see when those tendencies are getting kicked in by the fear.

Yeah, great. That covered a lot of really good things. And I'll just add a couple more that sort of tie back a little bit to some of the things we've hit on. The first being uncertainty, we've kind of been, that's come up a lot. lot so far. And I think, like we've mentioned, uncertainty is a really, is really challenging for a lot of people. People vary. There's a lot of variability in how well people tolerate uncertainty. And like I mentioned before, individuals with anxiety disorders tend to find it even more challenging usually.

And so I think in this time, an important first step can be to simply acknowledge how this is a time where there is quite a bit of uncertainty, uncertainty about how long this is going to last, about what this will mean for work and our financial situations and uncertainty about, you know, potential infection of us or our families. And instead of kind of trying to spin on spin and spin and spin and look for certainty, there can be some relief in trying to sort of just accept the uncertainty for now and tolerate it. think about other times that you've tolerated uncertainty and how you did that. And with that acceptance, like I said, there can be some relief.

And it's also okay to accept the discomfort that comes with the uncertainty and to notice that it's, you know, you don't like it or that, you know, it makes you feel anxious in your body. And so that, I think, can be a really helpful first step is to sort of give up problem solving, give up trying to find answers and really notice and acknowledge and accept the uncertainty of the moment right now. Another helpful piece here can be that there's significant evidence to show that people overestimate how badly they will be affected by future negative events and underestimate how well they will cope with and adjust to difficult situations.

So along with the acceptance of the uncertainty, it also can be sort of helpful to remind yourself of that and remind yourself that it's very likely that whatever comes your way in the next few months, getting sick, losing a job, any of those things, it's very likely that you will find a way to get through it, even if right now you can't imagine that you possibly would be able to. I think another really helpful thing in these moments is I hear a lot from friends, patients, family, the kind of thought of, I can't imagine how I would possibly get through this, another few weeks of this, another few months of this, and sort of, one of the things that makes it the most difficult is the idea that it might last for a while,

kind of this disruption to our life as we know it. And I think this is where we can bring in some of our mindfulness techniques and staying in the present moment can really help. So focusing on what can you do in this exact moment and kind of acknowledging that really all you have to do is get through this moment. And that can really feel a lot easier than things. thinking about getting through months of this. And we really don't know, right?

Again, there's that uncertainty. We don't know. We could see change tomorrow or it could be a few months. And so really all you have to do is stay tied to the present moment and get through the present moment. And then I think a last piece that kind of ties back to some of the challenges people are facing is a lot of us have lost access to things that give us meaning in life. And so how are we not going to fall into hopelessness and helplessness?

if we've lost contact with those things that give us meaning and how can we make meaning out of our life still given the current circumstances? One thing that we really encourage people to do is try to spend some time thinking about what your values are. So values are personally important principles that are kind of you as an individual find intrinsically rewarding. And these vary across individuals

can be things like creativity, learning, compassion, gratitude, social justice, all of those are our values. And in this time, it's a really good time to get in contact with those values and think about what can bring these into your life, despite the fact that maybe you're homebound or you aren't able to go to work or you aren't able to spend time with friends, if that's your value. And people have gotten really creative with this, you know, and I think that there's lots of ideas online. You can look up. But first, it takes figuring out what your values are and then finding ways to get creative to bring them into your life, right? So, for example, if compassion is a value of yours, can you find a way to bring in four different

ways that you get in touch with that value each day? So maybe that's, you know, asking a neighbor who, you know, if you can grocery shop for them or write letters to people who are quarantined or make drawings, if you have kids at home, have your, have your kids make drawings and and send them to family members or loved ones. Lots of different creative ideas. And one thing, it can be kind of difficult to actually think of these things when you are, when you are feeling low or you are feeling anxious because we know that sort of our mood impacts how we think.

So a really good idea is to actually have you think about these ideas for this and generate a list. And so that in times when you are, maybe your mood has kind of tanked a little bit. you can kind of access this list and force yourself to kind of engage in one of these activities, which then we know can have a positive impact in your mood and schedule them ahead of time. So even if in the moment you don't feel like doing them, it's a part of your kind of planning, a part of your day that you've planned and kind of do what you can to force yourself to go through with these activities or these ideas that you've had, because again, we know that that can have a

positive impact on your mood. Those are wonderful. Thank you. Such good advice, yeah. So, you know, for people who normally see a therapist in person, I know that you mentioned teletherapy, but what are some other resources or that they could use during this time or if someone has never maybe gone to see a therapist in person, what are some resources that they could use as well? Yeah.

So, again, I think a lot of people are on coming. with telehealth, so I'll just put in another plug for that and that it can be really effective. And I think even patients who are sort of resistant at first find that it's actually really nice to connect and easy to connect over the, through the computer, through the screen. You know, I think there's various platforms for it. Our clinic actually uses the HIPAA compliant Zoom, which means that it's all, you know, all of it is protected and, you know, not accessible. So it's very private.

And then a lot of the time, again, there might be little adaptations, but the therapy sessions look largely like therapy sessions look in person. You can see the person through the screen. You know, the therapy sessions usually actually end up feeling, I think, very, very familiar and similar to when they're in person. You know, there's things we help people set up, you know, a private place so that they feel like they are, have privacy. I think that can be a really key component of it. if there's family members or kids around. We might ask that they step outside or something like that. But it largely looks very similar to therapy in person,

but you're just communicating through the computer. Yeah, I would really echo what Rosie is saying. I mean, I've actually been, I was pretty skeptical about how telehealth would go doing therapy over it. I've been surprised at how well it's worked out. I really do think there's a lot of value to it, and it's going to be a major tool that we lead on throughout these events. that are ongoing. So I would kind of just, I would reiterate that plug for at least giving

telehealth a try if it's an option to you. And, you know, even if it's, let's see you're already in therapy, but for one reason or another, telehealth is not an option for you. You might consider still just reaching out to your therapist and seeing if you can kind of actively make a proactive coping plan together with your therapist for how to navigate that interim period until you're able to resume treatment. And that's probably something that's best done in consultation with someone's individual therapist. Similarly, if you've been in treatment, just kind of remembering what you have learned so far. And rather than approaching this as taking a hiatus from your treatment, to approach it as maybe an opportunity to practice and live with the skills that

you've been learning so far. So not to give up on those efforts. So you can practice that self-compassion, even if you might struggle to use the skills that you've learned effectively when you're outside of therapy, context. And that's okay. And so being compassionate with yourself as you're trying to do that, but really trying to keep up practicing those things that you've been learning. And then more broadly, I think if you haven't been in treatment, it's probably worth just being on the lookout for really some longer-term patterns of mood or emotional, behavioral, disturbances, particularly when they get to the point where they're really starting to interfere

with your daily activities or your general well-being. In that case, it might be a sign that it might be worth reaching out for some professional help. And I think that kind of resources are being developed on an ongoing basis in terms of where to find telehealth opportunities. But in general, individuals, insurance companies generally have kind of a directory of providers who are in network psychology today you can also it has several find a therapist tools i'm not sure if you know telehealth option has been built into that search tool yet and there's some other resources out there where you can kind of search for therapists to explore if telehealth was an option i would add um also just uh you know this this goes back to some of the things

pete was saying about validating that this is a stressful time um and it seems like it's a really good time to just for everybody to be practicing self-care so So thinking about the things that make you feel relaxed, the things that are comforting to you and try to build these into your life as well. And simple things, too, like good sleep hygiene. There's lots of information on the internet about, you know, good sleep hygiene. And sleep is so important, you know, it has a cascading effect on mood and anxiety, definitely. And anything we can do to kind of buffer against those right now is going to be important.

And so, you know, doing things like going to bed at the same time and waking up at the same time and, you know, limiting screen time before going to bed. Things like that can make a really huge difference right now. Taking a bubble bath if you find that relaxing. Anything that you can think of to build into your life right now that can just boost up your resilience and buffer against issues with mood and anxiety is going to be really important for everybody. Yeah, that makes a lot of sense. And we've kind of talked a little bit and touched on how wide ranging the kind of effects of this are in terms of mental health, socioeconomics, everything. So how can we as individuals help other people during this time? How can we be good neighbors, community members, good leaders,

while still protecting our own mental health? Yeah. So I think this ties into a lot of what we've been talking about. So I think on the most basic level, the advice would be, you know, like, follow those guidelines that we're getting from the CDC or from your state or county or city public health departments or departments of health.

You know, actually adhere to those guidelines that we know we need to be doing to you know, keep people healthy and protect those of us are at high risk. More on the kind of psychological or mental health side, the themes that we've seen emerging in terms of how to kind of

to go through this process in terms of outlook for our own and our community members mental health is to really embrace this attitude of flexibility, kindness, and creativity. So, you know, again, we're all navigating an unprecedented situation, and there is bound to be missteps along the way. Trying to take kind of a gracious and flexible attitude to that. Maybe watching out for negative assumptions about people's behavior and instead kind of considering that, okay, maybe we're all kind of trying to do our best here, navigating an inherently very difficult situation. We're all kind of trying to figure this out together.

And that involves extending kindness and graciousness to yourself and others and kind of just accepting that, you know, we're not going to be perfect through this. And that's okay. We're still going to do our best. I think intentionally practicing empathy can be helpful in those situations, really just embracing those creative ways that we can stay connected to the people, people we care about and to get creative about how we build in those sources of positivity and reward and things that fulfill our values into our life. I think this is going to entail having

to take a pretty open-minded approach to this and being open to some trial and error as we go along. So being willing to maybe try out new potentially unconventional ways of connecting with other people, whether it's virtual happy hours or watching a movie together over video chat, maybe playing a board game together or virtually, as well as maybe finding new ways to exercise if you can't go to your normal gym or of having trouble

kind of getting access to the normal way of the exercise. Maybe it's finding new things that you try out at home or walking around your neighborhood. And maybe those wouldn't have been your first choices up until this point, but it might be worth just taking open-minded approach to them and giving them a try to see if they work for you. I think this emotional support aspect

is pretty key. So offering emotional support to others when it's needed or when it's sought out by people you care about, kind of validating those feelings that are coming up and also seeking out that kind of support when you need it yourself. So if you're seeking someone to kind of process your emotional reactions to things with or to problem solve with, you know, be proactive about that. Seek someone out who you trust and have that conversation. That can be really beneficial for everyone involved. And then I think, you know, to the extent that we can offer concrete or physical support when it's appropriate to help our communities.

So there are some communities who are asking if anybody has, you know, extra N95 masks at home that they could donate for healthcare workers. Maybe there's philanthropic means in which you can have a positive impact in your community, those types of things. So being on the lookout for really what is called for by trustworthy, really reputable sources, participating in those efforts when you are able to. And just kind of doing your part to engage in these new practices that are being encouraged and to kind of kindly encourage others to do so as well. And just acknowledging that, you know, we're finding a new way to live

our lives for this time being. And that's a real challenge for all of us. Yeah. Thanks. Those are very helpful. So are there some specific resources that you, you can recommend for some of our listeners who may be struggling during this time, some specific resources they could seek out? Yes. So I think the two big ones are probably ones that everybody's heard, which are, if you want, you know, reputable information about coronavirus or the COVID-19 itself, CDC website and the World Health Organization website are two go-to sources that are reputable and generally up to date. More on the mental health side, there's actually a lot out there. So in general, we'd probably recommend making

sure that you're consulting trustworthy sources, government websites, professional organizations, as opposed to maybe taking mental health advice from social media or from memes that you see posted or from non-mental health professionals. So there are a lot of those professional organizations out there. Some of them that we have come across that have COVID-19 specific information on there that we liked. One was ADAa.org. That's the Anxiety and Depression Association of America. If you go to their front page of their website, they have an entire section devoted to helpful advice for dealing with coronavirus anxiety, and it's a great resource to consult. Another one would be SAMHSA or the Substance Abuse and Mental Health Services

Administration. So that's S-A-M-H-S-A.gov. Similarly, they have a wealth of COVID-19 related mental health information right on their front page there. A good place to consult as well. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keeffe's working hands hand cream is such a relief. It's a concentrated hand cream that is specifically designed to relieve extremely dry, cracked hands

caused by constant hand washing and harsh conditions. Working hands creates a protective layer on the skin that locks in moisture. It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours. It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments. It's been relied on for decades by people who wash their hands constantly

or work in harsh conditions because it actually works. O'Keefs is my hand cream of choice in these dry Colorado winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth, no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keef's. Just visit O'Keef's Company.com slash this podcast and code this podcast at checkout. This is Bethany Frankel from Just Be with Bethany Frankel. Listen, I have a bone to pick with these dog food brands calling themselves fresh, natural, healthy, Sounds great, but a lot of these quote-unquote fresh dog foods in your fridge are not even 100% human grade,

which is why feed your babies, just food for dogs. It's good enough for big and smalls, my precious babies, so it's good enough for your babies, 100% human grade, real ingredients, beef, sweet potatoes, green beans, delicious. These are foods that you would want to eat. Not that the babies would ever share. Just food for dogs is the number one bet recommended fresh dog food back by over a decade of research. No marketing fluff. My dogs lose their minds at dinner. They run to the bowl, tags wagging, paws tapping, full Broadway performance every single night. So I do care about the food I feed

big and smalls. So go to just food for dogs.com for 50% off your first box, no code, no gimmicks, just real fresh food. All right, quick quiz for the hiring managers out there. What's worse? Being understaffed or being poorly staffed? Well, that's a trick question, because both Both are recipes for chaos. Either way, just say to yourself, this is a job for Indeed's sponsored jobs. You'll get matched with candidates that meet the skills, certifications, and everything else you're looking for. Or go a different way and get no traction. Seriously, sponsored jobs posted directly on Indeed are 95% more likely to report a hire than non-sponsored jobs.

It really is a no-brainer. Spend less time searching and more time actually interviewing candidates who check all your boxes. Less stress, less time, more results. When you need the right person to cut through the chaos, this is a job for Indeed sponsored jobs. And listeners of this show will get a $75-sponsored job credit to help your job get the premium status it deserves. At Indeed.com slash podcast.

Just go to Indeed.com slash podcast right now. Indeed.com slash podcast. Terms and conditions apply. Need to hire? This is a job for Indeed sponsored jobs. Thank you again so, so much. to Rosie and Pete, we appreciate you taking the time. And honestly, like, it's, I can't tell you how much better I think we both felt, both during the recording. And then when I was editing it,

like, I almost cried several times because I was just like, oh, I feel validated. I feel like I understand more about why I'm feeling this way. And the importance of, you know, practicing these coping strategies. Aaron, I almost cried during the interview. Yeah. That's a good thing. I mean, I think that's a good thing. I think we've been. You know, just like barreling head, thinking about this constantly. And recognizing that it may not be a helpful thing to do was very important. And so hopefully you will find what they have said very interesting or relevant or helpful as well. Absolutely.

And one of the things that they mentioned was for some people who feel like you want to be doing something to help, if you are one of those people, Ologies is putting out a great episode where Allie interviewed Dr. Michael Wells, who put together a kind of database of scientists who want to volunteer to help. So check out that episode of Ologies if you want more detail on that and where to find the links to actually kind of sign up for that if you're a person who's interested in helping in that way. So, yeah. Awesome. Well, this isn't going to be the last, I'm sure episode. No, this will definitely not be the last episode. And we, you know, I think that one of the things that has really been illustrated by this pandemic, by the coverage of it, by doing this research on it, is that pandemics, public health, these are so multifaceted.

It's hard to comprehend. And it's hard to cover in a very efficient or effective. way. And so what we're trying to do is kind of reach each one of these different aspects of the disease. And so as we learn more, we may revisit aspects of the clinical disease or the vaccine development or the epidemiological patterns. But we also want to bring in some other things too. So hopefully we'll bring you episodes on the economic impacts of this, on how this disease or outbreaks like this work in countries that do not have the resources like the United States and other more wealthy countries have. So keep an easy.

ear out for those. Subscribe to our social medias. TpWKY is our Twitter. This podcast will kill you. Instagram. And, you know, we're also on Facebook under this podcast will kill you. And we also have a website where we're going to post FAQs and we're going to post updates and we're going to post new episodes as we have them. So as well as transcripts for all of these coronavirus episodes. We're working on transcripts for the past episodes as well. And yeah, If you're not subscribed to our feed already on whatever podcatcher you use, make sure you are, because I don't know when these new updates are coming, but they're coming. They're coming, yeah.

We're just going to do them as they get ready kind of a basis. Anyway, well, thanks again to Rosie and Pete for the amazing discussion that we had with them. Absolutely. And thank you to Bloodmobile for providing the music for this and all of our episodes. And thank you to you, listeners. We hope that you enjoyed this episode. and this series so far as much as we have enjoyed putting them together. And if you have more topics that you want for us to cover, shoot us an email.

This podcast will kill you at gmail.com. Absolutely. Okay. Well, until next time, wash your hands. You filthy animals. This is Bethany Frankel from Just Be with Bethany Frankel. Listen, I have a bone to pick with these dog food brands calling themselves fresh, natural, healthy. Sounds great.

but a lot of these quote unquote fresh dog foods in your fridge are not even 100% human grade, which is why feed your babies, just food for dogs. It's good enough for big and smalls, my precious babies, so it's good enough for your babies. 100% human grade, real ingredients, beef, sweet potatoes, green beans, delicious. These are foods that you would want to eat. Not that the babies would ever share. Just food for dogs is the number one vet recommended fresh dog food back by over a decade of research. No marketing fluff.

My dogs lose their minds at dinner. They run to the bowl, tags wagging, paws tapping, full Broadway performance every single night. So I do care about the food I feed big and smalls. So go to Just Food for Dogs.com for 50% off your first box. No code, no gimmicks, just real fresh food. The Emmy winning comedy Scrubs is back. The beloved original cast, including Zach Braff, Donald Faison, Sarah Chalk, Judy Reyes, and John C. McKinley scrub back in at Sacred Heart Hospital

for all new hilarious and heartfelt stories. There's a healthy injection of colorful new characters as well, including a fresh group of newbie interns and co-workers slash nemesis, Vanessa Bear and Joel Kim Booster. The new season of scrubs, Wednesdays at 8-7 Central on ABC, and stream on Hulu. Truck month is going on now at your local RAM dealer.

Hurry in for great deals and exceptional offers on a powerful selection of RAM trucks. And right now purchase and get 0% financing for 60 months on 20, 26 RAM 1,500 Big Horn and Laramie models. Don't miss this great offer. See your local RAM dealer. Not compatible with any other offers.

0% APR financing for 60 months equals 1667 per month per 1,000 financed for well-qualified buyers through Stalantus financial services, regardless of down payment. Not all customers will qualify. Contact dealer for details. Offer ends 3-2.