Mental Health in the times of a pandemic
by Dr. Young Lee
Mental health in the times of a pandemic Hi guys, I thought it's probably a salient time to touch on this subject. I know that everyone's level of anxiety is slowly (or rapidly) going up over the last few days. We've all seen Europe and America and thinking - oh shit - are we next? I've got an anxious wife at home who's immune compromised, I've got 2 kids who are thankfully cheerfully looking at the prospect of no school. I've got parents in Christchurch demanding masks even though I've told them 20x that it doesn't make much difference. I've got a Whatsapp group of my medical school classmates all having a minor panic attack talking about what we are going to do. And the wider GP facebook group who are collectively wondering what the future is going to be like. Then I get to write articles to everyone and pretend to be calm. Tell you what - let me be honest. I've got an underlying low level of constant anxiety now. Kinda like that small pebble in your shoe all the time when you are walking that is uncomfortable but not quite annoying enough for you to stop to throw it out. It's sort of giving me a mild brain fog and I'm starting to forget passwords I normally know and I'm also forgetting names of people unless I concentrate a little harder and then it's back. Is anyone else feeling this way? That's OK. That's actually a perfectly normal human response. What is actually happening is that our brains are designed to be able to imagine - that is what allows us to plan for the future, and to create amazing inventions. It also makes us worried about something that might happen in the future, or something that might not come to pass. It's illogical but it's how we are built. I think it's time to be honest here. Is this pandemic worth being very anxious about. - well frankly yes - the potential is terrible. 20x worse than the flu by most accounts. Those are big numbers. - is worrying about it going to change anything? Probably not - but at least it means we are changing our behaviours that may slow it's spread. I think the best way to try to calm our anxiety at this stage is to have trust and faith. Trust that the government is doing the right thing, and taking the appropriate measures at the right pace. Faith that this pandemic will end and things will come right. Remember - anxiety is often about imagined fears - such as the fear of death or the fear of economic poverty. Trust and faith are similarly imagined hope - which is the antipode of fear. Just as athletes delude themselves into believing they are the best until they win their match, we have to similarly delude ourselves into a hopeful state. I'm not saying you need implicit trust in the government - but if you get 85% there, I think your anxiety will reduce substantially. What if I feel so overwhelmed it's taking over my thinking all the time? Well then you have a problem. I have this theory that I heard from a doctor in South Africa. I call it the crap bucket theory, and I think some of you might have heard me talking about this before. We all have a certain amount of resilience that we are born with. I call this the crap bucket. It gets a bit bigger through life experience. Some people have more of it, some less. What happens if life is that we spend all day filling out crap bucket with crap. Crap is basically all the stressors we have in our lives - like work, relationships, money problems and in this case the impending threat of death of oneself or our loved ones. Then we spend all day emptying our crap bucket. This is through good habits and routines, such as spending time with people we actually like, regular exercise, sunshine and gratitude or meditation type exercises. I do it through my martial arts where I'm basically hitting something or throwing someone. The aim in life is to keep the crap bucket about 50% full, so that we have enough stress to make us do things (otherwise we'll procrastinate), but not enough to make us overwhelmed. This gives us a bit of leeway, as we have 50% more space to store any additional crap that comes up. The problems comes when your crap bucket is constantly 70-95% full. You have no resilience left. Any small thing makes you overwhelmed - making you anxious, depressed or burnt out - or a combination of all the above. This usually only happens with sustained stress, and it's usually more an accumulation of stressors. I describe the crap that builds up a bit like lego bricks, where it's not just one big thing - it's a combination of lots of things. The danger of the pandemic is that the stressors hit you at multiple levels: - threat of death - STRESS - threat of death of people you like - MORE STRESS - threat of economic poverty - the other day someone told me they were down $500 000 in the stock market - ouch - STRESS AGAIN! - just the sheer uncertainty of it all. Can't plan anything - STRESS! At least during the GFC in 2008 - it was mostly just financial. Look - if you feel overwhelmed to the point where you cannot reasonably reduce your stressors (well you can't MAKE the pandemic go away), or you can't empty your crap bucket (because all activities have been cancelled) - you might need to talk to a professional to get some help. Not everyone needs medications at this stage, but some people might - maybe just temporarily and sometimes maybe a bit longer. If you feel that you get to that stage, please give your doctor a call - he or she might be able to help you. Incidentally - those kinds of consults are ideally suited for non face to face contact video calls. Stay safe guys, wash hands, maintain social distancing and we'll eventually be OK. If you find this helpful, please feel free to forward it someone that might need it. If you are looking for a doctor, Find us at: https://www.baysidemedical.co.nz/ we are currently still accepting patients, but that may change in the near future.