Two weeks ago, we had a counsellor talk to our community about taking care of mental health in 2020. The counsellor, Rebecca Wamwene offered expert advice and answers to questions asked in the chat. In this article, we’ll share answers to questions on taking care of your mental health and coping with anxiety.
How can I cope with the stress and anxiety I’m experiencing with the Pandemic? I feel anxious about catching the virus while walking in public and transmitting to my family. What can I do? What if I’m already living with an anxiety disorder? Media coverage can be especially triggering. How can I cope best?
In approaching these three questions, the following is very key:
- Be sure what you are dealing with is that.
- Do not do self-diagnosis i.e. visit a doctor or a psychological counsellor to help you diagnose and learn how to cope with anxiety.
- Be ready to walk with a helper ie doctor or counsellor psychologist/therapist.
Let me explain Anxiety and Stress
Anxiety: According to the APA(American Psychiatric Association)
Anxiety is a normal reaction to stress and can be beneficial in some situations. It can alert us to dangers and help us prepare and pay attention. Anxiety disorders differ from normal feelings of nervousness or anxiousness and involve excessive fear or anxiety. Anxiety disorders are the most common of mental disorders and affect nearly 30 percent of adults at some point in their lives.
Women are more likely than men to experience anxiety disorders.
Types of Anxiety Disorders
Generalized Anxiety Disorder
This involves persistent and excessive worry that interferes with daily activities. This ongoing worry and tension may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping. Often the worries focus on everyday things such as job responsibilities, family health or minor matters such as chores, car repairs, or appointments.
Panic Disorder
The core symptom of panic disorder is recurrent panic attacks, an overwhelming combination of physical and psychological distress. During an attack several of these symptoms occur in combination: Palpitations, Chest pain, feeling of choking, Numbness or tingling, chills or hot flashes, nausea or abdominal pains, feeling detached, fear of losing control, fear of dying
Because symptoms are so severe, many people who experience a panic attack may believe they are having a heart attack or other life-threatening illness. Panic attacks may occur with other mental disorders such as depression or PTSD.
Phobias, Specific Phobia
A specific phobia is an excessive and persistent fear of a specific object, situation or activity that is generally not harmful. Patients know their fear is excessive, but they can’t overcome it. These fears cause such distress that some people go to extreme lengths to avoid what they fear. Examples are fear of flying or fear of spiders.
Agoraphobia
Agoraphobia is the fear of being in situations where escape may be difficult or embarrassing, or help might not be available in the event of panic symptoms. The fear is out of proportion to the actual situation and lasts generally six months or more and causes problems in functioning. A person with agoraphobia experiences this fear in two or more of the following situations:
- Using public transportation.
- Being in open spaces.
- Being in enclosed places.
- Standing in line or being in a crowd.
- Being outside the home alone.
The individual actively avoids the situation, requires a companion or endures with intense fear or anxiety. Untreated agoraphobia can become so serious that a person may be unable to leave the house. A person can only be diagnosed with agoraphobia if the fear is intensely upsetting, or if it significantly interferes with normal daily activities.
Social Anxiety Disorder (previously called social phobia)
A person with a social anxiety disorder has significant anxiety and discomfort about being embarrassed, humiliated, rejected or looked down on in social interactions. People with this disorder will try to avoid the situation or endure it with great anxiety.
Common examples are extreme fear of public speaking, meeting new people or eating/drinking in public. The fear or anxiety causes problems with daily functioning and lasts at least six months.
How To Cope With Anxiety and Tips to overcome Anxiety Disorders:
- Schedule your “worry session”. Take 30 minutes to identify what’s bothering you and what you can do about it. Focus on what actually makes you anxious.
- Be the boss of your thoughts. Hire and fire thoughts and ideas. Try to turn any negative thoughts into positive ones. Picture yourself facing your fears head-on.
- Become aware of the triggers eg. Is it the social media posts, is it news reports, are they the images of the dead etc
- Obey the rules: Keep distance, sanitize, mask, avoid crowded places etc
- Do not be over-sensitive: Ask yourself suppose I forgot my mask or sanitizing?
- Accept the reality: Corona is with us to stay.
Stress
Stress can be defined as the degree to which you feel overwhelmed or unable to cope as a result of pressures that are unmanageable.
Stress affects everyone.
Everyone experiences stress from time to time. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time. Some types of stressors are:
- Routine stressor likes family, school etc,
- Triggered stressors eg divorce, illness etc,
- Traumatic stress experienced during an event such as a major accident, war, assault, or natural disaster, pandemics.
Not all stress is bad
In a dangerous situation, stress signals the body to prepare to face a threat or flee to safety. In non–life-threatening situations, stress can motivate people, such as when they need to take a test or interview for a new job.
Long-term stress can harm your health
With chronic stress, those same life-saving reactions in the body can disturb the immune, digestive, cardiovascular, sleep, and reproductive systems. Some people may experience mainly digestive symptoms, while others may have headaches, sleeplessness, sadness, anger, or irritability.
Coping is the same as the ones stated above but we can add the following:
- Do a self Study. Recognize the signs of your body’s response to stress, such as difficulty sleeping, increased alcohol and other substance use, being easily angered, feeling depressed, and having low energy.
- Talk to your health care provider or a health professional and learn how to cope with anxiety and stress.
- Set your goals and priorities. Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much.
- Engage in exercises.
- Sleep enough.
How can I make mental health an ongoing priority?
- Self-care: Just make a choice to get frequent Psychological Assessment Tests. Speak to a counsellor for better coping mechanisms rather than wait for any mental breakdown
- Child care: Get in touch with your inner child and reparent that child.
- Self-awareness: Become aware of your temperaments, weaknesses and strengths. Practice self-awareness of healthy and unhealthy thought processes and self-talk.
How do I offer emotional support to a person who has been quarantined?
The American Psychological Association reports that Quarantine has a number of health risks such as poor sleep, poor cardiovascular health, lower immunity, depressive symptoms, and impaired executive function.
When executive function skills are impaired, you may find it more difficult to focus, manage your emotions, remember information, and follow directions. Going by this information, therefore, here are some few tips to help us offer emotional support to such people are such as not limited to:
- Stay Informed, but not overwhelmed. Learn as much as you can about the negative effects of quarantine
- Help them maintain a routine…eg sleeping at a certain hour, exercises, eating etc
- Listen to their complaints without judging them
- Help them maintain a positive self-talk
- Expose them to cool music and movies they love
- Seek professional help ie doctor and psychological counsellor
How do I talk to my children about COVID-19?*
Factor in their age and disabilities. Each age group receive information differently. Note we find it on TV and even the youngest of all see and interpret it in their styles.
- Before you tell them let them tell you what corona is in their own words. Observe them keenly as they define it. Are they terrified? Is it a monster to them? Are they laughing or tearful? Are they dramatic? etc
- Answer the question they ask to avoid over informing.
- Discuss in bits so you can be able to tell what information of corona invites more anxiety than the other eg..hand washing frequently, sanitizing, quarantine, going to school, death and burial.
- Check on your body language, the tone of your voice and the terms you use to explain COVID-19
- Do no stigmatize the patients.
Where can older adults find help for mental health?
They can visit a doctor, Psychological counsellor, psychiatrist or a clinical psychologist for Psychological Assessment Tests.
What are Warning Signs to watch out for when dealing with mental health?
Majority of mental health disorders will present like normal ups and downs. It only becomes a crisis when it gets extreme so kindly don’t wait for the crisis. It’s okay to see a doctor or psychological counsellor anytime. These extreme signs are:
- Confused thinking.
- Prolonged depression (sadness or irritability)
- Feelings of extreme highs and lows.
- Excessive fears, worries and anxieties.
- Social withdrawal.
- Dramatic changes in eating or sleeping habits.
- Strong feelings of anger.
- Strange thoughts (delusions).
What is PTSD? How can one detect it?
Post-traumatic stress disorder PTSD. It’s a mental disorder that is triggered after a person is exposed to traumatic events either by experiencing or witnessing. eg
- Sexual assault/rape
- Accident
- Natural disasters
- Fires
- Wars etc
Signs of PTSD
- A heightened sense of danger causing the person to feel stressed or fearful even in a safe situation.
- A high rate of suicidal thoughts, self-harm and this affects their day to day activities
- Stressful experiences that lead to anxiety and depression.
- Avoidance – refusing to discuss the event, avoiding places, things and activities
- Intrusive memories eg flashbacks, emotional distress, nightmares, fearful thoughts
- Negative thinking eg blaming, guilt, hopelessness, detached
- Change in physical and emotional behaviour: dizziness, headaches, shaking, chest pain, aches and pains, sweating.
- Irritability
- Anger outburst
- Aggressiveness
- Being easily startled, always being on guard for danger.
Situations that make this worse
- Having a job that expresses them to stress- eg. military
- Substance abuse.
- A history of family mental illness.
- Lack of a good support system.
Types of treatment
- Psychotherapy and counselling: visit a counsellor.
- Medications – See a doctor.
- In some cases, all are combined.
How do you know you are suffering from a burnout especially if you have just gotten a new job?
As I said earlier avoid self-diagnosis. It can be detrimental. Kindly consult a doctor or a psychological counsellor for a PSYCHOLOGICAL ASSESSMENT TEST. Many of the mental disorders have almost similar symptoms just like some physical illnesses have similar symptoms.
According to WHO, Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
- Feelings of energy depletion or exhaustion;
- Increased mental distance from one’s job,
- Feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.
NB : burnout reduces productivity and saps your energy, leaving you feeling increasingly helpless, hopeless, cynical, and resentful. Eventually, you may feel like you have nothing more to give.
The negative effects of burnout spill over into every area of life—including your home, work, and social life. Burnout can also cause long-term changes to your body that make you vulnerable to illnesses like colds and flu. Because of its many consequences, it’s important to deal with burnout right away.
Dealing with burnout requires the “Three R” approach:
- Recognize. Watch for the warning signs of burnout.
- Reverse. Undo the damage by seeking support and managing stress.
- Resilience. Take care of your physical and emotional health.
Looking at causes of PTSD and note it is called post-traumatic. Meaning this person must have gone through a traumatic event. A disorder characterised by failure to recover after experiencing or witnessing a terrifying event.
Can young children have PTSD if they lost a parent at a young age and start to wonder about it when older but don’t know how to go about it? What would you advise?
The condition may last months or years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions. This being the case the child may go through it if the loss was traumatic or if after the death the child was neglected, abused etc. A lot may need to be explored beginning with
- How old was the child?
- Did the child view the body? If yes, was she or he old enough to handle that?
- What narrative surrounds the loss?
Do people deny that they may have mental health issues? Why would that be?
I wouldn’t necessarily call it to deny. They simply do not know it until they are diagnosed. In the event, a person undergoes a psychological assessment test and they seem to refuse. It shouldn’t be taken as denial but a process. Depending with the therapist by and by they accept and own the process.
More so people stigmatize mental health disorders and label it names that may make one deny eg madness etc. If we could treat a disorder like any other sickness things would be different.
For those who live alone, how can they take care of their mental health in the midst of Covid?
A person who is mentally unhealthy is advised to have a caregiver. So kindly get in touch with a helper. But if it is mild keep in touch with your doctor and therapist through phone calls. Also constantly reach out to friends and relatives.
How would you support a family member who has psychotic episodes and is in denial?
Keep in touch with that person’s therapist. You don’t have to mention to them that they are psychotic. They will treat it like hate speech and they will be violent. Show them, love, make sure their environment is clean so they don’t have to harm themselves. Most importantly help them take their medicine
How do you start taking care of mental health in kids into young adulthood? Ie is it okay to constantly reaffirm?
The question is not so clear, but for proper development of any human being there is a need to
- Constantly affirm any positive behaviour.
- Constantly validate good actions through vicarious rewarding
- Discipline lovingly.
- Guide through mentorship.
So Covid happened and I lost my job as a result. My partner and I don’t stay together but he is supportive somehow. Since I got my baby in September things have been really tough. I underwent CS and had to get involved in house chores almost immediately because it’s just me and baby. Lately, it feels like he is becoming distant and I’m afraid at this rate he will pull away completely.
I get overwhelmed sometimes but I know I have to be strong for the baby. I got so frustrated that my blood pressure went too high. This really gets me worked up and sometimes I don’t have an appetite and I know this is bad because I’m breastfeeding. How do I cope with all these emotions?
Hi. I hear you and yes there is a lot in your plate. You may need to see a counsellor so you can be assisted to deal with these issues one by one. And yes it is possible.
How do you help a friend who is in a romantic relationship with the narcissistic person but you feel they don’t know and it’s affecting them mentally slowly, you can tell by the way they’re now holding themselves back from the real world? How do you help so it doesn’t get worse? It can be draining to hold on to such friendships when you’re regarded as the enemy all the time. Are there non-invasive ways to push them to get the help they need?
Help your friend to see a counsellor. Your friend may be feeling like you are judging unnecessarily. The only non-invasive way is when one does not impose their feelings and findings conclusively, but one can always make polite suggestions.
Is P. T. S. D curable? What would be the implications to family members including children living with a person diagnosed with P. T. S. D and what are the coping mechanism?
PTSD is curable. With the right combination of compassion, patience, and trust from a professional counsellor. The counsellor will help the client work to disempower the trauma that cripples them and practice positive coping skills in the context of well-rounded support and guidance.