The coronavirus pandemic has taken a toll, not just on people’s physical health, but also their mental health.
For some people, long-term planning or routine tasks that were easier last year are now roadblocks that are hard to get around. Others are suddenly overly focused on cleaning or washing their hands.
Reporter James Dawson spoke with Lily Brown, the director of University of Pennsylvania’s Center for the Treatment and Study of Anxiety on how humanity is processing its newfound stress.
The following is a transcript of the conversation:
LILY BROWN: One of the challenges with the pandemic has been a blurring of lines between what used to be considered excessive hygiene related behaviors and what now are kind of recommended public health behaviors around hand washing, around mask wearing.
The other thing that we've seen is just an increase in anxiety about a number of different factors. So we're certainly seeing increases in anxiety because of fears about the financial impact of the pandemic and also about concerns about the health and safety of family members and friends.
JAMES DAWSON: And for someone who's listening, who might kind of be thinking, well, wow, have I suddenly developed obsessive compulsive disorder, what kind of is that line that you and your colleagues seem to have drawn where it's an acceptable amount of cleaning?
BROWN: If people are engaging in a lot more hand washing, a lot more cleaning around the home than is typical for them, well, number one, that makes a lot of sense. But number two, the question I would pose to them is whether any of these cleaning rituals are getting in the way of their ability to live their life normally. Are you able to still work if you have employment? Are you on time for your for your work or are you having problems with connecting with people in the way that you usually did because you're so focused on making sure that things are hygienic or that you're not contracting the virus or spreading the virus? Some amount of anxiety right now is pretty normative. But when people start to notice that they're having impairment in living their life the way they would want to, that's when I would start to think about maybe recommending that they reach out for therapy.
DAWSON: Something else that I think a lot of us could probably relate to is this sort of coronavirus related brain fog where you are maybe addressing your your immediate needs, your you're getting the groceries, taking care of your maybe cleaning your house, but you don't necessarily have the capacity to to think in more long term ways. Is that something that you've been following or something that you've noticed as well with your patients?
BROWN: One of the symptoms of some anxiety related disorders is difficulties with concentration and difficulties with making decisions. And I and I find that this is the sort of thing that people on average are struggling with now more than ever. I think it's hard to know exactly why could that potentially be, you know, just because there's an elevation in baseline stress and anxiety or also depression and kind of low mood, which also can lead to problems with concentration. On the other hand, it could also be that for a lot of people, there are challenges now with setting sticking to, you know, firmer boundaries around, you know, where does work end and where does my personal life begin so that people feel like they're more on a hamster wheel in their in their work routine than they've ever been.
DAWSON: How about how the brain fits into this kind of brain fog? I mean, we're we're talking about a certain part of the brain that controls our fight or flight reaction, right?
BROWN: We are, yeah. So anytime we're thinking about anxiety, we're thinking about elevated activations in a part of the brain called the limbic system and particular part of the brain called the amygdala, which is involved in that fight or flight response. It's involved in anxiety and, you know, in responding to threat. And there there are a lot of data that suggest that this part of the brain has connections to the prefrontal cortex and the prefrontal cortex is the part of the brain that's involved in inhibiting responses. So telling us, no, don't eat that extra cookie, no, you really need to pay attention to your work now and not get on Netflix and binge watch. The reason why I think that matters now is some of the therapies that we do focused on helping people to manage their anxiety are really focused on helping people to do things like label their emotional experiences. So rather than just sitting with the emotion and feeling it in your body, pull on the language parts of your brain, describe what you're feeling, describe how you're feeling it. And in some cases, that pulls on activation of these prefrontal regions, which can then decrease activation in the fear, fear-based parts of the brain.
DAWSON: I guess, depending on which, I don't know, research you you kind of look at, the pandemic is expected to last another several months to another year or more. How long can humans sustain this kind of a reactionary response? And what are the long-term consequences of it.
BROWN: So, I think what we're actually seeing right now and what we encourage our patients to think about is when people are struggling with anxiety, they tend to get stuck in into a mode where they're thinking that, you know, I'm just anxious all the time. And in reality, what can be really helpful for people to do is to track their level of anxiety throughout the day. In doing that, one of the things you might learn is that there are actually discrete differences in level of anxiety throughout the day and that we need to practice time for self care and time for recovery. And if you can learn to track your emotions throughout the day, then you can build some insight around during what periods in time you were relatively less anxious and during which periods in time you were relatively more anxious, because I think we really don't know what the long term impact is going to be.
DAWSON: Well, by tracking your emotions, it kind of sounds like you were delving into the mindfulness territory as a as a form of self therapy, right?
BROWN: A common saying in in psychotherapy is the best way to change your behavior is to really understand it. And so why bring that up now? Is that often increasing awareness about our emotional experiences, including what kinds of thoughts go through your mind when you're having a strong emotion? What kinds of behavior urges you're having? Where do you feel it in your body? Increasing awareness of that experience is usually the first step in starting to think about behaving differently in response to that emotion.
DAWSON: Well, factoring in these kinds of techniques and, you know, if you need professional help, professional help as well, but you and your colleagues have been tracking resiliency, how does that fit into the resilience piece? And do you have any early results from from the survey that you might be able to share?
BROWN: My colleague, Ran Barzilay, was the leader in the project that you're referring to, and he has a number of interesting findings that are coming down the pipeline, looking at how resilience actually seems to be, you know, driving more power and predicting how people are doing in the pandemic than history of mental illness or history of struggles with mental health. And the reason why I think that matters is some factors as it relates to resilience are in our control. One thing in particular that I've been doing some teaching about is thinking about emotion, regulation or the capacity to control your emotional reactions as something that's trainable and that as something that helps to build resilience. And I think that that's the sort of thing that as we're thinking about forecasting into the future and thinking about how do we help people in building their resilience if we can all collectively work toward learning strategies to effectively regulate our emotions, I think that's really going to help us in building our resilience.
Follow James Dawson on Twitter @RadioDawson for more local news.
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