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What are you doing to not go nuts? (part 2)

May 5, 2020


As promised from yesterday’s “What I am doing to not go nuts? (part 1),” here is advice from a mental health expert, my good friend who is a board-certified practicing psychiatrist here in Austin. 

The many predictions about the impact COVID will have on our mental health are usually related to its contribution to trauma, suicide, and substance abuse. Let me be clear here that my field makes a distinction between diagnosable Depression, Anxiety, and Trauma disorders and the sadness, anxiety, anger, and fear we all feel. It comes down to severity and impact on functioning. At the best of times, I find these criteria vague and subjective; during COVID, as we are adjusting to our new normal, and when so much of our functioning is affected, it is particularly unhelpful.

So I’m not going to talk about diagnoses. I’m going to talk about our emotions of sadness, anger, anxiety, and fear because we’re all noticing an increase in these. Many people, both friends, and patients have described themselves to me as being on an ‘emotional rollercoaster.’  That’s because our brain is trying to make sense of this scary, frustrating, and completely unfamiliar existence. Based on what I am already seeing with my patients, I believe my colleagues and I will be treating this ‘second curve’ of sadness and anxiety related to trauma, grief, loneliness, financial insecurity, separation/divorce, and unmanageable substance abuse years into the future. 

No one needs me to tell them why they are experiencing an increase in these feelings right now. With pain, our human need is to feel better. So we come up with strategies to do this. Here are my ideas for how to manage our painful emotions in a mentally healthy way. It is not rocket science but it does involve an intentional, daily practice. And, while this is simple, it is not as easy as comfort eating, drinking alcohol, binge-watching Netflix, working too much, smoking weed, or picking up our phones. 

How we take care of our mental health now will have a huge impact on the Second Curve. So here’s my prescription:

#1 Create some structure.Our brains are comforted by patterns and familiarity. This can be done by #2 and #3.

#2 Sleep.Our brains need more of it to process new information and manage stress. Get at least 7-8 hours. No, you are not special and can ‘do fine’ with less. 

#3 Eat well throughout the day.Here, I go to Michael Pollard: Real food, not too much, mostly plants.

#4  Do at least 1 hour/day of any of these:

Physical activity. 20 minutes treats anxiety, agitation, anger, insomnia, and, for some, mood.

Play. Play is defined as something you do to seek joy, without expectation in the outcome. As adults, it is harder than you’d think.

Practice. Work on a new skill 10 min/day. The process of learning and recognition of improvement over time helps depression.

Create. So much research supports that producing something (art, music, bread) is healing.

Nurture. Your family, friends, community, pets, plants, the earth.

Work with purpose. Doing something to help (such as homeschooling, making masks, supporting front liners, sending informative emails - <wink> <wink>) during this crisis will reduce anxiety and boost mood. 

Laugh. Watch stand-up comedy. Share the memes.  Find the humor in our situation. There is a lot out there.

Process the painful feelings. Meditate, journal, talk to your therapist. There is power in acknowledging & working through our feelings rather than skipping over them

If you only do one thing for your mental health every day, make it connecting with other humans.

And, it is with that we end this mental health letter with...  

Stay emotionally connected and physically distant,


PS: This is a great Freakonomics episode discussing with such care all of the relevant topics related to reopening the economy.