One week ago, a mere glance at my phone between patients would have sufficiently caught me up on 30 minutes of disconnect from both social and mainstream media. Today, as I closed one virtual appointment and waited for my 9 o’clock follow-up to join me on-line, I was met with 16 texts, 148 WhatsApp messages, and four breaking news alerts from a variety of apps. Yes, I was thinking about what you’re thinking; that leaves no time for Facebook and Twitter.
While waiting patiently for my patient to join our virtual meeting (it seems this is going to take some getting used to), I found myself swiping quickly through the latest updates from Italy, the most recent CDC guidelines, and debates among “internet experts” about how best to disinfect a doorknob. As a physician, I have eagerly joined the chorus of professionals encouraging and educating on the importance of social distancing. Yet, as these days of distance turn into weeks (with the prospect of reaching well into the months ahead), there is another pandemic creeping slowly around the corner. The canon of evidence correlating loneliness and isolation with mood and anxiety disorders cannot and should not be lost on us. So I’m introducing a much-needed How-To guide to “flatten the curve” of mental illness that lurks in the shadows of the months to come.
How to social distance
As we all retreat into our private spaces, we should make a concerted effort to expand – rather than contract – our social circles of support. Make a list of people to call who aren’t otherwise in your “inner circle.” Now is the perfect time to reach out to the friend you haven’t seen in over a year or the uncle you always wished you got to know a little better. I tell every patient to schedule two virtual meetings daily: one with someone from their pre-COVID19 life and one with someone they wanted to reconnect with.
Most importantly, think of at least one person who can use your kindness today. There are people in your life and neighborhood who need you right now, and we all feel more purposeful when giving of ourselves.
How to watch the news
Things are changing faster than ever before, but they aren’t changing every 30 seconds, or even every 30 minutes. Delete the news apps from your phone and try to disconnect from social media. Then, schedule a 15-minute period for checking the news once per day (OK, twice if you cringe while reading this). I promise you, your buddy Joe’s Facebook post did not break that news story. If it’s true and relevant, you’ll find it in the mainstream outlets during your scheduled news time.
How to worry
Worrying is not only natural, it’s important. Our very instinct to worry is what keeps us following guidelines and working hard to maintain safety in the first place. But there’s a way to worry constructively, and there’s a way to self-destruct. Constructive worrying is a three-step process: First, you set aside 15-30 minutes a day (same time every day, not too close to bedtime). During this time, you take out a sheet of paper and draw two columns. Write down the things that are worrying you in column #1. In column #2, write what you plan to do about each of those things. If you don’t have a solution yet, write down what your next steps will be toward finding one. Now, what if it seems there is nothing to be done? That sounds like a worry that you can’t do much about. Let it go, or come back to it in the future when it’s constructive to do so.
Anxious worries have a way of creeping up again during all the worst times. When they do, just tap that sheet of paper folded in your pocket to remind yourself that you worried about this yesterday, and you will worry about it again – constructively – during the time allotted. There is no need to let it distract you during a romantic, virtual dinner with that girl you were too shy to ask out in person.
How to keep perspective
There is a lot of good in the world. Noting it daily can help you keep perspective. Before bed, list one thing about your life that is actually better than it was before this all began. Then list two other things that you are grateful for during this unprecedented time. Don’t repeat the same things every night. If you’re running low on material, re-read the section on how to social distance; you’re probably not doing it right.
How (and when) to find the help you need
Stress is normal, especially now. But if you notice those anxious worries chiseling away at you and your wellbeing, it is worth reaching out for help. Are they keeping you up at night or getting in the way of your relationships with loved ones? Do you find yourself withdrawing, staying in bed, and avoiding self-care? Are you having thoughts of harming yourself in an effort just to cope? If any of the above is true, ask a professional about the right help for you. There are many apps available for cognitive behavioral therapy or helpful virtual exercises in mindfulness and meditation. Many of them are free or very reasonably priced. For higher-level care, know that there are mental health professionals available and waiting. Start your search for local resources. Lastly, make sure you know the phone number to a suicide hotline in your local area. You or a loved one may need that listening ear.
As I watch the global news unfold, I am grateful and humbled by the selfless doctors and nurses on the front lines of this pandemic. But when it comes to the struggle for mental health in the midst of panic, we are all the front line. We need to be just as prepared and thoughtful for this one.
Aryeh L. Goldberg is a psychiatry resident.
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