Self Care Checklist
4 ways to take care of your mental health during the coronavirus pandemic
Millions in the U.S. and around the world are under stay-at-home orders as officials hope to slow the spread of the coronavirus. But how do those practices affect individuals’ mental health? What are the unique mental health challenges people are facing during the COVID-19 pandemic, and how do they affect health care workers, those living alone and those returning to work, among others?
Psychiatrist Dr. Jessi Gold of Washington University School of Medicine in Saint Louis and PBS NewsHour’s Amna Nawaz answered viewer questions on how to take care of our mental health and cope with things like fear and anxiety during the COVID-19 pandemic on May 6.
What are some tips on how to deal with anxiety from uncertainty?
A major cause of anxiety during the coronavirus pandemic is the uncertainty about what the near future will hold, which can be exacerbated by the prevalence of misinformation about the virus, Gold said.
Gold said the reason why we feel anxiety hearkens back to primal instincts to be aware of our surroundings, and to always be prepared to run from predators.
“It’s really, really normal,” she said. “Everyone is dealing with anxiety.”
Gold recommended everyone stay informed through their favorite, trustworthy, news sources to help alleviate some uncertainty, but to also limit that time in an effort to not get overwhelmed.
“I think you have to stay informed to some degree,” she said.
Anxiety can also come from growing daily to-do lists. Even the midst of all the demands, Gold recommends people always be kind to themselves.
“You’re going to be less productive right now,” she said, urging people to be patient with themselves.
She suggested breaking down big tasks into smaller, more manageable pieces to make them feel less daunting.
Beyond that, Gold said to explore relaxation methods such as meditation, but also said that method does not work for everyone.
“Don’t beat yourself up if it isn’t for you,” she said.
She also recommended activities like exercising and listing some of your favorite things as a way to get away from anxious thoughts.
How do you know when it’s time to seek professional help?
Living through a global health crisis is a new and trying experience for most, and some who have never experienced serious mental health issues may wonder if, and when, they need to seek help.
Gold assured that “it’s okay to always ask for help,” and that no one is going to turn you away for not having enough symptoms.
She also suggests that everyone becomes familiar with the common signs of mental distress:
Sleeping too much, or too little
Eating too much, or too little
Not interacting as much with friends or family
A lack of joy in things you used to like
Low energy
While these aren’t always definite signs, they are indicative of an affected headspace, which may require help from a therapist.
How do we deal with loneliness?
For many people living alone, social distancing has cut off everyday interactions that are critical for mental stability. Gold said she understands this on a personal level since she also lives alone.
“This is the first time it’s been very evident that I live alone,” she said.
Gold recommended everyone should make an effort to reach out to friends or family to maintain social interactions. That could involve just talking, or setting up a game or movie viewing night.
“It actually feels more like work … but it’s worth doing in the end,” she said.
She also suggested that, in this moment of isolation, that we can find the things we truly enjoy doing by ourselves.
PBS NewsHour viewers also weighed in with ways they have been coping and finding joy in things they enjoy, such as bike rides, working out, learning to meditate, knitting and watching new or favorite TV shows.
“Find what coping skills work for you,” she said.
What are some resources available during COVID-19?
As the pandemic continues, many doctors are concerned about the wave of mental health issues caused by extensive social isolation and anxiety about the virus. Gold said it’s important to first break down the distinction between mental and physical health.
“I think we like to separate things, but I don’t know if that necessarily helps us,” she said.
Many physical issues, like a lack of protective gear and helping to treat those with COVID-19, directly affect a person’s mental health. Gold said that means we’re probably already seeing the effects of poor mental health on a portion of the population.
Gold listed a few helpful mental health resources that are available during this pandemic.
To find a therapist, Gold recommended Psychologytoday.com.
For members of the Trans community, Gold recommended calling or texting the Trans Lifeline.
For the emergencies, Gold recommended the Crisis Lifeline, or the National Suicide Prevention Lifeline.
For frontline workers in particular, she recommended Project Parachute or Emotional PPE.
Gold said online services like Teladoc are helpful, but are limiting in many ways, even for the therapist.
“It’s really hard for me, I think I’m really used to the human experience,” she said. “But it’s a lot better than nothing,” particularly during this pandemic, where social distancing has been key to curbing the spread of the virus.
While telemedicine can be cost effective for some, Gold said many people do not have easy access to either the internet or a device in order to use these services.
“This is not something we can just assume people can use,” she said.
View the whole interview here: https://youtu.be/iS7z1XX-e5Y
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With Senior Year In Disarray, Teens And Young Adults Feel Lost. Here's How To Help
For many young people, sheltering at home means missing milestones and public recognition of their achievements. This is especially true for seniors graduating from high school and college.
Kendall Smith, a high school senior who lives in Tallahassee, Fla., says her school has many traditions leading up to graduation. But this year things are very different.
One of the most eagerly anticipated events is Grad Bash, a rite of passage when all graduating seniors head off to the Universal Studios theme park in Orlando. "It's something we've looked forward to since we were freshmen," Smith says. "And I remember hearing about all the memories and seeing them on Snapchat and Instagram, and being so excited about going with my friends."
So it was understandably disappointing when this highly anticipated event was canceled.
Smith, who plays flag football, says a big celebration for senior athletes was also canceled. "It's this huge event where people walk through the middle of the field with their parents and their family and they have flowers and you just really feel special that night," she says.
Teens are suffering from missing out on these experiences and the opportunity for connecting with their peers at critical transitions into adulthood, says Dr. Ludmila De faria, a psychiatrist with Florida State University.
She says they're "mourning the loss of important developmental milestones they were supposed to be doing at this time in their lives."
And experts advise parents to take these issues seriously and try to help kids process them.
These losses are also experienced by college students.
Waverly Hart is 21 and a senior at the College of Wooster in Ohio. One of the most memorable graduation events is I.S. Monday, short for Independent Study Monday, when seniors celebrate finishing their theses. Hart says it typically occurs on the first Monday after spring break.
"All the seniors skip classes, and there's a huge parade. And everybody on campus cheers us on and that's something that we've been looking forward to since we were admitted to Wooster. And now we won't get to experience that ... ever," Hart says.
As a competitive cross-country runner, Hart was looking forward to taking part in the last season of her college career, but that was canceled as well. "And it's really heartbreaking to know that the last race I competed in was indeed my last race ever. And I won't get another chance to compete in the black and gold Wooster uniform."
Graduation itself has been "postponed," she says, although she expects it will be officially canceled sometime soon.
As a freshman at the University of Michigan, 19-year-old Sophie Busch never expected to end up home before finishing her first year. She's proud of her freshman research project on childhood obesity and is disappointed she won't be presenting her findings at a large research symposium at the end of April. (It was canceled.)
"I was looking forward to presenting my research with the other freshmen in my lab, and I was just excited to show it to my other friends — and my parents and grandma were also going to come."
De faria, who works with student mental health, says when young people miss kinds of momentous events, "it's almost like they are forced to regress a little bit, or at least not progress as expected on their developmental milestone."
And she says, college students in particular are losing their support group during an important developmental phase. They had moved away from their families of origin, which is part of a process called individuating.
"They're finding their people, their identities and developing their ability to take care of themselves," she says. "The people they live with, their roommates in college become their primary source of support. They lost that suddenly."
This can be traumatic for a generation that "already suffers high levels of anxiety," she says. It puts them at greater risk of developing clinical anxiety and depression. Students like this may require some sort of therapeutic help from home, she says.
Many parents may be at a loss for how to reassure their children during a time of such great uncertainty, which could make things even harder on teens and young adults.
"It's unprecedented for all of us, but it's completely new for teens and young adults — and they don't have the wealth of experiences that older individuals have with transitions," says psychologist Lynn Bufka, spokesperson for the American Psychological Association. "They're trying to figure out how to do transitions and manage change within an environment where everything seems upside-down for them."
Bufka says she's hearing from young people that the situation is "very new and very different and very hard for them," she says.
"That need for strong peer relationships, coupled with less experience dealing with and adapting to adversity, means you have a generation that is going to struggle more," she says.
But there are ways to help them cope. Here are a few things parents can try.
Acknowledge their feelings
Bufka says an important way for parents to help high school and college students by simply acknowledging their feelings — the sadness and disappointment they feel about the loss of prom, celebrations and graduation.
Parents should recognize that for many young people, "this is the biggest thing they've experienced in their lives," she says. "They're too young to remember 9/11. Collectively as a generation, this is a really big experience for them."
When you're young, understanding that life is just not as predictable as they might have thought can be scary, she says. Parents can help by letting them talk about it.
Encourage them to stay connected
Young people need to establish a cushion of social connection they can lean on through these times.
Bufka says staying socially connected, even virtually, can be helpful. In fact, she prefers to describe distance precautions as physical distancing, not social distancing. "It's important to maintain social connection and intimacy even if this is not in person," she says.
And she encourages young people to take advantage of the many ways to socially connect, with all kinds of shared online activities, including group chats, dinners, TV and even movie watching.
Shift focus to what they can control
Bufka recommends talking to your teen or college-aged child about the things they do have some control over
Graduation may be postponed or canceled, but young people can plan special events for after the pandemic has ended. Perhaps a trip with best friends or a post-graduation party. Focus on the positive events that can occur at the end of this crisis. Envision how you can celebrate, and maybe even start making plans now.
Emphasize the greater good
It can help to point out to young people that they are making sacrifices right now not just for their own health and safety, but for the greater good. She points to a study that looked at previous infectious disease crises, including the 2003 SARS and the 2014 Ebola outbreak in West Africa. People are able to cope better, she says, when they "think about the altruistic reason they're doing this."
Changes in everyday life to limit the spread of disease may be hard, but "we're in it together and we're in it to benefit the larger community and to have a good impact on overall health and wellbeing."
Florida high schooler Smith says she and her peers understand this well.
"As disappointed as we all are that we're missing out on these important milestones in our life, we do understand that this virus is killing people and that if we don't sacrifice these things that we might contribute to the problem."
She adds they wouldn't want to be "the reason that a student takes home that virus to their family, maybe a grandparent that can't fight that off, or maybe somebody with asthma that doesn't have the lungs to be able to deal with coronavirus."
"We understand these sacrifices need to be made, and we know that we are doing our part in this, doing what we can for society," she says.
In the end, Bufka says once young people get through this crisis, they will realize they can handle tough situations and get to the other side.
"It will make us stronger — sometimes we surprise ourselves."
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When a Child's Emotions Spike, How Can a Parent Find Their Best Self?
With families around the world spending unprecedented amounts of time in close quarters – and under varying degrees of stress – emotions can run high.
In good times and in hard times, parents can take steps to help their children strengthen their emotional competence. As parents, “we are co-creating the emotion system for our kids” says Dr. Marc Brackett, Director of the Yale Center for Emotional Intelligence and author of "Permission to Feel: Unlocking the Power of Emotions to Help Our Kids, Ourselves, and Our Society Thrive."
“Emotions are constructed by our interactions with other people,” says Brackett. Caring for a child's emotional development is key to life-long flourishing “because while part of our success in life is knowing how to count and read and write, a bigger part of our success in life is knowing how to get along well with other people and deal with life's ups and downs.”
Parents may not always feel up to this task – especially in challenging moments – and yet parenting can be an opportunity for adults to strengthen their own emotional intelligence. In order to help children regulate their own emotions, we must keep working on regulating our own, says Brackett. “It's all about adult development.”
Responding to Children’s Signals
The emotion system is a signal system, and how we feel on the inside drives how we approach a task, says Brackett. How we read and interpret the emotions in other people also sends signals to our brain. “When I look at your facial expression, if you are displaying a lot of anger, it says to me, ‘Avoid. Avoid. Avoid!’ That's what emotions do. They signal,” says Brackett.
But here’s a crucial difference when it comes to parenting: when our children send out classic “avoid” signals – such as yelling or angry expressions – this is actually a signal to approachthem. “That’s really critical for parents: for kids, all emotions are approach.”
As adults, we often give our friends and partners space when they are in a bad mood. But with young kids, “you always have to follow up,” says Brackett. “It’s your moral obligation to know what your child is feeling and to support them in developing healthy strategies.”
This can be very difficult. When adults are under stress, our instinctive biological response is to fight, flee or freeze. “Many parents get easily activated and triggered by their kids. The kid throws something, the kid is crying, the kid is screaming, ‘I hate you!’ and all of a sudden you're triggered.” In these moments, take a deep breath and try to replace “fight or flight” with “stay and help,” says Brackett.
When both parent and child are emotionally activated, it’s “very hard to problem solve” – so parents may need to take a walk or time to collect themselves. But it is critical to circle back and attend to the child.
Getting Curious About Emotion
Feelings offer information about what might be happening within the individual. One strategy for improving emotional regulation is to become an “emotion scientist.” Brackett encourages adults to “get curious” about emotions – their own and their children’s. Parents are often tempted to be an “emotions judge” by challenging, shaming or minimizing a child's big feelings.
In contrast, “the emotion scientist is the curious explorer of their child’s emotions,” says Brackett. A preschooler’s angry outburst might indicate they are overstimulated, stressed, in need of connection, hurt by someone’s actions, or in need of a snack or a nap. “The emotion scientist says, ‘My child needs some support here.’ Let me see what kind of strategies I can use to help my child deal with emotions. The emotion judge says, ‘Get over it.’” When adults train themselves to see all emotions as information, they can use that data to support their child.
Using open-ended questions can help children process emotions. Rather than saying, “Pull it together,” a parent might say, “It looks like you are really upset about something. What happened? Tell me more about that.”
Brackett recommends the phrase, "Tell me more" because it’s simple, gentle and indicates non-judgemental curiosity.
The Skills of an Emotion Scientist
Brackett and his team use the acronym RULER to describe five key skills parents and teachers can help children cultivate. Here is how he describes them in his book:
R: RECOGNIZE our own emotions and those of others, not just in the things we think, feel, and say but in facial expressions, body language, vocal tones, and other nonverbal signals.
U: UNDERSTAND those feelings and determine their source— what experiences actually caused them— and then see how they’ve influenced our behaviors.
L: LABEL emotions with a nuanced vocabulary.
E: EXPRESS our feelings in accordance with cultural norms and social contexts in a way that tries to inform and invites empathy from the listener.
R: REGULATE emotions, rather than letting them regulate us, by finding practical strategies for dealing with what we and others feel.
For young children, developing an emotional vocabulary is a powerful tool. “Labeling emotions is a form of communication. It helps us make meaning of our experiences and communicate that to others.” Learning the difference between anger, frustration, annoyance, and disappointment can help children think about the causes of their emotions.
Take disappointment and anger, says Brackett. “Oftentimes they look the same, but their underlying cause is completely different. One is about unmet expectations. The other is about injustice. And I would say 99% of the people I talk to have no clue about that. Yet the strategy for helping my child manage disappointment would be very different than it is for anger.”
Take a child who says, “I hate school.” When the adult gets curious and asks questions, the child offers, “Nobody wants to play with me.” Now you are learning something, says Brackett. Ask a few more questions and you might discover that they sit by themselves as recess. “And now you realize that your child is feeling left out. They are not just sad – they are actually feeling isolated and alienated. That points to a different strategy you might take as a parent.”
“How Would My Best Self Respond?”
Children are great anthropologists of parent behavior. They watch how we handle stress and how we recover from episodes of fear, frustration, anger, and disappointment. Brackett urges parents to pay attention to their self-talk – because our children are listening when we say “I’m an idiot” or “ I’m going to lose it.”
With practice, parents can use self-talk to model healthier ways of moving through emotion. It might sound like, “Mommy had a really long day at work and needs a little space to take a deep breath. I want to talk to you, but first I need to take a little break and then come back to you”; or instead of saying “I’m so stupid! I always mess up this recipe,” saying “Well, daddy did it again! So now I’m going to take a step back and figure out what went wrong and how to fix it.”
When parents feel their emotions spike, they can take a meta moment, says Bracket. This is a process that helps us build awareness of our triggers, “and parents have a zillion of these – when my kids pull my hair, when they're nagging, when they are whining about going to bed, when they refuse to eat things.”
First, just be aware of your triggers. Next, notice where your brain goes when you experience one. What is your automatic, go-to self-talk? Is it “I hate my life?” Is it “I can’t handle this?” What is your go-to behavior?
When you are aware of your triggers and your habitual, unhelpful reactions, you can begin to purposefully move away from these into healthier ways of responding. “Immediately pause and take a breath,” says Brackett. “You have to give yourself space. That deep breath helps you deactivate the reaction and activate your best self. Ask yourself, ‘How would my best self respond?’”
Keeping your “best self” in mind helps you make better decisions in the face of strong, uncomfortable emotions. As Brackett shared, his “best self” is kind and compassionate. So when he’s triggered, he asks himself, “How does a kind, compassionate dad respond?”
These meta-moments “help you take a step back, shift your attention away from the stimulus, bring it back to your values and goals as a parent. And by the way, it's really freaking hard! So give yourself permission to feel, fail and forgive.”
The Good News For Parents and Kids
All parents have moments when they overreact – especially when they are under stress. “The good news is that we are more resilient than we think we are,” says Brackett. “We can undo things and learn new things. And that means you can start today and start tomorrow. We can change the relationships we have with our kids if we work on developing ourselves.”
In addition, “research shows that the mere presence of a caring and loving adult is a co-regulation strategy. If our children believe in their soul that the person they are with cares about them and is there for them – even if that person doesn’t say anything – that’s a strategy. Think about those people who, just being in their presence, make you feel safe.”
It’s never too late to strengthen your emotional skills and help your children strengthen theirs. “A child’s brain is still plastic, so the minute you start regulating your emotions better, their brains will change to reflect that.”
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Don’t feel like ‘getting things done’? It’s okay not to be productive during a pandemic
If you’ve found yourself trying to decide whether you should bake bread, join a meditation webinar, create a color-coded home-school schedule, or just curl up in a ball and cry, you’re not alone.
As we stay at home in the midst of a worldwide pandemic, we are being inundated not only with a storm of anxiety-inducing news but with an onslaught of suggestions for “making the most” of our (alleged) extra time. “There’s a huge push of people thinking that because we are home right now, we can be productive and that we’re all going to be able to stay as focused as we were a month or so ago,” says productivity expert Racheal Cook. “But that’s just not the case.”
Cook says there are a number of things working against the accomplishment of any tasks, so if you feel pulled in multiple directions and are having trouble focusing, it’s completely understandable.
It's difficult to be productive during a crisis
“We are going through a collective trauma experience,” Cook says, referring to the upheaval, fear and grief caused by the covid-19 pandemic. “Anxiety is up, depression is up. From a productivity standpoint, it’s challenging because we’re navigating these huge emotional hurdles with an uncertainty that most of us have never really experienced in our lifetime.”
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And the time and energy expended on adjusting our entire lives to this new normal — which may mean working from home while assuming the role of home-school teacher, caring for ill family members, sanitizing our groceries and dealing with the fallout of mass layoffs — are magnifying the intense emotions. “None of these things are setting us up for high productivity or high performance,” says Cook.
For some populations, additional stressors such as job loss, discrimination and access to health care may amplify anxiety even more, says Bukola Oladunni Salami, a registered nurse, expert on immigrant health and professor at the University of Alberta. “We’ve seen there are some immigrant communities experiencing backlash,” she says. People struggling to survive or afraid that accessing health care could lead to deportation aren’t looking for tips on reorganizing their spice drawers.
Because individual circumstances differ and people process difficult experiences in a variety of ways, psychotherapist Dana Dorfman says, “there’s no ‘right way’ [to get through this] other than allowing yourself to be your own way.” You are not obligated to accept every live-stream yoga or virtual happy hour invitation. If you’re carrying any guilt about not producing your best work, writing a screenplay, learning to quilt or putting together a 1,000-piece puzzle, you have permission to let that go. Dorfman says if you “respect the range of coping styles and view people’s behavior as their way to manage their anxiety, you can feel less judgmental” — of yourself and others.
Being productive can be a coping mechanism
It’s also okay to dive into a household project, pick up a new hobby or sign up for an online course, if that’s what you’re drawn to. “In the throes of something that is so frightening and can be somewhat traumatic, people often funnel their anxiety into productivity,” Dorfman says.
Being productive can be therapeutic in turbulent times, but Dorfman warns this coping mechanism can be maladaptive in excess. “Be careful not to overextend,” she says. “And do acknowledge what you’re feeling. That doesn’t mean you need to wallow in it, but labeling your feelings — recognizing you’re sad or overwhelmed in some moments — will allow you to function better.”
While you might have a surge of creative inspiration to complete a Pinterest project and cook a gourmet meal today, don’t be surprised if you feel differently tomorrow. “You’re going to vary. This is a one-day-at-a-time kind of experience,” Dorfman says. “There are going to be days when you’re less focused and more overwhelmed. And that is okay. This is a very stressful time and you shouldn’t be operating on all four cylinders all the time.”
Both Dorfman and Cook recommend tempering your expectations for the time being. “Start with compassion for yourself,” says Cook, and then extend the same to others. It’s okay to lower the bar a bit right now, “not because we don’t have high standards, but because we understand that during this period we need to give ourselves a little grace.”
That may mean starting your day with a simple three-point to-do list. “Focus on getting those tasks done and then give yourself permission for a break,” Cook says. If you’re feeling stuck, take some time to try something new. You don’t need to master everything, she adds; simply doing something different can “activate other parts of your brain and help you think more clearly when you sit back down to work.”
Doing nothing, if possible, is okay, too
Don’t underestimate the power of doing absolutely nothing if the mood strikes you.
“Everyone’s situation is different,” Cook says, “but if that’s an option for you — if you don’t have to work or you want to spend time with your family at home or if you can scale back and just take some pressure off a bit, go for it.”
This could help not just in the present, but in the future. “We’re at a point where foundational self-care is one of the first things everybody could implement to ensure that when things settle down, when the rubble is cleared a bit, we are able to be productive because we didn’t try to just grind through this whole situation,” she says. “We need to be sure we’re doing things that will help us navigate this not just from a productivity standup but from a human standpoint.”
And in the downtime, don’t be afraid to find joy. “That has reverberating benefits as well,” says Dorfman. “When we feel good or nurtured or feel like we’re discovering things about our relationships or ourselves, that enhances us as human beings and extends to other people. Despite social distancing, we’re all very connected.”
Although there is a tremendous amount of heartbreak and fear right now, it’s okay to experience positive emotions; we probably need them now more than ever. “You can have two very different, seemingly competing feelings” at the same time, says Dorfman. “Enjoying certain moments does not deny that you are also sad, scared, worried or anxious. Allowing yourself some kind of pleasurable, compassionate, loving moments will replenish your emotional inventory, so you are also equipped to help others.”
As Dorfman puts it, “this is a marathon, not a sprint.” It may help to even think of this time as a relay; we don’t all have to be running at the same moment. Some people, such as health-care personnel, may need to put their heads down and work for a period, then process feelings later. “If that’s survival mode, that’s acceptable, too,” she says. “When the crisis subsides, when the dust settles a little bit and you find yourself left with the trauma,” it’s not too late to reach out for help or find ways to understand and channel your emotions.
If, on the other hand, you are someone who wants to produce or contribute in some way, but you don’t have the bandwidth right now, there’s no need to push yourself. “There will be time and opportunities to offer support, to do work, to produce . . . not just in the eye of the storm, but in the reverberating experiences later on,” Dorfman says. “We just need to pace ourselves.”
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Teletherapy: Connecting therapists and clients during a time of separation
Teresa Brown has had a life without luxuries or much security, or any peace of mind.
Correspondent Susan Spencer asked her, "Talk to me a little bit about this feeling of stress, that has basically been with you since you were a child."
"In order for me to kind of talk about it, I have to think about the traumas that I've been through," said Brown. "Traumas like, not just growing up poor but growing up where we lived in apartments that didn't have heat, or grew up in neighborhoods that had high crime, or went to schools where you were bullied, those things."
She spent years trying to process those traumas, all the while raising her three nieces in New York City. Finally, she found help from a therapist.
"What kind of things do you talk to the therapist about?" asked Spencer.
"Pretty much what is it I could do to either relieve my stress, or find tools to help me deal with the situations I have been going through."
But three weeks ago, she wasn't sure she'd ever see that therapist again.
The pandemic meant that Mosaic, the non-profit mental health center in the Bronx where brown goes, had no choice but to close its doors to in-person visits – no one-on-one therapy, no counseling.
Spencer asked Donna Demetri Friedman, the executive director of Mosaic, "When you realized the magnitude of this pandemic, was there a time when you weren't sure that you'd be able to continue to serve your clients?"
"Yes," she replied. "And that frightened me tremendously."
Friedman said she could not imagine leaving more than a thousand desperate, low-income clients with nowhere to turn in the midst of a terrifying pandemic: "The stakes are very high. Some people have anxiety. Some people have major depressive illness. And that's all heightened, of course, in this crisis. So, we would be seeing people really begin to decompensate."
So, three weeks ago, Friedman's staff of 100 took drastic measures, switching all mental health counseling to teletherapy, a fancy name for using the phone. They were not authorized to do so until the pandemic hit, and New York State waived its regulations.
Spencer said, "It seems like this must have been a sea change for you."
"We mobilized immediately actually before we even had guidance," said Friedman.
"What about the challenges in terms of actually helping anybody this way?"
"There was some resistance from the clients, and some resistance from the staff: 'How are we gonna do this? Is this really gonna work?' But pretty quickly, people kind of have pulled together and are doing this and doing their part and responding."
Dr. Jeffrey Lieberman, chair of the Psychiatry Department at Columbia University College of Physicians and Surgeons, said teletherapy "is ideally suited to providing mental health care under the current circumstances. And it's being used more now than ever in history."
And it's a long history. Back in 1959, the Nebraska Psychiatric Institute first used videoconferencing. A decade later, teletherapy consultations were available to troubled travelers at Boston's Logan Airport. And about 30 years ago, telepsychiatry became a subject of serious study.
Spencver asked, "Do you think that really it's as effective as it is to have a one-on-one conversation?"
"Well, there's actually substantial data from systematic studies which show that it is effective," Dr. Lieberman replied.
It better be, now more than ever. New research shows that living in quarantine can have grave long-term mental health effects, as New York governor Andrew Cuomo recently recognized. "I am asking psychiatrists, psychologists, therapists who are willing to volunteer their time to contact the state," he said.
More than 6,000 people responded … no surprise to Dr. Lieberman. "This is gonna have a population-wide effect of PTSD proportions," he said. "It's almost primal. It's almost apocalyptic in its nature."
Spencer asked Katie Riordan, a mental health counselor at Mosaic, "What are the challenges that the whole teletherapy thing poses in itself?"
"What is lacking is the ability to see someone's face," she replied, "to, you know, feel what someone brings into a room, But I don't know where we'd be without [teletherapy] right now, frankly."
Lately, Riordan has been on the phone, a lot, offering therapy six days a week, about 10 hours a day.
"It's been exhausting, it's been exhausting," she said of the last few weeks. "It's, it's a strain."
One of Katie's patients is Teresa Brown, whom she knows as Teri: "Teri is the, you know, the guardian of a family balancing so many different challenges: financial, educational, physical space. This pandemic didn't get rid of problems that existed prior to it coming along, right? So, all these stressors that have led people to feelings of helplessness and hopelessness and anxiety and powerlessness before this emerged, now they're just compounded with the world as we knew it, you know, being shaken up."
"That's your challenge, isn't it?" asked Spencer.
"It's Teri Brown's challenge," she replied. "It's my challenge."
Brown told Spencer, "Yes, I have a lotta anxiety, but I am trying so hard to be positive about this, because it's not just for me. It's for my children. And I want them to understand that, 'Don't panic. Things will get better.'"
For now at least, that may be the best advice of all.
Journey to the wise mind
Working from home with ADD: Try these apps to stay on task
This isn't my first rodeo working from home with ADD, though. Experience has taught me to implement many of the same preventative work from home measures a lot of you already do: Be careful to rebuild and maintain the regular rituals of the workday, stay at the desk at all costs, don't ditch your medication without your doctor's orders, get proper exercise, keep an eye on blood-sugar levels and eat brain-healthy foods. Along the way, however, I've used some steadfast online tools to bolster my efforts.
Here are a few of my favorite apps and tools to help others with ADD work from home more effectively.
Hold your attention with timers and white noise
Getting started on a work task can be a beast, but staying with it through the end is the real fight for a lot of us. I use a combination of two digital tools to reinforce my follow-through: the white noise from the cockpit of a 1944 Boeing B-17 Flying Fortress and a stopwatch.
The stopwatch is a simple concept for me. I'll use the timer on my phone and countdown to the next coffee break, or set a hard deadline for myself to artificially induce those classic ADD adrenaline contractions that kick into high gear when a countdown nears its end. But staying in my seat requires something more.
Mynoise.net has been online since 2013 and has seen up to a million hits a month, with mobile apps available in both Google Play store and the App Store. While any number of online white noise generators could do the trick to distract your wandering mind (and Mynoise has nearly any to suit your taste), few sounds are as successful in muting the internal monologues of yours truly as a layer of propeller thrum interspersed with mostly unintelligible tower radio chatter.
Bonus distraction: If you're looking for a creepy thrill, check out Mynoise's Evil Charm soundscape.
Step away from social media
Hyperfocusing on social media is a silent killer. One second you're stopping to check a message, and the next thing you know 18 years have passed and a kid the state says is yours is somehow in college.
Try the RescueTime app. Available for free on Google Play store and the App Store, RescueTime automatically tracks which apps you're using and how long you're using each of them to populate visualizations describing where your day went. It's also available as a desktop app. You don't have to keep glancing at it either. RescueTime's notification feature pings you when you're getting too far down an attention-sucking rabbit hole, so you can pull yourself back on track. For the competitive among us, the app's "Productivity Pulse" gives you a chance to compare your days.
Yes, it's a privacy nightmare for those who'd rather not hand over a record of their every click to any single app. But if you're looking for something simple to keep track of time spent, it's a tried and true productivity hack that you can customize to help you sort your day out.
Break tasks down to avoid procrastination paralysis
One of the worst ADD feelings is the bottom of the almighty Project Cycle. You know what I'm talking about: You get all ginned up about a great project idea and start writing down all your hows and whens and whys in a fit of manic genius, only to come back to a disorganized mess of notes on scrap paper and the paralyzing feeling of having bitten off more than you can chew. You get overwhelmed by the ambitious scale of your big idea and its seeming insurmountability.
That's when you should Remember the Milk. This deceptively domestic errand-running app is designed to break down your to-do list into manageable tasks, rewarding you on each baby-step with the sweet serotonin hit of a check mark as you plow through subtasks toward larger and larger parts of your list.
Available for free (but with in-app purchases) in both the App Store and Google Play store, Remember the Milk is not specifically designed for my off-market project management uses, but instead to head off domestic interference during the workday by syncing across devices and integrating with Gmail, Google Calendar, Twitter, Evernote and other apps.
Focus your brain
When you've got an extreme need for social media distancing, there are plenty of ways to put your apps to sleep (she says, refreshing her Twitter mentions). But one of the easiest ways is to use the Brain Focus productivity timer.
The app is free in both Google Play store and the App Store, and is simple enough not to draw you into a spiral of attention-sucking customization options. Just install it, tell it which apps to shut up for you and set the timer. It will then block you from accessing those apps for the amount of time you set. If you want to track your time, it's got features to help you, but its streamlined interface is geared toward a quick tap to get you back to work, based on the Pomodoro Technique.
If you've never heard of the Pomodoro Technique -- long-time fan here -- your ADD might appreciate you giving it a go. It's a productivity technique that rhythmically cycles through short bursts of work and short breaks by setting timing micro-limits. Named for tomato-shaped timers common to Italian kitchens, the technique is designed to hitch your attention to an audible ticking and dinging until your brain starts pumping out focus like Pavlov's dog drips drool.
Brain Focus is just one of the productivity apps borne out of the technique, which might account for some part of its efficacy.
Jeez, my leg is really twitching today.
Wait... What was I saying... ?
