Poor Mental Health or A Normal Response?

The past year has been, and continues to be, emotionally exhausting so how do you know if you’re experiencing poor mental health or a normal response? It’s difficult to watch the news any given day without hearing a story about increasing occurrences of poor mental health. Often, the slant of the story is geared to support a particular policy objective.

I find this rhetoric dangerous and unhelpful. It increases the chance that we will begin to catastrophize normal responses that are, in fact, temporary and healthy. This is especially true if we are already isolated and lacking support. And it’s hard to dismiss worry about our mental health when we’re bombarded by emotionally taxing events one after the other: pandemic, insurrection, natural disasters, infrastructure failures, police shootings, and mass murders.

We know we feel different. Many of us have never been through an extended period of disruption and trauma. If an expert appears in front of us and says these feelings reflect poor mental health, we’re going to believe them. The reality is much more nuanced. and nuance is not the forte of news reporting or social media.

Most of us cling to the idea that if we can just get back to normal, we’ll feel relieved and joyful. But an ongoing experience of trauma is not that easy to shake. Knowing this can help alleviate excessive worry about our state of mental health.

One thing that can provide perspective is to view the effects of trauma as wounds. Think of them like a sprained ankle or a broken bone. If you sprain your ankle, you expect it to swell, bruise, hurt, and prevent you from walking normally for a significant period of time. In order for it to heal, you understand and accept that you’ll have to do things differently for awhile.

This doesn’t usually mean you’ll be crippled for life or never be able to wear those cute heels again. It just means that it is normal and reasonable to change your daily routine to facilitate healing.

If viewing an emotional wound as a physical wound doesn’t work for you, try thinking of a friend who is grieving. Would you be alarmed if they get choked up at unexpected times or don’t have the emotional energy to hang out? No, you’d understand that they feel sadness and loss and need time to work through that before they’re ready for fun and frivolity. And, most likely, you’d understand that their capacity for joy may be temporarily hidden beneath a flood of tears.

The point of all of this is to remind you that certain “negative” emotional states can be a normal and reasonable response to circumstances beyond our control. They are not problematic or signs of poor mental health unless they become chronic, or we use poor techniques for dealing with them.

For example, depression is a normal response to change. Think of Elisabeth Kübler-Ross’s five stages of grief: denial, anger, bargaining, DEPRESSION, acceptance. Depression is an expected, normal phase that represents great progress through the process. But watch the news and you’ll think any amount of depression is a reason for desperation.

The quicker we become aware, acknowledge, and allow ourselves to feel so-called negative emotions, the quicker we can release them and return to a positive state of equilibrium. It is more difficult to do this if we view such states as catastrophic or as signs there is something wrong with us. All of us want to avoid feeling that we’re defective.

We’d often rather hide our distress than acknowledge it. And there may good reason for that. Expressions of vulnerability can make the receiver of the message also feel vulnerable. To avoid that feeling, they may turn away from us when we share our deepest feelings.

If you’ve ever experienced this, you’ll be less likely to attempt to share again. This cycle can result in a significant lack of support for those who are experiencing trauma and attempting to express its effects. And unfortunately, the research of Dr. Brené Brown has indicated that most of us are not comfortable in a vulnerable space.

That means many of us will find that we must be our own best advocates in the arena of mental health. So where do we start? In any moment that I am struggling, I like to first examine what is going well for me before deciding what needs adjustment. This helps give me perspective when determining what I need to do next.

The easiest way to do this is to view myself as a close friend, then ask myself a series of questions: Am I sleeping well and on a regular schedule? Am I keeping my environment clean and uncluttered at the level I would when I feel I am functioning well? Am I eating regularly? Am I making reasonable food choices? Am I making time to move on a regular basis – walk, run, swim, lift weights, row, do yoga, bike, etc? Has my alcohol consumption increased? Do I rely on medication more than I did before? Am I doing too much? Am I able to feel or am I numb? Am I making forward progress at work? Am I able to be alone and feel content? Am I able to connect with at least one person?

If my answers to those questions wouldn’t concern me if they were a friend’s answers, I let go of the idea that I am suffering poor mental health and address anything that may need to change from the point of view of thriving. If I’m not sure, I reach out to someone I trust to help me gain insight.

Mind you, I’m not suggesting that anyone avoid professional help. In fact, I’d encourage you to seek the advice of a professional in lieu of assuming you fit some profile you saw online. My purpose here is simply an attempt to provide a path to find balance to the rhetoric that has become increasingly pervasive and alarmist.

I can’t determine whether you are responding normally, adaptively, problematically, or in the best possible way given a particular set of circumstances. But I know it’s always worth believing in yourself and asking questions before accepting someone else’s take.

If you feel pain over something, that pain is real. If you feel sad about something, that sadness is real. If you feel angry, it is a signal that you feel a need to protect yourself. Accepting that these feelings may be normal and not an indication of anything other than a response to the circumstances in which you find yourself, can be a great start toward thriving.

In this cultural moment when we are all experiencing trauma and there is the cancel culture tendency to only accept a narrow range of beliefs and behavior, it is important to step back, take a moment, and give ourselves permission to feel how we feel even if it’s out of step with the majority. If you are an introvert and enjoy being able to work from home, it’s okay to relish in it just as it’s okay to feel sad about the loss of breakroom chats.

Trust yourself. Trust your process. Just because the world is falling apart doesn’t mean you are. Give yourself some time and space to learn whether you’re experiencing poor mental health or a normal response to a difficult circumstance.

Many Diagnoses Come With Uncertainty

Just like this pandemic year, many diagnoses come with uncertainty. Truthfully, they all do. Getting comfortable with not knowing can help lead to the healthiest path for dealing with the coming months or a disconcerting diagnosis.

The contrasts of this year seem especially sharp as Christmas 2020 approaches. The middle road we often cruise has given way to distinct divisions between comfort and danger. And it feels disconcerting because many of the holiday traditions in which we usually find comfort are not currently safe. The pandemic has brought uncertainty we cannot avoid. Too much has changed too fast.

Under normal conditions, many of us shove uncertainty aside. We believe we know what each day will hold. We focus on that and tune out things we don’t expect or don’t want to deal with. We know that there will be minor mishaps – spills that stain a favorite blouse, flat tires, computer malfunctions, etc. We limit our expectations to those and move forward. That works great until an unavoidable life-altering event presents itself.

Big events often mean big decisions. It’s so much easier to make a decision if the outcome is immediate and known. But that’s not really how it works in most life-altering situations. Every choice is a gamble.

So how can we stay grounded and trust ourselves to make good enough choices?

It’s important to note that good enough choices aren’t always perfect choices. We can move toward health by making informed, if imperfect, choices. When we feel confident in our choices, we lessen the fear and anxiety created by uncertainty.

Fear triggers the urge to fight, flee, freeze, or fawn or hey, if things are really bad, all four! Just recognizing this can lessen the impact of the feelings when they arise. And there are ways to help calm your lower brain so that you can move in and out of fear deliberately and effectively.

Here are a few techniques to try:

Grounding – plant your feet firmly on the floor and press as if you’re getting ready for the starting gun of a race. If you still need to calm down, look around the room (leave your feet planted) and count all of the red you see, then green, then black, etc. You can continue by looking for shapes.

Tapping – Memorize a simple sequence of tapping. When you feel distress coming on, tap the sequence until you feel better.

Feeling your body – gently squeeze your arms noting how the skin feels and how the muscles feel beneath your arms. Continue with your legs or feet. Sometimes resting one hand on your chest just below your throat can feel calming. Feeling your body will help bring you into the present moment instead of getting lost in a panic of “what if”.

Breathing – stand in mountain pose and breathe. What I love about this pose is that you can do it anywhere without inviting the stares that downward dog would bring. If you’re at home, try alternate nostril breathing.

Once you develop successful methods to calm yourself, you will be ready to explore leaning into the feeling of fear. What works best for me is to allow myself to feel scared and to stay in that feeling as long as I can stand it. Having done this many times, I know that there will be a point at which things will shift and I will no longer feel afraid. If I can’t stick with it that long, I let it go for the moment knowing I can move in and out of fear as needed.

I don’t try to figure anything out or make any decisions when I’m leaning into fear. I just feel it and observe how my body responds. I trust that things will seem more clear once I’ve worked through some of the fear. When dealt with directly and immediately (or deliberately over a relatively short period of time), fear doesn’t have a chance to turn into long-term anxiety. It simply dissipates and goes away.

You can’t expect yourself to work through the fear brought by a diagnosis while you’re in the doctor’s office. At that moment, or any time you need to make immediate decisions under duress, I compartmentalize. I understand that many mental health professionals may not support that idea, but it works for me. The key is to create time and space soon after to feel my way through what has happened.

In other words, I compartmentalize temporarily. That gives me the clarity to proceed to another step of feeling confident in my decisions: gathering information. I set my feelings aside to ask the doctor as many questions as I can think of. I also ask the process for submitting questions that may come up once I’ve processed a bit longer.

Once I leave the doctor’s office, I research my options until I reach the point that I feel comfortable working with my doctor to devise a care plan. This sometimes includes getting a second opinion. Having the knowledge of more than one expert makes me feel more confident moving forward. While there is no way to know for sure whether we’ll achieve the outcome I desire, making informed plans builds my confidence and comfort level make uncertainty feel more tolerable.

Uncertainty can still weigh heavy. That’s when I like to get outside. Or on days like today, a trip outdoors offers an opportunity to bank good feelings to pull from when I need them. It’s such a gorgeous day! The work view I’ve chosen is from the porch overlooking my back yard.

Multiple birds chirp as they shuffle in and out of the wisteria on the arbor. Crows caw in the distance. Sugar snap peas extend their small white blossoms above the fence into a net trellis. The sun is full on my face and I’m comfortable in a light sweater. At sunset, we’ll be able to see Jupiter and Saturn align into a bright Christmas star. How could anything be bad?

Of course I’m aware of the perils of delivering gifts to my friends. Any other year, we’d be sharing food, wine, and laughter along with our gift bags. This year, we’re navigating quarantine just to get them to each other’s porches.

But while I sit under a brilliant blue sky, I don’t have to think about that. I can simply soak in the sun, the sounds, and the smell of BBQ when the breeze shifts just so. The smell of smoke from that nearby BBQ pit is a peril in itself. Live here long, and you’ll crave barbecue for breakfast.

As we move through stunted holiday celebrations into more months of pandemic uncertainty, some of us will receive unwanted diagnoses with the potential to increase anxiety. Having tools to reduce discomfort can mean better decision making and more peace of mind.

That’s my wish for all of us through the holidays…peace of mind and spirit!

What’s in it For Me?

Go ahead and ask, “What’s in it for me?” You may cringe when you read that. I know a lot of people feel like they’re currently surrounded by selfishness. But I really want to explore the opposite: What’s in it for me when I give my time to help someone else?

My timing may seem off to you. Most of us are struggling just to get through the craziness of 2020. But sometimes the best way to get past a struggle is to help someone else. I’m not suggesting that you leave your home or take more risks of exposure to COVID-19. There are many ways to contribute from where you sit.

When you feel bored, anxious, or worried, changing focus can work wonders. But it can be hard to think of a constructive way to use your time when you’re stuck at home with nothing on the agenda. So, let’s go back to the question at hand, “What’s in it for me?”

I’ve fallen into some really great opportunities to volunteer by attending a training, workshop, or lecture. I go for the intellectual stimulation, but I stay because I find a place I feel I can make a difference. This year, I’ve discovered I can actually attend more events because there’s no travel involved and fees have been lowered.

You don’t have to be passionate about any particular cause to make a difference. Perhaps your talent is making connections. You may be able to help a friend or associate find a new job by putting them into contact with people you know. You may be the perfect person to solicit committee members, put together a task force, or provide resources for a newcomer. You could end up introducing someone to a new partner. The right introduction can change a life.

If you’re a good communicator, you may want to write letters to teens residing in behavioral health hospitals. With COVID limiting visitors, children can use extra comforting words. Our nursing home residents and prisoners can also use extra comfort this year. Words are powerful. They can provide distraction and inspiration.

And let’s not forget healthcare workers. I have a handful of doctors I email or text on a regular basis to let them know I appreciate them. In spite of their added burdens, they often respond with encouraging messages for me. These are incredible people! And although it is not my intent for them to feel obligated to respond, there’s a lot of gratitude and reassurance available for me to absorb.

If you’re crafty, you can knit caps for newborns, sew masks for hospital visitors, or create Christmas stockings for teachers and fill them with supplies. This Christmas, I’m planning to fill stockings with holiday treats for my neighbors and leave them on their porches. I did this for Easter and the 4th of July. It’s a tiny thing to do, but brightening their day brightens mine.

And that’s the point. If you feel there’s something missing from your life, try giving that something to someone else. I’m not saying to do this in place of self-care, but as a form of self-care. We often think of giving as a tiring obligation, until we try it. Once you start using your time to create joy or comfort for someone else, you’ll be amazed how it will fill your heart and bring you joy as well.

There you have it. That’s what’s in it for me.

Volunteer Opportunities

Increase Your Chances of a Good Recovery

Increase your chances of a good recovery. Hospital discharge is a vulnerable time for a patient and one that’s rife with miscommunication. How can you increase your chances of a good recovery?

Different frames of reference coupled with broad, ambiguous recommendations mean that health messages are often misunderstood or interpreted in ways that surprise those making the recommendation. Last month, I weighed in on a discussion regarding hospital discharge instructions. Communicating discharge instructions effectively can have a significant impact on a patient’s recovery.

Discharge is known to be a vulnerable point in making a successful transition to a different location and level of care. With limited visitors currently allowed in hospitals due to Covid-19, patients are often alone when receiving oral discharge instructions. The absence of another set of ears leaves patients even more vulnerable to one of the unplanned re-hospitalizations that cost Medicare over $17 billion annually. While cost to the system is a factor, as patients we just want the best chance to recover as quickly and fully as possible.

The goals of patients, physicians, and hospitals often align at the time of discharge and yet according to one study, those goals are not met almost 20% of the time. There are many factors we as patients cannot control, but that does not mean we are helpless.

Here are 10 things you can do to increase your chances of a good recovery:

1)Have an advocate present when receiving discharge instructions. If visitation rules don’t allow you to bring someone with you in person, a video phone call can be a good option.  A voice call will also work and is best done in real time while the instructions are being delivered to the patient.

If you do not have family or a close friend available, request a patient advocate. Your hospital will most likely have at least one on staff.

2)Ask questions. Do not worry about wasting someone’s time or sounding silly and do not assume your question is stupid. We all sometimes misspeak or mishear things. And, many smart, competent, well-intentioned professionals are not skilled communicators. Clarification is good. Repetition may be necessary. Knowing the why may make the what easier to follow.

3)Request resources. If you need help navigating financial options and insurance coverage, ask that resources to assist with those be included in written doctor’s orders.

4)Get wellness support. A change in health conditions may mean a need for additional time for physical activity, mindfulness activities, support groups, or counseling. Other support services like housecleaning, babysitting, school pick-ups, or food preparation may be needed to free up time for wellness support.

5)Get another opinion. If you want to get another opinion about long-term or follow-up treatment, make a temporary plan with your doctor that will be reflected in any written discharge orders.

6)Request time to research. If there is no emergency and you are not sure which treatment option to pursue, ask for a temporary plan then schedule a time for a follow-up visit. Allow yourself time to read about up on all of the options available.

Make sure to use reputable sources like the National Institutes of Health, The Center for Disease Control and Prevention, The New England Journal of Medicine, The Lancet, and The Journal of the American Medical Association (JAMA) for your research. Social media sites are not reliable sources of information.

7)Ask for a referral. If your research leads you to a physician/facility that specializes in treatment of your diagnosis that is not offered by your current doctor or hospital, request a referral to a new doctor and/or facility and sign a form allowing the release of your records to the new facility.

8)Make sure treatment plans match your values and goals. If you and your doctor are not on the same page regarding desired outcome and the best way to achieve it, you will not be successful. Insist that you play a part in developing a plan.

9)Follow the plan. Once you and your doctor agree on a treatment plan, follow it. Period. No plan will be successful if you don’t follow it. (If you develop reservations about the plan, continue treatment until your follow-up visit or call your doctor and work out a revised plan.)

10)Give feedback. When you receive a survey about your experience, provide specific answers. This may not speed your current recovery, but it will help you and other patients in the long run. Your experience is valuable.

Sometimes getting sick is unavoidable, but a few simple steps is all it takes to increase your chances of a good recovery.