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Confinement (Circuit Breaker) Emergence and Mental Health: Be Kind To Yourself

Confinement (Circuit Breaker) Emergence and Mental Health: Be Kind To Yourself

Written by: Andrew da Roza, Psychotherapist, Promises Healthcare

As the COVID-19 confinement continues, you may have a nagging question on your mind – “what have I managed to achieve”?

Tidy, clean desk draws, closets, and glove compartments; a surprising proficiency in a new language; the final 100 pages of War and Peace; an impressive yoga position; a dazzling new magic trick?

Several weeks into the confinement in Singapore and with several weeks to go before we can be physically social with our friends, some of us may be deflated. 

When the confinement/circuit breaker started, we may have vowed to use all the new free time to do things we have never got around to doing. 

Now that time is gradually slipping by – we may think that we still haven’t accomplished our goals.

As a psychotherapist, I listen to many people starting to stress that this opportunity of more time isn’t panning out the way they imagined – and that critical voice in their heads is telling them they are inadequate and unworthy.

Feeling Stuck in Shame 

What I hear is the frustration of “stuckness.”   

Clients tell me: –

  • I must be more productive 
  • I should have achieved more since confinement began
  • I should be able to concentrate more and procrastinate less
  • I must have more enthusiasm, motivation and energy

Note the use of the words “should” and “must”. Our inner critic loves to remind us of all the things we should have done or must do.  

It is important to be compassionate to ourselves and banish these words from our vocabulary – at least for the time being.

We may have overestimated what we could achieve in confinement; and underestimated the power of the inner critic, worry and low mood. These are preventing us from feeling satisfied with what is. 

Perhaps we had the fond notion that confinement would be like a holiday – more rest, more family time, novel and interesting things to do, and relief from work and the other routines in life.

Reality may now be striking home. Anxiety about our jobs, income, and savings; fear about us and our loved ones contracting the virus; worry that food, masks, and other resources may be scarce; boredom at a routine in the cramped confines of home; the resurrection or development of old family dynamics, fraught with irritations, frustrations, disappointment, mistrust and anger. For some, isolation and loneliness may be an even more crushing weight.             

Reframing our Expectations

What will help is kindness – and, in particular, kindness to ourselves. 

Perhaps some of us are high achievers, driven by: concrete stretch goals, targets and objectives; KPIs; reports; numbers; test or exam scores. 

But COVID-19 confinement is not the time to measure yourself in this way. It’s like drinking soup with chopsticks – frustrating.

I recommend that we redefine productivity and measure our day by whether:

  • we have achieved an emotional connection with ourselves and others, 
  • ate healthily, 
  • slept well, 
  • got some exercise, 
  • meditated for a few minutes, 
  • did some yoga or Tai Chi, 
  • walked outside, 
  • read something (other than COVID-19 news or social media content); 
  • did something creative, like photography, videos, painting, made some music, baked something new; and 
  • spent “me time” – just sitting quietly, relaxing and enjoying being in the moment. 

 

This confinement is not a competition – so we do not need to compare ourselves against others. 

We must permit ourselves some numbing out to Netflix and videos – and not beat ourselves up if we eat some chocolate, cookies or chips. 

Let’s also be realistic and recognise that our routines will be different – and that we won’t accomplish the same things in confinement. We will have accomplished things – but they just won’t be the usual things.

Manage your expectations, be gentle with yourself and kind to others – and you will find that there is meaning and purpose to your confinement.   

 


Photo by Paolo Bendandi on Unsplash

Youth Depression in times of COVID19 Pandemic: How Can We Help?

Youth Depression in times of COVID19 Pandemic: How Can We Help?

Youths these days have a lot on their plate. Teenagers have to cope with the highly competitive education system, and the fresh graduates are worried about employment opportunities or career advancement. Coupled with the need to maintain good relationships with their friends and family, these individuals may be experiencing high levels of stress. Some people do thrive well under stress, but what happens when stress levels exceed the healthy range? For those who are unable to cope, chances are their mental wellbeing would take a toll.  

 

With young people unable to attend school in person regularly or go into the workplace during the circuit breaker, they might have felt increasingly isolated due to the lack of face-to-face social interaction over this extended period of time. Furthermore, having to fight for their own space while at home with their family members may have caused some conflict and frustration for some. Undoubtedly, cabin fever may have also kicked in for some of them. Although circuit breaker measures have recently been eased, youths may not be able to adjust back to the norms as easily as one might expect. Reports have shown that it is expected that more youths will be prone to developing mental health issues such as depression due to the various implemented COVID 19 pandemic coping measures. 

 

Depression is one of the world’s leading mental health disorders, and youths have become increasingly prone to it. Studies have shown that depression affects up to 18% of Singaporean youths. People with depression may turn to self-harm or experience thoughts of suicide. These are often methods they adopt in order to cope with their difficult emotions. According to the suicide prevention agency Samaritans of Singapore (SOS), suicide remains the leading cause of death among youths aged 10 to 29 in Singapore, and as of 2018, 94 of them had succumbed to suicide. In order to curb the rise of depression cases among youths, it is important that we are able to identify the early stages of depression. Doing so will allow them to seek treatment earlier and to help them get back onto their feet. Depression, if left untreated, will severely impact people’s lives in a negative light, causing personal, educational and familial difficulties. 

 

Here are some of the most common symptoms of depression that you should look out for (not exhaustive): 

 

  • Extreme sadness and low mood
  • Lack of interest in activities once enjoyed
  • Lack of self-worth
  • Increased lethargy
  • Experiences sleep disturbances and loss of appetite
  • Poor concentration and impaired memory
  • Sense of hopelessness and helplessness
  • Excessive self-criticism and self-blame

 

If you notice a friend or family member of yours showing such symptoms for long periods of time, perhaps it is time to seek help from a professional mental health expert. 

 

But how can we first better support troubled youths? When it comes to dealing with depression, individuals with mild depressive conditions could adopt self-help strategies such as trying to maintain a balanced diet, to pick up on relaxation techniques, embark on daily gratitude journaling exercises (e.g. 3 things I can be thankful for today) and get some exercise in, even if it’s just a stroll around the estate or exercises from ATHLEAN-X™ or Athlean-XX for Women. Try encouraging them to live a healthy lifestyle and maybe create a ‘Daily Wellness Plan’ – a list of little and big things they can accomplish on a daily basis to comfort and keep their moods up. However, it is key to take note that even though their depression may be perceived to be mild from a third person’s point of view, we should never make assumptions as to what they truly feel on the inside. We should never, under any circumstance, tell them to “snap out of it”. It is very important for us to be patient and listen to what they have to say if they do approach and confide in you. Stay empathetic and show your concern for the individual. Acknowledge and respect their feelings and worries. Listen actively by using active listening skills. Encourage them to join mental health support groups like those conducted by PSALTCare – journeying with others that are going through similar struggles can encourage social healing.

 

On the other hand, for those coping with moderate to severe conditions, we might need to encourage them to seek a multidisciplinary approach to recovery like psychiatric help and look to taking medications, with supporting psychotherapy or counselling sessions and support groups. They might also be afraid of the stigma attached to seeing a Psychiatrist or what would transpire in that session. Try to assure them that there is nothing to be ashamed of. In fact, it is a lot more common in Singapore now, and a trip to the Psychiatrist is as straightforward as seeing your family doctor.  Alternatively, these youths can book appointments for psychotherapy first. With appropriate treatment and support, it is entirely possible for them to move on and lead a more productive and happier life. Here’s a questionnaire that is widely used by Psychiatrists to help determine depression to help you with next steps decisions: www.mdcalc.com/phq-9-patient-health-questionnaire-9

 

If you or anyone you know are struggling and are unable to cope with the post-lockdown blues, we strongly encourage you to get professional help.  Do not hesitate to contact us when necessary. 

 


 

References:

  1. Teen Mental Health: Depression (Accessed 22/05) 
  2. CNA: Under pressure at home and in school, youths battle depression (Accessed 22/05)
  3. Photo by Yuris Alhumaydy on Unsplash

 

The Stress Of Being Caught In A Transient life: Moving Towards A New Normal

The Stress Of Being Caught In A Transient life: Moving Towards A New Normal

Written by a member of the Editorial Team

 

Stress. What is stress? This word is used so casually nowadays that it has lost its impact as something that can be detrimental to health, especially during this unsettling period of the Covid-19 pandemic. We might have adapted to the restrictions put in place, like wearing a mask and practicing social distancing wherever we are, but have we truly come to terms with these regulations, or are we trying to distract ourselves from the pressing concerns of our future? Adhering to the past few months of circuit breaker regulations definitely have not been easy on everyone, be it young or old. The stress and inconveniences experienced due to a sudden change in routine habits have been unnerving for many and as we progress on to the next few phases, what does this mean for us? 

 

By now, Singaporeans would have been working from home or have been home-based learning (HBL), adapting to these changes of environments whilst managing their hectic schedules. However, as the world economies bulldoze to get things back up and running, we cannot ignore that there might be no place for permanency again i.e. making our homes temporary workspaces then returning back to original practices or shuttling between the two. 

 

Undoubtedly, there are pros and cons to each family being at home together, where relationships are constantly tested and stretched. Some might argue that it’s been a good time for family bonding: to better understand one another as the rat race may have left some in a time capsule ignorant of changes; while others unable to compartmentalise their thoughts, feel that it’s a disruption to their workspace and schedules, having to juggle work and personal life in the same physical space. 

 

Moving forward, our government aims to have routines restored back to normal, this means returning back to the high demands of work and student lives, but what is normal? We wonder if it will be difficult to get back into the grind after the somewhat sedentary lifestyles some of us have been living in the past few months, giving up on flexible self-dictated work hours and or dragging our muscles to leave home and travel to work. Also, companies and schools will have to work around challenging social distancing measures, which can pose a problem considering our highly interactive nature. Whilst schools are drawing out plans for rotational return of students, trying to stagger and minimise cross contact within large groups, companies on the other hand, have to reorganise their “back-to-back” cubicle style like workspace that was easier for communication, into something less compact.  These new arrangements will potentially be disruptive to students’ learning, having to conduct lessons both online and face-to-face (f2f), along with teachers who will have to adjust their teaching methods accordingly and capture the essence of each lesson, whilst engaging students. Offices will have to convert into something less compact or cut down on the number of employees on site, which may not only slow down productivity but also potentially decrease employee satisfaction and well-being. Nevertheless, this creates a lot of physical, emotional and mental stress. 

 

At the initial stages, non-chronic stress may be beneficial to give people an adrenaline boost to encourage them to press on. However, if we are not capable of managing stress, it may become chronic. This can cause our brains, nervous systems and behaviour to affect the expression of genes in sperms or alter brain development of our offspring. 

 

A more immediate manifestation shows that the brain activates neuropeptide-secretion systems in response to stress, leading to a cascading effect involving adrenal corticosteroid hormones. This can result in stress-related brain diseases, like depression and anxiety disorders as well as post-traumatic stress disorder (PTSD). Moreover, chronic stress can stunt memory growth and even kill brain cells, which result in learning impairments. Not forgetting, the physical aspects of stress such as headaches, muscle fatigue, changes in appetite or insomnia, all of which can be overlooked as just temporary “disturbances”, rather than a contributing factor of stress that is beginning to pose a hindrance on daily activities. This might be threatening if it’s not diagnosed and dealt with in its early stages. Prolonged periods of stress can also cause some to turn to less favourable options like alcohol, smoking or even drugs, which should be avoided at all costs. 

 

Here are some suggested precautionary measures we could take to prevent the rise of chronic stress:

 

  • One of the possible solutions to relieve stress is exercise, although some might be deprived of going to their usual gym studios, we can opt for a nature setting outdoors to get some vitamin D too! Instead of being cooped up at home, fresh air is always welcomed. 

 

  • Another way to destress is picking up new hobbies like baking or cooking. Unknowingly, you can invest loads of time into learning new recipes to convert into practical use that may come in handy in the future! 

 

  • Next, meditation. Even though it might take a while to enter a full meditative state, this is definitely worth the try to keep calm and relaxed amidst this chaos, to be at peace with yourself. It also clears your head to think about self-goals and plans ahead. 

 

  • Last but not least, laugh! As the saying goes, laughter is the best medicine. This is easily attainable to get your tummy hurting watching humorous videos or sharing silly jokes and the best time to share happy moments with your family!

 

Food For Thought: If Covid-19 is here to stay, how do we embrace it without crippling our way of life?

Love in time of COVID: A Mothership SG interview recap

Love in time of COVID: A Mothership SG interview recap

Relationship Advice from Relationship Therapist & Coach, Winifred Ling

 

Chelsea, a stunning flight attendant and her partner, Clayton, have been experiencing the Covid lockdown blues. Being in the early stages of their relationship, they both confessed to feeling the effects of being apart from each other – while they were somewhat used to incompatible schedules, the loss of physical intimacy that was at least within reach before amplified the tattoo of each pining heart.

They shared how they were managing to stay sane and close throughout the lockdown – by making use of technological advances, utilising Zoom to keep each other apprised of the happenings in their lives. 

Winifred Ling, a Gottman Certified Relationship Therapist, featured in the Mothership vlog – gave this couple some tips on how to be “out of ‘touch’ but not out of love” and how to keep their relationships healthy. Love takes effort, and she relayed to her audience some suggestions that were remarkably common-sensical, like making sure to check in with your significant other with words of encouragement.

We are home to a few genuinely warm and empathetic relationship therapists. If you’re in a committed relationship, they’ll teach you valuable skills that you can employ to keep healthy and relationship strong. Additionally, even if you’re not quite sure of your chances of getting hitched but would like to learn more, there’s pre-marriage counselling available too.

Stay safe. Stay strong.

COVID-19 AND ADDICTION – RECOVERY USING ONLINE THERAPY

COVID-19 AND ADDICTION – RECOVERY USING ONLINE THERAPY

Author : Andrew da Roza

COVID-19 has posed a challenge to everyone, and those more physically vulnerable in our community clearly need our care and attention. 

There are also people whose mental vulnerability deserves equal care.

Mental illnesses such as depression, anxiety, and addictions are exacerbated by a pandemic crisis in multiple ways. 

Collective family and community fears are (in themselves) contagious; and the constant bombardment of medical and financial bad news, can leave those with mental illnesses lost in a cascade of negative rumination and catastrophising. 

The mentally ill and people with addictions commonly have compromised immune systems, and suffer stress or substance, tobacco and alcohol abuse related diseases – leaving them wide open to severe pneumonia with acute respiratory distress symptoms – and other complications from COVID-19. 

Isolation, separation and loneliness – caused by working at home and social distancing – are perhaps the worst contributors to: low mood; agitation; irrational fears; moments of panic; self-disgust; resentment; anger; and even rage.

People whose ability to pause, use reason and find practical solutions can be severely compromised. They may find themselves bereft of the motivation, and ability to engage in even the simplest tasks of self-care. 

Added to this, listlessness, boredom and frustration can lead to despair. Then self-harm and suicidal thoughts may arise, take hold, and even overwhelm them.

Those in recovery or active addiction may also turn to their compulsive and impulsive behaviours of choice, to sooth and find momentary respite from the moods and thoughts that have hijacked their mind. Triggers, urges and cravings may become relentless and unbearable. 

The solution may begin with finding a way out of isolation. 

Starting the journey out of this darkness can start with talking to people who can demonstrate unconditional positive regard, show kindness and compassion, and help reframe the situation. Such people can assist those suffering to put a name to and validate their emotions. 

In short – therapy can help!

In times of COVID-19, working with a therapist via teleconsultation can be effective using ZOOM, Skype, WhatsApp video and FaceTime. 

Although the calming and soothing sensation of the physical presence of a therapist is absent, for those in isolation – distraught with shame and despair – Internet enabled therapy can prove a lifeline.   

Isolation can be further broken, using similar Internet methods, by attendance in recovery groups such as Alcoholics Anonymous, Narcotics Anonymous and Sex and Love Addicts Anonymous – all of whom now hold Zoom meetings in Singapore. 

These Zoom opportunities in Singapore are supplemented by Zoom, Skype and telephone conference meetings in Hong Kong and Australia (in Singapore’s time zone) and in the U.K. and the US (during our mornings and evenings).             

Having broken the isolation, the second step therapists can provide is guidance and motivation towards self-care. This would include tapering or abstinence from the addictive substances or behaviour. A well thought through relapse intervention and prevention plan, specifically tailored to a person’s triggers, will also assist.

Triggers may be particular places, situations, people, objects or moods. 

The acronym “HALT” is often used by those in recovery; which stands for the triggers of being: Hungry; Angry; Lonely; or Tired.

When these triggers arise, people are encouraged to 

  • HALT their behaviour; 
  • breathe deeply, with long outward breaths;
  • think through consequences;
  • think about alternatives;
  • consult with others; and
  • use healthy tools to self-soothe.      

Daily mindfulness, meditation, exercise, sleep hygiene, healthy eating and following a medication regime are important aspects of self-care – and for some suffering mental illness – these actions – and time – may be all they need to find their footing again.

Luckily, the Internet gives a vast array of possible self-care options, including things to distract us, soothe us and improve us. 

Everything is available from: calming sounds and music; guided meditations; games; home exercise, yoga and tai chi; self-exploration and improvement videos; video chats with loved ones; to healthy food delivery options. They can all be had with a few keystrokes. 

Today we live at a time when suffering from mental illness and addictions is commonplace. But we also live at a time when the solutions are literally at our fingertips – if we only reach out for them. 

For information on teleconsultation for addiction therapy and addiction recovery meetings, contact:  Andrew da Roza at Promises Healthcare by email to andrew@promises.com.sg or by calling the Promises Healthcare clinic at: (+65) 6397 7309