Category: Lessons from the COVID-19 Pandemic Series

Existential Concerns and the COVID-19 Pandemic

The COVID-19 pandemic has had incredibly devastating and often lasting impacts both globally and on an individual scale. For some, it has even provoked a sense of chaos, making it increasingly challenging to make sense of the world. Historically, philosophers have tried to answer questions about the meaning of life and what our purpose might be as human beings. Existential psychology, which is rooted in philosophy, allows individuals to explore themes such as freedom, responsibility, and the search for meaning. It encourages us to grapple with the concerns of existence, including the existential dread and angst- states of anguish, despair, and insecurity related to the central existential themes- which are part and parcel of the human experience. You may be familiar with the more common term, “existential crisis,” which can cause symptoms of depression and anxiety. Below, I outline the ways in which the pandemic can give rise to existential concerns and how we may overcome them:

Dealing with Loss and the Finitude of Life

For those who had not faced the loss of a loved one before, it is likely that the pandemic had you worrying about the health of someone you care about or even worse, grieving the loss of a loved one. At some point in our lives, we are forced to contend with the fact that our existence is finite. This can induce anxiety, as we think about the close bonds or attachments we do not want to let go of, the people we do not want to leave behind, and the limited time we have to see out our life goals. It is normal to be deeply affected by these experiences or even the mere idea of them. It is important that we allow ourselves to feel the full spectrum of emotions that ensues from loss or anticipatory grief (feelings of grief associated with knowing that you are losing a loved one). In these difficult moments, there are unique opportunities to let people in our lives know how we feel about them and to help them understand the profound impact they have had on us. Furthermore, the pandemic has prompted us to reflect on what we value in life, which may lead us to alter our priorities. We can use these difficult experiences as a way to deepen our connections, reflect on who or what matters most to us, and to make significant changes that we may have been putting off, such as spending an hour less working in order to spend quality time with family.

Isolation

Prior to the pandemic, many of us led eventful lives with little time to spare. Although the pandemic gave us the opportunity to press the pause button on life, it has also kept us apart from our loved ones: grandparents who were not able to spend time with beloved grandchildren, groups of friends no longer planning get-togethers, or travel restrictions preventing people from visiting family in different parts of the world. These are a few examples of how we could no longer connect with others in ways that we are accustomed to or perhaps even took for granted before the term social distancing was even part of our vocabulary. The positive side of this is that we may now have a greater appreciation for those who enrich our lives when we are lucky enough to spend time with them. During quarantine, we were able to bear witness to the interconnectedness we all crave and need, as video calls became part of our daily routines. The pandemic showed us how resourceful we can be when it comes to staying connected, as we learned to grow our online communities, become friendlier with our neighbors, and forged deeper bonds with coworkers who could relate to our hardships.

Managing Uncertainty

For those of us who thrive in structured environments and value stability, the year 2020 certainly took a toll on our well-being. Even for those who appreciate spontaneity, the overwhelming sense of unpredictability has been challenging to navigate. We have had to manage frequent changes in the way we perform our jobs or attend school, how we socialize with others, the way we travel, and the way we manage our health, to name a few. This has made it abundantly clear that change can happen when we least expect it, forcing us to adapt. Although this can make us feel uneasy, it is worthwhile to learn to deal with change, which is a constant in life. When things feel or are out of our control, what we can do is shift our focus to what we do have control over. This could translate to practicing a balanced routine where we provide ourselves with the structure we need, such as setting work hours if we are working remotely, eating healthier, setting aside time for physical activity, engaging in fulfilling activities or hobbies, and staying connected with others in some capacity. It is also critical that we practice acceptance, one of the many attitudes of mindfulness. We can do this by establishing some sort of breathing or meditation practice or with a positive affirmation, all of which can help us feel grounded despite the lack of certainty.

These unexpected and sudden changes have caused us to ask profound questions and perhaps compelled us to find the subjective meaning in our lives. Despite the vicissitudes of this pandemic, we can reflect on our growth and find the inadvertent improvements to our quality of life. If you are having difficulty doing so or want to further explore these existential concerns in a supportive therapeutic setting, seeking therapists who practice from a humanistic-existential framework may be beneficial. You may also want to read books that deal with existential topics, such as Viktor Frankl’s Man’s Search for Meaning.

References

Bland, A. M. (2020). Existential Givens in the COVID-19 Crisis. Journal of Humanistic Psychology, 60(5), 710–724. https://doi.org/10.1177/0022167820940186

Koole, Sander. (2010). Existential Psychology. 10.1002/9780470479216.corpsy0329.

Price, M. (2011, November). Searching for meaning. Monitor on Psychology, 42(10). 

 http://www.apa.org/monitor/2011/11/meaning

 

Yalom, I. (1980). Existential psychotherapy. New York: Basic Books.

How the Pandemic Forced Us to Redefine Productivity  

Written by Dr. V. John Nguyen

 

I am not a productivity guru.

As a matter of fact, if you look at my phone, you’ll see a graveyard of productivity apps that were once downloaded with such promise. I also have sticky notes that have fallen to the ground around my desk over the years with things that I never got to. I’ve spent countless hours researching ways to be productive when I could have just been productive (whatever that means). Despite my public confession, I can’t deny the appeal of getting things done and I’ll probably always be attracted to new methods. There’s something oddly satisfying about checking things off a list, even if I went back to add it after I already did it.

The coronavirus pandemic changed the way that we perceive productivity in ways that will likely continue to unfold as we move toward our “new normal.” Early on, many of us took the opportunity to learn a new skill – like baking bread, cutting hair, and making masks. We also got unusually comfortable pairing work shirts with sweatpants but that’s a different discussion for a different day. But when the dust settled, and we realized that we would be in quarantine much longer than we had anticipated, it was time to get back to business. Perhaps during this phase of quarantine, you found it difficult to determine whether you were being “productive” or not. Compartmentalizing work life and home life became challenging because we did everything at home.

What follows are some tips on how to remain productive even if you aren’t sure what it means to be productive.

 

Try Not to Resist Change

The pandemic has tested our ability to accept change. While resistance can be good at times, it can cause unnecessary challenges in life – especially if it’s our default response to everything (I’m looking in the mirror). Here are some questions that can help you identify resistance and figure out if it’s working for you or not:

  • How do you know when you are in resistance?
  • Can you describe what is happening when you are resisting an experience?
  • Is the resistance benefitting you in any way?
  • How might the resistance not be serving you?

 

Prioritize Quality Over Quantity

Nothing groundbreaking, we hear this all the time. Checking items off a list can be nice but can become a rote exercise in futility if we can’t maintain or improve the quality of our work. Try and focus on the quality of time spent on projects, on interactions with coworkers, and on reaching the standards that you pride yourself on. You may not get the project done as quickly as you wanted but it the final product might better meet your standards (and needs).

 

Plan For Tasks to Take Longer Than You Think

Inevitably, things come up and derail us from completing tasks. This causes us to fall behind and feel bad that we did. Remember the three P’s: Planning, prioritizing, and pacing your activities. Planning can prevent you from putting too much on your plate at once while ignoring the possibility that something will come up. Prioritizing can give you an idea of what needs to be done today and what can be either pushed to tomorrow or even eliminated. Pacing can allow you to complete tasks without becoming physically and emotionally exhausted. It may seem like you’re doing less than you were able to because of frequent breaks, but you may find that you’re getting more done overall. Your energy level and productivity will become more predictable and thus more under your control.

 

Set Clear (and Realistic) Boundaries

Working from home blurs the lines between work life and home life. Creating boundaries involves designating both physical and mental spaces to complete your work. Scheduling blocks of time for certain tasks may be helpful in compartmentalizing your life even if you’re doing it in the same space. Adjust your boundaries as you see fit and do your best to adhere to them. You may be surprised at how well the people around you respond to your boundaries and how much you can get done.

 

Consider Self-Care Productive Time

Plan and engage in activities that promote self-care. This may take some time to get used to but consider self-care activities “productive.” These activities may not be related to the tasks in front of you but being in an improved state of mind can certainly improve the quality of your work – and who knows, might even make it enjoyable. Being in a better mood can also enhance your ability to problem solve and shift your attention away from the negative aspects of your day (beneficial during the daily reviews you conduct as soon as your head hits the pillow).

 

Focus On What Has Been Done vs. What Hasn’t Been Done

Focusing on what hasn’t been done might be your default setting. You may find yourself setting goals for the day, reaching them, and then adding new goals to your list. While this is consistent with today’s “hustle culture” mentality, it creates a never ending to do list. What tends to happen is, you’ll remember what you haven’t finished and forget about what you did finish.

 

Keep Things Simple

Don’t be like me. Keeping your productivity system simple will increase the likelihood that you’ll keep doing it. Try not to overthink things and focus on what it is that you’re trying to get done. Do you really need 20 apps to light up your phone with notifications to remind you to take your vitamins?

 

Here are some fairly simple productivity systems that you might find helpful:

 

The Getting Things Done Method

The Getting Things Done Method (GTD) was developed by productivity and organizational consultant David Allen in 2001. This method involves 5 steps with the goal of “applying order to chaos.” The steps are as follows:

  1. Capture: Collect what has your attention. Write, record, or gather all everything that has your attention into a collection tool. A collection tool could be a notebook, fancy notetaking app, or a wide array of colorful sticky notes.
  2. Clarify: Look at your notes and process what they mean. It is at this point that you decide whether the items are actionable. If actionable, decide on the next step(s).
  3. Organize: Put reminders of your categorized content in the appropriate place, grouping similar tasks together, and scheduling blocks of time to complete them.
  4. Reflect: Update and review all pertinent system contents to regain control and focus.
  5. Engage: Take action using the system you just created with confidence and clarity.

 

The Pomodoro Technique/Time Blocking

The Pomodoro technique is a time management system that encourages you to work with the time that you have, rather than against it. This method simply involves breaking your workday (or activities) into 25-minute chunks (called “Pomodoros”) followed by 5-minute breaks. After the 5-minute break, reset the timer for 25 minutes and start again. After completing four “Pomodoros”, reward yourself with a longer break – usually 15-30 minutes.

 

Bullet Journaling

Bullet journaling is a highly customizable productivity system that involves keeping and maintaining a single journal that is used to track almost everything in your life – schedule, goals, appointments, events, thoughts, and anything else you might find useful. Journal entries are meant to be simple bullet points with user defined symbols or colors to organize items.

 

The Daily Trifecta

This system involves creating a list of three key things you want to get done each day by writing them down the night before. This system might be useful if you tend to overload your to-do list. It is also helpful in that it allows you to be realistic about accomplishing the most essential tasks, not every task.

The pandemic forced us into figuring out how to balance our work and home lives. For some of us, there was significant overlap between the two. It forced us to prioritize and change the way we view productive time. If there is a silver lining in this, it’s that the definition of productivity is not entirely dependent on tangible rewards or outcomes. We can still be productive, even when we’re not feverishly crossing off items on a checklist or sacrificing self-care.

 

 

References

Curran, E. (2021, April 21). Work from Home to Life Productivity By 5% in Post-Pandemic U.S. Bloomberg.

https://www.bloomberg.com/news/articles/2021-04-22/yes-working-from-home-makes-you-more-productive-study-finds

 

Hickok, H. (2021, January 7). How The Pandemic Could Redefine Our Productivity Obsession. BBC.

https://www.bbc.com/worklife/article/20201230-how-the-pandemic-could-redefine-our-productivity-obsession

 

Pontefract, D. (2021, June 4). Productivity Better Be Top Of Mind In Post-Pandemic Work World. Forbes.

https://www.forbes.com/sites/danpontefract/2021/06/04/productivity-better-be-top-of-mind-in-a-post-pandemic-hybrid-work-world/?sh=1ac8d1865a58

 

Moore, K. (2019, November 12). Six Productivity Systems You Should Know. Monday.

https://monday.com/blog/productivity/6-productivity-systems-know/

 

 

What is Coronasomnia and What Do We Do About It?

Written by Sarah Jurick, Ph.D.

For most of us, the last year and a half has been difficult for many reasons. Many have lost loved ones, fallen ill, cared for sick individuals, found themselves out of work, and missed celebrations of important milestones with friends and family. Not surprisingly, these adjustments have led to ‘tandemics’—epidemics that run in tandem and are caused and exacerbated by the pandemic—such as increased rates of mental health disorders.

Poor sleep has been one of the many consequences of the COVID-19 pandemic, leading to the term ‘coronasomnia’, which is essentially insomnia that has been caused or worsened by the COVID-19 pandemic.

Sleep Changes During the Pandemic

Research studies have begun to document these changes in sleep. Perhaps, unsurprisingly, around one-third of healthcare workers report insomnia since the rise of COVID-19, with the highest prevalence among frontline workers directly working with patients diagnosed or at-risk of developing COVID-19 (Lai et al., 2020; Zhang et al., 2020). However, this is not unique to healthcare workers. Widespread complaints of sleep loss, poor sleep quality, and insomnia are also present in the general population (Cellini et al., 2020).

Effects of COVID-19 on Sleep

Additionally, a recent study found that 6 months following hospitalization for COVID-19, sleep difficulties were among the most common lingering concerns with 26% reporting continued sleep difficulties (Huang, 2021). The authors cited multiple possible reasons for sleep difficulties following COVID-19, including direct effects of the virus, the body’s immune response, corticosteroid treatment, staying in the intensive care unit, social isolation, and stigma related to contracting COVID-19.

The Role of Stress and Changing Work Schedules

In addition to the potential direct effects of the virus, the COVID-19 pandemic has impacted sleep through increased stress levels, confinement at home, and atypical work schedules (Morin et al., 2020). Specifically, sleep quality and duration are highly dependent on how long we are awake, daylight exposure, and routines that we engage in (e.g., rising at the same time each day with an alarm, meals, exercise, work, and social/leisure activities). Lately for many of us, routines have been thrown off by shift work schedules, remote work that can end up running late into the evening, and less exposure to daylight, leading sleep to suffer. In the short-term, poor sleep can cause low mood and decreased immunity. Consequences of long-term poor sleep include hypertension, diabetes, and depression.

“Sleep Hygiene” Techniques:

Fortunately, there are some relatively simple ‘sleep hygiene’ techniques we can engage in that have the potential to improve sleep in a big way. Adapted from Morin et al.(2020):

1) Maximize daylight exposure, particularly earlier in the day, by opening curtains, getting outside, and turning on lights. This will regulate circadian and sleep-wake rhythms.

2) Try to wake up and go to sleep as close to the same time each day. Having a consistent schedule with meal times and work will also help your body to know what to expect each day and make falling asleep and waking up easier.

3) Limit naps and if you need one, try to take a short nap (15-20 minutes) early in the day. This will help you feel tired when it is time for bed.

4) Avoid using electronics before bed as well as in the bedroom. The light from our cell phone and tablets sends signals to our brain that it is time to wake up, not go to bed.

5) Reserve the bed and bedroom for sleep and sex only. This will train your brain to associate your bedroom with sleep and not stressful things that keep your mind active.

6) Make sleep a priority and aim for 7-8 hours per night.

Although these behavioral techniques are helpful, if you are experiencing insomnia several nights a week, it will likely be necessary to seek professional help. Very effective, short-term therapies such as cognitive behavioral therapy for insomnia described here are available.

 

References:

Cellini, N., Canale, N., Mioni, G., & Costa, S. (2020). Changes in sleep pattern, sense of time, and digital media use during COVID-19 lockdown in Italy. Journal of Sleep Research (preprint).

Huang, C., Huang, L., Wang, Y., Li, X., Ren, L., Gu, X., … & Cao, B. (2021). 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet, 397(10270), 220-232.

Lai J, Simeng M, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open. 2020;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976.

Morin, C. M., Carrier, J., Bastien, C., & Godbout, R. (2020). Sleep and circadian rhythm in response to the COVID-19 pandemic. Canadian Journal of Public Health, 111(5), 654-657.

Zhang, C., Yan, L., Liu, S., et al. (2020). Survey of insomnia and related social psychological factors among medical staffs involved with the 2019 novel coronavirus disease outbreak. Frontiers in Psychiatry.

Long-Haul COVID-19: What We Know, and What We Don’t

Written by: Delia Silva, PsyD, ABPP-CN

What is Long-Haul COVID?

“Long-Haul COVID” is a term that has been used extensively in the media to describe people who have experienced persisting physical, cognitive, or emotional symptoms for months following recovery from the acute phase of the SARS-CoV-2 (COVID-19) infection. The reported symptoms have included: “brain fog,” sleep problems, temperature dysregulation, gastrointestinal problems, tachycardia with mild exercise or standing (Vanderlind et al., 2021) dizziness, headache, generalized aches or pain, and loss of smell or taste (Broche-Perez & Medina-Navarro, 2021).  While we may hear about “long-haulers” a lot in the news or may even know people who have experienced these symptoms, there continues to be very little scientific research about this phenomenon. The purpose of this blog article is to summarize what we do know, so far (as of August 2021), about the scientific underpinnings of long-haul COVID-19, particularly with brain functioning.

How Might COVID-19 Affect the Brain?

The way in which the SARS-CoV-2 virus might actually affect the brain is still largely unknown, but there are three main theories:

Cerebrovascular Ischemia:

What appears to be prominent in the scientific studies that have found neurological changes in COVID-19 patients is that these particular patients have had severe respiratory symptoms during the acute infection that required hospitalization, and in most cases, intubation. Additionally, people who are at risk for experiencing severe COVID-19-related symptoms tend to be older in age or have medical co-morbidities, such as high blood pressure or diabetes, which also increases their risk of having a stroke. People who require medical ventilation are at higher risk of experiencing hypoxia, or a lack of oxygen to the brain. There is insufficient research to state that the SARS-CoV-2 virus itself causes strokes or hypoxia. There are hypotheses that require further research about the virus leading to constricting of small blood vessels that could potentially lead to cerebrovascular events.

Secondary Neuroinflammatory Response:

There continues to be a lack of research with this theory, but the hypothesis is that the body’s immune system goes into overdrive to fight off the COVID-19 virus and produces a maladaptive inflammatory response cause more harm to the body’s tissue and organs, maybe more so than the virus itself. Essentially, the immune system may go into overdrive and attack the healthy body tissue. We know this happens with autoimmune disorders such as multiple sclerosis and lupus.

Direct Viral Infection of the Brain:

The evidence for this is still sparse, but there is a theory that the virus may enter the brain through the olfactory pathways in the brain. Loss of smell is a very common symptom reported by patients experiencing a COVID-19 infection, regardless of the severity of other symptoms (deMaria et al., 2020; Voruz et al., 2021). Some mainstream magazines have recently mentioned that the COVID-19 virus appears to specifically attack astrocytes (a specific type of brain cell involved in many “worker” functions), particularly within the limbic system (Douaud et al., 2021). However, those studies have not yet gone through the peer-review process required for publication into scientific journals, and therefore should be looked at with extra scrutiny.

Cognitive Functioning

There are very limited neuropsychological studies examining the neuropsychological profiles for COVID-19 patients at the present time, and the few studies that are available inconsistently exclude people from the sample that might have pre-existing cognitive impairment.

However, what does appear to be emerging from the research is that persisting cognitive symptoms appears to be most prevalent in COVID-19 survivors who have had severe symptoms that required hospitalization. This group of people was at higher risk for experiencing delirium, strokes, and hypoxia. People who experienced delirium during their hospitalization appear to be at highest risk for having persisting cognitive impairment (Burdick & Millett., 2021).

One meta-analytic study (Vanderlind et al., 2021) combined the results of 26 studies and determined that approximately 15-40% of the total participants who underwent formal neuropsychological testing were documented as having abnormal cognitive performance, 10-105 days following hospital discharge. Compared to matched controls, there were significant differences in performance on measures of sustained attention, executive functioning, visuospatial processing, attention, memory, and language. All of these participants had been hospitalized with severe COVID-19 symptoms. Patients who were treated in the ICU and required oxygen therapy were found to have lower scores across most cognitive domains.

On studies that solely looked at self-reported or observer-reported questionnaires that were collected 4-15 weeks after hospital discharge or recovery from the acute phase of COVID-19, approximately 25% reported cognitive complaints (de Graaf et. Al, 2021). People who had medical co-morbidities tended to report problems with concentration and memory loss more often (Mannan et al., 2021).

One study showed that poor cognitive performance was correlated with increased inflammatory markers (Zhou et. Al, 2020).

Psychiatric Symptoms

Psychiatric symptoms are commonly seen in COVID-19 survivors, regardless of the severity of the COVID-19 illness or if they were hospitalized. In some studies, people who had mild COVID-19 infections actually reported having higher levels of depression, stress, anxiety, and reported more cognitive complaints that people who had more severe COVID-19 symptoms (Vanderlind et al., 2021).

Depression

Approximately 10-42% of patients who were previously hospitalized due to COVID-19 reported moderate to severe depression, two to three months following discharge. Survivors reporting the most severe levels of depressive symptoms tended to have a prior psychiatric history (Vanderlind et al., 2021).

Similarly, in COVID-19 survivors who were not hospitalized, depression ranged from 15-68%. Risk factors for depression in those groups included female gender, older age, and decreased sense of smell (Vanderlind et al., 2021).

Anxiety

Across 25 studies, clinically significant anxiety symptoms ranged anywhere from 5 to 55.2% of COVID-19 patients. Risk factors for anxiety included: COVID-19 illness severity, co-morbid medical conditions, reduced quality of life, persistent shortness of breath, younger age, having close relatives with COVID-19, having a decreased sense of smell, and having a prior psychiatric history (Vanderlind et al., 2021).

Anxiety related to COVID-19 may be related to the unknowns of the disease process, as we simply still don’t know what to expect. This lack of information about the virus leading to frequent changes in public policies and the emergence of conspiracy theories and “alternative facts” certainly do not help the collective mental health for our society! More in-depth discussion about the day-to-day impact of the pandemic on our mental health can be seen in other articles in our blog series.

Stress most definitely has an impact on the brain and body. The stress response is mediated by the pathways between the hypothalamus, the pituitary gland, and the adrenal gland (“HPA axis”) which sends signals to the body to activate our primitive “fight-or-flight response” while inhibiting our ability to activate our higher-order thinking skills. The high rate of stress in individuals who have experienced COVID-19 infections may be a factor in the cognitive difficulties reported in the long-haulers.

Fatigue

Fatigue following severe COVID-19 infection appears to be the most common finding, with 40-69% of COVID-19 survivors endorsing ongoing fatigue that interfered with their quality of life, two to three months after hospital discharge (Vanderlind et al., 2021).

Sleep

On one study, about 26% of COVID-19 survivors reported persisting sleep difficulties, six months after being discharged from the hospital (Huang et al., 2021).

What Can We Do Now?

Overall, there’s still a lot more to learn about the long-term effects of COVID-19, particularly on people who have experienced mild cases of COVID-19 without severe respiratory distress. While the medical science is still figuring out the biological effects of the virus on the body and the brain, it appears that reducing inflammation may be a goal in treating long-haul COVID-19 symptoms. Nutrition should certainly not be ignored, as it is known that specific foods can lead to inflammation and others can help to reduce it. Meeting with a registered dietitian to determine an optimal diet is something to consider. Likewise, depression, anxiety, and chronic stress is known to have a physical impact on the body by mechanism of increased production of stress hormones and neurotransmitters (Vogelzangs et al., 2013; Salim et al., 2012). Therefore, psychological treatment for anxiety or depression should be considered as an essential part of a multi-disciplinary approach to treatment of persisting COVID-19 symptoms. Of course, following up with your primary care physician and recommended medical specialists while you continue to experience physical symptoms is recommended to obtain the latest treatment as the science develops.

 

References:

Almeria M, Cejudo JC, Sotoca J, et al. . Cognitive profile following COVID-19 infection: clinical predictors leading to neuropsychological impairment. Brain Behav Immun Health 2020; 9:100163.

Burdick, K. E., & Millett, C. E. (2021). The impact of COVID-19 on cognition in severe cases highlights the need for comprehensive neuropsychological evaluations in all survivors. Neuropsychopharmacology, 1-1.

de Graaf MA, Antoni ML, Ter Kuile MM, et al. . Short-term outpatient follow-up of COVID-19 patients: a multidisciplinary approach. EClinicalMedicine 2021; 32:100731.

De Maria, A., Varese, P., Dentone, C., Barisione, E., & Bassetti, M. (2020). High prevalence of olfactory and taste disorder during SARS-CoV-2 infection in outpatients. Journal of medical virology, 92(11), 2310–2311.

Douaud, G., Lee, S., Alfaro-Almagro, F., Arthofer, C., Wang, C., Lange, F., … & Smith, S. M. (2021). Brain imaging before and after COVID-19 in UK Biobank. medRxiv.

Mannan A, Mehedi HMH, Chy N, et al. . A multicentre, cross-sectional study on coronavirus disease 2019 in Bangladesh: clinical epidemiology and short-term outcomes in recovered individuals. New Microbes New Infect 2021; 40:100838.

Mazza MG, De Lorenzo R, Conte C, Poletti S, Vai B, Bollettini I, Melloni EMT, Furlan R, Ciceri F, Rovere-Querini P, COVID-19 BioB Outpatient Clinic Study group., Benedetti F Brain Behav Immun. 2020 Oct; 89():594-600.

Medina-Navarro, C. M. (2021). Neuropsychological & Cognitive Sequelae in COVID-19 Patients. MEDICC review23(2), 78.

Namdar, P., Mojabi, N. A., & Mojabi, B. (2021). Neuropsychological and Psychosocial Consequences of the COVID-19 Pandemic. Neurophysiology, 1-10.

Salim, S., Chugh, G., & Asghar, M. (2012). Inflammation in anxiety. Advances in protein chemistry and structural biology88, 1-25.

Vanderlind, W. M., Rabinovitz, B. B., Miao, I. Y., Oberlin, L. E., Bueno-Castellano, C., Fridman, C., … & Kanellopoulos, D. (2021). A systematic review of neuropsychological and psychiatric sequalae of COVID-19: implications for treatment. Current opinion in psychiatry34(4), 420. 

Vogelzangs, N., Beekman, A. T. F., De Jonge, P., & Penninx, B. W. J. H. (2013). Anxiety disorders and inflammation in a large adult cohort. Translational psychiatry3(4), e249-e249.

Voruz, P., Allali, G., Benzakour, L., Nuber-Champier, A., Thomasson, M., Jacot, I., … & Peron, J. A. (2021). Long COVID neuropsychological deficits after severe, moderate or mild infection. medRxiv.

Zhou H, Lu S, Chen J, et al. . The landscape of cognitive function in recovered COVID-19 patients. J Psychiatr Res 2020; 129:98–102.

Have You Heard About “Languishing”?

Written by Stacy Ann Aquipel, PsyD

If you’ve noticed yourself feeling more blah or meh in the past year, you’re not alone. Last April, a viral New York Times article identified languishing as possibly the dominant emotion of 2021. The term was coined by a sociologist named Corey Keyes, who compared it to the concept of flourishing, or a combination of “feeling good about and functioning well in life.” On the contrary, languishing can be experienced as not just surviving, but not quite thriving – or perhaps not overwhelmed necessarily, but certainly whelmed. The French also have a similar expression: ennui. Given the unpredictability and prolonged nature of the COVID-19 pandemic, not to mention social, political, racial, and even climate-related concerns and collective stress and grief, it makes sense that many of us have felt as though we’re stuck in a holding pattern, trudging along with less motivation, energy, enthusiasm, or even control than in the “beforetimes.” Here are a few tips and reminders to consider as we continue to weather this storm together:

Reframe: Languishing May Be Beneficial

It may be helpful to keep in mind that, just like every emotion and sensation we experience as humans, languishing may serve important functions and provide us with opportunities to grow in self-awareness. For instance, if we take cues from nature, there are reasons why some animals hibernate in winter, and why many plants do not flower all year long. We may be experiencing a summer heat wave in SoCal at the moment, but emotionally and existentially speaking, we’ve had quite a long winter – and one that doesn’t seem to be letting up. Fittingly, it may actually be helpful for us to conserve our energy, slow down, and maintain a little extra protection from the elements in the current climate (even if that means putting on a few extra pandemic pounds).

Make It a Habit to Check In with Yourself

While some of the changes you may have experienced over the past year have been obvious, such as shifts in daily routines, social activities, and eating and sleeping patterns, other changes may be less visible. For example, you may have noticed becoming uncomfortable in crowds since lockdown and now prefer increased physical distance in public spaces. Or perhaps watching the news has made you more irritable or upset than before. Or, if you’re like me, it may take you longer these days to complete tasks (such as writing this blog post!). Checking in with your emotions, physical sensations, and comfort level in different situations over time may help you better identify your current needs and boundaries, as well as promote a sense of safety and security.

Be Gentle with Yourself and Those Around You

In times of stress, it’s common to become more self-critical and compare yourself to others (or to who you used to be). You may also become so focused on “getting back to normal” or increasing productivity that it becomes easy to dismiss the hardships you’ve undergone, as well as forget how you have changed. It may be beneficial – and kind – to remind yourself and your loved ones that we’re living in unprecedented and challenging times, and that it’s okay to adjust our expectations, boundaries, perspectives, and standards as new situations arise, as well as celebrate the small accomplishments we have made along the way. Frustration and anger may be contagious, but so are kindness and empathy, and we always have the choice to cut ourselves and others some slack.

Be Creative (And Spoiler: You Already Are!)

When Darwin talked about survival of the fittest, he wasn’t referring to physical strength; rather, he meant that those that can adapt the best to change are the ones that survive. Back in 2019, could you have even imagined what your current day-to-day life looks like? We’ve already had to exercise profound adaptability and imagination to get to where we are today, mostly out of necessity. Now that the current realities have had time to set in, we can tap into our creativity more intentionally. For instance, we can explore what has helped us recharge our emotional batteries – or at least what has helped us conserve what energy we have left in the tank! We can also consider all the innovative ways we have been able to keep in contact with those around us, or if we’ve been feeling more isolated, perhaps we can start planting seeds to reconnect, if that’s what we want. But for now, if we sense that languishing is a dominant state of being, we can approach it with curiosity and discover new ways to befriend it.

References

Grant, A. (2021, April 19). There’s a name for the blah you’re feeling: It’s called languishing. New York Times. https://www.nytimes.com/2021/04/19/well/mind/covid-mental-health-languishing.html

Keyes, C. L. M., Dhingra, S. S., & Simoes, E. J. (2010). Change in Level of Positive Mental Health as a Predictor of Future Risk of Mental Illness, American Journal of Public Health, 100(12), 2366-2371. https://doi.org/10.2105/AJPH.2010.192245

Leon, A. K. (2021, April 26). I’m not languishing, I’m dormant. https://austinkleon.com/2021/04/26/im-not-languishing-im-dormant/

Lessons from the COVID-19 Pandemic Series: Work-Life Balance, Going From Survival Back to Thriving

Written By: Angela J. Patino, Psy.D.

 

The future is unwritten, 2020 is history, and one way we can improve our present is by reflecting on the lessons learned thus far. The following PNBC blog series will focus on highlighting lessons learned from the pandemic, with an emphasis on mental health.

 

While we continue to recover from the whirlwind year of 2020, the increased vaccination rates have a provided our communities a pivotal moment in the pandemic. Of course, in no way is the pandemic quite over, yet, the aftershocks are still very present. However, many states have re-opened, schools are expected to resume in-person this fall, and the employment sector is in a hiring/rehiring spree. Some individuals never stopped working – hats off to all essential workers! Some are slowly getting back into the grind. While others are trying to figure out their return to work. Whichever position you find yourself in, IT IS OK. Remember the year we all just had?

 

One of the first crossroads that many individuals faced at the start of the pandemic was maintaining a work-life balance. Now, maintaining a work-life balance was already a tough task for most, even before the pandemic. Combining the promoted work culture of high productivity, eating meals on the go, long work hours, and answering emails after hours, is a recipe for disaster. For many, especially for parents of school-aged children, this balance continues to remain in “survival mode.” As we enter a different phase of the pandemic, a new normalcy is settling in, and this work-life balance needs to switch back to a “thriving mode” for the sake of our mental health. The following recommendations bring light to different aspects of our day-to-day work environment and interactions that can be used to help achieve a more aligned work-life balance and decrease burnout.

Time management

What are your working hours? Are you sticking to them or running over time more often than not? Do you take your meal break or eat on the go? It is important to give yourself enough time to complete your duties and set appropriate resting points. Prioritize tasks into urgent vs non-urgent. If you find yourself frequently having trouble meeting deadlines, this may be a sign that you are doing too much and there may be a need for delegation.

Assertive communication

In connection to the last point, if you have too much on your plate, speak up! Being assertive in the workplace is vital as it allows you to speak your mind, share your ideas, express your needs, and wants in an effective, respectful, and clear manner. Hostile work environments feed on passivity and aggression. Assertive communication is a great way to place boundaries, which brings us to the next point.

Place healthy boundaries

From your labor rights to professional etiquette, learn when to say no. Prioritize what is important to you. Is staying an extra hour worth missing out on _______? The same can be applied at home, do you feel overwhelmed with household chores, can some duties be delegated to a partner or roommate?

Let go of perfectionism

Do you have perfectionist tendencies? Perfectionism is difficult to achieve, and someone who takes pride in perfecting their craft, may have difficulty clocking out. This often leads to long work hours with limited personal time, a perfect combination for burnout. A great read for embracing imperfection is “The Gifts of Imperfection” by Brené Brown (link: https://brenebrown.com/thegifts-hub/#close-popup).

Make time for exercise

The documented benefits of exercise are exhaustive; no, really just do an engine search! A healthy body = clarity in mind = improved mood = better you. Prioritize your exercise as if your health depended on it.

Relaxation

What do you practice to promote relaxation? Yoga, meditation, music or just deep breathing exercises help us recharge and obtain mind clarity.

Sleep

Are you getting the recommended 7-8 hours of sleep? Or are you answering emails during your usual bedtime? Similar to exercise, sleep is crucial to our overall health.

Nurturing relationships outside of work

Positive social support is also important to our mental health. Research has shown that social support helps ward off the effects of stress on depression, anxiety, and other health problems; this is especially so for women and older adults (Cohen, 2004; Harandi et al., 2017). People found creative ways to maintain social contact during the pandemic, be it through a glass door, parking lot car-meal meet-ups, or videoconferencing calls. Human nature calls for human connection.

Time-off

This year brought unprecedented times in more ways than we can count. Even taking just one day off to unwind and detach from work can have positive effects on your mental health. It is important to realize when it is time to “take a break, before you break.”

Seek professional help

If you find yourself struggling to maintain a work-life balance, especially through the pandemic, you are not alone. None of us could have predicted the challenges that have come our way this year. Ensuring your mental health is being managed properly is important. If you think that talking to a mental health professional about your struggles may benefit you, PNBC is here to help.

 

The following hotlines also provide free and confidential emotional support 24 hours a day, 7 days a week:

National Suicide Prevention Lifeline: English 1-800-273-8255; Spanish 1-888-628-9454

San Diego Access and Crisis Line: 1-888-724-7240

 

References:

Cohen, S. (2004). Social relationships and health. American Psychologist, 674-84.

Harandi, T., Taghinasab, M., & Nayeri, T. (2017). The correlation of social support with mental health: A meta-analysis. Electronic physician, 9(9), 5212–5222. https://doi.org/10.19082/5212

Hart, S. (2020). The Differences Between America’s Working Culture and the Rest of the World. The National Digest. Retrieved from https://thenationaldigest.com/the-differences-between-americas-working-culture-and-the-rest-of-the-world/