February 19, 2021 • 12 mins
You're not alone if you're feeling down or anxious, nervous or restless because of the pandemic. Taken together, these symptoms and others are known as PTSE: Pandemic Trauma and Stress Experience. I share things you can do to boost your mood.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
These are challenging times, but you don't have to navigate
them alone. Welcome to How Can I Help? I'm Dr
Gail Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight and advice. The questions I'll be
answering today relate to growing new mental health problems as
a result of the pandemic. The psychological consequences of the
COVID nineteen pandemic on individuals, families, and communities are both
(00:47):
dramatic and also subtle. There's grief over what's been lost,
uncertainty about how to navigate daily pandemic life, and fears
for the future. The resulting experiences of depression, anxiety, sadness, loneliness,
relational conflicts, substance abuse, and violence increased daily, as do sadly,
(01:11):
the number of deaths. But there are also resilient experiences,
as some people and families are benefiting from more time together,
and some spend more time being creative and actually caring
for each other. The American Psychoanalytic Association's COVID nineteen advisory
team has started referring to this constellation of responses and
(01:33):
adaptations as pandemic trauma and stress experience or pt s E.
So this is different from PTSD and has something in
common with it as well. Unlike a symptom based diagnosable
mental illness or disorder, we're all accumulating some version of PTS.
(01:57):
This looks different in different people and in different situations.
The range of things you might see include a fear
for the future, weariness for the present, and grief for
a lost past. You might see increased frustration and despair,
increased withdrawal, isolation, and fear of others as a source
(02:19):
of infection. You might note a grinding weariness and decreased
attention to personal and public safety, a loss of focus
on specific tasks and also on general goals, increase mental mistakes.
Like you have a kind of fuzzy thinking, You might
(02:40):
note hyper vigilance to potential losses, thinking about it, worrying
about it. But you also might not realistic worries about
your finances, and disruptions of normal patterns of behavior. It's
not all negative. On the plus, side, Close or family
ties and reliance on friends has been an upside, and
(03:03):
increased altruism, including worrying about others and maybe even taking
care of them, has also been on the plus side.
Today's questions, while different from each other, reflect the numerous
challenges for all of us with PTS. So let's get
to it and see how can I help our first
(03:28):
question today, says dear Dr Saltz. Everyone has a different
COVID comfort level. Sometimes I avoid meeting certain people, even
in safe settings, because I don't feel comfortable about how
their lifestyles may have exposed them to the virus. How
do I have comfortable conversations with these people in ways
(03:50):
where I don't make them feel bad or like I'm
shaming them? Everyone has different levels of concern about getting
COVID because people have different ages, risk factors, living situations,
thoughts about the virus, and thoughts about their mental health
and social isolation. These lead to different equations about what's
(04:13):
safe and what's not. Then, in turn, we become deeply
invested in and even defensive of our stance about the
safety because the decisions feel like really big ones regarding
who to see and how to see them. And also
staying safe. Because you feel so invested in your view,
(04:35):
you may see someone choosing differently as wrong and even shameful.
When you feel it's shameful but don't want to offend them,
the tendency is to actually project that feeling and imagine
they will feel shamed even if you don't shame them,
or you may feel pressured to reassure them against the negativity,
(05:00):
either doing it their way or by convincing them to
do it your way. I would advise neither. You should
do what makes you feel safe for you and the
people you live with, but make room for others to
disagree about what that looks like. You can express your
desire to see them and wish to maintain close ties
(05:23):
with them, and at the same time tell them you
won't be able to do the in person indoor thing.
While the COVID numbers remain high. You don't need to
reflect on their lifestyle choices, and it's likely doing so
will not change anything they actually do. It may only
change what they will be honest with you about. They
(05:44):
get to make their own choices and you get to
make yours, including not seeing them in person indoor without
a mask. The tremendous pressure of this weird neo normal
makes us all feel more afraid and in turn more
judgmental of others. Just recognizing this allows you to do
you let them do them, and even if you talk
(06:09):
via phone or zoom and discuss other things, you can
still be us together. Seeing them outdoors more than six
ft apart in masks for all, is still a way
to safely meet up and not need to consider their
lifestyle exposure, so you can think about that as well.
(06:32):
How can I help with Dr Gail Salts? Will be
back after the short break? Question two? Hello Doctor Salts.
As the months passed, I find myself sleeping in later
and later to the point where my normal wake up
(06:55):
time seem impossible. My routine has been disrupted by the
pant emmic, so I simply don't have the motivation or
reason to get up. How do I create productivity when
I don't have structure? Work has blended in to consume
home life. There seems like there is no work break
(07:15):
because it's all the same work versus play at home.
Everyone working from home means that the work environment doesn't
feel like one. If kids need stuff and parents or
partners asked stuff which intrudes into your day. That seems okay,
It all seems the same. As you mentioned, not having
(07:36):
to get up at a certain time to commute means
why get up at all that early, and so all
these things erode the structure of the day. It's true
that lack of structure can negatively impact motivation, but so
can chronic anxiety, frustration, weariness, and isolation. So the real
(07:58):
question becomes, which of these many things is eroding your
motivation or is it some combination. Adding structure back is
actually the easier thing to do. Create a space in
your home that is your workspace. Don't work in your bed,
don't work while watching TV or while eating. Work only
(08:19):
at your designated workspace, and when you step away, don't work.
It's important to have non work times. It's really important
to have play and relax times in order to maintain
the actual work times. Set up a regular wake up time, shower,
and dress for the day as though you're going somewhere,
(08:41):
Eat breakfast, and then go to work. Go to your space,
and after five or six pm, when the workday is done,
no more work. Don't look at work email and don't
respond because then co workers and bosses will grow to
expect that actually you're off. By creating this structure, it's
(09:03):
easier to be motivated in the hours that you've designated
as on and to be refreshed from having hours that
you are off. But also consider the possibility your motivation
has been zapped by the emotional tumult of the times.
In this sense, treat yourself kindly, talk to others for support,
(09:24):
and take some vacation days from work to nurture yourself
in what is a difficult time for all. I hope
that was helpful. Generally speaking, when it comes to PTS E,
the American Psychololytic Association recommends a few things. Cultivate and
(09:45):
preserve generally positive experiences and relationships as much as you're able.
Identify your specific physical, emotional, and mental stressors that are
caused by the pandemic. Seek ways to mitig gate the
effects of individually specific stress. In other words, whatever is
(10:05):
specifically stressing you out, think about ways to specifically address
those things. Try to identify and then maximize sources of
individual and collective resilience. This means, basically, how can you
build more coping tools to manage the difficult feelings? That
you're having. That's what builds resilience. Seek help when it's needed,
(10:30):
and accept help when it's offered. This is a big deal,
and in fact, many even health professionals have not been
accepting help when it's offered. But we all need some
help now and we all can benefit from it. So
please reach out if you are feeling really badly, or
a telehealth appointment or an in person appointment if it's
(10:52):
allowed in your area, or even to an app but
do get help when needed. Be most mind full of
the following core areas that are central to emotional and
physical balance. They are medical, so taking care of yourself medically, physical,
thinking about how your physical body feels and how you
(11:13):
can relax it. The mental and psychological sphere as we've
been speaking about, and reaching out for help if you
need it. Spiritual something that can really be a big
support for many people is turning to their church or
temple or some form of spiritual engagement. And last, but
(11:33):
not least, community resilience. Are you in touch with your community,
Can you contribute and help with your community, and can
your community in turn help you finally take control over
whatever you can do for yourself and the community to
help end this pandemic, especially wear your mask and get
(11:55):
the vaccine when it becomes available to you. Do you
have a problem I can help with. If so, email
me at how Can I Help? At Seneca Women dot com.
All senders remain anonymous and listen every Friday too. How
can I help with me? Doctor Gale Salts
These are challenging times, but you don't have to navigate
them alone. Welcome to How Can I Help? I'm Dr
Gail Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight and advice. The questions I'll be
answering today relate to growing new mental health problems as
a result of the pandemic. The psychological consequences of the
COVID nineteen pandemic on individuals, families, and communities are both
(00:47):
dramatic and also subtle. There's grief over what's been lost,
uncertainty about how to navigate daily pandemic life, and fears
for the future. The resulting experiences of depression, anxiety, sadness, loneliness,
relational conflicts, substance abuse, and violence increased daily, as do sadly,
(01:11):
the number of deaths. But there are also resilient experiences,
as some people and families are benefiting from more time together,
and some spend more time being creative and actually caring
for each other. The American Psychoanalytic Association's COVID nineteen advisory
team has started referring to this constellation of responses and
(01:33):
adaptations as pandemic trauma and stress experience or pt s E.
So this is different from PTSD and has something in
common with it as well. Unlike a symptom based diagnosable
mental illness or disorder, we're all accumulating some version of PTS.
(01:57):
This looks different in different people and in different situations.
The range of things you might see include a fear
for the future, weariness for the present, and grief for
a lost past. You might see increased frustration and despair,
increased withdrawal, isolation, and fear of others as a source
(02:19):
of infection. You might note a grinding weariness and decreased
attention to personal and public safety, a loss of focus
on specific tasks and also on general goals, increase mental mistakes.
Like you have a kind of fuzzy thinking, You might
(02:40):
note hyper vigilance to potential losses, thinking about it, worrying
about it. But you also might not realistic worries about
your finances, and disruptions of normal patterns of behavior. It's
not all negative. On the plus, side, Close or family
ties and reliance on friends has been an upside, and
(03:03):
increased altruism, including worrying about others and maybe even taking
care of them, has also been on the plus side.
Today's questions, while different from each other, reflect the numerous
challenges for all of us with PTS. So let's get
to it and see how can I help our first
(03:28):
question today, says dear Dr Saltz. Everyone has a different
COVID comfort level. Sometimes I avoid meeting certain people, even
in safe settings, because I don't feel comfortable about how
their lifestyles may have exposed them to the virus. How
do I have comfortable conversations with these people in ways
(03:50):
where I don't make them feel bad or like I'm
shaming them? Everyone has different levels of concern about getting
COVID because people have different ages, risk factors, living situations,
thoughts about the virus, and thoughts about their mental health
and social isolation. These lead to different equations about what's
(04:13):
safe and what's not. Then, in turn, we become deeply
invested in and even defensive of our stance about the
safety because the decisions feel like really big ones regarding
who to see and how to see them. And also
staying safe. Because you feel so invested in your view,
(04:35):
you may see someone choosing differently as wrong and even shameful.
When you feel it's shameful but don't want to offend them,
the tendency is to actually project that feeling and imagine
they will feel shamed even if you don't shame them,
or you may feel pressured to reassure them against the negativity,
(05:00):
either doing it their way or by convincing them to
do it your way. I would advise neither. You should
do what makes you feel safe for you and the
people you live with, but make room for others to
disagree about what that looks like. You can express your
desire to see them and wish to maintain close ties
(05:23):
with them, and at the same time tell them you
won't be able to do the in person indoor thing.
While the COVID numbers remain high. You don't need to
reflect on their lifestyle choices, and it's likely doing so
will not change anything they actually do. It may only
change what they will be honest with you about. They
(05:44):
get to make their own choices and you get to
make yours, including not seeing them in person indoor without
a mask. The tremendous pressure of this weird neo normal
makes us all feel more afraid and in turn more
judgmental of others. Just recognizing this allows you to do
you let them do them, and even if you talk
(06:09):
via phone or zoom and discuss other things, you can
still be us together. Seeing them outdoors more than six
ft apart in masks for all, is still a way
to safely meet up and not need to consider their
lifestyle exposure, so you can think about that as well.
(06:32):
How can I help with Dr Gail Salts? Will be
back after the short break? Question two? Hello Doctor Salts.
As the months passed, I find myself sleeping in later
and later to the point where my normal wake up
(06:55):
time seem impossible. My routine has been disrupted by the
pant emmic, so I simply don't have the motivation or
reason to get up. How do I create productivity when
I don't have structure? Work has blended in to consume
home life. There seems like there is no work break
(07:15):
because it's all the same work versus play at home.
Everyone working from home means that the work environment doesn't
feel like one. If kids need stuff and parents or
partners asked stuff which intrudes into your day. That seems okay,
It all seems the same. As you mentioned, not having
(07:36):
to get up at a certain time to commute means
why get up at all that early, and so all
these things erode the structure of the day. It's true
that lack of structure can negatively impact motivation, but so
can chronic anxiety, frustration, weariness, and isolation. So the real
(07:58):
question becomes, which of these many things is eroding your
motivation or is it some combination. Adding structure back is
actually the easier thing to do. Create a space in
your home that is your workspace. Don't work in your bed,
don't work while watching TV or while eating. Work only
(08:19):
at your designated workspace, and when you step away, don't work.
It's important to have non work times. It's really important
to have play and relax times in order to maintain
the actual work times. Set up a regular wake up time, shower,
and dress for the day as though you're going somewhere,
(08:41):
Eat breakfast, and then go to work. Go to your space,
and after five or six pm, when the workday is done,
no more work. Don't look at work email and don't
respond because then co workers and bosses will grow to
expect that actually you're off. By creating this structure, it's
(09:03):
easier to be motivated in the hours that you've designated
as on and to be refreshed from having hours that
you are off. But also consider the possibility your motivation
has been zapped by the emotional tumult of the times.
In this sense, treat yourself kindly, talk to others for support,
(09:24):
and take some vacation days from work to nurture yourself
in what is a difficult time for all. I hope
that was helpful. Generally speaking, when it comes to PTS E,
the American Psychololytic Association recommends a few things. Cultivate and
(09:45):
preserve generally positive experiences and relationships as much as you're able.
Identify your specific physical, emotional, and mental stressors that are
caused by the pandemic. Seek ways to mitig gate the
effects of individually specific stress. In other words, whatever is
(10:05):
specifically stressing you out, think about ways to specifically address
those things. Try to identify and then maximize sources of
individual and collective resilience. This means, basically, how can you
build more coping tools to manage the difficult feelings? That
you're having. That's what builds resilience. Seek help when it's needed,
(10:30):
and accept help when it's offered. This is a big deal,
and in fact, many even health professionals have not been
accepting help when it's offered. But we all need some
help now and we all can benefit from it. So
please reach out if you are feeling really badly, or
a telehealth appointment or an in person appointment if it's
(10:52):
allowed in your area, or even to an app but
do get help when needed. Be most mind full of
the following core areas that are central to emotional and
physical balance. They are medical, so taking care of yourself medically, physical,
thinking about how your physical body feels and how you
(11:13):
can relax it. The mental and psychological sphere as we've
been speaking about, and reaching out for help if you
need it. Spiritual something that can really be a big
support for many people is turning to their church or
temple or some form of spiritual engagement. And last, but
(11:33):
not least, community resilience. Are you in touch with your community,
Can you contribute and help with your community, and can
your community in turn help you finally take control over
whatever you can do for yourself and the community to
help end this pandemic, especially wear your mask and get
(11:55):
the vaccine when it becomes available to you. Do you
have a problem I can help with. If so, email
me at how Can I Help? At Seneca Women dot com.
All senders remain anonymous and listen every Friday too. How
can I help with me? Doctor Gale Salts
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