Every May, Mental Health America observes Mental Health Month, and encourages organizations from across the United States to join their initiative. These usually involve in-person conferences and events, though unfortunately this year we cannot engage in fellowship to bring awareness to this concern. A stay and home order also alienates many of us from our primary strategies and habits that promote wellness—both physical and emotional!
With so much change in our lives, identifying and managing mental health concerns may go unnoticed. Brandy Haden, the HRCSB’s Behavioral Health Wellness and Learning Coordinator, was a guest on WSVA’s Early Morning show to talk about the impact isolation can have on our health, offer some advice on how to manage those concerns, and additional resources.
1. What is depression?
a. Depression is a mood disorder that is characterized by feelings of sadness and/or a loss of interest in activities once enjoyed. As a spectrum disorder, the impact of those symptoms can range from mild to severe.
2. What are the symptoms of depression – how do I know if how I’m feeling is depression?
a. Some things that may indicate depression would be low mood, changes in appetite and sleeping, loss of energy or increased fatigue, difficulty concentrating, slow movements, and in some cases thoughts of death and suicide.
3. What is the difference between depression and just feeling blue?
a. What’s tricky about mental health concerns is that the symptoms are often emotions that we’ve all experienced at one point or another. If those symptoms start having a negative impact on your ability to work, maintain safe satisfying relationships, and do daily activities—then what you’re experiencing could be a diagnosable concern.
4. I’ve never been depressed before. Why am I feeling like this now?
a. There are several factors that can play a role in depression, like biochemistry, genetics, personality, as well as environmental factors. The loneliness caused by isolation, the stress due to the nature of the pandemic, and the barriers disrupting health promoting routines can certainly contribute to the “why now”.
5. My (mother, spouse, child, etc.) is sad and crying all the time. How can I help?
a. People react to overwhelming emotions differently—and usually can tell you what they need. I recommend my “three part epoxy” approach to engaging in a conversation.
i. “I’ve noticed _____, ______, and _______.” Make a point to list specific impressions/behaviors you observed. This sets the stage for why you’re talking about things—and gives them less opportunity to deflect.
ii. “I’m concerned”. Expressing your concern through “I” statements will have the most impact, and is less likely to raise someone’s defenses.
iii. “Could we talk about it?” Talking about what feels bad can be really difficult, and they may be feeling defensive or like they’re in trouble—asking for permission to speak gives some of the power back in their court.
1. If they say not right now, we should honor that. Validate their emotions, and then ask if you can set a specific time later to talk—this will give you both an opportunity to prepare and not feel like the conversation when nowhere.
2. “I understand, this type of thing isn’t easy to talk about. Do you think you’d be able to talk later tonight?”
iv. Once they agree, it might be hard to start into the conversation—here are some helpful guiding questions:
1. How long have you been feeling this way?
2. What happened around the time this started?
3. Have you ever felt this way before?
4. Have you ever spoken about this with anyone else?
5. How have you been coping with this?
6. Why can’t they just pull themselves out of it and deal with this like everyone else has to?
a. Environmental factors are only a portion of the risk facts that can contribute to a mental health concern—but no matter the cause once things have moved into the diagnosable realm, it’s no longer a matter of willing yourself out of it. There are mechanisms with in the brain that aren’t function at their best—it could take medication and specific behavioral based therapy to re-program the brain to fire in a way that promotes wellness.
7. Are they just being dramatic and over reacting?
a. What can happen is that people, when they fear they won’t be heard or taken seriously, will begin to explain their symptoms in a way that is a bit off putting. It’s likely that no, they’re not just being dramatic for drama’s sake—they’re trying to ask for help in the only way they know how.
8. When do I know if I (or my loved one) need help?
a. First, I’d say try incorporating some new (or rediscovering old!) coping strategies into your daily routine. If you don’t find your or their mood lightens, and the symptoms are still negatively impacting those three areas (work, relationship, & daily activities), then it may be time to contact a professional.
9. What if my loved one is threatening suicide?
a. That is such a scary place to be in—because it’s everyone’s first reaction when someone discloses their suicidal thoughts or behaviors, to feel responsible for keeping them safe. Always take them seriously—and try to collaborate with the goal of keeping them safe. Here’s an example that may help you come to a mutual decision:
i. “Thank you for telling me that—I know that must have been hard to say. So, you’re having thoughts of suicide, which must be really overwhelming. I want to keep you safe, would you like to talk to the HRCSB’s Emergency Services, go to the emergency room, or call 911?” Again, validate the emotion and how difficult this is to talk about, use an I statement to clarify your intentions, and then give options to put power back into their court. Here are some additional resources:
1. Suicide Prevention Lifeline:
a. Hotline: 1 (800) 273-8225
b. Text line: text HOME to 741741
c. Chat line: https://suicidepreventionlifeline.org/chat/
2. Sentara RMH Psychiatric Emergency Team:
a. (540) 689-1000; Ask that the PET be paged
3. Harrisonburg-Rockingham CSB 24/7 Emergency Services:
a. (540) 434-1766
ii. Please, do not leave an actively suicidal person alone. If they do not want to utilize services, you can call on their behalf. When calling 911, you can ask for a CIT officer to attend the scene—CIT stands for Crisis Intervention Trained. Both Harrisonburg City and Rockingham County have officers that have attended this 40 hour training.
10. How can I feel better or help my loved one feel better?
a. One of the areas in our life hardest hit by social distancing are daily routines, and opportunities for fellowship and connection with others. A good place to start is thinking about your morning and evening routine! What are 4-7 things can you do every morning after waking up, and in the evening right before bed? With so much change happening every day, knowing there are at least 20 minutes of everyday that you can predict and count on really helps our unconscious brain de-stress. We crave routine!
b. When we are impacted by loneliness, many of our first instincts is to find distraction. Instead, turn the TV or radio off and call a friend or family member, or journal! If you’ve never tried a journal before, try it for a couple days—it may surprise you how helpful it is to get those sticky thoughts out of your head and down on to paper.
11. What suggestions do you have for dealing with the feelings that come with being socially isolated and unable to visit with family and friends?
a. First and for most, I’d say acknowledge them. That is a normal human reaction, to a completely abnormal and distressing situation! If you try to bury or distract from those emotions, that can make the situation worse. Once you recognize that you’re not at your best, it’s easier to be patient with others too—because it’s very likely they’re not at their best either. Try to schedule times for interaction over the phone, or at a distance in your neighborhoods. Some other creative ways to interact safely would be leaving chalk messages outside their homes, placing (and Lysol-ing!) small gifts or notes in their mailbox, driving by with posters or messages written on your car. We’ve also seen people write supportive messages on their fences or put posters in their yard—which always puts a smile on my face.
12. How do I avoid negative coping strategies?
a. Negative coping strategies are activities that, while they work in distracting or lessening overwhelming emotions, create the possibility of fostering other negative health risk. Be very caution with activities that either over stimulate (like constantly reading or watching the news, over/under eating, online shopping, and binging on television shows and movies), and activities that under stimulate (using substances to numb emotions, over sleeping, and ignoring daily activities)—these can lead to the development of habits and consequences that will last long after social distancing.
13. What are positive coping strategies?
a. Positive coping strategies are habits and activities that help you stay present in your body (with all the hard emotions), in the present moment, and help turn the dial down on the intensity of those emotions. Things like a consistent routine, daily movement, time outside in nature, prayer or meditation, and hobbies like gardening are all healthful habits that contribute to overall wellness.
14. What role does technology play in helping you to stay connected?
a. What most people are missing now is face-to-face time family and friends. Speaking over the phone or writing letters is a great way to stay in contact, but there is so much nuance lost in relationships without body language. If possible, use programs (like FaceTime, Zoom, or House Party) that allow you to stream your face, and see others! While phone calls are great for staying up to date, what we’re all really missing right now is the connection that comes from whole communication.
15. How do we socialize at a distance?
a. While there is a learning curve to programs that allow you to video chat, technology is really one of our greatest resources when it comes to distant socializing. You can look up tutorials online to show you how to download and set them up for free—on your phone or computer. It may be challenging, but the reward of seeing your friends’ and love ones’ face is truly special.
You can find the full interview here: https://wsvaonline.com/podcasts/wsva-early-mornings-4-27-20-issues-in-aging-presented-by-vpas/.
If you — or someone you know — needs help, please call 1.800.273.8255 for the National Suicide Prevention Lifeline.
For the HRCSB’s 24-hours Emergency Services, please call 540.434.1766.
M.Ed., Behavioral Health and Wellness Coordinator
Harrisonburg-Rockingham Community Services Board