Caring for Yourself in Times of Fear and Illness

This week has been a stressful one for many people.  The combination of the coronavirus, the stock market, the grey skies and rain, school and college closures, and the world news each day has been very hard.  But . . . in all of this, did you catch any of the good news?  It’s a bit hard to find, I learned, as I went to locate some for you to try to balance the week.  I did finally find a couple of pieces: 

            The La La Land Kindness Café in Dallas has hired 9 foster kids who aged out of the foster care system and were having trouble locating jobs.

            How about the House and the President agreeing, within just a couple of days, to relief legislation for victims of the coronavirus? 

            The Dow started a rebound today – that’s very good news for most!

            All of the fast action employers and schools/universities are taking to protect their employees and students – it seems unprecedented to me, although it may not be.  From Amazon in Washington to ASU to Ford to many others many are limiting exposure by providing employees with laptops and having them work and study virtually.  

All of these are truly ideas that are very positive news – and get covered in the anxiety so many are feeling, and the care for family that is often at the root of this.  Just tonight I learned one of my sisters-in-law may have been exposed to it, and her father likely has it.  Yet of the 16 members of my family nearby, she is the only one, which is good news thus far. (Edit 3/15/20: Good news! Her father’s test results reflected negative results.) See how we can flip it?  In psychology it’s called reframing the bad or difficult situations by looking at life a bit differently, without denying the hard does exist as well.

We sent out notices about Covid-19 procedures for our office this week.  Now it’s time to also offer some concrete help along with the above reframe tool.  The American Psychological Association and the National Association for the Mentally Ill are the two sources I’m using for the ideas that follow.  I wanted you to have some resources to print or click for the coming weeks.  What I know from 911 and other events is that when we are faced with being bombarded on social media and news media with information that is difficult, we tend to seek out more information and stay focused on the difficult situation.  This merely drives fear and anxiety up further.  We do need to know what we can do to try to protect ourselves; but once we know, i.e.:  wash hands to count of 20, do not shake hands and stay a further distance from others, and isolating someone with clear symptoms including fever, cough, and shortness of breath, we need to also look at how we care for our family and selves in a way that minimizes the fear and focuses on good things in life.  And, in the situation we have right now, we also need to know how we can cope with isolation whether from working at home, not going out for social events, not being able to travel to family or friends on trips we have had to cancel, or other reasons.  And we must have a method to deal with the uncertainty, fear, loneliness, depression, resentment, and challenges we face trying to secure things we may need.  So, here goes!

  1.  Make sure you have some games to play that are age appropriate for you and your family, and especially if you have children.  If isolated, the family will need ways to entertain themselves, laugh, enjoy each other’s company, and get through the days together.  We know that closeness breeds irritation, so have some things that can break up the days and draw you together, not apart.
  2. Have a plan with your doctor.  My physician sent out a text announcement to all of his patients tonight just letting us know he’s there, where to go for trustworthy medical information on the virus, and what to do if we are having symptoms.  Reach out to your pediatrician, cardiologist, pulmonologist, or primary care to know ahead what to do and how their office is managing this.
  3. Use the tools that help your mental health on a regular basis.  So…do:
  4. Keep up your physical activity – there are some great YouTubes on how to do yoga, walk along with you to keep your steps up (I like Leslie Sansome’s https://www.youtube.com/watch?v=m9yI2LGZRE0), and many others depending on what you prefer to do.
  5. Make sure you have enough medication or supplements like Rescue Remedy, Vitamin C and B, and other things around to keep you feeling better and less anxious. 
  6. Stay on a schedule.  We can get very loosey-goosey when at home too long or too much.  So make sure you keep an agenda to normalize your life and not fall into the doldrums too much.
  7. Make sure you can connect with Messenger, FaceTime, and the others available.  It helps for you to actually see friends, not just text.  We’re learning that the more texting that is done, the lonelier people are becoming.  So, in this time of increased stress – reach out even more and if you can’t touch one another, at least see one another.  I know someone who was separated from a loved one for quite some time, and they would watch a favorite show while connected on Facetime.  Another dad who was away who would play checkers with his children.  Get creative in your connection!
  8. I know you get tired of it – but remember to breathe when anxious.  Or start a mindfulness app during this time.  The website has a number of these on the Links page, and this is a great time to learn to do it and practice.
  9. Listen to music that uplifts you – for me that might be one thing – but what is it for you?  Listen!  Music does a lot to impact our moods.
  10.  Keep some numbers available if you need to reach out to a warm line, i.e.:  you’re not suicidal but you are feeling isolated and need to connect.  See SAMSHA’s line for disasters at 1-800-985-5990 or locally at 602-347-1100.  And remember AA, Al-Anon, and many other groups have online and phone meetings.  Take care of your sobriety as well! 
  11.  Pay attention to your spiritual practices.  I love labyrinths and downloaded the Mount Mojo Labyrinth Journey app to my cell phone quite some time ago.  I can walk it by finger on the phone even if I have only 5 minutes and can’t get to one locally.  Or, call a friend to pray.  Watch a Joel O’Steen, Beth Moore, or even your own pastor or rabbi may have something online to watch or even just listen to. 
  12. Humor, humor, humor!  You have to laugh!  I go to Bob Newhart videos, Carol Burnett, or Tim Conway as well as Friends and Frazier.  My mom loved SpongeBob Square Pants (I did not ever figure that one out!)  How about funny movies often free on Amazon Prime, Netflix, and other places you may have membership. 

All of these are tools – now you just need to use them.  As I said in my letter to current clients, I’m here and I am available.  Feel free to call and schedule an in-person or video therapy session.  The teletherapy appointment is on an encrypted service that meets HIPAA standards, we don’t use FaceTime or other things that might seem easier – but don’t offer the privacy.  So, if you can’t come – we’ll walk you through how to set it up. 

May you find these ideas helpful – and know there is a hand to reach out to.  And keep reaching out to friends as well.  Do you have other ideas?  Let us know and we can share those on our Facebook page. The disasters end.  The illnesses come to an end in such large proportions.  The blue skies come out again.  Something my mama told me growing up is that “it’s always darkest before the dawn”.  Obvious, right?  But it kind of normalizes problems and difficult times.  And reassures us – that “Joy will come in the morning!” (Psalms 30:5).  And so it will!

Take good care of yourself!

Dr. Beth

Yoga and Your Brain

Yoga. It can feel like an intimidating word for the uninitiated, can’t it? Visions of perfectly chiseled bodies in spandex holding positions that look impossibly difficult. But yoga is so much more than that. I’ll leave it to the countless experts who explain that the physical movements of yoga are only a tiny part of the whole practice (google will lead you to lots of resources if you’re interested). But the physical piece which ties into the mental component and so many other benefits is a great way to move forward and “deepen” your healing.

After an accident or an acquired brain injury the sheer volume of appointments of follow up care can feel like a full-time job. But yoga is a practice that can be added at any time in the recovery process and shows great promise at helping those who have sustained a brain injury with balance, balance confidence, range of motion, pain control, strength and mobility. Studies have shown the practice to improve balance by 36%, balance confidence by 39%, lower extremity strength by 100%, and endurance by 105%. Those statistics speak volumes for the benefits of such a gentle exercise and practice. In addition, it can be helpful to so many who suffer from anxiety related to post-traumatic stress disorder after an injury or even a car accident without injuries. One study done at two centers involving a Canadian location and Brigham and Women’s Hospital in conjunction with Harvard University found a 10% reduction in PTSD anxiety symptoms following only an 8-session program of Kundalini Yoga.  Another study through Boston University and the Trauma Center found significant reduction in PTSD symptoms after 5 weeks of yoga, and individuals held an improvement for at least another 5 weeks.  So, it seems that we should be thinking about yoga much more frequently in the field of PTSD and brain injury!

There are studios throughout the country which offer yoga classes geared toward those with brain injury through the Love Your Brain Foundation and rehab centers. You can find some resources online at https://www.loveyourbrain.com/yoga though if you do a search right now you’ll find that in AZ, classes are not yet available (check back soon as a provider training is happening in April and is already full—so we should see some offerings coming!) The other place to check is the outpatient rehabilitation program through your local TBI hospital. In the Phoenix area, Barrow has some yoga classes with details found here. Although they have no specific yoga offerings at this time, Ability 360 is also a great resource for those with brain injuries and changes. A recent search of google for trauma and yoga in Phoenix brought up several studios with classes specifically for traumatic stress or PTSD. So, there appear to be some options, but take caution with these studios, doing homework to ensure their credentials are what you’re looking for and are the best choice for you.

These in-person classes are a great resource and whenever possible, I do recommend that people attend with an instructor present. That hands on advice and adjustment to a position can be very beneficial, but if it can be intimidating to try something new, can’t it? A big barrier to entry for an untried activity is the lack of understanding what the cultural norms are, what’s to be expected, and not wanting to look foolish doing something for the first time. Rest assured, the classes that are geared towards beginners, and specifically for those with brain injury, are not going to include the difficult poses that you see highlighted in yoga articles or images. Everyone in the class will enter with about the same level of expertise, that’s why there are classes for a variety of different audiences. Also, there are modifications that can be made to make this gentle stretching available to anyone, in any condition. If you’d like to see what a class may include, or would like to try something at home without an audience, there are some videos of classes for brain injury you can try at your own risk (check with your physician first to be sure you’re ready for these). Love Your Brain says it best, and I agree with their statement, “I cannot assume responsibility for any exercise and/or subsequent injury you may incur, “Yoga is for everyone. However, when online, it is up to you to assess whether you are ready for the class you have chosen. The techniques and suggestions presented here are not intended to substitute for medical advice. LoveYourBrain assumes no responsibility for injuries experienced while practicing these techniques.” And we cannot assume any responsibility for injuries experienced either through their program or others. That’s why it’s best to check with your doctor or physical therapist first. Classes online are an option for you to try if you cannot find anything available near you and once cleared by your medical health provider. Take a look at https://www.loveyourbrain.com/yoga-videos for some classes geared toward healing from a brain injury.

As we move through 2020 and we continue to explore our word for the year, deepening, I hope you’ll give some of the ideas I propose a try or use these suggestions to look for ways to incorporate new ideas into your life. I will be offering a workshop for you and your partner or spouse in April that will discuss the changes brain injury has on your work and home life. For more information, click here, and together let’s incorporate strategies to help you heal to be the very best you can be.