I am a doctor. It’s not just what I do; it’s who I am. I think about health and the human lifecycle through the day and into my dreams. I constantly observe my own experience and listen to those of others, mining for more understanding about what it means to be human and to support health in all of its forms.
Right now, COVID-19 is all I can think about, as this experience is deeply relatable, invasive on all planes of our social conscious and functioning, and globally omnipresent.
And this crisis impacts and connects us all.
Millions have become unemployed as a result of the epidemic, and I am now counted among them. Though all logic flies in the face of a doctor being put out of work during a pandemic, I’m among a group of primary care doctors who are also experiencing the economic sequelae of this crisis.
I continue to volunteer, but like so many others, I am facing the precariousness of the unknown, starting anew in this collectively anxious climate. Transition and uncertainly rub on the psyche like nothing else. Gabor Maté documents in his In the Realm of Hungry Ghosts, “The research literature has identified three factors that universally lead to stress for human beings: uncertainty, lack of information, and loss of control. To these we may add conflict that the organism is unable to handle and isolation from emotionally supportive relationships.”
We each encounter grief and confusion in our own ways, as we face widespread illness and death, joblessness or the fear of it, loss of normalcy, and an unclear trajectory ahead. Our world is in for much of this to come, and now is the time to address the health of our bodies and minds, to embrace prevention, and to utilize this collective experience for the good that is there.
Let’s start small…
Hopefully by now we’ve all perfected the art of hand washing (check out https://washyourlyrics.com/ to generate infographics based on your favorite lyrics).
And please do wash your hands for 20 seconds each time; the significance of this simple, preventive measure cannot be overstated.
And please stay home, recognizing that this sacrifice gives grandly to the prevention of more cases, deaths, and weight on our frontline providers.
Let’s go deeper…
Breathe in. Breathe out. Identify how you are feeling.
Identifying and allowing ourselves to feel—as opposed to suppressing, projecting, or shaming and blaming ourselves or others—can be very impactful. We all need more compassion, for ourselves and others. It is normal to have feelings about a life-altering crisis, and these may shift throughout the day. Such prolonged uncertainty and unprecedented change can incite stress and grief that takes on many forms. For some, this may trigger familiar attachment trauma, which typically originates from earlier experiences and may manifest as feelings of insecurity, relationship conflict, or mental rumination.
By identifying and allowing compassion for our underlying feelings, we may better understand ourselves and give greater space for feelings to evolve. We may then be able to recognize our needs, such as to have a break, to ask for help, or to do something fun. Identifying feeling can also connect us to the more creative parts of ourselves, highlighting what is important to us or what we may dream of doing next. Feeling in these ways is useful information.
Identifying feeling can be challenging for some; it is indeed a skill that many are not taught or are outright discouraged from learning. This can also be challenging to do alone. In these cases, it makes sense to get help from a professional counselor or other mental health specialist.
Which brings me to my next point…
Continue to address mental health.
We can meet our current needs and prevent future crises by not forgetting what is foundational to health, not least our mental wellness. Addressing mental health is essential for all people. This is especially the case for those individuals who have depression, anxiety, or other mental health disorders that pre-date or develop from the pandemic. Stress and uncertainty, compounded by the grief of loss and change, may predispose the vulnerable to more vulnerability.
Just as we are physical distancing in order to prevent the spread of COVID-19, we must also take preventative measures to address the spread of stress and mental disease associated with this time.
This may mean starting a therapeutic relationship or upping your frequency of sessions with a counselor. This may mean communicating with other healthcare providers (i.e. via Telehealth) about a plan to address symptoms, ideally before they arise. This hopefully means connecting with others, whether the other is a family member, a friend, a pet, or a professional.
For those who are more vulnerable: please communicate with those around you about fears you may have and how you may need support if depression or anxiety worsens. Unfortunately for some this may mean considering in advance what you’ll do if you are experiencing suicidal ideation. It is a good idea to have a proactive safety plan in place, which includes having go-to hotlines and other resources should you need them:
U.S. National Suicide Prevention Lifeline: 1-800-273-8255
U.K. Suicide Hotline: 1850 60 90 91 (email helpline: [email protected])
For healthcare providers on the frontline, recognizing signs of burnout, which at this time are unfortunately all but inevitable, can be vital in the treatment and/or prevention of associated mental health crisis.
And for all people…
A reminder that all things foundational matter.
Good sleep, healthy nutrition, physical movement, stress reduction (meditation, breathing exercises, etc.), connection with loved ones (including pets, plants, and virtual connections), and other foundational determinants of health will make a difference. If smoking or other addictive substances that may compromise health are part of your stress patterning, you may benefit from guidance to address this.
If a health crisis makes anything evident, it is that we rely on health to keep a system working. This is an opportune time to consider how you engage with your health. If you need support, form an alliance with a friend, consider fostering or adopting a pet, or connect with a healthcare provider trained in lifestyle and preventative medicine, such as a naturopathic or integrative doctor.
And don’t forget to…
Appreciate what is going well.
As we all manage our way through one of the most difficult times in our history, appreciating the good can also help to move us forward. By recognizing the freedoms we’ve enjoyed, which become more evident if lost, we may also find what we still have.
Appreciate your health, home, and loved ones, if you are so fortunate to have them.
Appreciate having a body, a breath, an immune system.
Appreciate the cleaner air, time to reflect, and food.
Appreciate the call for positive change that this crisis demands.
Appreciate that your actions, great and small, matter.
Appreciate your unique skills and how these can help you to be resourceful, resilient, and giving.
Appreciate the courage and sacrifice made by those who put their lives at risk for all of us.
Just as we are moving through transition individually, many of us divided, so can we be united.
About the Author
Dr. Ana Ruediger practices in Santa Monica, California, focused on providing individualized interventions for her patients (http://anaruediger.com/). She earned her medical and counseling psychology degrees at Bastyr University in Seattle, Washington. In addition to her primary care residency training, she has specialized training in integrative addiction and mind-body medicine. She completed an internship in a dual-diagnosis inpatient treatment facility for patients in addiction and mental health disorders recovery. Dr. Ruediger leads with the philosophy that all people can benefit from being heard, and an individualized, whole-person approach can empower patients to make changes to achieve optimal well-being.
