“Now is a time where we need to speak and be honest about how we are handling everything,” said Dr Fried. “If the anxiety, irritability, and catastrophizing is owning too much of your physical and emotional world, you may consider speaking to a psychiatrist and take some medication,” he added. There is a lot of stigma and shame around mental illness in the US still, and now may be a good time to remove the stigma. Reach out to a mental health provider or hotline (and recommend your patients do the same) if you feel like you are at a breaking point. We process trauma and emotions very differently and having an impartial ear can help if you are still unsure how to handle the negative thoughts and feelings. Tables 1 and 2 includes resources for the general population and health care providers, respectively. Some recommendations from the Centers for Disease Control and Prevention are available in Table 3.14
Important Last Words for Anyone Who Is Alone Right Now
Reach out to people, even if it makes you tired. I personally know how exhausting it can be to constantly be on Zoom calls, text message chains, and social media. However, it is really important we remind ourselves that we have a support system and family who love us, even though we may be living or isolating alone.
Dr Fried recommends people with introverted tendencies to be aggressive with seeking contact and through whatever means possible. In addition to video and phone calls, you can join chat groups, send emails, or write letters. He also suggests volunteering to listen to people who are struggling right now, talking to medical students and residents, or participating on local health boards in the community. “Even if it does not feel ‘right,’ reach out to people,” he emphasized. In addition, Dr Fried recommends finding a hobby or something engaging where you have a concrete thing to show at the end of the day, such as a puzzle or reading a book. Maintaining a healthy diet and staying physically active by following an exercise routine is also critical.
For those of you whose gut response is “I am not that kind of person,” Dr Fried says:
“I am not the kind of person” is a statement about what was up until this minute. I can be any kind of person I want to be. We are all novels and in a state of evolution in our lives and every day is an opportunity to start new, either chapter 13 or 313. In chapter 313, I became the kind of person who does spend time online, I became the kind of person who does volunteer. So, I am not the kind of person is a cop out and a hiding place. And, just because you don’t feel like you can, you can.
The coronavirus pandemic has turned the entire world upside down. “The only differences between this pandemic and the rest of the fears in life is how quickly it came, how intense it seems, and how much we have been affected by our day to day normalcy,” said Dr Fried.
We are once again in the midst of change, and there is no way to predict the future. A lot has happened since the beginning of 2020, and the year is only halfway over. I hope this article at least gave you steps for how to shift away from anxiety-inducing thoughts, as well as some useful resources for yourself, your family, and your patients.
One last thing: we often forget as a society, especially in the sciences, about the importance of language in how we understand the world. Language not only names what we see but also shapes how we see it. Use opportunities when talking about the state of the world to mention at least one positive thing that has happened, take time to write down one positive or even neutral thing that you did during the day, focus on affirmative statements, and be conscious of how you talk to yourself, your family (especially children), and your patients, because the words you use matter now more than ever.
Ms Weiss is associate editor of The Dermatologist.
Dr Fried is a board-certified dermatologist and clinical psychologist in private practice in Yardley, PA.
1. Morgantini LA, Naha U, Wang H, et al. Factors contributing to healthcare professional burnout during the COVID-19 pandemic: A rapid turnaround global survey [published ahead of print May 22, 2020]. medRxiv. doi:10.1101/2020.05.17.20101915
2. Wan W. The coronavirus pandemic is pushing America into a mental health crisis. Washington Post. May 4, 2020. Accessed June 10, 2020. https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/
3. Hollyfield A. Suicides on the rise amid stay-at-home order, Bay Area medical professionals say. ABC 7 News. May 21, 2020. Accessed June 10, 2020. https://abc7news.com/suicide-covid-19-coronavirus-rates-during-pandemic-death-by/6201962/
4. Reger MA, Stanley IH, Joiner TE. Suicide mortality and coronavirus disease 2019—a perfect storm? JAMA Psychiatry. Published online April 10, 2020. doi:10.1001/jamapsychiatry.2020.1060
5. Restauri N, Sheridan AD. Burnout and posttraumatic stress disorder in the coronavirus disease 2019 (COVID-19) pandemic: intersection, impact, and interventions. J Am Coll Radiol. Published online May 27, 2020. doi:10.1016/j.jacr.2020.05.021
6. High proportion of healthcare workers with COVID-19 in Italy is a stark warning to the world: protecting nurses and their colleagues must be the number one priority. International Council of Nurses. March 20, 2020. Accessed June 10, 2020. https://www.icn.ch/news/high-proportion-healthcare-workers-covid-19-italy-stark-warning-world-protecting-nurses-and
7. Zheng L, Wang X, Zhou C, et al. Analysis of the infection status of the health care workers in Wuhan during the COVID-19 outbreak: a cross-sectional study. Clin Infect Dis. Published online May 15, 2020. doi:10.1093/cid/ciaa588
8. Nguyen LH, Drew DA, Joshi AD, et al. Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study. medRxiv. 2020;2020.04.29.20084111. Preprint posted online May 25, 2020. doi:10.1101/2020.04.29.20084111
9. Centers for Disease Control and Prevention. Characteristics of health care personnel with COVID-19 - United States, February 12-April 9, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):477-481. doi:10.15585/mmwr.mm6915e6
10. Cave D. New Zealand lifts lockdown as it declares virus eliminated, for now. New York Times.June 8, 2020. Accessed June 10, 2020. https://www.nytimes.com/2020/06/08/world/australia/new-zealand-coronavirus-ardern.html
11. Flaxman S, Mishra S, Gandy A, et al. Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe. Nature. Published online June 8, 2020. doi:10.1038/s41586-020-2405-7
12. Hsiang S, Allen D, Annan-Phan S, et al. The effect of large-scale anti-contagion policies on the COVID-19 pandemic. Nature. Published online June 8, 2020. doi:10.1038/s41586-020-2404-8
13. COVID-19 dashboard by the Cneter for Systems Science and Engineering at Johns Hopkins University. Johns Hopkins University. Updated June 15, 2020. Accessed June 15, 2020. https://coronavirus.jhu.edu/map.html
14. Coping with Stress. Centers for Disease Control and Prevention. Updated April 30, 2020. Accessed June 10, 2020. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html