Saturday, April 4, 2020

Guide to Social Distancing

We have been hearing a lot of talk about "social distancing" as a method to help prevent the spread of COVID-19.  I thought we might talk more about what that is, and how best to practice it, so that you can stay safe and healthy.

What is social distancing?
Social distancing is not the same thing as being quarantined or being in isolation.  All of these things are being used to minimize coronavirus spread.  Here is the basic difference between these safety measures. 

Guide to Social DistancingA quarantine or isolation restricts a person's movement within a certain area.  If you have been exposed to the coronavirus, or think you may have the virus, you should quarantine or isolate yourself.  This means that you should not leave your house during the two week quarantine period for any reason.  You should not be going out into any public spaces, and other people should not be coming into your home.

Social distancing does not limit your movement or your access to public spaces.  It is a behavioral practice to lower the risk in most circumstances.  It basically means putting distance between you and others around you, particularly when you are outside your home.  It is a fairly general term, and there are different types of practices that can fall into the category of social distancing.  Working from home is one way of practicing social distancing, but not everyone is able to work from home.  There are a number of things that you can do that fall into the category of social distancing.  Here are a few: 
  • Avoid unnecessary trips outside your home.  Leave home for work if necessary.  Go to the grocery store or pharmacy only when necessary and buy enough to avoid frequent trips.  Take advantage of any available option for buying groceries online for delivery or pick up.
  • If you must go to work, try to avoid in-person meetings.  Use email or the phone when possible.  If a meeting is unavoidable, it should be in a large room, where people can remain 3-6 feet away from each other.
  • Avoid gatherings of more than 5 people, or any gathering where close contact with others is likely.  This includes gatherings in open spaces.  Just because you are on a beach or in a park, does not mean that you are safe.  The virus spreads in open spaces if you are close to someone.
  • Try to keep a distance of at least 3 feet, and preferably 6 feet, between you and other people.  Avoid shaking hands or hugging people, even if they are friends.  Familiarity with someone provides no assurance that they do not have the coronavirus. 
  • Avoid public transportation when possible (walk, ride a bike, or take your own car instead).  If you do need to take public transportation, try to go early or late to avoid crowds.
  • Avoid crowded restaurants.  Do take out or delivery instead.
  • Avoid playdates for your children. 
As a compliment to social distancing measures, we should also focus on good infection control measures, which include the following:
  • Clean and sanitize frequently touched surfaces often
  • Wash your hands frequently and encourage children to do the same, or use hand sanitizer 
  • Avoid touching your face
  • Use a tissue to cover a sneeze or cough, then throw it in the trash
  • Do not go to work if you are sick
It can be hard to change some of these behaviors, but we all need to work together to stop the spread of coronavirus.  If we all work to stop the spread together, we can make an impact and save lives.  You may even save the life of someone you love.

If you have any questions about social distancing, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Saturday, March 28, 2020

Behavioral Health Tips to Adapt to COVID-19

With all of the news and changes surrounding COVID-19, anyone can feel overwhelmed and anxious. Adjusting to challenges of the new recommended restrictions related to COVID-19 can be stressful. We know that some stress helps to build a stronger immune system. Too much stress can lead to a weakened immune system, promote diseases, and disrupt your behavioral health. COVID-19 has all the major elements to make our alarm bells sound. Learning healthy ways to manage stress as soon as possible can help prevent long-term troubles. I would like to offer some strategies, based on research findings, that can help you build resilience while coping with the many lifestyle changes related to COVID-19. 
 Behavioral Health Tips to Adapt to COVID-19
Tips to Help Deal With the Stress of COVID-19

Keep a structured day. Staying close to your normal schedule can be helpful for you and everyone in your household. Not having structure often contributes to anxiety in children who have grown accustomed to a daily routine. Structure provides a sense of control. However, within your routine, you can be flexible with normal rules of your household. Decide ahead of time which rules you will continue to hold firm and which rules you will allow some flexibility.

Acknowledge feelings and emotions. Expect a wide range of emotions - including sadness and anger. These are part of adapting to the challenges we are all facing.

Create A Few New Routines. Enjoy family meals together, spend quality time together as a family, or learn a new game or activity. Start a new hobby that you have been putting off until you "had time" or re-engage a hobby you have neglected.

Engage in Physical Activity. If you normally go to the gym, take advantage of online/YouTube fitness classes in your own home. This can be done individually or as a fun family activity. If you are exercising outside, remember the CDC recommended guidelines about social distancing. Consider doing a virtual/video fitness with a friend. If you have not been physically active, this could be a great time to start. Consult with a physician for guidance before you start an exercise program.

Limit media time. Stay informed while avoiding getting saturated and overwhelmed with news through multiple venues (national/local news, Facebook, Instagram, Twitter, etc.). Research finds that social media can escalate anxiety more than traditional media. As more data is gathered about COVID-19, information changes rapidly. There is also mis-information about this virus, treatments, cures, and restrictions. Negotiate with family about the specific amount of time with social media. Social science evidence shows that too much media of any kind can increase stress and anxiety.

Help younger children feel secure. Ask younger children what concerns them, instead of providing information that may be confusing. Model healthy coping behaviors, good hand hygiene and other practices recommended by the CDC, including social distancing.

Embrace Individual Differences. Although we have similar physical reactions to stress and  anxiety, our psychological reactions can be very different. We all deal with anxiety in our own ways. We can use this opportunity to help those around us deal with COVID-19, and learn from others better ways to handle these uncertainties.

Reach out for behavioral health care. If you are struggling, reach out for behavioral health care. Resources for behavioral health are expanding with COVID-19. Please don’t hesitate to contact our medical team with any questions on when and how to seek reputable behavioral health care.

Allow house members social, psychological, and physical space.  Each morning agree to check in with each other throughout the day.

Enjoy sunshine and fresh air. When possible, spend time outside, while avoiding crowds. Sunshine has many benefits, including improving mood. Even 10-15 minutes of sunshine can be helpful. Use sunscreen and always practice extra steps for safety.

Rise to the occasion. Reach out (calls, letters, virtual visits) to loved ones who are homebound, isolated, or self-quarantined. Too much isolation can cause you to feel disconnected and ill-at-ease, which can lead to feelings of anxiety and depression. Rekindle neglected relationships. Evidence supports that a sense of belonging builds resiliency, especially during times of increased stress.

Fight boredom. Boredom can allow your thoughts to go into places that increase anxiety and a sense of loneliness. Boredom can also lead to habits or activities to avoid - overeating, excessive consumption of alcohol. Ahead of time, write a list of activities that you can do to combat boredom. Invite family members to create their own "go to lists" as well.

Give back. Find a meaningful way to support your community, such as dropping off canned goods at donation centers or donating blood. Studies show that giving to others boosts your physical and emotional well-being.

Take One Day At a Time.  In all of this uncertainty, you have an opportunity to flourish. Remind yourself that we are truly all in this together and will remain in this together until the COVID-19 crisis abates.


If you have any questions about behavioral health concerning COVID-19, please log into your account and send us your question. We are here to help.

Dr. Joseph A. Banken, PhD, Licensed Clinical Psychologist

Friday, March 20, 2020

Tips for Stress Management

I think most people are feeling a little stressed lately.  There are a few very practical things that you can do to stay calm when the world around you seems to be spinning out of control.
Here are some things that you can do to help you manage your stress.   

Breathe -
Tips for Stress ManagementControlled breathing can help to physiologically control your stress.  This is one part of your body over which you have significant control.  Take slow, even, deep breaths - 7 seconds in, hold for 1 second, then 7 seconds out.  Use your watch to time yourself.

Why does this work?  When you control your breathing at a slow pace, you actually slow the circulation of blood flowing through your lungs.  Slowing the circulation through your lungs will slow your overall circulation, leading to a slower heart rate.  Slowing your heart rate can help to make you feel more calm, and can help slow the racing thoughts in your brain.

Be Mindful -
When you have a lot going on, and your mind is thinking of all of the worst case scenarios, racing thoughts can take control and get away from you.  Make yourself stop and focus on being exactly where you are for just one or two minutes.  Do this by taking the time to notice:
  • 5 things that you can see
  • 4 things that you can feel
  • 3 things that you can hear
  • 2 things that you can smell
  • 1 thing that you can taste
You may not be able to notice all of these things, but the idea is to reach out with your senses and notice the things around you.  Maybe you will notice how intense the lights are in the room, or the pressure of your body in the chair, or maybe the sound of a bird outside your window.  Be right here, right now.  Avoid going backward or forward in your mind.  Just be in the moment, in the exact place that you are.
Find a Good Distraction -
You don't want to be distracted all of the time, but when things seem overwhelming, it can be helpful to distract yourself for a bit.  It can protect your brain, lower your blood pressure, and give you a chance to live outside of the stress for a little while.  Give yourself permission to have a time out.  Watch a funny TV show, or read an engrossing story, or maybe try Duolingo to learn a new language!
Try to Keep Things in Perspective -
As bad as things might feel right now, they are likely to get better with time.  Take the time to think about the things that are good right now.  For instance, maybe you are getting to spend more time with your family than usual. 
Things Over Which You Can Have Control, Take Control -
  • Try to get enough sleep.  This can definitely improve your stress level.
  • Try to eat regularly and in a healthy way.  Try to avoid emotional eating and avoid eating a lot of junk foods.  This can be hard as we all tend to crave junk foods when we are stressed!
  • Try to get some exercise on a daily basis.  Even if you are not able to do your usual exercise routine because you can't go to the gym, there are ways that you can exercise at home.  Maybe go for a walk a couple of times a day, even if it is just in your backyard, or around the inside of the house.  Do some jumping jacks or turn on some music and dance.  Maybe you could have a dance party with the kids, and you could all use up some energy!
  • Try to get some time outdoors every day if you can.  Even though you may be stuck at home, most of us can get outside without being exposed to others.  If you are not able to get outside, try to get curtains open in every room to get plenty of light in the house.  Sun exposure can improve your mood.  
  • Keep your living space clean; not just sanitized, but organized.  Organizing the space around you can give you a significant sense of control.
If you have any questions about managing stress, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor