August 31, 2021 – Looking for Light in an Unbelievable Time
When I sat down to write this post, one of the phrases I started with but didn’t necessarily plan to keep was “family physicians are stressed beyond belief.” I thought those last two words, “beyond belief,” might sound exaggerated or dramatic.
Now I think that’s exactly where we are: beyond belief.
I can’t believe this country has logged 38.4 million cases of COVID-19. I can’t believe this virus has killed more than 630,000 Americans. I can’t believe that, a season past when there seemed to be light at the end of the tunnel for our strained practices and our colleagues and our families and our patients, the delta variant and the politicization of prevention and vaccination have for now eclipsed our hopes.
I can’t believe that, in the very same week the FDA announced its full approval of the Pfizer-BioNTech COVID-19 vaccine for all patients 16 and older, the United States just repeated a cruel milestone: We’re back up to 100,000 hospitalizations for the first time since the start of 2021.
Honestly, it’s not just stressful. It’s exhausting.
It’s exhausting to see how many Americans don’t believe the evidence-based science of the COVID-19 vaccines, even when they’re hearing it patiently but urgently explained by their family physicians. It’s exhausting to see how many people have steered themselves toward misinformation or demagoguery about masks, endangering themselves and their families and imperiling their communities. And it’s incomprehensible — it’s devastating — to know how many people who could have prevented their infections or lessened the impact of the illness have gone from beyond believing us to beyond rescue.
All of these elements are taxing the capacity of the health care system — including us — beyond its limits. Again.
5 Podcasts to Reset Your Mind
It is safe to say that 2020 has taken a significant toll on our mental and emotional health. The ongoing pandemic, social upheavel, mass unemployment and a heated presidential election created a constant feeling of uncertainty and anxiety as we navigated this year. You, our family physicians, have faced an especially challenging year as frontline workers seeing first-hand the impacts of COVID-19.
Prioritizing mental health as we enter the winter months has always been key, but with the continuing pandemic as an added stressor, checking in on your mental health will be even more necessary.
To help with this, we've compiled a list of five, must-listen podcasts to help reset your state of mind going into the new year.
Mental Health During the Pandemic (by Jonathan Temte, MD/PhD)
It’s happened to me three times so far. I get a text message from the US Census Bureau requesting, “Please answer survey on COVID19 crisis.” Although my mind initially said, “scam,” I connected using the hot link to find that there is an ongoing assessment of the American population. Among the questions related to employment, changes in income, health care utilization, and food security, I immediately recognized four from the PHQ-2 and GAD-2; these are validated screening instruments for depression and anxiety, respectively, in primary care.
Upon tracking down the Census results, I found that almost 30% of responding adults reported feeling anxious or nervous and 23% reported not being able to stop or control worrying more than half the days or nearly every day in the preceding week. Moreover, 19% reported feeling down and 21% reported having little interest or pleasure in doing things more than half the days or nearly every day during the previous week. Anxiety and depression are following in COVID-19’s wake.
A recent research letter compares the rates of serious psychological distress in early April 2020, using data from a reliable survey platform representing the US adult population, and in 2018, using data from the National Health Interview Survey (NHIS) and yields similar results. Between 2018 and 2020, the estimated prevalence of serious psychological distress increased by 3.5 fold, from 3.9% to 13.6%. The groups with the highest current rates are young adults (age 18—29 years: 24%), those with household incomes of <$35,000 per year (19%) and Hispanic adults (18%). The lowest levels were for individuals aged ≥55 years (7%) and with household incomes ≥$75,000/year (8%). In addition, one in seven respondents reported that they always or often feel lonely, increasing from one in nine in 2018.
Coping tips for those serving on the frontlines
Throughout Wisconsin, frontline workers provide essential health and safety services that keep our communities functioning during the COVID-19 pandemic. Braving increased risks to help others is part of their jobs, but it can come with a cost. Routine stress, added to the rational concern many frontline workers have for their own health and the well-being of their loved ones, can leave these professionals—and their families—vulnerable to the negative effects of secondary trauma and other mental and behavioral health challenges, like suicidal thoughts and harmful substance use.
Explore Resilient Wisconsin
Try these five strategies
Resources to help you manage stress and adapt to change
Physician Health First
If you want to maintain good health, then it all starts with small decisions you make each and every day. Mental health is just as important as physical fitness. In times like these, stress can be heightened by a number of factors. The AAFP Physician Health First initiative is devoted to improving the wellbeing and professional satisfaction of family physicians by addressing the causes of physician burnout, including the broken U.S. health care system, the organizations employing physicians, the practice environment, individual wellbeing, and a physician culture of self-sacrifice over self-care. Learn more
Check out great resources available to help you practice self care, including opportunities for CME credit!
Apps for Mindfulness & Wellbeing
Family Physicians are working tirelessly to provide critical support to patients and families in their communities during this time and the added challenges you’re facing during the pandemic add a lot of additional stress. There are several recommended apps available to support the wellbeing of healthcare providers:
Calm (free options, can pay for additional features)
CBT-i Coach (free)
Happify (free options, can pay for additional features)
Headspace (free for providers for the rest of the year with verification by NPI; otherwise 2 week free trial for non-providers)
Healthy Minds (free)
Insight Timer (free)
Recovery Path (free)
Ten Percent Happier (free options, can pay for additional features)
Sanvello (free premium during COVID-19 crisis; additional features available with qualifying insurance)
Stop, Breathe & Think (free options, can pay for additional features; free kids version)
Woebot (free)
Wysa: Mental Health Support (free options, 20% off subscription cost right now)
Support for Healthcare Providers Coping with the Pandemic
The COVID-19 pandemic is taxing the human, material and financial resources of individuals, communities and countries around the world. This unprecedented public health crisis is impacting every aspect of daily life, but the toll on healthcare professionals in particular is immense.
There are many tips and resources to help caregivers find information they need to continue supporting each other and caring for themselves during this extremely difficult time on The Schwartz Center for Compassionate Healthcare website.
The Schwartz Center’s mission to put compassion at the heart of healthcare holds true no matter how extraordinary or difficult the circumstances.
Caring for Yourself & Others During the COVID-19 Pandemic: Managing Health Care Workers’ Stress (The Schwartz Center)
COVID-19: Stress and Coping (CDC)
This article from the CDC provides general tips as well as coping strategies for emergency responders and ways to reduce secondary traumatic stress reactions:
– Acknowledge that secondary traumatic stress can impact anyone helping families after a traumatic event.
– Learn the symptoms including physical (fatigue, illness) and mental (fear, withdrawal, guilt).
– Allow time for you and your family to recover from responding to the pandemic.
– Create a menu of personal self-care activities that you enjoy, such as spending time with friends and family, exercising, or reading a book.
– Take a break from media coverage of COVID-19.
– Ask for help if you feel overwhelmed or concerned that COVID-19 is affecting your ability to care for your family and patients as you did before the outbreak.
– Seek additional information about stress management for first responders from the Disaster Technical Assistance Center(SAMHSA)
Be sure to check out AAFP’s Focus on Wellbeing page dedicated to family physicians. This site is full of content and includes inspiring stories from fellow family physicians, blogs, AAFP news coverage and tools.
Deep breaths are like little love notes to your body.
Mental Health of Healthcare Workers Podcast
In this podcast, The Happiness Lab host, Dr. Laurie Santos of Yale, talks to doctors on how they cope with isolation and lack of self-compassion. They explore doctor’s mental space as they explore advocacy in crisis, meditation, courage and more. See how here.
Physicians Support Line
Support line service made up of 600+ volunteer psychiatrists, joined together in the determined hope to provide peer support for our physician colleagues as we all navigate the COVID-19 pandemic.
Mental Health
During this time it’s emotionally difficult for everyone and physicians are not exempt. Mental Health First Aid has a website full of articles available that are specific to COVID-19 and mental health; relevant for anyone including physicians, family & friends and patients.
Another source for now and anytime you may want to consider is an app to help routinely practice mindfulness and medication. Check out Headspace, an app that teaches you how to meditate. Headspace is offering free access to Headspace Plus for all US. healthcare professionals working in public health settings during the crisis.
Be gentile with yourself. You’re doing the best you can.
Four principles for handling stress during a crisis:
In times of crisis, such as the COVID-19 public health emergency, stress can be heightened by a number of factors. AAFP offers advice for physicians to address their stressors and support their own well-being in the midst of a pandemic in this week’s AAFP FPM Journal blog.
“Self-care means giving yourself permission to pause.”
-Cecilia Tran
