Staying Sane in Insane Times

“The end is nigh” I say under my breath as I see articles about the spreading wildfires in Colorado and California, read headlines about continued covid cases, see that hurricanes and tropical storms are bearing down on us, think about the draught, police brutality, homelessness, unemployment, online schools, and whatever else is out there right now (what happened to the murder hornets?) threatening the safety of the world and its inhabitants. I grew up attending religious school. Catholic school by week, Islamic school on Sundays. We learned a lot about the apocalypse, end of times, whatever you want to call it. As I watch the news unfold, I can’t help but notice a link to the stories in the testiments and Quran about how the end will come about. I have a sinking feeling of dread every time the news is on. If I let my mind wander too much, I worry that we are reaching the end. How will it all end? Will there be some survivors, or none? This leads me to wonder, what is the point of all of this? Should I bother worrying if nothing actually matters and we’re all going to die soon? This is definitely starting to leak into my daily life. Looking into the future, a small part of me thinks that everything is futile. Should I recycle? Is there any chance of saving the world now? Do I need to save money for my daughter’s education, or will we all be gone? Will the world end tomorrow, ten years from now, or a thousand years from now? I’m finding it harder to work with my patients who are worried about day to day problems, when I don’t think the world is going to survive. I have a young patient with autism who has been struggling for about a year now with suicidal thoughts in the context of not thinking there’s a point to living. Never has active thoughts, just questions about what the point is, why we’re alive, and why it’s necessary to feel pain. We call it the existential crisis of their time. It’s been hard for me and the parent to walk the patient through this, and increasingly I’ve felt helpless in trying to figure out a way to explain to this patient why they shouldn’t feel hopeless. And yet, even with all of this “end of the world” nonsense, I still find myself happier than I’ve ever been in my life. Things seem to be going well for my small family, with no major set backs. The stress though, seems to weigh on me. THe constant fear of something bad happening, or the stress of caring for people under stress, or the uncertainty of it all, can sometimes get to me if I’m not careful. And I can only imagine how hard it’s been on everyone else. So how do we manage and keep our sanity. The answer to that is different for everyone of course. However, I think there are common themes we can hold onto. 1). Try to create some form of structure in your day People really don’t think about how important structure can be. We all think it would be great to live a completely carefree, unscheduled life. The truth is, most humans strive off structure. We need some sort of routine to get through our day. Kids in particular need structure, and they need someone to help provide it for them. Work and school are great in providing a sense of structure and stability. We know when we have to get up, how to get ready, when we need to leave, what’s going to happen through the day, and when we go home. This has been one of the hardest things for us to give up. So if you don’t have school or a trip to the office to provide this for you, make a schedule for yourself each day. It doesn’t have to be as strict as it would be if things are “normal,” but something to keep you realizing that today is a separate day from yesterday, and this moment is a separate moment from the last. Otherwise everything feels monotonous and pointless. I like to tell families to wake up at the same time every weekday (even if it’s a little later than it would be for school), get dressed, eat breakfast together, and do something that signals the start of their work/school day. This could be going for a walk, or getting all their work organized. There should be a space that is dedicated to home work that is (if possible), different from where you eat, have fun, or sleep. You should hang out in that space during “work” hours, and set times for how you’ll get work done, breaks you’ll need, and meals to eat (no mindless snacking! Set meal/snack times!), and a specific end of work time. Once it’s end of work time, do something to signify that your day is over (like another short walk). Have dinner at a specific time, and go to bed at a specific time. You can allow some spontaneity in your day, but the skeleton of structure helps keep you focused. 2). Take care of your own health as best you can We all can do things that will keep us healthy even in an uncertain time. This includes washing our hands, socially distancing, wearing our masks, and not having big get togethers. We may not be able to control what everyone else is doing, but we can do our part. Even if no one else is cleaning down your work station, you can clean it before you start. You can choose not to spend time with people who refuse to wear masks. Eating healthy, exercising, and staying on a sleep schedule is also very important to staying healthy. Take your medications, go see your doctor for your medical needs, etc. This also involves taking care of your mental health, which is very tied into your physical health, and the other things I list below will be helpful with this step as well. Make some time for yourself. Take a shower. Do your hair. Try yoga. Take a day off from work if you can to relax and reset. Turn off the news. I only allow myself one hour tops of news a day. I check headlines a few times a day on my phone, read the most important articles, and leave the rest. Limit your time on social media, we don’t need that trash right now. Watch cat videos. Take up a relaxing hobby, something that can distract you from everything. 3). Find people who are supportive of you Human beings are social creatures. Prolonged isolation is not good for us, even the self proclaimed introverts. We need to be able to interact with other people. Doing so over text message, zoom, or the phone doesn’t feel as comforting as in person, but it’s what we’ve got to reach out for. Make connections, talk to people, and ask for help when you need it. Find people who can give you love when you’re asking for it. Find people who understand your desires and needs. Set boundaries with those who can’t. As the days become weeks and months, it’s hard to remember when the last time I called my best friend was, but as soon as I do, I feel better. Check in with your support groups. 4). Practice “going with the flow.” This one is tough for a lot of us. Many people don’t like uncertainty, and it’s hard for plans to change so frequently. How do we plan for the future if everything is constantly changing? I find it so hard to pivot to a new plan when my plan goes to hell, but sometimes having multiple contingency plans helps me out. “If this happens, I’ll go do it this way, but if this happens, I’ll do it another way.” It’s a good exercise in flexibility. You get to be angry that your plans didn’t work out. All of this sucks, and that doesn’t change. And still being able to find a way to move forward and do what you can. 5). Take control of what you can, let go of what you can’t. This is similar to going with the flow, but more about knowing what you can change, can’t change, and how to be ok with those distinctions. For example, I can’t control whether my neighbors wear masks. But I can choose to always wear a mask when I’m out, not let anyone in my house who isn’t wearing a mask, and not engage in neighborhood parties. I can’t control that I’m back at work, but I can wear my mask and limit my other activities. I can decide I’m going to continue recycling whether others do, and teach my child kindness, and provide as structured of an environment as I can for my family. I can do my job within the systems, and work towards trying to change the system, without taking responsibility for everything. 6). Stay physically active “exercise releases endorphins, and happy people don’t kill their husbands.” If nothing else, remember this “Legally Blond” quote when you ask yourself why you have to get up and work out. Remember that there are multiple ways to be physically active. Running, swimming, biking, weight lifting, dancing, going for walks, or doing yoga/pilates are all important ways to get your blood flowing, keep you in good shape, and calm down your overactive nervous system. Making sure you plan breaks in your day to get up and move around. This is a great time to get involved in a home workout. Make it a family affair, have everyone go for a walk together. Or have it be your alone time. There are great apps and youtube videos for home workouts, no equipment needed! 7). Practice mindfulness Mindfulness is my new love affair. I used to think mindfulness was only about meditation, and I hated meditating. I’m learning that mindfulness is so much more. It’s the practice of being physically, emotionally, and mentally present in a moment. And now, more than ever, we need to be using mindfulness to cope with the uncertainty of the world. There are so many great apps, workbooks, webpages, and books about how to be mindful. My advice is to try a bunch of different things to see what suits you best. My favorite form of mindfulness is taking a moment to check in with myself. Between each patient, I take a huge, long, steady deep breath in and back out. I sometimes close my eyes for a bit. I willingly let go of all the stress I’m feeling in that moment so I don’t take it into the next appointment. This five second practice helps me get back into myself and calm down before I move on with my day. Other forms of mindfulness I use include actively stopping my thoughts (this take a lot of practice), listening to music, rubbing my fingers together while on a run to focus in on something else besides how much I hate running, taking some deep breaths, and doodling. I am not in love with meditation yet, but I like short ones. Progressive muscle relaxations help me get to sleep when I’m too anxious, or really short guided meditations from apps like Headspace. Practicing mindfulness helps you use it when you’re stressed. Because I do daily mindfulness exercises, when I get super stressed out I have the skills I need to bring me back (most of the time). I can actually use the deep breathing techniques to get me feeling better. Sometimes I have to do something bigger, like taking a break, or crying in the corner. But I’m less often getting to that point because I’m more in control of my emotions, and my baseline is low. 8). Keep hope alive. Imagine the future you want. I recently saw a cartoon in which two characters made comments about how important it is to imagine, dream, and day dream. “It keeps hope alive” the last caption said. I hadn’t thought of it before. If we can imagine a better world, we can keep hope alive that we can create it. And hope is what will get us through this. Having hope that things can get better is the first step in being willing to take action to make things better. Dream of that future, when all this is over. Create it in your mind how you want it to be, and then take steps to reach those goals. Allow the dream to change as things change. Most of all, remember that this is hard, and we’re going to get through it as best we can. Stay safe and healthy out there