Staying Sane During COVID

Staying Sane During COVID presentation

Webinars:

• Critical Events and Stress Management
• Embracing Change: Tips for Self-Care During a Crisis

Articles:

• Isolation & Self-Care During COVID-19
• The Importance of Self-Care During the Holidays
• Using Self-Care to Curb Addiction and Mental Illness

Welcome to the Community Education Series, hosted by the Recovery Village and Advanced Recovery Systems.

Thank you, everybody, for joining. I’m actually kind of excited today that I can see people’s faces on the screen, so that’s a wonderful thing. Normally, I do these and I can’t see who’s listening. So, I appreciate everybody taking time out of their day today to come and listen to “How To Help Stay Sane During COVID.” We were kind of being silly with the title; I think life is entirely too serious to not laugh and be able to find some humor in things. So, I’m glad everybody’s here in attendance. As with every presentation, I feel compelled to have objectives. So, I’m hoping that you all will gain insight into how you might best manage things during this stressful time — looking for some areas to focus on where stress management might be helpful. We are going to actually do a relaxation exercise during this presentation, and hopefully, you’ll get to have some benefit and feel what that — I don’t know, I guess — the best way to how that feels for you individually, because everybody responds to relaxation differently. And then there’ll be a few resources at the end just to tap into — if, that is, y’all are needing something extra.

One of the things I just want to emphasize is how we each individually react to stress is as individual as we are. So, some people become functioners: They get very busy, they keep tasks. Some people overfunction: They get really busy and antsy and they have to keep getting things done, and it makes them feel better when they’re stressed. Some people underfunction: They slow down, they internalize, they need additional reps. So, keeping that in mind, both are valid. Everybody needs to find what way they cope the best. And as we think about this — so, as we go through this presentation — I want you to think about you, individually. How this looks for you. But I also want you to consider who you’re with. Who’s surrounding you, whether that’s people in your home, people that you work with, friends that you interact with, and just be aware of that because everybody handles things differently. And if it’s different than us, sometimes, that ruffles our feathers or maybe makes us have conflict where we haven’t had conflict before. But everybody needs to find their own way to cope.

I thought this was an important thing to put in. I want everybody to think about how you define stress. Again, it’s going to be defined differently for everyone. I mean, there’s buzzwords that come up: tension, hassle, worries, scream, nervousness. Anxiety — that’s kind of the most synonymous one in my head. I’m a clinician, so that’s kinda how it goes, but when we think about anxiety, it affects us in three ways. So, it affects us physiologically, psychologically and behaviorally. As we go through these pieces, I want you to kind of look at those areas. How do you see them impacting you? What works for you? What hasn’t worked for you, and what maybe has exacerbated it or made it worse? So, I’m kind of changing things up. I thought about putting the relaxation at the end, but I thought some people might bail on me early ‘cause they had to get to the next thing. So, we’re going to start with the relaxation.

What I would like everybody to do is think about a scale of zero to 10 — zero being totally chill, relaxed, no stress whatsoever, and 10 being the most stressed or anxious that you’ve ever been. Take a couple of seconds. Think about where you fall on that scale of zero to 10, and I want you to write it down on a piece of paper in front of you. Alright, so we are going to go into a deep muscle relaxation exercise. I’m going to hide my screen so you’re not looking at me. This is a recording that I did of a program when I worked at the VA, so it is my voice, but I just thought I would put a different picture on the screen for you to focus on. And then when we come back, we’ll wrap up with the rest of the presentation, but I thought it might be a good way for us to all start. We’re going to kind of center ourselves and breathe.

The first exercise is deep muscle relaxation. The goal of deep muscle relaxation is to increase awareness of tension while giving you a way to release it. Noticing the contrast between tension and relaxation is important to be able to dispel it. We will be sequentially tensing and relaxing various muscle groups in the body. Each muscle should be tense to a level of 50%. You do not want to strain. If you have pain in any part of your body, just skip that muscle group. Instead, focusing on your breathing. We will hold the tension in each muscle group and then hold a relaxation following. Sit comfortably in your chair; you may have your eyes open or closed during this exercise. Uncross your legs and have your arms to your side. First, I would like you to clench your fist. Both at the same time — hold it, feel the tension, and then release, feeling the relaxation. Clench your fists again, holding them tight, feeling the tension. Hold it, and relax.

Next, I’d like you to bend your hands backward at the wrist, feeling the tension in your forearm; hold it, and release, letting the tension escape. One more time — I’d like you to bend your hands backward at the wrists, feeling the tension in your hands and forearms. Hold it and release. Feel the tension release and the relaxation come. Next, I’d like you to flex your bicep muscles. Feel the tension, hold it and then release. Feel the tension leaving the muscles. Flex your bicep muscles again. Feeling the tension, holding it, note the difference in the tension and then release, letting the relaxation come through your muscles. Next, I’d like you to push your shoulders back into your chair. Hold them back. Feel the tension, and release. Let the tension go. Push your shoulders back a second time in the chair. Hold it, feel the tension and relax, feeling the relaxation come over your shoulders. Notice the difference.

Next, I’d like you to hunch your shoulders up towards your ears, holding it and feeling the tension. Recognize the level of tension in your muscles and then release, feeling the relaxation and the blood flow. One more time — hunch your shoulders up towards your ears, holding it. Note the tension and then relax. Next, we’ll tilt your head to the left shoulder. Feel the tension, hold it, maintain your calm breathing and then relax, feeling the release. One more time. I’d like you to tilt your head to the left shoulder. Hold it, feel the tension and then relax, letting the relaxation come over. Next, I’d like you to tilt your head to the right shoulder; tilt it to the side, feel the tension, hold it and release. Feel the relaxation come over your neck. Appreciate that relaxation. And again, tilt your head to the right shoulder, feeling the tension as you do this. Maintain your breathing and relax. Let your neck relax.

Next, I’d like you to put your head down and tuck your chin towards your chest. Hold it, feel the tension and release. Feel the relaxation. One more time with your head down — tuck your chin towards your chest and hold it, feel the muscles tense, feel the difference and then relax. Recognize the difference in how you feel after relaxing your muscles. Next, I’d like you to press your head back against your chair, holding it, feeling the tension, and relax, letting the relaxation come over you. Next, I’d like you to press your head back against the chair again, holding it, feeling the tension and then relaxing, letting the tension release. Next, I’d like you to breathe air in deeply through your nose and hold it in your lungs. Hold it and release, exhaling slowly. Next, I’d like you to breathe deeply into your lungs again, in your nose. Hold it. Feel the tension and exhale, feeling the release. Next, I’d like you to tense your stomach muscle as if someone has hit you in the stomach. Hold it, feel the tension, feel the tightness and release, letting go of the tension. Tense your stomach by contracting your muscles as if hit in the stomach. Feel the tension, hold it and then release, feeling the relaxation come over your stomach muscles.

Next, I’d like you to wrinkle up your forehead and your brow, noticing the tension in your forehead. Feel it, hold it and release. Notice the relaxation that comes over you. And one more time — I’d like you to wrinkle up your forehead and your brow, holding it, tensing, feeling the muscles. And release — let relaxation come over you, feel the tension leaving. Next, I’d like you to close your eyes tightly, feeling the tension in your eyes. Hold it, and release. Feel the difference as the tension leaves and the relaxation comes over you. And again, I’d like you to close your eyes tightly, holding it, feeling the tension, and then relax. Feel the release of this tension. Next, I’d like you to open your mouth widely. Feel the tension in your jaw. Hold it, and release. Let the tension go. Notice the sense of relaxation. And again, I’d like you to open your mouth widely, feeling the tension. Hold it, and let it go, feeling the release as you relax. Next, I’d like you to purse your lips; hold them tightly and feel the tension. Hold it and feel it, and then release, noticing the sense of relaxation that you feel. One more time — purse your lips. Feel the tension, hold it and release, feeling the relaxation.

Next, I’d like you to bear down slightly on your back teeth. Feel the tension in your jaw. Hold it and release, feeling the relaxation. One more time. I’d like you to bear down slightly on your back teeth, feeling the tension as you press your jaws together. Feel it, hold it and release, feeling the tension as the blood flow improves. Feel the relaxation as the blood flow improves. Next, I’d like you to arch your back slightly, feeling the muscles tense. Hold it, feel the tension and then let it go. Relax and let the tension leave. Maintain your calm breathing. One more time. I’d like you to arch your back slightly, noting the tension as you do so. Feel all the muscles, and then release, feeling the blood flow through your muscles again and tension dissipate. Next, I’d like you to stretch out your right leg and bend your toes backwards. Feel the tension in your toes and your foot. Hold it, and release. Feel the relaxation come over your toes. One more time. I’d like you to bend the toes backward on your right. Hold it, feel the tension and release, feeling the relaxation come over your toes.

Next, I’d like you to stretch out your left leg and bend the toes back on your left foot. Feel the tension, hold it and release, feeling the relaxation come over your toes and foot. One more time. I’d like you to bend the toes back on your left foot, holding it, noting the tension, and release. Let go of all the tension. Feel the relaxation as it comes over you. Next, I’d like you to go back to your right leg — stretch it out and point your toes away from your body. Hold it. Feel the tension as it goes up your leg, and release. Feel the tension go away and the relaxation come over you. One more time. I’d like you to point your toes with your right foot away from your body. Hold the tension. Feel it, and release, feeling the tension go, feeling the relaxation come over. Next, I’d like you to stretch out your left leg and point your left toes away from your body, feeling the tension as it goes up. Hold it, and release. Notice the relaxation, feel the tension go. One more time. Point your left toes away from the body, feel the tension, hold it and release. As you release, feel the tension go away and relaxation come over your leg.

Lastly, I’d like you to curl your toes in your shoes. Feel the tension as you do so. Hold it, feel it and release, feeling the blood flow and the relaxation come over your feet. Enjoy how this feels. One more time. Curl up your toes in your shoes; hold it. Feel the tension and release, letting go of all the tension left, and feel the relaxation as that comes over your body.

Okay, I’m curious. What I’d like you to do before we move on too much is to scan your body. Do that zero to 10 scale again — zero being completely calm and relaxed, 10 being completely stressed. Rate yourself again, zero to 10, and write that down also. If anybody would like to share their scores before the exercise and after the exercise, I would love to see people’s responses. I think that one of the things that is very apparent with things like this is how infrequently I do them. Even though I know it’s a good thing to do, and even sitting here at my computer with nobody watching and nothing else to do, I still struggle to stay focused on it. So, I think that that’s one of the things, you know, that people need to know what works for them.

Here’s somebody who said she was a three before and now she’s a zero. I think that that’s a benefit, right? Even if you have — I mean, already starting at a three, she was pretty chill anyway. Here’s another one: five to one, four to one. So, even for people who weren’t really high on the scale to see benefit, and that was 20 minutes. We’ll talk about relaxation a little bit later; I don’t want to get too caught up in that ‘cause I could easily do that. So, I wanted to keep focused, but I do appreciate you all taking a moment to do that. Hopefully, people feel a little bit calmer and a little bit more centered. I think that coming in from whatever your day was to try to focus on giving yourself the time to attend this webinar — I was kind of in a flurry to get it going. We had technical difficulties, so for me, I’ve definitely felt a change. Seeing the numbers, most people had some benefits, some people not as much, but I appreciate y’all sharing — keep sharing if you feel compelled to. But when we talk about how to stay sane, we need to kind of look at what our normal — I’ll use “normal” in quotations because I’m not sure what’s normal anymore — what things normally look like for us. Do you know what’s changed for you since COVID has hit? Do you know what you need? Do you know what’s missing for you? These are all things that I want you to think about as we go through some of these slides and we start looking at how do we manage.

When we look at what’s changed since COVID, I feel like almost everything has changed. I think that most of us are working from home or some hybrid version, right? Kids are home from school or home from summer activities now. A lot of lost jobs, a lot of financial struggles, kids are back from college unnecessarily or unexpectedly. I don’t know about you guys, but my house feels a lot smaller when everybody’s home all the time. This can bring about conflict — maybe just trouble adjusting to the change, too much time together, trouble sharing the space, right? If you’re not used to sharing space, or somebody leaves during the day or multiple people leave during the day and you kind of come and go, then all of a sudden, it feels really close. I think that there’s a lot of loss and fear going on right now. Almost a grief cycle, looking at how so much has changed and how do we navigate through that. So, there’s a lot of isolation. There’s a lot of illness and a lot of unhealthy coping that’s going on.

I work for Advanced Recovery Systems, and we do primarily addiction treatment, so I have to make sure to throw that out here. When we look at unhealthy coping, what do we do to help manage? A lot of people use substances — alcohol, tobacco. All legal, but not necessarily healthy coping skills, you know? And then we have the other pieces, where addicts have been in recovery for a long time. They’ve had a great focus on healthy coping. A lot of people are falling back into old behaviors. So, we look at are we using substances? Are we using illicit substances? We have eating issues, right? I mean, I’m snacking a lot more because I’m home. We have screen addictions that are a real thing, and that’s part of how it’s infiltrated our kids that are adolescents to college kids. But as we look at how much time we spend on screens today, I don’t know how many of you, during that exercise, were able to not attend to what else was going on on your computer. It’s hard for me. I have to shut down everything in the bag, but my phone still buzzes on the side. So, screens are just so much a part of how we do life regularly, and now with COVID, the intensity has just grown astronomically.

Do you know what you need? A lot of us don’t; we don’t attend to our own needs. We don’t pay attention to us. Maybe we’re taking care of other people, whether that’s friends, family, loved ones that are ill, but I want you to get back in touch with what do you need. What’s missing? How can you get it? For me, I’ve always known I was an extrovert, but being stuck at home has really made me realize that I am absolutely an extrovert and how much I need connection. I miss connecting with people. I used to be a private practice clinician, and I connected with clients all day, every day. And as an outreach professional, I’m in the community talking to different treatment facilities and patients and family members, really helping them connect, but it rejuvenates me. It fulfills me to be able to have those connections, and that’s something I’ve desperately been longing for. So, I love the ability to do Zoom. This is the first webinar I’ve done in a while where I actually get to see who’s in attendance. Some people are showing faces, some are not, but it’s still nice to see that there are people there.

So, how do we maintain connection? And that can be different for everybody. Structure is huge. When all this started, I think people kind of flew by the seat of their pants, so to speak. I know that I was much more lax with my daughter about how she was on her phone or on the computer, but as this became a more long-standing thing, structure has been more, you know, getting back to what structure used to be. But trying to make a structure that works for you? I have to get up at the same time every day, walk my dog, take a shower, get ready for work and get that going. Positive interactions — it’s easy to get lost in them. The mundane or the day-to-day. We have routines, but sometimes, when we see everybody the same all the time, it gets trite.

So, schedule positive things. Have movie nights, have family walks, have game nights, do things that allow you to still connect in a positive way because things are just more stressful than they have been for us in a long time. And then on the other end, disconnect. Find ways that you have your own private time. I love being able to see my family more, but I still need time to myself. I used to get that when I would drive. I’m not out driving anymore, but sometimes, I go take a drive down to the beach. Thankfully, we live in a beautiful place, and I go drive for an hour and just have time to myself, put music on whatever I need. So, think about how do you disconnect? Whether that’s exercise, whether that’s reading or meditation. In conjunction kind of with the game night I had the first week of COVID, we changed our dining room table into a place to kind of disconnect. We had a puzzle, we had Mad Libs and coloring books and monopoly and cards and all different things out. So, if somebody wanted to get away from their screen or from their seat and they needed to change it up, there was a place to do that. So, just thinking of different ways, getting back to what you used to do, maybe.

When, again, we’re looking at what’s missing, if you had things in place before COVID, they still will work now — you just may have to alter how you do them, right? Relationships with friends and family. I have a father that’s in his 80s. So, having him come over and hang out with us isn’t necessarily the thing to do. But we had him over and sat in the driveway more than 10 feet apart in our chairs and got to see each other, whereas normally, we would just see each other on a regular basis. So, looking at how do you get what you need with the adaptation of what we have in front of us? Mental health — look at therapy. Is that something you did before? Maybe you thought things were good and you didn’t need it, but now, things are more stressful. There’s so many options for therapy right now. Almost every private practice clinician I know is doing telehealth, so there’s a lot of accessibility there. Reach out to your support, whether that’s friends, family, co-workers, whomever, a sponsor, and work on that.

Join groups; there’s so many groups. Again, one of the struggles I think is a lot of the groups are virtual. So, here we go, getting back online or getting back on the computer. But when you look at what you get from that, that probably will outweigh the screen time in that situation again. What do you need? You need physical activity. I know for me, sitting at a desk most of the day can be incredibly difficult, so I try to — you know, I have my Fitbit that buzzes when I haven’t moved enough — but I try to have lunch outside. I make sure I get my walk in the morning. Try to do things to keep moving, try to have healthy habits. Like, I was joking about snacking — if I’m going to snack, have a healthy snack. Try to have new hobbies, whether that’s bike riding or going to a nature trail. Crocheting or knitting has incredible relaxation and mental health benefits.

Is there something spiritual that you need in your life? Maybe it was there before and you kind of gave up because, all of a sudden, people couldn’t meet in groups, or activities you used to participate in are no longer accessible. Find other ways to do that.  Finances are very stressful for a lot of people. How did you focus on them? How did you manage them before COVID, and what adjustments do you need to make? Whether that’s changing the budget, looking at how you save or what you’re spending the money on, and different ways to invest to make sure things can be more stable for you. And then again, like I said, structure. Maybe being redundant in that, but I think that that’s so important. You know, we have work, we have school, we have childcare, we have all of these external things that put structure on us. But when we’re left to our own devices, are we still maintaining structure? And structure really is healthy and it is beneficial — that predictability can help reduce stress.

Again, basic survival tools. How do we keep ourselves sane, and how do we maintain a healthy way of moving forward? Again, that structure piece is huge. I mean, when I first started working from home, I kept doing all the same things but had a lot of colleagues that would hang out in their jammies, put their hair up in a bun and sit on the couch, and that worked fine for them for maybe a week or two. But then they realized that they weren’t getting out of first gear, right? They were just staying in that relaxed state, but almost to the point where their motivation changed and they started to feel more negative or have trouble getting things done and being as productive as they had been in the past. So again, that’s one of the places we look at — how do we do things to keep things structured to help us move forward?

Healthy coping — again, back to the basics. What works for you? I had a colleague that I worked with that’s in recovery, and she said one of the things that was so important to her — because she couldn’t go to her 12-step meetings, she couldn’t see her sponsor — was getting back to the 12-step books. All of the books you’ve read in recovery, and that helps you stay focused on what was good for her. What was healthy for her. If exercise is important to you, if family activities are important to you — whatever you need, stick with the basics. Again, find alternate ways to express yourself spiritually, whether that’s meditation, whether that’s Zoom and online meetings — 12-step meetings are everywhere online right now. And there’s a lot of different groups available. I mean, even I connected somebody with a cancer support group for Moffitt. They’re doing support groups online. So, there’s a lot of support available, whether it’s traditional therapy or it’s something a little different than that, but there’s definitely a lot out there.

Again, friendships — how do you nurture those? How do you keep those going? I mean, when we’re out and about, we meet people, we go for lunch, we go for walks together, we do all of those things. So, I hear a lot of people talking about doing Zoom calls or FaceTime calls with friends and groups of friends. It’s a good way to stay connected. It isn’t the same, but it still allows us to have some connection. And then, again, family. Look at family time, work time and private time. We all need time to ourselves. How does that work when you’re stuck at home with everybody in the same space? Maybe you have designated spots. You have designated time where you have access to certain parts of the house, but find a way to allow yourself to have you time because that’s still incredibly important.

So today, we did deep muscle relaxation. It’s one of my favorites. I love the feet and the leg thing. That’s like my favorite part of that one. It tells you kind of where you hold your tension. So, in thinking back to that exercise, I want you to think — where did you feel the most release? Most women carry it in our necks and our shoulders, so that’s not an uncommon place for people to recognize that they have it. But if you felt any benefit from today, what I can tell you is if you start practicing relaxation on a regular basis, your response will improve. So, if you went down two or three today, that could become a regular thing. And the more you practice, the quicker the response can be. So, you’re going to work on that and improve that over time and just put yourself in a better headspace. And whether you use it — you know, I had some patients that used to use it to wake up because it gets your blood flowing — it gets everything moving.

I had some that would use it to help them go to sleep because it does help relax you and calm you. And sometimes, if you have something stressful before a big meeting or after a meeting. So, find ways to incorporate that. So, there’s the deep muscle relaxation, there’s visualization, meditation and guided imagery, and then there’s grounding. And those are just four basic ones. You can look at — there’s all sorts of great apps out there now.  There used to be — can’t remember the name of the publication, but they used to rank the top 20 anti-anxiety apps, and there’s a variety of them. Most of them have a free version, which is all I ever do ‘cause I’m cheap, but I have a relaxation app on my phone that I’ve had for probably 15 years. I mean, I use the same one all the time and I love it.

So, finding ways to take advantage of the technology we have, but to add that piece of relaxation because 20 minutes a day isn’t that long. But if you felt any benefit, I really would encourage you to find a way to incorporate that in. So, we have about 12 minutes left. Just a couple of quick resources. Psychology Today website has a lot of great resources for therapists, support groups. If you feel like that would be beneficial or helpful, please reach out and look online for that. The Recovery Village — we have a website and we do all levels of care for addiction treatment, detox, residential, partial hospitalization, intensive outpatient. We also offer outpatient and sober living. We’re doing outpatient, IOP and PHP via telehealth now, so people can access that and still be at home.  We also offer mental health treatment as well for adolescents and adults, so those resources are available, and we do a lot of things online as well.

And then there’s SAMHSA, which is a great resource for looking for any type of addiction treatment. And then I listed myself as a resource — on the next slide, I think, is my contact information. If you have any questions for me, need to reach out, I’m happy to help in any way.  It has my email and my cell phone. Please feel free to reach out.  If you have any questions about treatment, finding a good therapist in the community, I live in the Tampa area, but I have colleagues all throughout the state of Florida. Happy to help in any way. We can help you get connected with something that would be beneficial to you.

If you have any questions, any comments, I’m happy to take those now, or feel free to reach out to me individually. I hope everybody found it useful and a little bit entertaining, I guess. I really love to do relaxation and hope that you all benefited from that. I know, sometimes, that’s not what we expect when we get on a Zoom call, but I wanted to kind of mix it up a little bit. And hopefully, everybody took something from today. I enjoyed doing it.

Thank you for watching this video. We hope you enjoyed the presentation.