SPECIAL EDITION: CORONAVIRUS: Dr. Gail Saltz on Managing Stress and Anxiety

their power for purpose. We'll talk to experts and leaders on the front lines of the coronavirus and share tips, tactics, and inspiration. Today I am just delighted to be joined by Dr Gail Saltz. She's the clinical Associate Professor of psychiatry at the New York pressy here In Hospital and the host of the media podcast Personality. Thanks for joining us, DARTR. Salts, thanks for having me today, so so much to talk

about um on your topic. So, the coronavirus has struck, I would say fear and anxiety in much of the world in a very fast manner. How is mental health to concern in this moment? The mental health right now is very close second to physical health at this moment. Obviously, I know, you know, people are appropriately concerned about the virus, and you know those will get extremely ill and those

who will perhaps die of this virus. That being said, those numbers are probably much much, much smaller than a number of people who are going to suffer really debilitating mental health issues during this time, because this is new, because it's entirely changed our structure as a as as the way we function in society, because of the understandable anxiety and fear related to the virus, because of financial difficulties and stresses that people are having as a result

of what's what's occurring in reaction to the virus, because people are having to stay you know, socially distanced and perhaps and in fact often are being socially distanced in close quarters with people that they aren't usually uh, you know, in close quarters with, and that is changing a lot of dynamics. And you know, at best case, spraying spraying your nerves, but for some people doing more than that.

And it's important to remember that, you know, at some point or another, close to half of all Americans will have a mental health issue, and those who already do are going to have an even more difficult time dealing with what's going on. So I want to unpack a lot of what you just said, because you've touched on so many incredibly important topics in this moment. So I hear a lot of people facing just general anxiety, UM, and I think it has to do with this lack

of control, uh, fear isolation. What are you finding is mixed? Is it is there one thing that's really driving this or is it just a combination. I think it depends on the person. You know, which things stoked you more so, But generally speaking, uncertainty I would put close to the top of the list. I think for most people uncertainty, which you know, we've learned to accept in different areas of day to day life. You know, you crossed the street and obviously no one could promise you a hundred

percent that you won't get hit by a car. Um, But we crossed the street all the time, or we get in our cars and drive all the time, even though there is the possibility of being in an accident. We've learned to accept uncertainty and certain arenas. But now we're being presented with a a sort of never seen before new whole host of uncertainties and that makes people

very anxious. Appropriate you know in some ways that that that's a normal response, and I think most people are understandably anxious, But for some people it's it's really difficult to deal with the uncertainty. And you could, you know, add on to that the lack of control, UM, many things will be taken out of your control, financial markets, um, you know, but potentially depending I mean, you have the

ability to socially isolate yourself. Is that I mean you won't get the virus, not necessarily um, because it's impossible to be you know, on another planet. But uh so that lack of control in that sense UM is difficult for a lot of people. And that this is a health issue and that you know, there are people who are going to die from the virus. So being faced with mortality UM and illness is something that typically stoke

anxiety and fearing people. And so are there are there tactics here recommending finding for that, uh that ability to deal with uncertainty. Well, generally speaking, the more one pushes back UM and and seeks reassurance for uncertainty, usually the worst it gets. So uh, people for example, are looking at the news about every sixty seconds in a wish that something is going to pop up that would give them some certainty, you know, like they found the thing whatever,

you know that that there's some answer. And the more that one looks around for a way to undo those feelings or to get certainty, UM, usually the worst that it makes. It. So really what I would tell people at this time as it is about accepting that there will be a certain degree of uncertainty while keeping perspective that too. Relatively speaking, these are small numbers. You know that more people are dying, you know, of the flu still at this point from what we can see from

testing at this juncture. So in the words, a certain amount of acceptance, a certain amount of giving it perspective of you know, the kinds of numbers that we're talking about. Uh. Using distraction um is important at this time. Honestly, there are you know, you've got a creative about the ways that you can distract yourself of focusing exclusively on this material and in rooting yourself in other more certain, more stable parts of your life, whether that's socially talking to

people online hopefully or on the phoneo UM. You know, because you want to shore up and keep and maintain

those good relationships. And that's good for you, whether that's trying to embed yourself and work as much as you're able to, uh, to concentrate on that and focus on that as a distraction from the news at hand, even though I recognize you'll mostly be doing that from home and that makes it harder, but still doing that and activities that are distracting you know, what was it that's watching you know, a comedy or or or playing a game with the people that you're socially isolated with, or um,

you know, going online and doing a virtual tour of a zoo or museum as people have discovered, you know, as possible. UM, that distraction during this time is important as well. We'll be back after this break. So you also touched on, you know, maintaining healthy relationships with our loved ones or other people that we are isolated with. UM. It kind of brings up that joke which maybe yeah you've heard, which is you know, for better or for worse,

but not for lunch, UM kind of thing. So you know, now it's like, well, you're we are all the time together, UM. And I think people are coping with that in different ways. Uh. We you know, we hear that, for example, divorce rates

have gone up in the other countries already. Um and uh and so what do you recommend as it relates to uh, you know, dealing with this new Yeah, I mean this is really important because you know, relationships are probor you know, honestly, they're the number one source of happiness in life and uh, um, you know they're they're

vitally important. And actually when people are struggling from mental health perspective, one of the things that we're pretty much uniformly recommend in an office to a patient who has depression or has anxiety is to socially interact with other people because it helps. Um. So, whether it's maintaining stability of the relationships that are close of the people that you're in touch with, or but also distracting from those relationships and being able to talk to people that are

you're not socially exocated with is a help. So, you know, getting you know, having kids, going to the computer with grandma and grandpa even though you're not together. Um, is time that your kids aren't necessarily underfoot for you. Um. But are you know, having social noss and are with

with the grandparents who may feel isolated. Um, you know, it's okay for you, for example, as a couple to still have quote dinner out with your friends by setting up your computer, making dinner, you know, having the kids have dinner earlier and you know, entertain themselves while you, you you know, have your computer date you know with your friends. That that is, I would say a good thing to do in terms of me mataining some sort of normalcy.

But your point about um getting frustrated with everybody who's home? Yes, no, you know, people do not stay you know, home and collected together all the time. And what we are seeing is, you know, the concern obviously about divorce, but there's also concern about UM, domestic violence rates going up. UM and uh, people getting incredibly frustrated with their children, realizing, oh, we should be paying teachers a whole lot more than we

are paying them. Who knew? Um, that is it is difficult And really what I what I'm saying to people is the more that you can maintain structure in your day. So get up at your usual time, shower, have them you know, have your meal, have a workstation, have it in a corner of one part of your house to Have your kids have a workstation in a different corner

their part of house. Have your spouses have workstations in opposite ends of the houses, so that you feel like you have some space to do other things and you're not constantly sort of having to be on top of each other. Um, talk about strategies for you know, managing emotions as they come, so you know, sort of bottling it and then exploding at each other. You know, which is more likely to happen during this time? Is not a strategy? UM. Saying you know, uh, I find this

difficult or this makes me feel this way. Um, what can we do to alleviate that? So talking yeah early, using I not you like you're this, you're that, but

you know I feel this way? UM, talking about it early and UM, having you know, some playtime that you know that's not just we're talking about coronavirus or we're trying or we're looking at our finances code down, but you know, is just fun time whatever that might be a card game, have sex, that's you know, the basically intimate fun experience together is not something that has to die because you know, this is going on and it's

actually important to maintain it. If you can, um, because actually it will help both of your moods, which actually

help in the being together. Well, I have heard also that you know this is either going to be a Corona romance or Corona divorce, and so you decide kind of thing, yeah and I and there'll be a lot of people in between, and and you know this will be this could be a difficult time for a lot of couples, but it's not going to stay this way, and that people have to try to remember that it's

not going to stay this way. Um, So this is not forever and it I now it feels like forever at the moment um, but you know, realizing that in certainly some months this will end, and you do want to not have taken your years of relationship and torpedoed it in the meanwhile, So it's worth putting in the work to think about how to make it through this time and having relaxation techniques for all your family members, whether that is you know, for some people yoga and

stretch and you know, or the practice of mindfulness for others who just don't do any of those things. Now is a good time to start, Like you know, intermittent periods of slow, deep abdominal breathing or muscle relaxation or taking a warm bath. But basically, you want to find moments during the day to really relax your body, which helps you relax your mind, which helps you be less irritable,

which helps to have fewer fights during this time. Exercise a another real again could be together, could be separate, but leave the house, go for a run while socially distanced. Um. But real aerobic exercise decreases anxiety, increases mood. And again, the more that you can also do for yourself as an individual, the better for your relationships in the house, because frankly, you can tolerate more. You had mentioned a couple of really great tips, and also you talked earlier

about the media. I mean, what do you what do you recommend in terms of how much media time you have? So I'm recommending that people turn off their phone alerts. UM. The phone alerts like pin you uh, you know you get the baby, you think you have a sense of dread or anxiety, um, And it's just happening constantly during the day. So I really recommend people turn off the phonowers. There's very very little in the phone al arts that you actually need to know, UM and just check in

you know, maybe morning, maybe midday, maybe evening. UM too, very reliable sources that you feel that you can trust. UM that matters because you know, unfortunately all the mistrust

right now, UM is it just breathes more anxiety. So CDC dot gov, the WHO site, you know, a major news you know, even for many people, I would say right now, actually a local news site might be better than a national news site because a lot of things are happening really in your area based on local government, UM and what they've instituted or not, and that checking those not more than you know a couple of times

to day's day informed. Because doing what you need to do, what you should do, what is problem solving, So you know, the the hand washing, the um you know, the social distancing, the things that you do need to do. So that's good for anxiety. Actually, UM, it does give you feel of mastery and control. But too much obsessively checking of

the news tends to drive up anxiety. Yeah, so this is definitely the time to go on a media diet and just treat it as seriously as you're you know, you're I don't think it has to be um by media diet. I don't. I don't think that people should make like Jared Leto and disappear in the in the woods for twelve days and come out and go what happened?

I I do think staying informed because the rules are changing right now, right and you know, I think that one should be prepared to you know, if you need to get some food or get you know, be stocked, etcetera. If you need to. The rules are changing and you need to know what's going on so that you can

prepare yourself. That's good. Um, but you don't need to look all day long, which is what a lot of people are doing, especially since their home and have nothing going on, and having the news on in the background with children is a terrible idea. It does stoke anxiety for them. And when your children get very anxious, even if you're saying don't worry, don't worry, but you're acting worried and the news is telling them worry something, then um,

they will be. And kids, you know it's it's they act out when they're anxious and fearful and uh, and that will make it much more difficult for everybody. Now, I know you and I are based in New York City, which does not have a lot of real estate, So in terms of setting up that home office or separating from your from your loved ones, it's a little harder when you're in these small environments. Any recommendations for those of us living in a smaller environment, right, Well, it

is it is harder. Uh. I can't uh, you know, pretend it's not. But I would say that you you can get creative. Um. I know people who literally set up a desk in their bathroom. Um, and so you know, when you need to use about them, you come in. But otherwise it's like a separate little room, separate little space for me and um and that then that's fine, is I guess what I'm saying. I think you know

for now? Um, you know getting you know, if you if you literally put up a sheet to divide the room, um, just to give you a sense of having your own space. You can wear headphones with a little soft music and as you don't have to listen to everything that the other person is doing or saying, which make it on

your nerves. I think you have to create using your senses, so you know, visually, a space from your auditory perspective, a space and uh, and that was just help you to feel that you at least have some time of being on your own and then perhaps embedded into something else. We'll be back after this break. So now, of course we have the kids are at home, UM, we have everyone working from home. And we know that typically women carry a double burden of caretaking in good times. Um,

so what is your advice for women? How can caretakers manage stress? I mean women are now dealing women and men are dealing with this, but we do know that women often carry a double burden there, what is your advice for women? Well, you know, uh this these are extraordinary times and they call for extraordinary measures and no one can be superhuman and do everything all themselves. So the reality is that even if this has been the case, chances are your partner's home and um, and there there

has to be some you know, give and take. And I would say, you know, don't take it all on yourself. I mean, sometimes it happens because it's it's been the way it's been. Sometimes it happens because it's both of your expectations. Um, But if you change your expectation, then it will make it easier for him to change his expectations. Um. And so it's a matter of just sitting down and saying, you know, we're we're all here, and I need us to sort of evenly, you know, handle what's going on.

If if one of you feels that you're so much better at managing with the children because that's how you feel, UM, then maybe you're the one wants to take over all the housework um or or vice versa. Or you may just find that fifty fifty feels pretty good for both. Um. Most people do feel like they need to break at some point from the kids. And so I think sitting down at this juncture and saying, um, we both you know,

we both have things we have to get done. We both can't do them all the time with the kids in our hair all the time. So let's get creative about what we can do to set them to have some independence, because that's a good thing, and for each of us to have a vision of labor in terms

of when they can't have independence. You know, at the end of all this, what what you're what we're really talking about has an upside, and that is that in extremely difficult times, people have the opportunity to build coping skills. And when you use a bunch of coping skills that you've developed and you get through an incredibly difficult time,

at the end of that, you've essentially built resilience. That is that is uh, something you get to permanently own and it is something that you can take back out and use for the next whatever might come. And so I think that, um, you know it's uh people if they could try to look at it that way, Essentially

you are this is not for nothing. Uh, You're going to develop some skills that are going to be good for you and your partner, but you're also going to help your kids build some coping tools Like this is you know, we don't know this the once in a lifetime occurrence and what other difficult things will come. But life always brings difficult things, and it's your kids learns sees you model and learns how to build their own

coping tools in this time that is very good for them. Yeah, that's kind of priceless for the rest of their life. So so I you know, I'm also very cognizant of people who are raising children by themselves single moms, which there are obviously a lot um anything special that you can recommend for them. Obviously they've already have great coping skills. Um. But but but this is an unusual challenge. It is an unusual challenge. Is harder when you're when you're doing

everything on your own. UM. Probably something that they've been doing intermittently or may have been doing intermittently, but if they haven't, certainly would do now? Is you know, this is when it might be worth you know, being together with another family member of sibling, uh, an older a parent, um or a friend who is also a single mom. But you know, being that you're not supposed to be in big groups, but you know we're going to be

in this for a long while. So having another person, another adult that you feel comfortable that you could live with and share the work with, is not a bad thing at this time. Yeah, community is becoming so apparently important, so obviously important, I should say, And you know, I feel that even though we're not physically together, I think community and reaching out with community is changing people's lives

pretty quickly right now. But I think your point is so important that if you can build a smaller community right now, even in person community, if you need it, it's it's the time to do it. UM. One of the things that we stand for at Seneca Women. Uh, it's really based on the principles of know your power,

find your purpose, and connect with others. UM. And what I've been finding personally, and I think those of uh, those of us at Seneca Women have been finding, is that actually reaching out and trying to help other people is bringing a lot of peace. Uh. And and is a way to cope, UM and bring so much positive energy. So are you seeing people reacting to being useful in this moment in different and new ways? Very much so.

I not in new ways in the sense that, UM, whenever there is you know, real trauma and real difficulty, could talk about a natural disaster post nine eleven or you know, other illnesses. UM. Contributing is a coping mechanism, and we know, I mean there's lots of data that show that basically giving you know, boost your own mood from the helpers, yeah, and decreases your own anxiety exactly. So contributing is in the ability to steel helpful. I think one of the most difficult things we to go

back towards. You originally talked about dealing uncertainty and feeling lack of control. Feeling helpless is another real difficulty in this that is stoking trouble for people in terms of their mood and the more that one is able to do to feel helpful, even if it's not directly, people create, you know, collecting for donations for things that don't have,

you know, to do with the virus per se. But even people who are saying, I'm going to go through my closet now because I'm stuck at home and I'm going to donate you know what, I think I don't wear enough. Um and uh, you know people who are like, I'm gonna, I'm gonna foster dogs because when that whole rumor went around about maybe coronaviruses and dogs, which was completely untrue, some people gave up their dogs and the foster system got overloaded, and now there are a bunch

of dogs who don't have homes. And and so I've seen people say, Okay, I'm gonna I'm gonna figure out how to walk or feed a dog or foster dog or all all manner of you know, ways of contributing and helping others. And like I said, helping others doesn't even have to be directly related to the coronavirus, but it is. It is actually a good coping tool. Well, we've tried to set up some resources on cening women dot com and on our app um, just giving a list of things you can do to help help women

and the greater community in this moment. So for us it's made a great difference. Um. So before we go, I just want to ask you one last question, UM, what makes you optimistic in this moment? Well, uh, what makes me optimistic is twofold. Um, we have weather. You know, history always repeats itself and if you do you know, for people who have looked back at difficult things, at the end of the day, we always do weather and

come out the other end. And we're already seeing signs that that in this very specific incidence can happen that you know, China is no new reported cases. Um that at some point, if we do the right thing now, we will you know, see a resolution to this at some point. Um. So obviously that gives me direct and concrete optimism. But I also feel optimism because I think it is part of human nature two m to cope, to develop resilience, sometimes to actually be extraordinary in the

face of trauma and difficulty. I see this in my practice all the time, and uh that you know there will be extraordinary individuals coming out of this and contributing, and in that way we will we will be for the better. Well, I cannot thank you enough for joining us. I know you have an incredibly hectic schedule during this period, and uh, I know a lot of people will benefit from hearing you, So thank you so much for joining us.

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