Prof Dr. Philip George (Dept of Psychiatry, IMU) & Leong Hui Yen (Semester 8, MBBS, IMU)
We have now progressed to the 2nd phase of Movement Control Order which will take us to the 14th of April, 2020. These are challenging times. Each time you go on social media or switch on the TV, there is another update or announcement on the COVID-19 situation. On top of that, your daily routine has been turned upside down with the fear of contracting the disease and with the Movement Control Order.
By isolating ourselves and social distancing there can be a toll on our
mental health. The uncertainty will also put pressure on our emotions and resilience. A recent survey of Medical Students showed 70% felt the pandemic and MCO caused significant impact on their lives. 40% reported moderate to intense anxiety about the pandemic and the risk of contracting the disease. It is normal to feel afraid and worried in the face of this but there are also things we can do to look after our mental health and wellbeing during these times.
This is especially a good time to focus on our own mental health and to build skills that will be essential and helpful working in a healthcare career. Some steps we can take include;
Focus on what is under your control
Worrying will not help solve the situation. Instead, spend the time and energy on the things that matter to you, such as your family, your schedule as well as observing proper hygiene to keep everyone safe. Eat a balanced diet, with adequate portions of fruit and vegetables. Drink plenty of water and ensure you get adequate sleep. Recommended number of hours are 6 to 9 hours a night.
Get your information about the pandemic from reliable sources and limit the number of times you consume this in a day. You need to also build a balance in the amount of video and online games or movies and serials you engage in. Exercise is essential in this period. It is a stress reliever and helps to stimulate your endorphins – the feel good neurochemicals. There are many excellent home workout videos and apps available online. Yoga can also decrease the secretion of cortisol, the primary stress hormone, which in turn can improve your overall health plus improve flexibility, strength, and posture.
Teaching and Learning
You will now be engaged in online learning and teaching and this can be a challenge as internet connection may not be the best for all. Some faculty may not be well versed with social media connection tools and need some guidance by their mentees. But these may be teething problems in the path to a new long-term way of learning and teaching. Social distancing may be required for longer than we anticipate and so too this new form of learning and teaching. Of course when things get back to normal experiential learning and face to face will recommence.
Much of the learning that occurs online is self-directed and you have to be active participants. Learning online requires strong time management and self-motivation. Set a fixed schedule for your learning activity and ensure there are no interruptions during this time. Do your own reading before your online teaching session and have your questions prepared well in advance to make the session more beneficial and meaningful for you.
Build Resilience and Positive Mental Health
It is ok to take time for yourself when you are feeling stressed and overwhelmed to do things that will help manage your stress. You must take care of yourself first so that you can continue to take care of your loved ones and your daily responsibilities. But we don’t need to wait for stress and that overwhelming feeling to incorporate a lifestyle that builds our mental health resilience.
Just as we look after our dental hygiene daily, we can invest and incorporate mental health skills or hygiene into our daily life. This helps us to cope with the stressful career that we have embarked on as a healthcare professional.
Some of the useful techniques include;
1) Relaxation Techniques
You may already know what helps you relax, like having a bath, listening to music or talking to a friend. But it will also be good to learn skills that have been evidenced to help manage stress and cope better. There is deep breathing exercise, mindfulness, meditation or even talking to a professional. Some useful sites that help in this process especially during this period of the pandemic include,
a) Befrienders phone counselling service at 03-79568144/45 (24 hours Kuala Lumpur)
b) Psychosocial support services provided by MOH with collaboration of Mercy Malaysia at: 03- 29359935 or 011-63996482
c) Women, family & Social Welfare Ministry helpline (24 hours):0192615999
2) Help others
Evidence shows that helping others benefits our mental wellbeing. This does not need to be in the form of donations but can be a charitable activity where we give our time and effort. We can offer to pick up some provisions or medicines for our neighbours or the elderly in our neighbourhood (of course, make sure this is done safely). We can contact those who we know might be isolated, as they may be feeling lonely and would appreciate a call to see how they are doing. We can be thankful to the incredible people working through COVID 19. Acknowledge the amazing health care workers, first responders, support workers, enforcement officers and others who are keeping us safe. We can utilise social media to express our gratitude and support.
3) Connect with others
Good relationships are important for our mental wellbeing. They provide emotional support and allow us to support others. They also give us an opportunity to share positive experiences and help build a sense of belonging. Staying connected is even more important now and we should try to regularly stay in touch with others on social media, e-mail or the phone. But it is important that we assess our social media activity. Evidence shows that overuse of social media use can be associated with rumination and feelings of depression especially in people who are vulnerable. If we find that spending too much time on social media is causing us to worry, then we need to take some time off and find a balance.
Gratitude is the emotion of expressing appreciation for what one has or has achieved. Research shows that, over time, feeling grateful boosts happiness and fosters both physical and psychological health. In the face of uncertainty, especially now, concentrating on things you can be grateful for can help cope with anxiety and negativity your mind may experience. Some ways to foster gratitude include, keeping a gratitude journal where you can write down three things that have gone well for you in the day and identify the cause. You can also think about people who have inspired you and what about them was most significant. Do an audit of the past 3 years and identify all the positive events that you should be grateful for. And finally engage in “mental subtraction”, which is where you imagine what your life would be like if some positive event had not occurred. The app below can help in this process;
5) Keep a stress diary
There are a lot of favourable and unfavourable events that can happen in a day. Some minor things could make you feel stressed. By having a diary to record your daily activities, you are able to identify the causes of short term or frequent stress in your life. As you write down the events, think about why this situation stresses you out. Next, list these stressors in order of their impact and which affect your health, well-being and productivity most? Then, consider using some of the approaches to manage your stress.
6) Stress relief
Finding a proper way for stress relief is not easy and it varies from people to people. Sometimes you feel lost or lack self-confidence to continue with your daily activities. Hold on and take some time to have a proper rest and temporarily remove yourself from the current situation. You can talk to your family and friends, or engage yourself in some recreational activities. Make sure that you rest your mind and muscles completely before resuming to your task. It is important to monitor your stress and psychological symptoms such as anxiety and depression, and to find suitable way to improve your mental and physical health.
7) Staying flexible
As you encounter stressful circumstances and events in your life, it is helpful to maintain flexibility and balance in life so that you have a resilient mindset. You may allow yourself to experience some strong emotions, and realise when to put them aside and continue with your daily function. You may also step forward to deal with your problems and to step back appropriately to have a rest and to reenergise yourself. You may also spend time with your loved ones who offer support and encouragement to nurture yourself.
8) Skill acquisition
Acquiring a new skill can play an important part in building a person’s mental resilience. It helps to develop a sense of mastery and competency. These can be used during challenging times and to increase self-esteem and problem solving abilities. Skills to be learned will depend on the individual Some examples include learning new hobbies and improve your acquired skills to help with everyday functioning. It benefits more on your mental health if you learn a new skill in a group with your closed ones especially during this period of Movement Control Order.
It is important to seek joy especially during this period of pandemic. Do not panic and overwhelm yourself with the news online. Watch something funny on the television, enjoy some good music, take your time to do your work and enjoy this precious moment of staying at home with your family.
10) ‘Worry container skill’
This helps to effectively manage your worries. It is an activity where you need to imagine in detail a container or a box with a lid that closes. Find the thing in your mind that worries you the most. Imagine moving this thought from your mind and placing it into the container. Close the container firmly with the lid and move this container to another place. You can leave the container there and have more space for you to focus on other things.