Dr. Craig Sawchuk: Coming up on Mayo Clinic Q&A, the amount of
stressors and different uncertainties that we've been
going through. So, it's that wear and tear gets to us, and if
there hasn't been an opportunity to do some more restorative
things, then after a while we do become more fatigued.
Narrator: The lingering COVID-19 pandemic is not only causing
fatigue, but it's also contributing to stress and
anger. Today on Mayo Clinic Q&A, we'll discuss our mental health
and get some tips to minimize the effects of pandemic related
stress.
Dr. Craig Sawchuk: Because there's probably a whole host of
things that we're getting really angry and frustrated about that
are really based upon things that we don't have much control
over. Maybe we can put aside some of the parts that we don't
have as much control over and try to use that anger in a
motivational way because anger is an upper regulating emotional
state, can we funnel that anger towards doing something that may
be more productive or may be able to help us out a little bit
more?
Dr. Halena Gazelka: Welcome, everyone to Mayo Clinic Q&A, I'm
Dr. Halena Gazelka. The Delta surge is just the latest wave in
the ongoing COVID-19 pandemic. For healthcare and frontline
workers, there's fatigue due to stress, fear, and sadness about
ongoing disease and death that they see every day. But this is
taking a toll on all of us. For over 18 months now, we've all
lived under a heightened level of stress with COVID-19, and
it's taking its toll. Nearly four in 10 Americans have
reported that worry and stress related to COVID-19 has played a
negative role in their mental health. So, how can we better
cope with this and deal with our feelings? Well, here with us to
discuss today is Dr. Craig Sawchuk. Dr. Sawchuk is a Mayo
Clinic psychologist. He's the Division Chair of Integrated
Behavioral Health. Thanks for being here today, Craig.
Dr. Craig Sawchuk: Great. Thanks for having me back. Dr. Gazelka.
Dr. Halena Gazelka: Well, I love to have you here, Craig, because
you're a boots on the ground guy. You're not just a guy who
works in research, you are seeing patients in the clinic,
day in and day out, and I'm sure are familiar with the stress
that COVID-19 is taking.
Dr. Craig Sawchuk: Yeah, without a doubt, you know, it really is
a blessing to be on the front lines with our colleagues in
primary care, family medicine, and pediatrics. And under normal
circumstances, that's the first place that people go to for
their health care, mental health included. But certainly, over
the course of the pandemic, we have been seeing everything that
our patients, and also our staff, have been going through
on a day in and day out basis across the entire pandemic.
Dr. Halena Gazelka: Yeah, I do love, it's a discussion for
another day, but I love the concept of you being integrated
into the primary care clinics. I think that's fantastic.
Dr. Craig Sawchuk: Yeah, it's the best way to deliver mental
health care these days. And there's certainly no shortage of
mental health things that we're able to do to help folks out
now.
Dr. Halena Gazelka: That's great. Craig, tell us a little
bit about compassion fatigue, what is meant by that? And what
are people experiencing?
Dr. Craig Sawchuk: Well, you think about it, not only from a
healthcare perspective, or a health care, professional
perspective, but just a human perspective, being
compassionate, and empathetic is just part of the normal human
experience. And whether it be that you're caregiving for folks
in your own life, being just a supportive, you know, colleague
or friend, or just even the reasons why you know, folks get
into health care in the first place. Just being empathetic and
compassionate, helps us to connect and to be helpful. But
at what point does it become too much of a good thing? You know,
we think of just the wear and tear that the pandemic has had
on all of us, we kind of think about it almost like an erosion
effect over time, with the amount of stressors and
different uncertainties that we've been going through. So, as
that wear and tear gets to us, and if there hasn't been an
opportunity to do some more restorative things, then after a
while we do become more fatigued. So, this is where
people may start to get a little bit more edgy, a little bit more
irritable, a little less patient. And of course, that can
happen on a continuum as well.
Dr. Halena Gazelka: Why do you think people are becoming more
edgy and even, I mean, I would say angry sometimes in some of
the things that I see on social media, for instance,
Dr. Craig Sawchuk: Well, the latest catchphrase is panger.
You know, how our kids used to talk about being
Dr. Halena Gazelka: I didn't hear that one yet.
Dr. Craig Sawchuk: Yeah, well as our kids used to talk about
being hangry you know, being irritable when they're hungry.
Well, now it's kind of irritable with the pandemic. So, panger is
what we're seeing. And honestly, the anger is coming from so many
different angles. And again, it's been going on for a long
time. So, we can think about just frustration with wanting to
get our lives back. You know, we're just hoping for the end of
the pandemic so we can get back into doing the things we would
ordinarily do, the things that we've been cut off from over
time. Then we can think about just frustration that we can
have with people that we feel are not doing their part, to
manage a pandemic, whether it be pushing back on vaccines, not
social distancing, or masking, or doing other things like that.
And then reverse some people who are just angry because they feel
like their rights are being infringed upon because of these
different mandates that are put into place. And then you also
like take this backdrop of other stressors that have been
happening to us that also evoke anger, you know, civil unrest,
and some of the political things that have been happening. So,
it's just been a lot of anger all coming together kind of at
the same time.
Dr. Halena Gazelka: So, how can we fight that? Craig, how can
we encourage the development of empathy in ourselves and in
others?
Dr. Craig Sawchuk: Well, I wish it was as easy as it is, would
be to say, well just stop being angry, you know, just relax.
It's not that easy. It's a lot easier said than done. I think,
you know, the number one thing is we have to acknowledge, you
know, the anger. Anger is a normal human emotion. And there
are lots of things to be angry about, you know, these days. So,
we just got to be honest with ourselves that just because
we're feeling that anger, feeling that frustration, we
don't want to overly pathologize it. Now, again, it can be too
much of a good thing. But there's a couple of strategies
beyond acknowledging that, that you want to pay attention to.
The first one is actually recognizing that as emotions get
cranked up that flexibility in our thinking, and our ability to
problem solve actually goes down. This is true for all
emotions, anger included. And unfortunately, we can all point
to experiences in our own lives where, yeah, anger has kind of
gotten the best of us. And then after the fact we're thinking
that probably didn't come off, you know, the right way, or it's
gotten us into trouble in some ways. So, one of the first tips,
you know, beyond acknowledging that anger is to even do some
brief relaxation related exercises. These are among the
most easily done portable types of skills that we can have out
there. But what it does is it helps to give us more
flexibility in our ability to think and to problem solve. So,
doing relaxation is one. Second is part of our mindset as well,
too. And that's really where acceptance comes into play.
Because there's probably a whole host of things that we're
getting really angry and frustrated about that are really
based upon things that we don't have much control over. So, if
we can acknowledge, well what parts of this equation can I
have control over and what parts do I not? Maybe we can put
aside some of the parts that we don't have as much control over
and try to use that anger in a motivational way, because anger
is an upper regulating emotional state, can we funnel that anger
towards doing something that may be more productive, or maybe
able to help us out a little bit more?
Dr. Halena Gazelka: Craig, one of the things, little practices
that I have in my life that I think has helped me is that I
try to practice gratefulness on the way to work in the morning.
So, I have about a 15-minute drive into Mayo Clinic in the
morning. And so, I try while I'm driving in the car to list
things. I'm alone, so I can do it out loud, that I'm grateful
for and I try not to make it be the same things every single
day. But I think that helps put me in a better frame of mind as
I'm facing the day.
Dr. Craig Sawchuk: That's another great strategy that you
identify there because it's very portable. And it's really
helpful for us because if we think of how the brain works,
the brain is just naturally hardwired for threat. So, we're
much more likely to pay attention to that threat, and
again, there's threat everywhere these days. So, we actually have
to like help our brain to kind of balance it out and refocus a
little bit, and doing very deliberate practiced
gratefulness exactly like how you're describing it and kind of
weaving it into already part of you know, the daily routine is a
wonderful way to kind of get your mind in that better
mindset. And kind of depending upon the morning, and where
you're at sometimes maybe taking a scenic route into work and
maybe giving yourself 20 minutes or 25 minutes to get in, you
know might be helpful as well, too.
Dr. Halena Gazelka: I might need a little more time for my
gratefulness.
Dr. Craig Sawchuk: Exactly, exactly.
Dr. Halena Gazelka: Craig, I've been curious about the toll that
the pandemic has taken on mental health in the United States. I
have often wondered if there will be some incredible fallout
from this in some way. Is there are more anxiety and depression
due to the pandemic?
Dr. Craig Sawchuk: Yeah, we initially saw this anecdotally,
but clinically and now the research is really backing it
up, as time is going along the studies are now starting to come
out that are just tracking what's the pulse of mental
health symptoms that people have been reporting across time in
the pandemic. And one of the largest studies that have come
out over the course of the pandemic, has looked at reports
of symptoms of anxiety, depression, even trauma, and
insomnia are up anywhere between two to four times higher over
the course of the pandemic, as it was at the same time, kind of
pre-pandemic. So, we're seeing, you know, this big surge and it
totally, you know, again, it totally makes sense when you
think about the human experience of dealing with these stressors,
the uncertainty, the job instability, economic fallout,
you know. As you mentioned, and all these other things, not
being able to do the things we'd ordinarily enjoy doing or blow
off steam. A lot of that is leading to just that increased
pressure. And you really see not only people that historically
have struggled with some mental health related difficulties, but
we're also seeing people that maybe have, you know, have had
stressors in life, but maybe not to the point where it's gone
into the direction where they've been experiencing more
breakthrough mental health symptoms. We're seeing a lot of
that as well, too.
Dr. Halena Gazelka: Craig, do you think people are more
willing to seek help for mental health issues now? And how
should an individual know if they need to seek help?
Dr. Craig Sawchuk: Yeah, it's been in a weird sort of way it's
been one of the silver linings to the pandemic, again, I say
that.
Dr. Halena Gazelka: I love silver linings.
Dr. Craig Sawchuk: Yeah, we need silver linings as part of the
things that we're grateful for. But do we ever want a pandemic?
Of course not. But one of the big things that's come out of
the course of the pandemic is just an awareness of the toll
and the mental health toll that this is having on us. So, in
turn, we've seen a lot more public health messaging about
the importance of looking at your mental health, as health.
We've also seen a lot of clinics and other hospital, you know,
programs, really investing more in their mental health services,
companies increasing, you know, their insurance to be able to
help support people with mental health. We've seen transitions
in the delivery of mental health services by going from in person
to now doing virtual, both individual and groups. So, these
are some really good things that have come out of it. Certainly,
when you're finding things like worry, and stress, and even your
mood going down to the point where it's really causing
problems in your day to day living, being able to keep up
with things, whether it be at work, or at home, or even
withdrawing more socially much beyond what we're recommending
from a public health perspective, these days. That
would be important, you know, to check out. And always one of my
favorite places, and I know I'm biased with this, but one of my
favorite places to check out first is to talk with your
primary care team. They know you, they know your health care,
they also know what resources are available, and they can help
you with focusing your search on finding what might be the best
mental health resource or resources for you.
Dr. Halena Gazelka: Again, I'm going to switch us a little bit
to the holidays because they're looming large. We're getting
very close to October right now. As we get to the holidays, is it
okay for family members to discuss their vaccination
status, and to make decisions for the holidays based on that?
Dr. Craig Sawchuk: Yeah, when you take a step back, we're
still in a public health crisis. And when we think about the
nature of COVID, where it's a publicly transmittable, you
know, condition, and the consequences of that can be, you
know, quite terrible, it totally, totally makes sense,
you know, to be able to have this as a focus of conversation
in your planning beforehand. And chances are, we're this deep end
of the pandemic that families already have been having these
conversations, sometimes arguments, you know about where
they stand, you know, on the pandemic. But when we think
about, like, under normal circumstances, under non
pandemic times, when we get together with our families
during the holidays and traditions, well, what does it
look like? We're all kind of crowded in a small area,
probably not ventilated, you know, the best where we're
hanging out, there's lots of contact and touching, we're
sharing food and other things. I mean, and that's great. And
that's how holidays should be spent. But if we think about
that in the context of a pandemic, you know, right now,
that's really hard to navigate. And especially folks that may
not be vaccinated, you know, during that time. And that's
where I think it's very, very appropriate that people do hold
those conversations so they can think about the planning for
that.
Dr. Halena Gazelka: How do you say that nicely if you feel you
shouldn't participate? How can individual share that and be as
least offensive as possible?
Dr. Craig Sawchuk: Yeah, and this is where we always want to
think about both the message and the delivery of it. But we'll
Dr. Halena Gazelka: Thank you for that, Craig. That's always
take a step back. And I think what's important too, is pay
attention to your own values. What's important to you?
Is important for you to maint in safety and health of not o
ly yourself, but of your family as well, too. And if that'
a primary value, that should b a good motivator to hold,
ou know, these conversations wh n we're worried about getting in
o a situation, or maybe ev n pressured or guilted in
o getting into a situation th t objectively is higher risk. S
, it's important that when we' e planning on having
a conversation like this is th t we're doing it in accordan
e with our own personal value . Now, it's also important to kn
w that this isn't going to be a debate. The last thing t
at anybody needs to do is get dr wn into a debate to defend,
ou know, their position on things. So, you can always couch
it in a way that, I love you, an I want to be there, or a fami
y wants to be there, but giv n where we're at right now in th
pandemic, we're unfortunatel going to have to take a pass o
it this year. Likewise, you ca also look at, well, what ar
some maybe alternate option that can be found? Is there an
kind of middle ground of bein open to that, whether it b
doing some of this virtually, o maybe during a time when there'
not as many folks gettin together with a smaller grou
who are more vaccinated? Or ca you do the drive b
Thanksgiving, where you chat ou on the driveway where it's mor
ventilated and other things. So there are some flexibility an
ways maybe that we can approac it. But trying to approach th
situation with sensitivity an compassion, but remember, it'
not a debate. If, you know, i 's consistent with your valu
s, this is what you need to do, hen just couch it in that mann
r.
Dr. Craig Sawchuk: Right, and we're craving so much to get
difficult, and I think the pandemic has in some ways real
y polarized things a bit for fou folks.
back together again. So, as the calendar comes right back around
again, it's like we were dealing with this stuff in 2020, and we
thought for sure by 2021, it was going to be the best
Thanksgiving and the best Christmas ever. And now we're
looking down the barrel of, okay, well, we've kind of had
some practice, you know, with this. So, again it's
acknowledging that it's been really, really tough, and we
desperately want to get back together. But the best way that
will get us out of this pandemic is if we continue to take all
those good public health measures.
Dr. Halena Gazelka: Thank you so much, Craig. Any last words of
wisdom for our listeners today?
Dr. Craig Sawchuk: Yeah, just continuing to stay optimistic
about things. I know things are going to get better. They will.
And we've made already tremendous progress. When we
consider where we actually were at this time last year, we now
have, you know, vaccines. Our therapeutics are getting better.
The boosters are here and almost here for other parts of the
population as well, too. So, we'll eventually get to the
other side of this. We just got to continue to work on our own
patience and continuing to treat other people you know, with
patience and kindness as well.
Dr. Halena Gazelka: I like that. And I love that you mentioned
silver linings about COVID. I love to think about the silver
linings because I think it's part of that remaining
optimistic.
Dr. Craig Sawchuk: Well, you got 15 minutes at the start of every
day on your drive into focus on silver linings. Just make sure
you're also paying attention to the road while you're driving in
too.
Dr. Halena Gazelka: Thank you so much for being here today,
Craig.
Dr. Craig Sawchuk: Great. Thanks for having me.
Dr. Halena Gazelka: Our thanks to Mayo Clinic psychologist Dr.
Craig Sawchuk for being here today to talk to us about
COVID-19 and mental health. I hope that you learned something.
I know that I did. We wish each of you a wonderful day.
Narrator: Mayo Clinic Q&A is a production of the Mayo Clinic
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