Practical Steps to Ease Stress and Anxiety During COVID-19 with Dr. Susan Albers

Podcast Transcript

Deanna Pogorelc:  Hi, thanks for joining us for this episode of the health essentials podcast brought to you by the Cleveland clinic. I'm your host Deanna Pogorelc. We're broadcasting virtually today because at this time many of us are under stay at home orders to help reduce the spread of Covid-19. Now, Covid-19 is a respiratory disease that causes physical illness, but there's growing concern about the impacts that this pandemic is having on our collective mental health and well being.

Deanna Pogorelc:  So joining us today to talk through some techniques for coping with the stress and anxiety of the situation is psychologist, Dr. Susan Albers. Hi, Dr. Albers. Thanks for being here.

Dr. Susan Albers:  Hi. Thank you so much.

Deanna Pogorelc:  And to everyone at home, please remember this is for informational purposes only and is not intended to replace your own physician’s advice. So Dr. Albers, can we start by talking a bit generally about stress and anxiety? And I hear these two words used interchangeably a lot and together a lot, but can you clarify if there is a difference between stress and anxiety?

Dr. Susan Albers:  Well, stress and anxiety are very similar. They have both a physical component and a mental component. So if you are feeling stressed and many of us are feeling really stressed right now, if so, you are not alone. So this is very collective experience of stress and anxiety. So stress and anxiety, you may feel a bit overwhelmed, you may have difficulty sleeping, headaches, you may have some mood changes, lack focus, irritable.

Dr. Susan Albers:  With the Physical symptoms, you may notice that your heart is beating really rapidly. Some muscle tension, again, those headaches. The difference between stress and anxiety though is that with stress, there's often a trigger and we deal with that stress and find ways to cope and then we kind of move on. Anxiety lingers a bit longer and we may have a lot of mental worry and anxiety, fear around what's happening.

Dr. Susan Albers:  So, for example, a lot of my clients right now are talking about the different stresses and challenges that they're facing. Our bodies and minds are wired to resist change and all of a sudden we have an enormous amount of change, all of a sudden. So we've had to find different ways to cope. For example, a lot of people are talking about homeschooling, they've never had a homeschool before.

Dr. Susan Albers:  It's causing a bit of stress, but they're finding different ways to cope by reaching out to teachers, Googling about it, finding different ways and strategies. Anxiety on the other hand can really ... it can keep you up at night and maybe you have a lot of worries about where things are going in the world. So one of my mantras or what could be helpful for this stress and anxiety is to focus on your mindset of what is versus what if.

Dr. Susan Albers:  When we get into those what ifs, we start catastrophizing and thinking about all of the possibilities that could happen down the line and we don't know. All we can focus on and control right now is what is and focusing on that is going to help to lower your anxiety and to lower your stress level.

Deanna Pogorelc:  Is there any such thing as a good amount of stress? Does it serve some purpose in our lives to motivate us to do something?

Dr. Susan Albers:  Yeah. I mean right now we've all had a lot of stress and maybe it's motivated us to take action. For example, we are washing our hands more. We are reaching out to others in creative ways. We are finding new ways to cope that we didn't even know existed and we're also, for example, technology, maybe you are someone who never did your job online and now you are motivated due to this stressful event to find new ways to do your job.

Dr. Susan Albers:  So stress is not all bad and we can find different ways to cope, but if it does become overwhelming and something that you're having difficulty coping with, it's important to pay attention to. Don't ignore it because what we often find is that when we're stressed, our bodies are flooded with cortisol and it's that stress hormone. And when we are flooded with cortisol, we start doing a lot of things that are not so helpful for coping.

Dr. Susan Albers:  The number one thing I've been hearing about, and maybe if you're listening your experiencing this too, is emotional eating.

Deanna Pogorelc:  Yes.

Dr. Susan Albers:  Even people who have never emotionally ate in their whole lives find that this is one of the ways that they're coping and it makes sense because every day we do things that make us feel good, that provides serotonin and dopamine to our brain. And suddenly many of those things came to a screeching halt. We used to go to the gym, we used to go out and connect with friends, go to restaurants, distraction and those things are gone. But what is still around? Food.

Dr. Susan Albers:  So you might find that you are doing a lot more emotional eating. It is beckoning to you from the kitchen, the food, when you are feeling bored, anxious, stressed, any kind of emotion. So I think if there's sort of a take home message about this, if you're struggling with stress and emotional eating is to pay attention to that. And before you eat, take a moment to check in with yourself and say, am I really hungry or am I bored?

Dr. Susan Albers:  And one of the ways that we know that we are mindlessly eating or stress eating is that we're just popping it in our mouths kind of like zombies and not really experiencing or tasting it.

Deanna Pogorelc:  So are there other things that we can turn to instead of food that could give us that I guess comfort that we're seeking?

Dr. Susan Albers:  Yes, food gives us a bit of pleasure, but chocolate gives us a bit of a joy. But what we really need is soothing during this time. And it can be, and soothing is anything that helps us to relax our body. So it can be taking a hot bath, wrapping in and cocooning in things. A lot of people have been talking about wearing comfy clothes at home, that they have not gotten out of their comfy clothes.

Dr. Susan Albers:  And that's okay because that is soothing and that's what we need right now. It's really important if you do one thing, one thing that is going to help your mental health right now it's to get outside, even if it is for 15 minutes. There are many studies that look at what is called forest therapy and what they have found is that even just 15 minutes outside helps to reduce your blood pressure, helps to boost your serotonin and to help your mood.

Dr. Susan Albers:  So even if it's a cold or chilly, even if you can get outside during those days when the sun's out a bit also helps with your vitamin D level, and vitamin D is correlated with a positive node. So make sure that you get outside.

Deanna Pogorelc:  So on the topic of mood, I know you mentioned some people are finding they're maybe a little more irritable or maybe quicker and to kind of snap at a partner or a child, are there any strategies that can help us kind of pause and stay in the moment before responding to someone in that way?

Dr. Susan Albers:  So this is a great time to practice mindfulness and mindfulness is being aware, slowing down and responding rather than reacting. And that's what we do when we're irritable. We are reacting to the situation. So I have a little acronym, very easy to keep in mind when you're feeling irritable and it's stop. S-T-O-P. So S stands for stop. Take that pause when you notice yourself getting worked up or irritable. T is take a breath.

Dr. Susan Albers:  Now I would recommend take three breaths and if it helps, put your hand on your heart so you can feel your heart going in and out. It's three deep breaths. O is to observe how you're feeling. Name it. Whenever we name how we feel, it helps to lower our stress level as well. Just putting it into words and then P is to pick your action and really thoughtfully and consciously, whether it's something soothing, taking what I call an adult timeout, whatever it is. So, S-T-O-P, use that in the moment if you are feeling really stressed.

Deanna Pogorelc:  I think one of the hardest things of this situation is just all the uncertainty and that we don't know how or when it's going to end or what the world is going to look like after all this is over and that's really scary. So how can we prevent ourselves from kind of catastrophizing like you said, and getting in our heads and really getting stuck in playing out these worst case scenarios? It feels so easy to do sometimes.

Dr. Susan Albers:  It is. And it's true that these are very scary and uncertain times and one of the things that is important, that mindset again that can help in a mantra is to focus on what we can control and what we can do versus what we can't because we can get really stuck in, I can't go to work. I can't go outside, I can't connect with my friends and we can dive into that or we can focus on what we can do and there is an ... for many of us, sometimes we can make a list of those things that we still can control, that are completely within our control.

Dr. Susan Albers:  Things like what we eat because what we eat impacts how we feel and how we feel impacts what we eat. So we have control of that. We have control over movement. That's another technique I've been talking about with my clients is any kind of mindful movement. It doesn't have to be exercise. You don't have to dive into a strenuous exercise routine. Just get some movement can be really helpful to your serotonin level and your dopamine level.

Deanna Pogorelc:  So that could be something like yoga or something kind of relaxing that-

Dr. Susan Albers:  Yoga, one of the things I think is really important right now is journaling and writing. We are going through a historic time and things that we've never experienced, so writing them down, documenting them for yourself can be really therapeutic. You can get the perspective of your kids, your family members, you can interview them. You can ask questions like, what have you missed? Really insightful questions.

Dr. Susan Albers:  Also, a really fun thing to do is a recipe log and trying new recipes, writing down what you're eating every day, how you liked it, how your family liked it. Because our food choices also tell us a lot about our experience. So that's something that I highly recommend is to start journaling, start documenting. And if you're not a writer that's okay. You can take pictures, there are lots of kind of books that you can put them into albums and put text next to it.

Dr. Susan Albers:  It's a really fun thing that your family can do to keep you distracted. But also, like I said, it's very therapeutic.

Deanna Pogorelc:  So for those of us who are staying home, it feels like there's a bit of pressure to be really productive and to have the house clean and take up a new skill or do that house project we've been putting off. Are those realistic expectations for us to be having for ourselves at this time?

Dr. Susan Albers:  I would recommend every day waking up and taking your emotional temperature, think where it ... where are you every day because some days we are going to feel really motivated to do things and some days we're not. And that is okay. But as you're mentioning that we need to take the pressure off ourselves to be super productive and get things done. Really right now, many of us are just surviving and we have to focus on that.

Dr. Susan Albers:  And the two most important things for survival is paying attention to what you eat and how you sleep. So having some really concrete routines around those two things are really great, but if you do want to learn a new skill or do something new, that is great, that's great for our minds, our creativity keeps us really stimulated. One thing I've been recommending is that sometimes it can be very stressful to start something completely new, but choose something that you already like and do well and sharpen your skills a bit.

Dr. Susan Albers:  So for example, if you already play the piano, learn a new song. If you'd love to cook, do a new recipe, something that's going to really sharpen those skills and that's going to be ... cause a bit of excitement but not too much stress.

Deanna Pogorelc:  That's a great idea. Another thing I want to ask about is I've seen a lot of people giving or doing something generous during this time, kind of taking the downtime to write cards or write messages on their driveway and chalk encouraging people and that feels really good and I'm curious why that feels so good right now. Is there a certain power behind giving or being generous that makes us feel good?

Dr. Susan Albers:  Absolutely. Research shows time and again that when we help other people it helps us. We feel good when we are reaching out to other people. So if you can reach out or help someone in any way, whether it's getting groceries for an elderly neighbor or writing a card or reaching out to somebody from your past, whatever it is that you can do to help someone, that's great.

Dr. Susan Albers:  Another thing I ... a client did was write some encouraging signs and they put them in their yard. So when people are driving by, they would see them and they put some messages in other people's mailboxes. So there's all different kinds of ways that you can encourage people or provide help either ... also too, if you are seeking help, I really encourage people to continue to reach out who are struggling to their mental health professional.

Dr. Susan Albers:  So right now, therapists like myself have moved from in session to online. We're doing teletherapy. So if you're somebody who has already done therapy or was thinking about it, this is a great time to do it because from the comfort of your home, many people are online and they're there for you. So, don't forget to reach out.

Deanna Pogorelc:  I want to go back and talk about some of the other strategies that we know are effective in fighting stress that we can build into this new daily routine that we're creating. And you've talked a bit about movement and about taking breaths. Is there anything else?

Dr. Susan Albers:  There's another breath exercise that I just love, really easy, but it includes some visualization and mental imagery, which I love because I ... that helps me to complete it. So this is what I call the squeegee breath. And we've all used the squeegee on our windows to clean them. And what you do is that you can close your eyes or not, whatever feels comfortable and imagine that squeegee at the top of your head and in one as you are breathing out, imagine all those black or toxic negative thoughts flowing out from you.

Dr. Susan Albers:  And as you take a deep breath in, imagine the clean air or clean water, filling your lungs, filling your heart and repeating that imagery. And I just really liked that because I think it's one that we all need right now. We can ... we all have a lot of toxic thoughts and just as you breathe in and out and breathe in, those positive thoughts I think are ... can be really helpful.

Dr. Susan Albers:  Also, connection. You've probably seen right now a lot of pictures of people on Zoom connecting with their family members. What a great way to help to boost your mood right now. So schedule those Zoom or whatever kind of platform you use. Phone calls, gather with your family, have a meal with them, invite them to a virtual dinner or you can have a dance party. That's another fun thing that you can do as well to incorporate in that movement. So I think that's ... there's connection that can go a long way.

Deanna Pogorelc:  So I think it's good to stay informed about all that's happening in the world right now. But is it possible that if we're constantly getting news alerts on our phone and logging into social media to see what's going on, could that be actually contributing to some of this stress and anxiety that we're feeling?

Dr. Susan Albers:  Absolutely. Be mindful about how you consume the media and in particular not before you go to bed, maybe first thing in the morning or actively check in. Mute some of those alerts unless they're really important and urgent. But what I've found is that people who are watching a lot of the news before they go to bed, causes a lot of anxiety and insomnia that, that's the last thing that you're thinking about before you go to sleep. So be just really mindful about consuming that media. That's going to be very helpful to your mood.

Deanna Pogorelc:  And if we're able to develop some good new habits during this whole thing, maybe we do get better about the phone hygiene and creating good habits and moving, how can we make sure that we continue doing all of those things when all of this is over and we're back out in our regular lives?

Dr. Susan Albers:  I think this is a big exercise and life lesson, right, of maybe it's not academic lessons, but life lesson and what we can take from it I think are some really ... some points of resilience that we as a society and people, we find ways to cope and those aren't really things that we can carry forward. A lot of my clients are doing reading right now and some of the things that they're doing are reading stories about people's lives who have ... who've had to go through a lot of difficult times or trauma or things like that and were resilient and actually came through it on the other side.

Dr. Susan Albers:  So that's something that can help to motivate you as well if you're looking for something to read is some biographies on people who have really struggled and taken those life lessons and moved them forward into being successful. And I think that's something that we all can do. So every day, list what you are grateful for because there are many things that we did not appreciate before that we are grateful for now.

Dr. Susan Albers:  And those will, I'm sure carry forward as well as any lessons that you have learned that you want to continue. Maybe it's a new routine, maybe it's a new way of connection, whatever it is that you want to continue forward, write it down so that it sticks with you.

Deanna Pogorelc:  And then what are some signs that people maybe should, you had mentioned a lot of mental health providers are practicing virtually right now, what are some signs that maybe that would be helpful to someone?

Dr. Susan Albers:  So if you are not sleeping, if you're really having a lot of difficulty sleeping, if you're having changes in your appetite, if you have lost your appetite or you feel like you're overeating or your eating is out of control, if you're turning to any substances repeatedly, if you are using traditional ways that you cope and they're just not working and that it's not subsiding, these are all really big red flags that it's time to reach out to your mental health professional or your physician.

Dr. Susan Albers:  They're doing virtual visits as well and if you just feel like you're struggling or maybe other people are putting this out to you or if you're isolating, often people aren't kind of crawling into bed and putting their covers over their head and they are just isolating even more, that would be a sign as well that you're struggling and it's time to reach out and that's.

Deanna Pogorelc:  Great. Well you've given us some great tips. Is there anything else that we haven't covered that you want to share with the listeners?

Dr. Susan Albers:  I would just say to stay well, be mindful. Use those mindfulness skills and just that here at the Cleveland clinic we are really thinking about you and we want everybody to be safe and to take care of yourselves.

Deanna Pogorelc:  Great. Well, thank you so much, Dr. Albers for being here. For the latest Covid-19 from Cleveland clinic, visit clevelandclinic.org/coronavirus and to listen to more Health Essentials podcast with our experts visit clevelandclinic.org/hepodcast or subscribe wherever you get your podcasts and for more health tips, news and information, follow us at Cleveland Clinic, one word on Facebook, Twitter, and Instagram. Thanks for joining us.