Fear and uncertainty caused by the outbreak of coronavirus disease 2019 (COVID-19) has been overwhelming for many in our community. Necessary self-isolation and the inability to be near our family and friend support groups only further exacerbates the stress we’re all feeling. To help readers understand how they might better manage anxiety and avoid harmful thought patterns and behaviors during this time, we reached out to a local expert for some guidance. Dr. Daryl Appleton, LMHC is an East Greenwich and Newport-based therapist and owner of Polaris Counseling & Consulting. Here’s what she said about mental health management and how accessing therapy is changing during these unprecedented times.

What are your recommendations for managing mental health and anxiety during social distancing and isolation when there’s a crisis – a time when people naturally want to physically be together?

Evolutionary psychology has taught us that we are pack animals. Social distancing is something that goes against that innate nature to want to be a part of something. My tips for managing your emotions in a time of separation:

1. Stay connected. one of the best signs I have seen in Newport said, “stay home but stay homies”. Check in with your tribe “face-to-face”, FaceTime, Instagram, Facebook, WhatsApp all have video messaging capabilities. This is also a really great time to expand your social circle as well. There are lots of really great communities popping up virtually that are also a great way to expand on interests, grow your network, and touch base with other people.

2. Make sure your basic needs are met. Let’s take this a step further. Make sure your basic needs are WELL met. This means food, water, exercise, shelter, sleep. Getting through our first week may have incited a bit of a food/sleep/binge watch frenzy but now that we got it out of our system let’s try to refine the process. Grab your favorite cookbook (or any cookbook) and try new meals. Set an alarm and keep a routine to get from being sluggish. Workout with local gyms streaming videos or apps. Keep your space clean and as clutter free as possible. These will help keep you sane in the times in between checking in with others. 

3. Work on yourself. I help those who work with me name their emotions, normalize their feelings and navigate through difficult times. While having a therapist or a coach is helpful in this process you can also find things to work on yourself at home. Grab a journal and start to process feelings that come up with online prompts (you can check out my Instagram page @drdarylappleton for these). Start listening to podcasts, webinars, and reading on topics that speak to changes you’d like to make in your professional, personal, and parenting life. Challenge unproductive habits and amend emotional and psychical processes and responses. 

What are your recommendations for people who manage mental health issues such as addiction, depression and general anxiety disorder at this time?

One in four Americans suffer from a mental heath disorder, for many depression and anxiety are a normal part of life. While the rest of the world is feeling the panic of COVID-19 a lot of people suffer from this level of emotional distress everyday. For many who are struggling, this type of event could feel like a setback in progress, but that is not necessarily true. Lean into your resources, virtual therapists, online access to readings/videos/teachings etc. If there are any thoughts of suicide reach out to 9-1-1 or the Providence Center Crisis Stabilization Unit or Butler Hospital. 

For others, many untreated symptoms of excessive worry/panic/or depression can and most likely will lead to clinical issues if not properly treated. I recommend everyone speak to a therapist during this time anyway (though I am biased) but I absolutely think that if you finding yourself in a mental space that includes elevated worry, difficulty sleeping, change in eating, intrusive thoughts, and anger/irritability call right away. 

What can we do to best support loved ones struggling with mental health issues during this difficult time?

Support looks different to everybody. Asking your loved ones “what do you need”? is sometimes the most simple yet meaningful way of checking in. Allowing others space to process out loud and being a validating force can make all the difference. My specialty is in working with people in high-functioning, high-stress / high-burnout jobs. Right now, health-care workers are at the top of my list to challenge in caring for self. Long hours, vicarious trauma, and solving complex high-risk problems are grounds for future burnout and issues with wellness. It would behoove many of those in medicine to look into ways to self-care and cope when outside of their job. 

How is social distancing affecting people who regularly attend group therapy, such as AA? How is group therapy adapting?

With things changing so rapidly, people losing their jobs, and being separated from routines and loved ones can absolutely impact sobriety. AA.org has a great list of resources, YouTube videos, Grapevine audio and digital resources, online “intergroups” and more for anyone struggling with recovery. Recovery is an action word and while COVID-19 has changed many things – it has not changed the fact that effort and intention are still needed in leading a healthy life that is supported by choices and overcoming challenges.

What changes to your business/practice did you have to make in response to COVID-19?

For the safety of our clients and staff we moved all sessions online using Zoom and good old-fashion telephone calls

How are therapists adapting to the need for social distancing? How are virtual/video meetings affecting appointments – does it make therapy harder?

Therapists have really taken to the internet in some amazing ways.  In addition to being able to provide virtual sessions, many of us have been offering free webinars, live streams and video content as a way to connect with anyone struggling with emotional challenges as well as gaining skills for coping/communication/parenting/etc. The clients who have had hesitation with virtual therapy have mostly been because it feels unfamiliar and more “exposed”. At times they worry about the “awkwardness” or the lack of privacy. In all reality it makes therapy a lot easier. People don’t need to interrupt their days, fighting traffic, finding childcare or leaving meetings, to get to my office. They have therapy access anywhere, can make more last minute appointments, and have better luck of getting in, when needed. My advice, try it – with a few adjustments and many some creativity of getting yourself alone – you may find it to be just as good as sitting on the coach across from your therapist.

For the safety of our clients and staff we moved all sessions online using Zoom and good old-fashion telephone calls. 

Anything you want to share with the community or think it’s important for people to know during this time?

There is hope! There is a lot of research that highlights the benefits of difficult times in post-traumatic growth (PTG). PTG is a concept that is rooted in positive psychology and shows that we can use traumatic situations as an opportunity for personal and community growth. It is a chance to change the narrative from “why is this happening to me” to “what is this trying to teach me”. 

Check out the Polaris website and Instagram (@polaris_ri) for additional resources and announcements to free webinars.