Published on Apr 14, 2020

  • Published on Apr 14, 2020
  • Society "wasn't designed to hide out and live in fear," so steps must be taken to recognize and overcome the losses.
  • COVID-19 could be a triggering event for a subset of kids who has anxiety or obsessive compulsive disorder.
  • Calling, texting, or video chatting with the eldely and others experiencing lonliness can bring joy and distract both parties from the current anxious situation.
  • Upon waking, don't focus on fears but instead be mindful of what you can do and how you can show love.

Video Transcript

JOHN WHYTE, MD, MPH: Hello. I'm Dr. John Whyte, Chief Medical Officer at WebMD. And welcome to Coronavirus In Context.

Today, we're going to talk about some of the mental health effects that might be occurring as a result of the pandemic. And my guest today is Dr. Seth Gillihan. He's a Clinical Assistant Professor of Psychology at the University of Pennsylvania. Dr. Gillihan, thanks for joining us.

SETH GILLIHAN, PHD: Thank you, John. It's good to be with you.

JOHN WHYTE: Now, we've seen some different information in the literature whether the elderly might be more at risk for developing mental health issues, or maybe they're less at risk. Tell us in your experience who's most at risk of developing some mental health issues as a result of kind of these mitigation strategies that we're using?

SETH GILLIHAN: Well it's a great question. I think the biggest issue is that all of us are at risk in some way. And so I think the best we can do is recognize what our particular risks are.

So for the elderly, it may be you know certain types of isolation or you know, the greater threats that they face if they do get the virus. But you know, for young people who had to leave college abruptly or not come back from spring break, there's that additional challenge not only of being away from friends, maybe being away from a girlfriend or boyfriend, but also having the joy of living with their parents again for an extended and indefinite period of time. So I think we all need to think about what has changed in our lives as a result of this social distancing.

JOHN WHYTE: Is there a sense of loss that people are dealing with right now?

SETH GILLIHAN: There is a tremendous loss, John. I think part of the risk that we face is not recognizing all the things that we've lost and how profoundly our lives have changed. I think there's -- I mean, for good reason, I think a lot of us are looking for silver linings. Or this is great. I'm getting to spend more time with family.

And maybe we all need to take a collective sigh and take a breath so to speak. And yet, we were not designed to live this way. We weren't designed to live in fear of other people and kind of hiding out. And so we need to recognize things have been lost, so that we can as you suggested, mitigate those losses as much as possible.

JOHN WHYTE: Is there a risk our children are going to be afraid of close contact with people because they're being told to stay you know, 2 meters, 6 feet from anyone?

SETH GILLIHAN: It's certainly a concern about my wife and I have for our kids not wanting to train them to be afraid beyond what's necessary for the current crisis. The -- It seems to be the case that for most people, there won't be long-term effects -- that we'll manage the short term, and then kind of go back and adjust back to the way things need to be when things are resolved. But there are certainly as a subset of kids who probably are susceptible to anxiety or obsessive compulsive disorder. And this could be their triggering event.

JOHN WHYTE: And then how do we manage that?

SETH GILLIHAN: I mean, it's more difficult when one person is prone to a lot of anxiety or obsessions. But I think, you know, we would do the reasonable thing from a health perspective, and then you would not go beyond what we have to do. And be somewhat vigilant for signs that those precautions are extending beyond what's necessary now or beyond when the danger -- the immediate danger has passed.

JOHN WHYTE: And you reference we're all living together. Some of us now have extended members of the family back into our home. Sometimes it can be tight quarters. What are some of the emotional issues that are a result of this closeness, I'll call it?

SETH GILLIHAN: Well John, I'll have to rely on other people, because all we're experiencing here is joy, happiness. But I mean, seriously, I think my family is probably not that different from typical families where we're experiencing a good bit of frustration at times, a certain tension. There's a stress we can feel that kind of pervades our experience.

So it's not like we're always at each other's throats. And there are times of real connection and closeness, but also a sense of you know, just like, some space. I would just like a little social distancing within these four walls, if possible.

JOHN WHYTE: And how does the role of uncertainty play into this? It might be different, right, if I told you need to do this for two weeks. But I'm not sure how long I have to tell you to keep doing it. Does that play a role in kind of our mental health, our physical health?

SETH GILLIHAN: Yes, that's a huge role. I was just talking to my wife this morning about this. And we were thinking together about how uncertainty really is central to what makes this so difficult. Because even if we knew it was going to be, let's say December, all right, we could adjust to that. But it's that -- the human mind and our spirits have a really hard time with managing that uncertainty. So not knowing just yet, it makes it very hard to tolerate.

JOHN WHYTE: And on the other end, how do we deal with elderly parents elderly friends who might be alone, who aren't living with other people? How do we address the issue of loneliness?

SETH GILLIHAN: Well, as much as we can, I think we can reach out to them, whether through the phone, texting, email, video calls, if you're up for that kind of thing. But that can be a really useful exercise for ourselves to get out of our own heads or kind of anxious preoccupation with am I going to be OK? How's my loved one doing? Reaching out and calling them can help them and ourselves.

JOHN WHYTE: And if you had a couple tips to share about how to maximize our mental health and our physical health during these times of quarantine, these times of uncertainty, what would they be?

SETH GILLIHAN: The first one would be managed to the bookends of your day so when you wake up, ask yourself the thoughts, worries, fears -- oh yeah. I'm in the middle of a coronavirus crisis. That's going to come to mind right away. But if we can shift to, all right, who do I want to be today? What do I want to bring to this day? What quality of presence?

How can I show love? So set the scene from the beginning of the day. At the end of the day, ask ourselves what went well? And you can give thanks we've made it through another day. So that's the first. And the other is, get good practice at recognizing the mind stories, because we're telling ourselves stories all the time. And a lot of them are trigger anxiety stories like, I'm going to get sick, or this is never going to end, or I can't stand this, or I'm going to lose it. These predictions that we mistake for a direct read on reality.

So we can recognize, all right, that's a story my mind is telling. Maybe it's true. Maybe it's not. That can loosen the grip of some of those anxious thoughts and turn our minds into an ally instead of an enemy.

JOHN WHYTE: Do we need to limit our intake of news and social media? Some people are calling this an infodemic as well as an epidemic. How does that exacerbate perhaps, some underlying mental health issues?

SETH GILLIHAN: Well, there is this sense that we need to be constantly vigilant. And there's -- and -- because things are changing relatively quickly, but probably not nearly as quickly as we're checking. You know, they're not changing twice an hour, for example.

So yes, I think backing away from some of the constant intake of news. Because there is enough to absorb if you check once or twice a day, then constantly looking for -- I mean, I think coming back to the uncertainty you mentioned, that we're all looking for a resolution to that uncertainty. But it's not going to come with the next mouse click. This is going to have to unfold over time.

JOHN WHYTE: Well, that's good advice. Thank you, Dr. Gillihan.

SETH GILLIHAN: Thank you, John.

JOHN WHYTE: And thank you for watching Coronavirus In Context. I'm Dr. John Whyte.