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8 Steps to Caring for your Mental Health During COVID-19
By Dr. Geoffrey Grammer , Chief Medical Officer for Greenbrook TMS
As COVID-19 impacts the world in an unprecedented way, it's more important than ever to support and manage your mental health. Anyone's resiliency can be taxed by factors such as loss of control, social isolation, fast-moving information, mortality fears, and an uncertain end date to this situation. For those already managing depression, maintaining your mental health during the coronavirus can be an even bigger challenge. However, there are many small things you can do to help yourself push through this difficult time. I'd like to offer some actionable strategies to preserve your physical and mental well-being during this crisis.
Maintain Normalcy With a Routine
We all will need to establish a new sense of normal by modifying our lifestyle to stay physically well and sustain good mental health. Here are some simple steps to help you set up a new routine. Consider selecting one or two to start with, and then gradually adopt more habits from there:
Step 1: Wake up at the same time every day, even if it means you have to set an alarm.
Step 2: Take care of your normal hygiene tasks, such as showering and brushing your teeth.
Step 3: Get out of your pajamas and put on daytime clothes each day.
Step 4: Prepare breakfast, and continue to eat nutritious meals throughout the day using a variety of food groups. Do try to eat regularly, but avoid eating non-nutritious foods in excess. Also, avoid excessive alcohol consumption and illicit drug use.
Step 5: Utilize technology to reach out to friends and family , whether on the telephone or the internet. This will help you to feel more connected and less socially isolated.
Step 6: Get some exercise. It's just as important as ever.
Step 7: Go outside for some fresh air and sunshine while staying compliant with recommended social distancing guidelines.
Step 8: Establish a bedtime and stick to it each night so your circadian rhythm doesn't become imbalanced.
Additionally, challenge yourself with something that will exercise your mind, such as learning a new skill or playing a game with others in your household or with friends online. You may want to try building a model, painting by numbers, or knitting a scarf. Identify little things you can accomplish in a specific period of time, not big projects that might be difficult to accomplish or would take extended time to complete. These tasks can offer you a reprieve from the general feelings of uncertainty during this time.
Managing Your Mental Health Care
Fostering a robust immune system and protecting your mental health during the coronavirus crisis are big parts of your overall well-being. The Centers for Disease Control and Prevention recommend
patients continue with their mental health care . While for some this may mean keeping up with talk therapy appointments and medication regimens, at Greenbrook NeuroHealth Centers we want you to feel reassured that you can still get TMS therapy at our locations, which remain open to provide needed care to our patients even as the world practices social distancing and sheltering in place.
To ensure your TMS treatments are provided as safely as possible, we are continually updating our policies and procedures to account for COVID-19 considerations. As of today:
- We are staggering appointments to keep our waiting rooms as empty as possible, and we disinfect waiting areas several times a day.
- Staff are practicing social distancing and modifying approaches to device placement to minimize risk of respiratory spread.
- We are requiring anyone—staff and patients alike—who has symptoms associated with COVID-19 to be assessed and released from quarantine recommendations by their primary care provider before they can return to the center.
- We disinfect all equipment and surfaces between patients, and our devices use hygienic barriers, which are changed between patients.
- Our staff will be wearing masks to minimize the risk of spread of respiratory droplets.
- We offer telemedicine services for some types of appointments.
What to Do If Your Symptoms Worsen
A pandemic can challenge anyone's coping mechanisms. Disruptions to routines create barriers to coping strategies, which makes
managing your mental health during a crisis an additional trial to contend with. You may find yourself tending toward catastrophic thinking due to the narrative of this pandemic, which can create a harmful feedback loop. You may also find yourself tempted to adopt unproductive coping strategies.
You can prevent worsening symptoms by working on a healthy routine, staying mentally active, and avoiding maladaptive behaviors, such as sitting on the couch all day or not connecting with friends and family. Don't hesitate to reach out to a professional if you need to. Let your provider know if you have difficulties with sleep or nutrition, you develop thoughts of self-harm, or you notice your symptoms getting worse over time. If you are taking medications, make sure to take them as prescribed. Don't compensate by taking more than prescribed or try to ration them by taking less. If you need immediate help, please refer to our list of emergency resources .
Above all,
stay engaged in your mental health care. Getting support and treatment for your mental health is no less important than fixing a broken arm or seeing a cardiologist for heart disease. Mental health treatment should not wait, so please
reach out to us if you need assistance. We at Greenbrook TMS care about your well-being. We will be here for you during this pandemic and as you take steps to recover.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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