Beating the lockdown blues

Contact Talk Radio. And on tunein.com, hang.fm, and UpSnap Mobile. Contact Talk Radio. Welcome to Medicine and Health with Dr. Paul Anderson. This is a show about opening up the often mysterious world of how doctors think. The goal, to empower the listener to gain access to the best healthcare possible. Good day and welcome to Medicine Health with Dr. Paul Anderson. That's me, I'm Dr. A, and today we are, uh, going back to— I don't know if you watched last week's, uh, long podcast, but we're going back to more questions. But, uh, last week, if you listened, uh, it's it's in the podcast queue, is Q&A with Dr. A about immunity, etc. Well, if you listen to that, you probably heard a lot of very specific questions around, you know, how do we take care of our body? How do we take care of our immune system? What's going on with, you know, reinfection and all these things? There were a bunch of other questions that led up to, I think, a really important thing to consider. And so the title today is, you know, Beating the Lockdown Blues. That was the gravity of the other questions that really came up. And so when you think about this, I think there's nobody anywhere probably in the world who hasn't felt one level or another of, you know, infringement or change in their normal, uh, operating, you know, parameters for their day or whatever. But you've got things like depression, substance abuse, ill health generally in people, uh, a lot of mental emotional problems going on. And statistically, they're all on the rise. And this rise of this sort of COVID funk, you know, that many people are in doesn't seem to be really slowing down. And here we are at, you know, past a year and a half going on, you know, at least since we sort of officially said COVID was here and we need to do something about it. So I think that the majority of the questions really wrapped around, number one, You know, what statistically is going on? Is it really a bigger problem, or is this just something, you know, that the media is sort of blowing up? Is, you know, sometimes there's both can be true at the same time. So, you know, statistically, what's going on? What kind of things are people reporting most commonly that are going on? And then, you know, what are some strategies to help to deal with this? Um, and I wanted to really make this focus on information like I try to do usually, uh, getting you, you know, actual factual statistical information about the— paint the picture, how good or bad is it, what are the major problems. We certainly won't talk about everything today, but what are the major problems? But then really, you know, what are some strategies for us to deal with these things? Because You know, this isn't changing anytime soon. There is now, if you look at the United Kingdom, remember I keep talking about the UK because they're ahead of us, like with Delta. They're now looking at this as not a pandemic but an endemic, endemic, you know, kind of a chronic infection in the human population. And basically what that means is it's endemic like influenza is or the common cold, et cetera, meaning it's gonna be here. So even with higher vaccination rates and reaching herd immunity and all of that, it's gonna be a while before things really shift and change. And in North America, Canada has had sort of some different rules than the US. The US, depending on what state you're in, has different rules. But we all recently, if you're listening to this, live, and this is of course September 2nd, 2021. If you're listening to this live right now, uh, you all have, you know, lived through the, you know, mask mandates and then no masks if you had a vaccine, and then go back to having mask mandates and all of those things. Um, so I think realistically, although technically this infection and the human population are reaching a herd immunity state, that will be helpful. And that's a combination of natural, uh, natural immunity due to post-infect— past infection and immunization, or some combination of the two. Um, that's a really good thing, but it's going to be a while before I think this all settles down in the world of, uh, you know, you could say the media and public opinion, and also government and what they're doing about it or what they're not going to do about it. And then just state and local rules. For example, You know, when mandates were reimagined after they were taken away by the CDC for masks, different states have done different levels of this. And so you have states like Oregon where I think— I'm not in Oregon, but I'm close— where they have outdoor mask mandates. Here in Washington, we have basically the same mask mandates we had before. 4. And other states, you know, have different versions of all of that. So I think that it is important to realize that, you know, the way that this is affecting us, what I'm calling the COVID blues, just for lack of a better term, that's going to be around for a while. And so I wanted to start with some actual numbers because You'll have to apologize. My throat is very, uh, dry today, so I will be drinking during the, during the talk here. But, um, I want to start with numbers because the, um, the level of anxiety and unclarity and a number of other things rises when we lack information. And to be honest, some of these are numbers I've seen all along, but I never sat down and went through them, uh, from, you know, a reputable source and looked at them, you know, all in one place as far as, um, the, the major topics we're going to talk about today. So there is a website, it's very simple, so I, I won't even list it because it's so simple. It's K like kappa, F like Frank, F like Frank, kff.org, org, kff.org. And they have some really, uh, amazing, uh, types of data on there, data that have been collected through, you know, surveys and other means. And I think when it comes to things like mental emotional things, substance abuse things, jobs, all that stuff, that's not a bad way to be looking at it because you can see trend with survey-type data. And so one of the things that they led off with was— because I, I was looking for, you know, a good source where I could share it with you if you're interested. And so it's not, it's not great, you know, it's not happy news. If you don't want to read unhappy things, I wouldn't go there. But they were looking and Just in reporting of anxiety and depression symptoms in adults before COVID their ratings were about 1 in 10 adults. After COVID had been in for 6, 8 months, something like that, the ratings went up to about 4 in 10. So from 10% roughly to 40% roughly. That is an incredible population change. And I think that one of the things that we see with this is it is so pervasive that we forget that we are living with this going on. And yet then we wonder why we're seeing more outbursts and violence in, in the travel community, people on airplanes being taking off and blowing up and having all kinds of issues going on, uh, on, on airplanes. I mean, all sorts of things going on, uh, that, you know, and I've seen it, you know, I've seen it in person, uh, as I've traveled on airplanes. I, you know, I travel not as much as I used to, but I have to sometimes. So I see it, uh, I've seen it in person, uh, and also I've seen it, you know, at grocery stores and other places. People are just on on the ragged edge, you know, of their last nerve, so to speak. And if you step back and say, well, you know, yeah, it's just, you know, COVID and it's changing things for everybody and all that. But if you look at just for that gross anxiety and depression in adults, a fourfold increase in, in the population feeling more anxious and depressed, of course there's going to be, you know, fallout from that. There's going to be consequences of that. So it's not like a small problem. Um, now the other thing, um, that has shown an increase were suicidal ideation, suicidal thoughts. It's really horrible, horrible thought there. And then substance use due to stress, those have gone up quite a bit. And interestingly, the percentage of people with depression and anxiety symptoms follows an age pattern almost in a linear fashion. So depression and anxiety symptoms are the lowest with 20— 29% is not a small number— in 65 and older people. 50 to 65 is 34%. 25 to 50 is 49%. 50— half of people have anxiety or depression symptoms. And 18 to 24 is 56%. So almost 60% of people 18 to 24. That is an incredibly large amount of humanity. So I bring this up, you know, not— I mean, these are not really, you know, upper sort of statistics, but I bring them up because number one, I do like to start with the facts as much as we can find them. And It really— like, this is, as I said, data that I really have avoided digging too deeply into because it's, uh, it can make you feel depressed on its own, and it's pretty negative. But on the other hand, by the same token, uh, this data helps to show us how big and how pervasive this problem is. And even if you're, you know, sitting there listening, uh, or watching, or both, And you're thinking, well, you know, thank heaven that's not my problem. I'm neither anxious or depressed by this. I'm, I'm just getting along with my life. That's great, by the way. We don't want everyone to have a problem, but you need to remember that up to, you know, 6 out of 10 people around you, depending on their age, may be having these problems. So they may be different to deal with. They may not only have shorter fuses, but they may, you know, become involved in, you know, kind of obsessive behavior around watching either the news or looking at certain people's websites or whatever that kind of soothes them on the inside. So there's a lot of things going on. Now, the other thing, just some real, you know, hardcore statistics, when they look at households and employment. So a lot of people have had job changes or loss. There have been— in looking at a whole household, so that could be 1 of 2 or 2 of 3 or any combination, whoever's in the household— when they just said, in your household, who has suffered a job loss, it was over 50% of people. Now, doesn't mean the whole household lost all their jobs. But half of the people losing a job, if you don't think that that on top of, you know, somewhere around 40 or 50% of people being anxious and depressed has an effect across the board, you know, you really have your head in the sand. And I don't say that to be mean. I, I have, as I said, avoided these statistics too, but I decided, you know, just with some conversations I've had in the last week active COVID patients who are getting better, but now they're super anxious. People, you know, who are fully vaccinated, but, you know, they got sick anyway, and, you know, and maybe spread the virus, and they're, you know, depressed about that. And other— just, just the stuff that's happening. I thought, well, it's, you know, it's, it's time to look at this from, you know, just a very cold, hard place. And then we can sort out what to do about it. Now, other things. If we narrow down, so we went from population things to age group things, now then to households and jobs. What else can we look at? Essential workers. Boy, when they look at essential workers versus non-essential worker type jobs, and that, you know, I know this is playing with words and it's a classification, but if you're looking at, say, healthcare workers who are getting the brunt of a lot of things, okay, and it doesn't mean that other jobs don't have those problems, they certainly do, but the essential worker category, uh, anxiety and depression is 12% more than, than the, the, those considered non-essential. Substance use increase is 14%, almost 15% more. And suicidality, considering suicide, is 14 to 15% more. And the total levels, if you look, of anxiety and depression in, uh, in both groups, you know, over 40%, uh, suicidality and increase in substance use, uh, is 25%. So that— I mean, that's, that's a lot of people. Okay, now I do— I'll say them here, and I'm also going to say them at the end. Um, there's a government website that is not a therapy website, but it is a resource, and it can get you referred or to the right agency. And it's called samhsa.gov. So S like Sam, A like apple, M like Mary, H like house, S like Sam, A like apple, .gov. Samhsa.gov. And this is a substance abuse and mental health clearinghouse website that the government has. So regardless of your insurance status or what you need or where you are, you can go on to that website and they will try to— well, both, there are a lot of resources there, but they will also try and direct you to the appropriate either type of help or agency that may be able to help you. Say, you know, there's confounding variables like you're out of food or, you know, something of that nature. Um, and then there's some other references and resources I'll bring up at the end as well, because, you know, one of the things I— although I'm starting out with this whole, um, nasty statistics, uh, just to be real about everything, we want to look at this from a point of what's the problem and then what are solutions we can enact and impact into our lives and other people's lives. Because if we're looking at, you know, between a quarter and a half of people being affected by these different things. That is not a small number. That is enough people to completely change the dynamics, both interpersonally, uh, but also impact on the healthcare system and impact on their own lives. Uh, it's way, way, way accentuated a lot of problems. Now, when you look at— so the first group I want to talk about would be around mental-emotional changes. And when you look at these, the 3 categories that usually are reported on are depression, anxiety, and suicidality, or the idea that you might want to kill yourself. Okay, and you look at that and you think, well, you know, those, those things have, you know, are encompassing, you know, 40 to 60% with depression, anxiety of whole population more, uh, you know, higher than it was before. And suicidality, you know, like 15 to 20%, 25% in some studies, uh, those are huge, huge numbers. That means out of the 4 people, you know, near you, uh, if you had enough of these groups of 4 people, 1 person would be— have thought about suicide, and 2 of them would be depressed or anxious. Not a small problem. Okay. Um, yeah, I talked to a COVID patient this week who's doing great, recovered, cleared to go back to work. But the whole experience— and I think, and this is an essential worker too, so they're in a healthcare job— um, they now cannot go into their job without having a panic attack. Uh, and they are, you know, they're asleep at night, but they have one of those sleep monitors and they're actually getting very, very little actual sleep. So they're sort of unconscious but not getting restorative sleep, which, by the way, is not good for you either. So some of the causes that we've seen are, you know, isolation. Now, there's a lot of people, you know, maybe that Have, you know, and I know most places now— depends where you are in the world— but most places aren't in a hard lockdown right now or shelter in place. But many people have extremely— especially with the revision of, you know, some of the mandates and all that stuff— they have extremely limited access to moving around and seeing people. Isolation takes on many, many forms, one of which is simply Being separated from people that you formerly were fairly commonly in contact with, and that can— that, you know, even for a week, but you take a year, year and a half, that can really disengage you from a lot of the activities that keep your mental and emotional health happy and working. And so that can be family. I know a lot of people who it's been 2 years since they've seen their family. And, you know, that's not an uncommon thing, especially if there's any distance to seeing the family. And, you know, it's, it's, it's bad enough when you have distant family to have to be apart from them because it's just hard to travel at a long distance. But then when on top of it you're sort of forced not to do that, or, you know, maybe, maybe your health is not so bad, but maybe you've got some kind of fragile relatives that their health's not so good, and, you know, maybe you're not sure about the situation, and maybe it just doesn't make sense to do it. So the isolation is huge. Also, I've known people where, you know, for parts of all of this going on, they might have had family in the same town, but they were, you know, afraid of getting all together because, you know, each family is sort of a pod and they have different people they interact with and they weren't sure about exposure and all of that. The other thing, you know, in addition to isolation, is change in routine. Humans and human nature is, is heavily revolving around You know, habit and routine and all of these things, even if you don't so much like routine or whatever, it gives you predictability. And if you think about predictability and change in routine, one of the things that I've seen when I talk to people, whether they're a COVID patient or they're, or they're just somebody trying to avoid getting COVID or whatever. A lot of the security that people have goes back to the ability to have predictability in their life. And one thing about this situation is you don't, and we don't. Okay. You have people putting maybe way more savings stock and faith in a therapy, or putting way more stock and faith in an environmental control or something. And if you look at the therapy or the control or whatever they're doing, statistically it's not nearly that comforting, uh, to, to be doing that, but it makes the person feel better. And then, you know, this creates then, uh, their circle of predictability and routine that they're making now for themselves. So then you interact with the next person and they have a different set of values and ideas about predictability and routine, and, uh, and it causes, you know, some pretty nasty interpersonal reactions. You know, I have seen, um, friends, uh, and people I've known a long time, you know, who have a very difficult time talking to other friends, you know, who they've known a long time Because they have differing opinions about how conservative or how non-conservative they should be around anything, you name it. Change in routine and isolation are huge. The other thing, and I was not going to bring this up as strongly, but looking at those statistics I just shared with you, this is a big pervasive problem in people. There is so much fear right now. Fear is a normal human emotion. There's nothing wrong with being afraid. Fear keeps you alive in many cases by keeping you from doing maybe dumb things or ill-advised things, or maybe not, you know, keeping you from going to the wrong place or whatever. So fear is built into us, but COVID has generated so much internal fear. Because if you think about it, the fear response is kind of, you know, fear response is kind of related to part of our initial, say, fight-or-flight response, the sort of, you know, shifting of our neurochemistry so that we can get out of bad situations. Well, fear is part of that. Now, the fight-or-flight response is supposed to be short-lived, like get away from the bear or get out of the bad situation where you're in danger or whatever, and then go back to living normally. When you have something that is external that you cannot control, your level of fear rises to above where it normally is, and it stays there. It's sort of like if you had someone that followed you around And they were behind you all the time and you couldn't do anything about it. And every now and then they would hit you over the head with something unpleasant, stick or whatever, and you don't like that. But you knew that that person never was going to be absent from you, and they were going to hit you, but you didn't know when it was in the future. That creates a level of not only fear, but of cognitive dissonance, where you eventually retreat into a place where, um, you start to change your thinking about a lot of things, and you start to, uh, you know, put up, uh, mental and emotional barriers, and you can shift. So let's say if you're somebody who's maybe more prone to being anxious, your anxiety will ramp up. if your constitution is more prone to being, uh, in a depressive state, you— that will ramp up. You'll be the more depressed. And that's a situation that we have with, uh, COVID and the pandemic, uh, you know, world that we live in, especially with the media, you know, telling us the— just the worst side of everything, uh, and the most scary side of everything. Our brains are being pushed not only into fight or flight constantly, but they're being pushed into this change Based on the fear of something that we cannot control around us that's very bad. And so then you have people thinking, will I get it? When am I going to get it? Will I die if I get it? Will my family get it? Will they die? What about my friends? And now with, you know, some of the changes with Delta, where we've talked about this a lot, but basically, you know, you have something that transmits to more people more quickly. Although it's a lesser intensity of COVID it's still in more people. So that means just by mathematics, there's gonna be more people going to the hospital and more people, you know, high level of illness. But the number of people who have low-level illness is much bigger than it used to be too. So it's not, you know, it's, it's worse because you're hearing more and more of your friends saying, yeah, I've got COVID. Uh, or, yeah, 2 weeks ago I got it, uh, didn't realize I had it, or I had a breakthrough infection, or I had whatever, you know. Uh, 3 weeks ago I talked to 3 doctors who had all been immunized, and they all had breakthrough infections because just exposure to people. And, you know, they were pretty sick for a week. And, you know, yes, the immunization seems to cut off the, you know, the the nastier stage of the illness, but it didn't, it didn't keep them from a week of fairly large discomfort. So, you know, these things are just going on. Well, imagine we now are numb to this fear and this idea that there's this sort of, you know, amorphous boogeyman out there called COVID, and we don't realize what it's doing to us. So it's beating us down. Um, the other part of this is that really makes it worse is the unknown. You know, we have the unknown around us all the time. We don't know how bad Delta is going to be. If it's like the United Kingdom goes up and then back down, we're hoping for that. We don't know. It's the United States, who knows? We don't know if the Lambda or the Mu variant is coming next, what that's going to be like. We don't know how long this is going to last. We don't know, now that it's more transmissible, are we for sure going to get it? Like, even with all of our avoidance and everything else and masks and all that stuff, are we still going to get it or get a breakthrough infection? It's all unknown. We don't know how long we're dealing with all of this. We don't know how bad it's going to get or how good. Now, I mentioned job loss and job changes. All of this fits into the mood disorders. And so the big ones we're thinking about are depression, anxiety, and suicidality. Now, the other one, and I just want to go through the kind of the, the effects and then what causes them, and then we'll get to strategies for dealing with all of them. But the other one, which I mentioned, had risen extremely. And these, the statistics I mentioned, are increases. So it's not like people, you know, all were not doing anything before and now they're doing it. It's like They either were or weren't, but now overall, there's an increase. And that is substance use. So substance use is, if you look at any set of statistics in the world, the use of substances, whether off-label use of prescribed substances, like you're taking somebody else's anxiety or pain medicine or something like that, or, um, the, uh, use of a drug like, you know, it could be anything, uh, increased use in cannabis or cocaine or whatever. And I'm not saying that all these things are the same, I'm just giving examples of what's in the research. But the fact— and of course alcohol and all of that— the fact that substance use has continued to rise through this should not surprise anybody. Now, part of that is the very normal, very common and pervasive human nature thing, which is called self-medication. So when you feel bad, and if you've had an experience with a substance, you take that substance or use that substance to try and change your state, to try and change your mental emotional state, where you're at, where you're going, and all of that. Um, that can be a really good short-term answer. Often it is, uh, not only not a great long-term answer, often it can kind of come around the other way, uh, and be a problem for you because maybe you develop a dependence or an addiction. Maybe you develop other health problems because of it. And that could be anything. That could be, you know, using prescribed medications that aren't for you or using them improperly. That could be using, you know, a substance that's not prescribed. Whatever it is, that winds up being very, very difficult. Now, another substance, which is another topic of ours to look at, is, uh, food. So, uh, the level of people in engaging in both eating disorders, overeating, all sorts of other stuff— a lot of that goes back— not all of it, but a lot of it goes back to the use of food and feeding as a substance that does change our neurochemistry and temporarily, uh, puts us in a different state, but then we have fallout from that, which is just that better state doesn't last very long. And also, um, we, uh, we often get negative health benefits or, you know, bad health from, uh, using food as a substance to try and make us feel better, whatever that might be. So substance use is huge, and So other triggers can just be boredom, apathy. I've got nothing else to do, so I'm gonna, you know, drink more, I'm gonna use more marijuana, I'm gonna whatever, you know. That's a real common one. I was having conversation with a group of doctors, and we were sort of talking about all this, and everyone was sort of Talking about, yeah, you know, in the first three months when we were doing more like shelter in place and all that stuff, I found myself, you know, you know, doing more of X, Y, or Z, and it was sort of universal amongst everybody. Now, that like like eating or any other thing, you know, some people have. More trouble with one thing than another, and the next person may have no trouble with the thing you have a problem with. So it becomes very individualized if you try and, you know, like generalize that, well, everybody's drinking more, everybody's using more, you know, stimulants or whatever. It doesn't work out that way. Um, people tend to gravitate towards the substance that helps their brain go to place, at least temporarily, where it feels better. That's, that's the behavior control that most substances have. People rarely take substances that they know are going to make them feel worse or not the way they want to feel. Okay, uh, and I, I remember, um, long a very long time ago, uh, when I was an intern, I worked in a number of drug treatment centers. Uh, many of them were really intense with a lot of, you know, criminals, and some of them were actually in like lockdown jail settings, and some pretty intense folks. So I got to talk to a lot of people with a lot of addiction history. And as we know, people with addiction, you know, can perpetuate the addiction, uh, you know, to the detriment of their health and even their death. And we see that. But I remember talking to heroin addicts, and one time I was going to go and draw blood from this heroin addict who was in detox. And if you've never been around active detox, you know, the first few days are a little rough because the people are coming off of their drugs and they can be dangerous, angry, all sorts of things. This guy had been there for about a week and he was fairly dried up. Um, but I started to go to draw his blood and he was like, oh my God, no, no, no, I hate needles, I hate needles. And I was like, you're shooting heroin with needles into your vein, like, how does that work out that you're afraid of needles? And he says, man, Because I've always hated needles, but I like the heroin effect better. So I would get myself all worked up and I would, uh, you know, like psych myself into jabbing the needle in my vein, and I'd inject it because I knew very shortly after I would get the feeling that the heroin brought me. Now, heroin and opiate addiction is very— it's a horrible addiction because the chemistry, if, if you are a person prone, you know, not everyone is this way, but if you're a person prone to having that shift in brain chemistry because of opiates, it takes over like it's the only thing that your brain wants to do. So I tell that story to say addiction and substance use and all of that is, you know, it's not only a disease It is a literal, you know, biochemical, neurochemical disease, but also it is that powerful. And I bring it up because I also talk to people who don't use any substances. They either did or they never have or whatever, but they're just— it just doesn't do anything for them. Uh, and, and those people are kind of fortunate in respect to not becoming addicts. Uh, but, uh, some people don't realized how powerful substances are of any kind. Okay, and I'm not picking on any drug here. There— if it's the wrong one for you, it's as bad as whatever other drug you can think of, you know. I mean, you know, we think of like methamphetamine is pretty darn bad, uh, that's kind of universally ends to a very bad place. Heroin leads to a very bad place, etc. But the thing is If, if you are the person, uh, in your chemistry, in your brain says, I need drug X, drug X is the problem for you or its family. Okay, so when we see things like substance abuse rising at big levels, we know that again, if you look at your neighborhood and there's 50 houses in your neighborhood, you know, there's going to be 10 to 15 houses worth of people who are using more and more substances, and you don't think that changes the, you know, kind of dynamics of everything around you. Now, I mentioned that, uh, in the world of substances, you can also put in food. Well, statistically, um, eating disorders of all types have increased again on the order of, you know, 15-plus percent, plus or minus, probably more. There's more eating disorders being noted in children, etc. So food and food issues of all types are another big, big problem. I mentioned, you know, eating disorders in children. Another thing, while we're, you know, being thoughtful about people around us and kind and, you know, and patient and Also being vigilant to watch out for the effects on people around us. Keep track of the young people in your life. As I mentioned earlier, the rate of the highest amount of anxiety and depression for young adults 18 to 24, higher than anybody else. But if you go earlier than that, so below 18, And if you talk to any children, you know, who are anywhere between— you know, I've talked to kids as young as— well, I talked to kids of all ages, but about this particular problem, you know, I've spoken to children between the ages of 5 and 12, so certainly way under the age of 18 that the statistics were looking at. And they're, um, they're frustrated. and upset by what's going on. Same reason the adults are, but it hits children differently. Remember that what humans normally crave is some sort of normality, some sort of routine to get into, some sort of predictability in their life. And now we're saying that you don't have that anymore. Remember, you used to go to school and Maybe you didn't like school, but school was there and you knew the schedule and all of that. Well, now you're doing school online, or you're doing school online for this amount of time, and now you're online 3 days and at the school 2 days, or you're, you know, whatever. Or, you know, you can't see your friends, you can't do this, you can't do that, or if you do see your friends, you know, it's this big thing to try and, you know, get it all sorted out. This stuff is affecting the younger children incredibly intensely, and what, what I tend to see in them is anger, anxiety, just confusion about why the world is doing what it's doing. And realizing, you know, they don't, they don't have the memory of maybe other things going on in the past. to say, well, you know, we've been through rough times before. This is hitting them, you know, completely out of left field. And remember that one of the things that breeds fear, fight-or-flight response, all these bad things, uh, the most is the unknown. Not knowing how things are going to go, how bad this disease is. I heard it's real bad. Are my parents going to get it and die? Am I going to get it and die? Well, you know, what's going on? And, and whether or not that should be a reasonable fear, it doesn't matter. Okay, this is a fear and a tape that goes on inside of, uh, everyone's head, but children especially. And if you look at, uh, you know, statistics from American Academy of Pediatrics, which is a pretty good place to go for pediatric statistics usually, um, you're seeing increased amounts of, uh, you know, Mental-emotional needs and changes that heretofore you very rarely saw in the younger groups of kids, eating disorders, as I mentioned, and other things. Now, getting on the food thing, eating disorders are in the category of the mental-emotional things that we talked about, there's certainly things that are not only disturbing and disordering to your life, but just like an addiction, they take over your mental-emotional state, and that's all you can do. We need to be very thoughtful and open and aware of the people around us because again, not everyone has eating disorders, But those people that do, it can become so bad that the person will die. I have known many patients with eating disorders that, despite all of the best treatment and interventions, their eating disorder kills them. So that's not to say that happens with everybody, but it's that serious. It's as serious as an addiction or whatever. So we do need to be mindful that the things that trigger eating disorders are much the same as the things that are triggering everything else we talked about, you know, in this sort of lockdown blues idea. Um, all of the things around the unknown and fear and anxiety over what may or may not happen and the irregularity of life, those, you know, in, in somebody who's an addict, they trigger their addiction. In somebody with eating disorder, they trigger the eating disorder to be worse. And people who didn't, you know, were on sort of the edge of an eating disorder, pushes them into it. Very, very, very common. And so we have to be really open about that and monitoring of these things, because the biggest thing, you know, as we sort of move into what do we do about all this, is especially with, you know, addictions, things that are going to harm your health, eating disorders, you know, suicidality, anxiety, depression, that person needs to get help. And because the medical system has been overburdened, but also in this weird place of, well, what are we doing, and, you know, all of this, the medical system hasn't been as available. Okay, but the worst thing that any of us can do if we have— so if it's us personally we have someone in our lives, you know, who is struggling with an addiction, an eating disorder, suicidality, anxiety, depression, whatever, is not do everything you can to try and help that person get connected somewhere where they can be helped. And again, we'll, we'll look at some resources there at the end. But beyond eating disorders, there's just the fact that all of us eat 2 or 3 or 4 times a day, and so food has a way of magnifying good choices and bad choices. And one of the things that I've seen just in my world and talking to patients and talking to people I know and all this during this last year and a half is the triggers for eating and not eating well are huge. So you may have no eating disorder, but you're just eating in a way that's very unhealthy for you. People are gaining weight, people are, you know, getting worse, you know, whatever else. So we wind up having triggers like boredom. Not everyone eats out of boredom, but a lot of people do. Breaks in your routine, all those things that we said were triggering the mental-emotional stuff, huge things. There's also just, all right, who cares, you know? I can't see my family. I can't go into my office. I can't do this or that. Yeah, maybe I still have my job, but I'm doing it online. I don't like that. And so you reach a place of literally, who cares? So I'm gonna drink more. I'm gonna eat more. I'm gonna eat foods that, you know, I had sort of stopped eating because they're unhealthy for me. All of these things. And suddenly it's like, hmm, forget it all. You know, I'll, I'll, uh, I'll eat, uh, drive-through a lot. And, you know, I know talking to people, like, early in the early phases of lockdowns and stuff where a lot of restaurants were closed, what was still open? Fast food drive-throughs were still open, weren't they? They still are. And because that was the only place a person could go, you know, outside of their house to get food, that became not only a common thing but actually a habit. And, you know, that's— I mean, I think we all know that if, you know, on the scale of healthiness of food, fast food drive-through might be on, you know, the less healthy end, let's say. I don't want to get sued by anybody, but it's probably not the greatest for you to do a lot, but it's certainly easy. The food is designed in such a way where Your neurochemistry sort of lights up when you eat it. And so, you know, you start to think, well, it's easy, it's fast, I'm tired of making— you know, I'm not going to make my 40th version of, you know, my stir-fry at home. I'm going to go over to the drive-through and get something. Well, that's a big thing that's happening too. And then the other thing with food literally is self-medication. We as humans Because self-medication is not about drugs, it's about chemistry. We as humans can do that with food very handily. There's a lot of people who would never think to touch a drug and would never think to, you know, don't— wouldn't go down the road of being a drug addict or something like that. But they'll do the same thing with food, and that's extremely common. It's become more common. throughout all of this. So some things that we can talk about here as far as coping, and I'm gonna look at some things that I came up with and some that the CDC has on us. If you go to CDC and you look up stress or COVID stress, you'll go to this page. This is a mishmash of me and the CDC's ideas, so Here you go. Um, take a break from media. It's really hard to do, and media is actually very addictive as well. And I have seen, you know, myself and other people where you, you just want to get caught up and you watch the thing and you think, oh, that doesn't sound good, I better watch, you know, the next news cycle and see if there's some more information about that. And the problem is, um, Couple of things. One is it's not just our TV. We all have, you know, a device in our hands and a pad and everything else. We can literally have 24-hour access to bad news. And it's not that you should stick your head in the sand and not do anything, but you can only handle so much. And so even the CDC says, you know, stop it, disconnect from the mainstream media. And put yourself on a diet of media and, and update yourself with the news, you know, 15 minutes a day or whatever, and then you're done with it. Other things that can be done are taking care of your body. A lot of us have been more sedentary because we're not out doing the same things that we are, maybe our gym closed or whatever, but we're just more sedentary. And yes, I know we can still do stuff at our house, but that's going on. So you need to do things around your health, or your body needs to make some plans around your diet. You need to do some things, you know, around movement and other things of that nature. So I want to just kind of summarize here a couple of things. Big picture things: reach out. Even if you can't physically see your friends, stay connected with Zoom or FaceTime or a telephone call or even texting them or anything. Everyone pretty much agrees on that. The next thing is reach out to professionals if you need to get help. There are ways, regardless of your income and insurance status, to get help if you need it. And one of the ways is that government clearinghouse. Again, it's samhsa.gov. So S like Sam, A like Alpha, M like Mary, H like House, S like Sam, A like Alpha, .gov. samhsa.gov. And that is a place for substance abuse and mental health issues to guide you to resources and also even places in your state to get help. There's also out resources. I'm not connected to any of these. These are all— no one's paying me to say this or anything. I'm just saying Talked to a lot of people who've used online resources like betterhelp.com, so just betterhelp, no space, betterhelp.com, and that is a referral source for mental health providers, etc. Um, the other thing is plan and then turn those plans into goals because you're going to need goals and stuff to get yourself Through this. So what you do is make a list of what's going not well and what's going well, because you want to have positive, negative. Break out the not going well ones into areas you want to address. So you might say, I need to clean my diet up. Well, you're not going to do that tomorrow. You're just not. And so you want to break that down again and say, the first week I'm going to make a goal to do one thing that will have impact. So I'm going to remove this type of food from my diet, and I'm going to get it out of my house so I stop eating it. And then step 2, in maybe 3 days or maybe a week later, whatever it goes for you, I'm going to add in something good— this— to each meal, at least 2 meals a day. Okay. And you get those going, you get some momentum. And then you're cleaning up your diet, you break it down again, and maybe you want to say you're going to limit or take away trips to fast food. And you work on that and track these things. The only way you can get these goals— and then you can do the same for exercise or any other thing— the only way you're going to get these things achievable is to know what's going well and not well, break the not well down into big picture goals like clean up my diet or start exercising, and then take a baby step there and do it one week at a time, literally one day at a time. But usually a week you can make a step and then you can add on. And if you do that, you'll be surprised how far you get just within a few weeks. Well, I'm Dr. Paul Andersen, Dr. A, Medicine Health Dr. Andersen. It's been my pleasure talking to you today. I know it was a rough topic, the blues around COVID, but I hope I gave you some good information and some things to do. But I've got to get off the radio for the next person, so I'll see you all next week.