As if the COVID-19 pandemic, social unrest and natural disasters weren't making 2020 stressful enough, the majority of U.S. adults are also suffering with election stress disorder. The stakes are high. People are divided. And there is much uncertainty surrounding the outcome of the Presidential election.
Host, Jonathan Fialkow, M.D. and his guest, psychiatrist Rachel Rohaidy, M.D., explain how long periods of elevated stress affect our health, and provide real-life strategies for coping during this stressful time.
For more information about COVID-19 please visit BaptistHealth-coronavirus.com
As if the COVID-19 pandemic, social unrest and natural disasters weren't making 2020 stressful enough, the majority of U.S. adults are also suffering with election stress disorder. The stakes are high. People are divided. And there is much uncertainty surrounding the outcome of the Presidential election.
Host, Jonathan Fialkow, M.D. and his guest, psychiatrist Rachel Rohaidy, M.D., explain how long periods of elevated stress affect our health, and provide real-life strategies for coping during this stressful time.
For more information about COVID-19 please visit BaptistHealth-coronavirus.com
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At Baptist Health South Florida, it's our mission to care for you when you're injured or sick and help you stay healthy and fit. Welcome to the Baptist HealthTalk podcast, where our respected experts bring you timely practical health and wellness information to improve your family's quality of life.
Dr. Jonathan Fialkow:
Hello, Baptist HealthTalk podcast listeners. I'm your host, Dr. Jonathan Fialkow. I'm a preventative cardiologist and certified lipid specialist at Miami Cardiac and Vascular Institute and chief population health officer at Baptist Health South Florida.
If there's ever been a more stressful period in this country during my lifetime, I can't remember it. I'm sure the same is true for many of you out there listening. The COVID-19 pandemic has completely disrupted life as we know it, and now a very contentious election is adding yet another level of stress to the mix. It's enough to make anyone feel depressed, anxious, even physically ill. So the big question becomes, how do we deal with these feelings? What can we do to help ourselves, our kids, our loved ones cope at this time? For answers to these questions, we've turned to Dr. Rachel Rohaidy, a psychiatrist with Baptist Health, whom we first spoke with about coping with the new normal back in May. Welcome back to the podcast, Rachael.
Dr. Rachel Rohaidy:
Hello, thank you for having me back.
Dr. Jonathan Fialkow:
So thanks for coming back. I remember it was a great conversation in May. We were at the peak of the pandemic surge and actually just before the peak of the pandemic surge in Miami, but I think the discussion and your recommendations were well taken and they remain so today, since then, what are you seeing in your practice and what are you seeing in the community regarding any exacerbations or continuations or any trends regarding mental health issues? What are you seeing right now?
Dr. Rachel Rohaidy:
So what we are seeing and what we've seen since the beginning of the pandemic is an uptick in anxiety disorders, new anxiety disorders, but also anxiety disorders that are a resurgence. We're seeing also a lot of substance use disorders. So substance use disorders that have been at once controlled and also new substance use disorders. So everything got a little worse, but the upside of that is that we've been more accessible to our patients. So I do see people reaching out for help a lot more.
Dr. Jonathan Fialkow:
And I think accessibility and you and I have talked about this in the past. People should realize with the advent of telemedicine, virtual visits, people could actually get help. Don't have to leave their home. Don't have to leave a loved one. And are you using telemedicine visits in your practice? Are you seeing others do it as well?
Dr. Rachael Rohaidy:
I am, absolutely. In both of my offices I am seeing patients online and I'm also seeing in person, but it has brought accessibility to people. It takes about 10 years for someone to actually get psychiatric help. And so even notice it themselves or actually reach a psychiatrist. And I think that now with these new online platforms it's been accessible and people are reaching out, people are seeing the importance of it.
Dr. Jonathan Fialkow:
That is something that the pandemic has accelerated the move towards, the ability for virtual visits and not necessarily to take the place of an office visit for people who may not have access, so I'm glad to hear that. So we know that there's been a persistent, if not worsening, as you say of people who are seeking help for mental health issues, which can be anxiety and depression, and unfortunately substance abuse. Let's talk a little bit about now the acute issue, which is this election stress disorder, as it's been called by some in the media, it really is. It's a contentious time, we're concerned and there's a lot of uncertainty about the validity of the elections and the processes. Obviously there's a lot of partisanship and divided camps in the country. How is that affecting the patients you're seeing and what are you seeing regarding this election stress disorder? And then of course, we'll follow up with recommendations how people can avoid falling into that.
Dr. Rachel Rohaidy:
Absolutely. So what I'm seeing again is just this increase in anxiety disorders, generalized anxiety disorder, panic disorder, and inundation of information. Again, we have this great technology. We have our phones their basically computers in our hands, right? And so what I tell people is just to kind of limit, limit the amount of information you're receiving, limit the amount of time that you're online and watching news. Again, remember we can't control everything. We can only control us, so if we can try to limit the amount of information, our inundation. I think that we can really help to mitigate some of these stressful factors.
Dr. Jonathan Fialkow:
It really is something people have to be aware of because they may not be realizing what's driving that anxiety and those concerns I myself have found myself just turning the TV off. I don't want to hear about it. I don't want to be exposed to it because it generates that level of, like you said, anxiety or just discomfort. What about certainly as a cardiologist and certainly [inaudible 00:05:12] I'm sure other physicians are as well, palpitations, not sleeping well, overeating, you mentioned substance abuse. These are real physical concerns, physical manifestations of obviously these stress-related situations. Speak a little bit about that mind, body connection.
Dr. Rachel Rohaidy:
Absolutely. Our minds are connected to our bodies, right? Our brain is connected. There's no separation between brain and body. So everything that we're feeling, we feel throughout our entire body and that stress, that low mood is kind of like the foot on the pedal, on the gas of our runaway stress response system, our HBA system. And so having increased amounts of this stress chronically, we're not talking about just a fight or flight moment, right? We get a little scared. Our blood pressure goes up a little bit, blood flow to our muscles because we're going to run away, but we're talking about chronically turned on stress response system. So high levels of cortisol. And that brings a strain to the heart, to our blood vessels. We find that we are eating more. So we have more chances of obesity and we're increasing cholesterol, increasing rates of diabetes, our possibility of stroke. And so, having this stress response system chronically on at high levels all the time, isn't doing our body any good. And it's actually bringing on some medical chronic illnesses.
Dr. Jonathan Fialkow:
And the point is people should connect it so that if someone who's again, agitated, concerned, the election period really is something their taking to heart, no pun intended, but if they have a physical manifestation it's good for them to recognize, wait a minute, it's not that my heart is causing the problem because it's racing a little bit or it's not my blood pressure's up I need more medications, but maybe I should obviously recognize it's this situation around me.
Dr. Rachel Rohaidy:
Exactly.
Dr. Jonathan Fialkow:
So what are the kind of things that people can do? What would be some of these coping mechanisms? You already mentioned a few, for example, turning off the TV and social media.
Dr. Rachel Rohaidy:
Right.
Dr. Jonathan Fialkow:
But what are you seeing and recommending to your patients and people you're talking to?
Dr. Rachel Rohaidy:
So I really have three top things here. Number one is setting limits. So having time for yourself and not being inundated with all this information. So setting limits, and I say that to everyone, I have to practice it myself. Half of the week, I'm home working. When you're done, you're done, that's it. Put away the phone, no more emails, no more social media, no TV, have family time and set those limits and follow those limits. And don't just set them for yourself, but set them for the whole family. A lot of us have children who are also being inundated with all of this information and all of these things online because have a lot of our kids do have smartphones. Set limits and try to ease some of that anxiety, bad mood, not able to sleep and just eating chips all the time because I'm so stressed and really limit that for you, for yourself. That's my number one tip is setting limits.
Dr. Jonathan Fialkow:
Let's keep going.
Dr. Rachel Rohaidy:
Okay. The second one is sitting with your emotions, accepting your emotions, right? Taking care of your feelings, being mindful. So it's normal to be stressed. It's normal to be upset. It's normal to be anxious, right? Sit, realize what you're feeling and how it affects you physically. I think it's very important to be aware of what is normal and what is not normal. And so having been presented with a situation and being angry about it, that's normal being stressed about it. That is something normal, but allowing it to ruminate through the day and take up your entire day and you can't work because of it. And you can't have dinner with your family because you're too upset or you're... When it starts kind of bleeding into social functions and work functions, that's when you have to say, "Wait a minute, I need to get help for this." There's something there that I can't control. I can't bring this back. So I need to reach out to somebody. And so being mindful of that is really important.
Dr. Jonathan Fialkow:
So that would be like I say, if you're avoiding certain things that normally would take part of, if you're not getting out of bed in the morning, I mean, something that's really impacting your normal daily workflow. Is that any way to look at it?
Dr. Rachel Rohaidy:
Absolutely. Absolutely. And then my last tip is you're human, don't take on too much you're human. It's okay to cry. It's okay to scream. It's okay to have these feelings. And again, once it starts impacting negatively your life, that's the point where you say, "All right, this is beyond my control now. And now I need to reach out for help."
Dr. Jonathan Fialkow:
Do you find that a lot of the people you're seeing and I'm asking from again experience are they just, "I really need help and I'm going to reach out." Or, do you find other people, coworkers, loved ones would say, "Hey, listen, you really would benefit from seeing someone, can I help you arrange that?"
Dr. Rachel Rohaidy:
Absolutely. So the stats are that it does take about 10 years for someone to reach out for help sometimes.
Dr. Jonathan Fialkow:
Yeah.
Dr. Rachel Rohaidy:
And so by the time I see my patients, it's really because "Dr. Rohaidy, I'm about to lose my job. Dr. Rohaidy, my wife is going to leave me." So at that point, it's because they've been pushed to see me. Psychiatry, there's still a huge stigma surrounded by psychiatry. I have patients that sit, they put their head in their hands. I can't believe I'm seeing you. And so, it's tough to say, "I need to reach out for help." That's not an easy thing. And so by the time that I do see patients it's because other people have pushed them to see me.
Dr. Jonathan Fialkow:
When a patient comes to you as a psychiatrist. And again, speaking from your own experience, but representing the discipline, is it automatically going to go on medications? Do you work with people who avoid medications? Do you refer people out, maybe to a psychologist? What kind of pathways would people take once they get to your level?
Dr. Rachel Rohaidy:
So when a patient comes to see me, I like to say that I'm not the bus driver. They are the bus driver. I'm the annoying little GPS that tells them, maybe you can turn right or maybe you should turn left. I don't think medication is completely magic. Right? I think you have to also incorporate other things like sleep hygiene and healthy eating. I think part of that is seeing a therapist and it can be a psychologist. It can be a therapist. I always say, it doesn't have to be the most authored psychologist in the entire world. Somebody that you connect with, somebody that you can tell your deepest and your darkest, and that can really help you get through this time. I think that is key. It is key to incorporate all of it, not just the medication.
Dr. Jonathan Fialkow:
Again, well said. And then of course, other lifestyle components, getting exercise if you can.
Dr. Rachel Rohaidy:
Absolutely.
Dr. Jonathan Fialkow:
Good night sleep, [inaudible 00:12:57]. I know you're a big proponent of again, non-medication component ways of improving one's mental health state. Right?
Dr. Rachel Rohaidy:
Absolutely. But remember, when they come to see me, they're already at that point where other things haven't worked. And so most of the time when a patient comes to see me, we will start medication. We will also start, I will also be annoying and give you pamphlets about the whole eating healthy and exercise and sleep hygiene and therapists and all of that sort of stuff. So I definitely like to be very inclusive. I like acupuncture. I'm going to send you to your primary care. I'm going to send you back to your cardiologist. So I like whole body treatment.
Dr. Jonathan Fialkow:
No, again, I agree with you a hundred percent. And I think there's lots of components of what lead to a problem. And there's lots of ways to assess and mitigate the problem, whether it's diabetes or the anxiety or depression and whatnot. So I think that's well said, what about, I'm going to throw a little curve ball out there. A lot of people will take supplements in hopes of helping their anxiety and depression and whatnot. And we know these are dietary supplements. They don't have any medical indications. Are you exposed to that at all? Or, do you get into that with your patients at all?
Dr. Rachel Rohaidy:
Yeah, a little bit. I do have a lot of patients that prefer to also incorporate vitamins and herbs and things like this. I'm not going to pretend to be an expert on all of it, but I certainly say, be careful what you put in your body, I can sell almost anything, right? And say, this is for anxiety and depression, but we don't really know what the side effects are. Also, be very careful with supplements that can increase your risk of bleeding, increase your risk of liver damage. So you just want to be really careful with what you put in your body. Usually, if you can't say the name or the ingredient, it might not be that great to put into your body.
Dr. Jonathan Fialkow:
I agree with that comment as well. And we had this in a previous podcast that people think something's natural, it's good for you. And I would say, arsenic is natural and cyanide is natural and no, that's not the case. And if you're at the point where you feel you have a need and you're taking something being sold at a store by someone who's not an expert, then maybe it's another indication to say, maybe I should seek some professional help. So this is really, most helpful. I think the timing could not be better. I have a feeling every couple of months, we're going to be having these conversations because I don't think this is going away anytime soon. But I think of all the things you said the third point you made in your ways of approaching is that we're only human. We all try to be superhuman and we have to be there for ourselves and family members. And we judge ourselves if we can't cope, but these are overwhelming times and people should reach out when when they feel-
Dr. Rachel Rohaidy:
Right. I've heard many times patients say to me, I thought I could do it on my own. I guess I'm not strong enough. And I try to always tell them you're strong because you've reached out for help.
Dr. Jonathan Fialkow:
Right.
Dr. Rachel Rohaidy:
That's what gives you strength. It's not that you've fallen. It's how you pick yourself up.
Dr. Jonathan Fialkow:
Again, that's a wonderful sentiment. Any final comments, any final thoughts? I think we hit all the important points recognizing the increase in mental health needs regarding pandemic and in particular, and then the election stress disorder, which is real. Any other components or things you want to bring up before we wrap up?
Dr. Rachel Rohaidy:
Yes. Okay. So I think a really important factor for all of us during this really stressful time is going to be really coming together as a family unit, having that family dinner, children, teens, adults alike, we are inundated with a lot of this stress because of the unprecedented times that we find ourselves in. Having a moment to have a nice dinner with your family I mean, it doesn't have to be nice. It could be pizza. It could be whatever you want, but having that moment to actually talk to your family members and coming together, I think it's going to be really key for us in the next coming weeks.
Dr. Jonathan Fialkow:
Thank you very much, Dr. Rachael Rohaidy, a psychiatrist with Baptist Health. To all of our listeners as usual if you have any thoughts or ideas for future podcasts, any comments, please email us at baptisthealthtalk@baptisthealth.net that's baptisthealthtalk@baptisthealth.net. Stay safe everyone.
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