How COVID-19 hinders the growth of understanding a misunderstood and discriminated population.
The LGBTQ community is an at-risk population for COVID-19 contraction. According to the Human Rights Campaign, the LGBTQ community is more at risk than the general population for such struggles such as poverty, access to healthcare, limited access to health supports, paid medical leave and basic human needs. One in ten LGBTQ people are unemployed and impoverish than straight people, therefore leading to struggles affording doctor’s visits and acquiring and keeping health insurance. These high rates of poverty and unemployment also can be linked to discrimination, which leads to possible loss of jobs, being looked over for promotions, or not being considered for a job in the first place. (1)
Because of the rates of poverty and lack of employment, the 2018 BRFSS reports 17% of LGBTQ adults lack any kind of health care coverage as well as 23% of LGBTQ adults of color, 22% of transgender adults, and 32% of transgender adults of color. (1) With the lack of healthcare and limited financial resources, LGBTQ adults are less likely to receive care and treatment if they experience any COVID-19 related symptoms or health issues.
LGBTQ community is also at risk for contracting COVID-19 due to the population being more likely to smoke every day (up to 50% more than general population,) (transequality.org) which affects the respiratory system. The LGBTQ community also has higher rates of HIV infection and cancer, weakening the immune system and making this population more susceptible to infection. (1,2)
Besides having issues with accessing healthcare, financial hardships, and poverty, the stay-at-home orders mandated by Governors around the US and the President causes LGBTQ people to quarantine in environments that may not be as supportive and more isolating than before the mandated quarantine. Being a part of the LGBTQ community comes with the fear of being discriminated against in many atmospheres, the home being one of them. Living with family members who are not supportive of their lifestyle can cause deterioration to their mental health. LGBTQ older adults are also more likely to live alone and less like to have larger families such as a spouse or children, therefore feeling more isolated from supports as well as not having close family members to help take care of them if they fall ill. (1)
If anyone is feeling alone or isolated, either if they are living alone or with others, it is important to reach out to those that are supportive. Utilizing other forms of communication such as cell phone, FaceTime, and different online video chat options can help with connecting with those closest to us while also maintaining healthy social distancing. TIME Magazine online posted, with several Pride events around the world being forced to cancel their activities due to stay-at-home mandates, Interpride and the European Pride Organisers Association are organizing a “Global Pride” event for June 27, 2020. There will be a 24 hour live stream “including remote contributions from international Prides, speeches from human rights activists, workshops with activists, and high profile performers.” (4) I’ve also attached Funders for LGBTQ issues, discussing funding for LGBTQ related issues and places to receive support during this time.
Remember to try and reach out to support systems and take care of your medical needs with the resources available to you. Reach out to a therapist that can also provide you support via telehealth platforms as well and remember to stay safe.
- Human Rights Campaign Brief: https://www.hrc.org/campaigns/covid-19
- National Center for Transgender Equality: https://transequality.org/covid19
- USA Today: https://www.usatoday.com/story/news/nation/2020/03/18/lgbtq-coronavirus-community-vulnerable-covid-19-pandemic/2863813001/
- TIME: https://time.com/5814554/coronavirus-lgbtq-community-pride/
- National LGBTQ Cancer Network: https://cancer-network.org/coronavirus-2019-lgbtq-info/
- Harvard Health Publishing Blog: https://www.health.harvard.edu/blog/covid-19-and-the-lgbtq-community-rising-to-unique-challenges-2020043019721
Funders for LGBTQ Issues: https://lgbtfunders.org/covid-19-response/
COVID-19 vs. Your OCD Symptoms
For many people, the COVID-19 pandemic may be specifically impacting your OCD symptoms, including your obsessions and/or your compulsions. If this is the case for you, read on for some specific information based on your subtype. IF YOU STRUGGLE WITH CONTAMINATION FEARS:
- Give yourself permission to set a basic safety plan based on the recommendations of trusted health organizations, and do not add to it.
- Disinfect surfaces once a day. Focus on the surfaces in your home that are frequently touched, and think about whether this is truly needed (for example, if you stayed home all day and had no visitors, do you really need to disinfect that doorknob?). This process shouldn’t take you more than a few minutes per day.
- Wash your hands with soap and water for 20 seconds after being outside or in public, before eating, after going to the bathroom, and after you’ve coughed/sneezed/blown your nose. If soap and water are not available to you, use hand sanitizer that contains at least 60% alcohol.
- If you want to do more than this, pick a person to help you figure out what might be a reasonable and rational safety measure to take.
IF YOU STRUGGLE WITH PERFECTIONISM:
- Remind yourself that no one can protect themselves “perfectly” from COVID-19, and no one expects you to. Times like these call for using your common sense instead of going to perfectionistic extremes.
- Remember that trusted health organizations aren’t thinking about people with OCD and/or perfectionism when they set public health guidelines, and thus it might be helpful to talk to a trusted friend, family member, and/or your therapist to help figure out what “common sense” might mean. Your therapist can be especially helpful in figuring out how to apply these guidelines in a way that meets health standards without sending you deeper into your OCD.
IF YOU STRUGGLE WITH THOUGHTS OF HARMING OTHERS:
- Be mindful that your OCD may take advantage of COVID-19 fears by telling you that you might have infected someone or that you are going to infect someone in the future, whether accidentally or on purpose.
- If you’re noticing these intrusive thoughts, or that you’re doing compulsions related to these thoughts, check in with your therapist and let them know how your symptoms might have changed. They can work with you to come up with new exposures and/or homework activities to help contain them.
Anxiety & COVID-19
In the world of COVID-19, change and uncertainty impacts every human on earth. On one hand, we know we're all in this together. On the other hand, we may feel alone and isolated. Whether you're an essential worker, working from home, laid off, furloughed, unemployed, learning to be a teacher for your kids, or any other host of dispositions, life is constantly and drastically changing all around us. Cities, and entire countries, are shutting down to flatten the curve and reduce the spread of coronavirus, and even though this is vital for our safety, we are all in uncharted territory, and are bracing for changes that have yet to come. Living in a constant state of uncertainty will weigh down anyone, and if you struggle with anxiety, its more important now than ever to ensure your mental health is a priority. Thankfully, there is help, and there is hope.
I want to emphasize to anyone reading this that your feelings are valid. Right now, what most of us once thought of as “normal” no longer truly applies. You may feel sad, anxious, helpless, lonely, overwhelmed, irritable, fearful, agitated, stuck, distracted, unmotivated. Tasks that were previously manageable may now seem unmanageable. You may be unable to get restful sleep, and many are experiencing very vivid dreams or nightmares. You may be finding it harder to stay productive, engaged, or focused during your daily routine. All of these feelings contribute to mounting stress and anxiety that demands to be addressed – but how? We’re in luck! Communities around the world have worked to provide meaningful tips and skills to manage anxiety and stress during COVID-19. Here are some of the most common suggestions.
- Limit your media exposure (social media, local news, or national news). Find your news updates from trustworthy sources such as the CDC and the WHO, or your local public health authorities. Limit how often you check for updates, and limit how long you read about them.
- Recognize what is and is not within your control. Do your best to focus on the actions you can take – stay home, wear a mask, wash your hands thoroughly and frequently, maintain appropriate social distance if you must leave the house, practice self-care, etc.
- Be kind, forgiving, and compassionate with yourself. It’s okay not to be okay. There is no “right” way to deal with this.
- Maintain a routine to the best of your ability. Moving all of our daily activities into our homes during quarantine has blurred the lines between work, school, and home. Routines help us reestablish those lines and boundaries.
- Move your body. Take a walk outside, look online for exercise videos that are easy to do from home, stretch frequently. Exercise releases chemicals in the body that improve our ability to combat stress and anxiety.
- Stay connected with loved ones, even from home. One of the biggest struggles of COVID-19 and mental health is learning how to live with feeling isolated and alone. Check out our blog post about Coping with Isolation for more helpful tips.
- Practice self-care consistently, and recognize when you need help. Many therapists and treatment providers, including those of us at Jefferson Oaks Behavioral Health, are providing telemental health services to help you stay connected while prioritizing the safety of all.
“Conversations will not be cancelled.
Relationships will not be cancelled.
Love will not be cancelled.
Songs will not be cancelled.
Reading will not be cancelled.
Self-care will not be cancelled.
Hope will not be cancelled.
May we lean into the good stuff that remains.”
-Jamie Tworkowski, founder of To Write Love On Her Arms
For additional tools, tips, resources, articles, and education about COVID-19, mental health, and recovery efforts, please visit our COVID-19 resource page at www.jeffersonoaks.com/resource.
Coping with Isolation
How are you holding up with this quarantine? This is a very common question being asked currently with the events of the COVID-19 pandemic. These circumstances have created a sense of grief and loss on a global scale. Young, old, male, female, introverted, extroverted; everyone has been touched by the changes going on currently. Many people have canceled family events, weddings, funerals, birthday parties, holiday gatherings. These celebrations that help bring us together and give life meaning. We are also seeing people suffering from a loss of income due to jobs having to shut down or only operate at the bare minimum. Schools have been closed or are switching to an online format. Our very sense of structure and routine has been disrupted. It can be very hard to feel connected with loved ones, while also social distancing for their safety. What was considered to be “normal” has been completely turned upside down. Being cut off from so many things can create a sense of loneliness and isolation. These feelings are often associated with depression, anxiety, anger, or fear. Often, during times of distress it is helpful acknowledge the feelings of grief and loss as they come. Grief happens in five stages, Denial, Anger, Bargaining, Depression, and Acceptance (Kubler-Ross & Kessler, 2014). These stages may occur in any order and someone can experience a stage more than once. “Loss and grief do not occur in a vacuum. An individual’s grieving involves a continual process of negotiation among the various sociocultural influences specific to that person and to the environments in which she or he lives.” (Humphrey, 2009). But how can we cope with this loss when there is so much that seems to be keeping us apart? Here are some tips for helping with isolation.
- Practice Mindfulness- It’s hard to address a problem when you do not realize there is a problem. Denial is one of the five stages of grief and loss. Acknowledging that these events are hard and create emotional distress can help open up a path towards healing and acceptance. Using tools like mindfulness can help to increase your sense of awareness. Mindfulness can be defined as “Paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” (Kabat-Zinn, 1994). Allow yourself the chance to be upset about the things you have lost. It’s ok to miss things like going to the movies, work, or school. This can be helpful in reducing resistance, which can cause increased levels of distress. Journaling, meditation, breathing exercise, and talking to someone are just a few of many different tools you can use to acknowledge how you are feeling in the moment.
- Make time for Self care- It can be very easy to get caught up in the daily grind of things. Making time for self care is very important in maintaining overall health and happiness. “Learning how to eat right, reduce stress, exercise regularly, and take a time-out when you need it are touchstones of self-care and can help you anti-stress, stay healthy, and be resilient.” (Davis, 2018). Self care can also involve taking hot baths, watching your favorite movie or show, going for a walk out in nature, engaging in creative projects, or even playing games. Reframing your mindset from “I’m stuck at home” to “I have a chance to relax and do things that I enjoy” can make a huge difference in getting through these difficult times.
- Build connections- Connections are important tools in living healthy lifestyles. “A deep sense of love and belonging is an irreducible need of all women, men, and children.” (Brown, 2010) We are in an age where staying connected with others can be done from the palm of our hands. There are many different apps and websites that allow us to video chat, play games, share pictures, and etc. There are even ways to watch movies and TV with friends without being in the same house. Even though there are things keeping us apart, there is so much more that can bring us together. Not only can we connect with our family and friends through these services, but there are many options for increasing health care options. Medical and mental health providers are becoming available through telehealth options. As we encounter problems that require us to stay distant, many health professionals have found solutions to still provide services to those who are in need. One option that can be very helpful in building connections is doing group therapy via video chat.
References Brown, B. (2010). The gifts of imperfection. Center City, MN: Hazelden Publising Davis, T. (2018, December 28). Self-Care: 12 Ways to take better care of yourself. Psychology Today. https://www.psychologytoday.com/us/blog/click-here-happiness/201812/self-care-12-ways-take-better-care-yourself Humphrey, K. M. (2009). Counseling strategies for loss and grief. Alexandria, VA: American Counseling Association. Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditations in everyday life. New York: Hyperion. Kubler-Ross, E. & Kessler, D. (2014). On grief; grieving: Finding the meaning of grief through the five stages of loss. New York: Simon & Schuster
Addiction Recovery During a Pandemic
The Signs of Drug and Alcohol Dependence
The signs aren’t always clear that you or someone you know has a dependence on drugs. It can take a while before you’re aware your intake has created an addiction. These are only a few of the signs you could have a substance abuse problem. It’s a subtle transition, but it’s important to keep an eye on your habits. It is important to know the signs of dependence:
- Cravings – you think that you have to have it right now
- Dependence – you depend on the substance to get through your day
- Isolation – withdrawing from others, lying, avoidance
- Money issues – you continue to use despite financial consequences
- Neglect – you fail in obligations/responsibilities at work/home/school
- Withdrawal – you get sick or feel pain after stopping use
It is rare for you to wake up one day and think “I’m going to become addicted to something.” No one goes about their lives aiming for substance abuse. The problem with substances like drugs and alcohol is that they rewire the brains functions. Some drugs, like opiates, work by sending abnormal signals through the cells. This effects how certain areas of the brain perform, leading to addiction.
Addiction is a process which means that recovery will be too. It is very easy to fall into relapse justifications such as “one drink won’t hurt,” or “just this once.” Intervention in the addiction and relapse processes are essential for a successful recovery process. Next we will look at a few tips to help make recovery a little easier.
Tips for the First 90 Days of Addiction Recovery
The first 90 days of addiction recovery are some of the hardest and most rewarding times of your sobriety. Some recovery programs mention attending “90 meetings in 90 days” to help reinforce sobriety and hold an individual accountable. In addition to seeking treatment for your addiction/substance use issues, here are a few tips to work through the first several months of recovery.
- Create and keep a schedule
- Make sober support meetings a priority
- Find and stay in contact with your sponsor
- Continue seeing your doctors and therapists
- Create a safe environment for yourself
- Ask for help from your loved ones
- Make a list of goals that support your recovery
- Pay attention to your diet, sleep and physical activity
- Don’t rush back to work/school
- Avoid major life changes
- Celebrate your successes (even the small ones)
- Stay grateful
Addiction didn’t stop just because the pandemic started, and neither should recovery. It is important, now more than ever, to utilize outside resources to continue working through addiction and substance use issues, as well as taking care of your mental health. At Jefferson Oaks Behavioral Health, Inc. we are making sure to be there for you and your needs during this time by offering telehealth services for mental health and substance use treatment.
Resources for Individuals and Families