This is the 117th day of the coronavirus pandemic in America and the current world state of chaos is in uncharted territory with little chance of complete resolution of everyday disruptions in the near future. Indiana is in phase 2 of a five-phase plan to reopen, but there is a patchwork of confusing responses across our country and many of our citizens feel bruised, defeated, exhausted, and on the brink of a breaking point. Several friends have confided in me that they are struggling with negativity, anxiety, depression, anger and sleeping problems. Please reach out to appropriate professionals if needed and check out the Be Well Indiana website at bewellindiana.com for mental health support and reliable COVID-19 information.
For those of us who are still able and willing to work toward avoidance of reaching an emotional breaking point, and to help hold up our most vulnerable community members, the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a five axis system of diagnoses and understanding of many disorders that are being magnified by the pandemic. When it comes to psychological and emotional issues, if you can name it, you can tame it. Axis 1 describes clinical disorders including anxiety disorders, mood disorders, sleep disorders, adjustment disorders, and includes dementia’s and Alzheimer’s disease. Imagine the nightmare the coronavirus pandemic is for our citizens with dementia, especially the ones in nursing homes where visitors have been limited to window visits at best.
Axis 2 of the DSM includes descriptions and an understanding of our vulnerable people with mental retardation and people with personality disorders, including paranoid and antisocial personality disorder, which are surely exacerbated by the fear associated with the coronavirus. Axis 3 considers general physical medical conditions that may have a bearing on understanding a client’s mental state. People of any age who have a serious underlying medical condition might be at higher risk for contracting and have more severe illness from COVID-19. People who are immunocompromised should be particularly vigilant; for example, patients with a rare condition called myositis are often treated with prolonged use of corticosteroids and other immune-weakening medications, making them more vulnerable to illness. May is Myositis Awareness Month and I encourage you to check out The Myositis Association for information on this serious condition.
Axis 4 of the DSM includes psychosocial and environmental problems, including those associated with primary support groups and social environments (i.e. nursing homes), educational and occupational (i.e. unemployment) problems, housing and economic issues, difficulty with access to health care, and other environmental problems such as disasters ( i.e. pandemics). This axis covers many urgent issues related to the difficult situation in which we find ourselves. In addition, axis 4 considers problems related to incarcerations and we are experiencing massive COVID-19 outbreaks in correctional institutions and other institutional settings. Axis 5 is simply a global assessment of functioning based on the previous 4 axis and is useful for planning treatment and interventions and predicting outcomes.
The DSM is useful to name and tame an emotional dysfunction. The criteria for a professional diagnosis is typically if it significantly impacts your daily life, but many of us are not at that tipping point at this time, and we want to work to not go there, but it takes daily effort and commitment. In addition, we want to hold up our vulnerable citizens from the waves of this pandemic in any appropriate way we can. May is Mental Health Month, which aims to raise awareness about mental health issues. The coronavirus pandemic is universally throttling us with uncertainty, anxiety and lack of control, so please understand that you are not alone and these feelings can be expected in these extreme times.
As always we need to hold up and nurture our children in these frightening times as school-aged kids are finishing their school year at home and younger ones are often off their normal schedules. It is creating a challenging dynamic for families and it can be tempting to put children in front of the television to watch mind-numbing programs and ignore our children’s needs as we try to cope ourselves. It is natural to try to protect children from the turmoil, but also important to engage them in age-appropriate conversations about the world they live in. As the saying goes, smooth seas produce poor sailors; children need to be able to navigate difficulties in life.
Children appreciate opportunities to contribute and feel connection to their community. An example is the Buttonwood Kids Bicycle Club whose members recently organized a well-attended food drive to benefit local food banks. In most cultures, childhood is about learning values, skills, and self-discipline. This is what makes kids feel their connection to the great scheme of life and creates a sense of responsibility to the common good. When we keep children unnaturally insulated and separated from the issues of their communities, they often feel lost and without necessary skills. The Buttonwood Kids Bicycle Club provides an example for us that we all can find ways to contribute.
We all are experiencing an unprecedented amount of stress, anxiety, and uncertainty during this pandemic, you are not alone. We can take care of ourselves by keeping healthy schedules and sleep habits, getting some type of appropriate exercise, limiting television viewing, being vigilant about social distancing and medically advised safety measures, and always seeking appropriate professional help if needed. We can look for ways to help our most vulnerable citizens and be agents of positive change. Ultimately, the great challenges we face will cause us to grow stronger or become smaller people. The obstacles we are facing are not roadblocks, but temporary detours to ultimately the greatest national recovery we have ever known.