Youth anxiety and depression are at record levels. Mental health hubs could be the answer

Posted on March 30, 2021 by particularkev

Christine Grové, Monash UniversityThe COVID pandemic has shone a light on the ongoing decline in young people’s mental health. Psychologists have warned if we don’t start to address the mental health emergency of young people’s anxiety and depression, it may become a “trans-generational disaster”.

Paediatricians have said they are seeing growing numbers of young people coming to the emergency room because of a lack of other treatment options.

In an effort to address the rising rates of anxiety and depression in children, Victoria trialled mental well-being coordinators in ten schools last year. The initiative is now expanding to 26 primary schools in 2021.

Meanwhile, the royal commission into Victoria’s mental health system has recommended youth mental health hubs, some of which will soon be rolled out in priority areas across the state.

Developing specialist youth mental health hubs is one of several strategies also suggested by the Australian Psychological Society to the federal government in a recent budget submission.

So, what are youth mental health hubs, and will they work to stem the tide of mental health issues young people are experiencing?

Everything in one place

Australia’s National Strategy for Young Australians defines youth as young people between 12-24 years of age. Evidence shows half of mental disorders first emerge by the age of 14, and 75% by the age of 24.

Left untreated, these mental health problems have high rates of recurrence and cause negative outcomes for the individual, including reduced economic productivity, as well as social costs.

Youth mental health hubs provide mental health and social services in one location. This is partly because a range of risk behaviours come with mental health difficulties including tobacco, drug and alcohol use, sexual risk taking, reduced levels of physical activity and poor nutrition. Evidence also suggests young people prefer to have their needs met in one place, rather than across a number of locations and will then be more likely to seek help when they need it.

Youth hubs should therefore have a range of specialists on site, such as trained mental health clinicians, sexual health support counsellors and psychiatrists.

Young people also want and need access to mental health information and resources. So a youth hub should be a safe place for young people to get the information they need.

Youth hubs would be connected physically and/or in partnership with schools, community organisations (such as homelessness services) and with medical specialists.

They are ideally co-designed by experts and youth with lived experience, on equal grounds. Ideally, the hubs are a youth friendly, one-stop-shop for support ranging from referrals, assessment, therapies and intervention.

Don’t we already have youth hubs?

Traditionally, mental health services, including some youth services, have not been accessible to a range of youth needs, instead targeting children or adults. Others are geared towards specific certain types of conditions.

In Australia there are two youth-specific hubs: Orygen and Headspace.

Orygen is co-designed with young people. But it specialises in youth who have had an episode of psychosis, mood disorders, emerging borderline personality disorder, and youth at high risk for a psychotic disorder.

Headspace centres provide early intervention mental health services to 12-25 year olds. The service was created to provide youth with holistic mental health support. But there are shortcomings with the model. It has been described by some experts as not being able to support some youth with complex presentations such as those with personality disorders, schizophrenia and/or substance abuse issues.

Many other services restrict youth access to support depending on age, diagnosis or additional illness.

Youth engagement in non-youth focused specific services is low, and transitioning youth between and across services is often unsuccessful.

Young people also prefer services that include young people as staff members, which is not common in traditional mental health support. Youth participation as staff was found in only just over half of the mental health services available in Australia.

A young woman talking to a young psychologist. — Young people prefer mental health support that is youth led.
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So, what is the ideal youth hub?

There are youth hubs available across the world, including in Ireland, New Zealand, UK, Canada, France and Australia. All of these provide different services and care. However none provide a single example of best practice yet.

Key elements of youth mental health hubs identified in the World Health Organisation framework include:

a co-designed youth-focused approach that is flexible and adapted to youth’s changing mental health needs
an accessible, central location (close to shops or transport), with extended spread of opening hours as well as opportunity for self-referral and drop-in services
a place that responds to all young people quickly
youth working in the hub
services and support types personalised as needed by the context.

Research also suggests the hubs should be an informal space, as opposed to clinical looking, such as a shop front or café design. They should also:

provide recreational or arts activities, as well as a hang-out space
be included and known by the community
keep ongoing evaluation of the services provided and provide feedback back to young people.

Keeping all services in one location works well, but it doesn’t necessarily mean a coordinated, collaborative approach to care is provided. Some hubs may house a range of services in one spot but continue to work in a separated way. This defeats the purpose of coordinated care.

We need better investment to improve current hubs or co-design new ones to enact the WHO guidelines of best practice. This is critical to ensuring more young people access the care they need, for the success of current and future generations.

Christine Grové, Senior Lecturer and Educational and Developmental Psychologist, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How setting aside some ‘worry time’ can help reduce anxiety over COVID-19 lockdowns

Posted on August 21, 2020 by particularkev

Dougal Sutherland, Te Herenga Waka — Victoria University of Wellington

Many New Zealanders will be feeling anxious, disappointed and even angry about the return of COVID-19 in the community.

Many of us prefer to suppress these emotions because they are unpleasant or we may feel under-equipped to manage them. But if left unrecognised and unchecked, they will drive our behaviour.

We may act without thinking clearly and rush to the supermarket to stock up. We may lash out verbally or physically at those we see as threatening us. Or we may fall too easily for social media posts that give us a sense of relief, even if we’re not sure about their accuracy.

Times of heightened anxiety are fertile breeding grounds for conspiracy theories, especially among those with low levels of trust in the government.

Anxiety and anger are normal reactions during uncertain times. We experience these emotions when we feel under threat, but the simple act of acknowledging them can ease their intensity.

Recognising your emotional reaction

Research New Zealand has been conducting regular polls of New Zealanders since the first lockdown in March and April. Results show heightened levels of concern about health, losing a job and the economy in general. The most recent poll also shows New Zealanders were worried about a new outbreak.

A heightened level of worry keeps us in a state of “flight or fight” — the evolutionary system that drives our response to fear. But if we pause to notice what we’re feeling, even correctly labelling our emotional state can reduce the intensity of these feelings.

The regular practice of mindfulness, best described as deliberately paying attention to the present moment, has been shown to help reduce the reactivity of our flight or fight system. Physical activity helps to dampen our physiological symptoms of anxiety, and diaphragmatic or belly breathing is a simple but effective means of doing this.

Once we’ve gained some measure of regulation of our emotional state, we are better able to engage our prefrontal cortex in planning, reasoning and decision making. Noticing what we are thinking and saying to ourselves is a first step and a core part of cognitive-behavioural therapy, which has a strong evidence base in the treatment of stress and anxiety.

If we say to ourselves that this is “disastrous” or “unmanageable”, we may feel increasingly emotionally overwhelmed. If we think that “someone has exposed us to infection”, we may feel quite angry toward that person. In contrast, if we recognise that this style of thinking is not helpful, we may be able to adopt a more balanced view of the situation.

Managing your anxiety

Anxiety wakes you up in the middle of the night as your brain churns over and over. It’s important to recognise what our brains are doing in these instances. They are trying to remind us not to forget about something we perceive as a threat.

This makes sense from an adaptive point of view. Being alert to perceived danger can ultimately keep us alive. But it can also bring with it a sense of loss of control.

Having a “prescribed worry time” can be an antidote to this loss of control. Setting aside a set time of day to deliberately focus on your worries can both reduce our avoidance of unwelcome emotions and send our brains the message that we won’t forget about this “danger” – so our brains don’t need to keep reminding us of it so much.

Within this worry time, focusing our thinking on what is within our ability to control, rather than on what is outside our sphere of influence, can also reduce levels of anxiety and helplessness.

Ultimately, while our emotional reactions to the return of lockdown are normal and nothing to be afraid of, it can be comforting and motivating to remember that we’ve done this before and can do it again. And we may even learn some tips for coping under stress that are useful for the rest of our lives.

Dougal Sutherland, Clinical Psychologist, Te Herenga Waka — Victoria University of Wellington

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Pregnant in a pandemic? If you’re stressed, there’s help

Posted on June 3, 2020 by particularkev

Monique Robinson, Telethon Kids Institute

If you’re pregnant during the COVID-19 pandemic, you might be feeling a unique type of stress.

You might be uncertain about how an infection could affect your unborn baby. That’s over and above the stress you might be feeling about the pregnancy itself, and its impact on your relationship, job or lifestyle.

But there’s professional support to help you manage these stresses. And there’s lots you can do at home to ease your worries.

How will the coronavirus affect my unborn baby?

One of the first studies to look at the effect of coronavirus infection while pregnant found the health of unborn babies or newborns of women infected in their final trimester did not differ to those expected with uninfected pregnancies.

But this small study, from Wuhan in China, was rushed to publication and didn’t look at infection earlier in pregnancy.

A review of 41 pregnancies complicated by COVID-19, as well as another 38 complicated by other coronaviruses (SARS, severe acute respiratory syndrome and MERS, Middle East respiratory syndrome) gave us more information.

It found a small but significant increase in preterm birth (before 37 weeks’ gestation) in COVID-19 pregnancies.

However, the researchers couldn’t differentiate between spontaneous preterm birth and babies who were induced to arrive before 37 weeks.

So far, the evidence of harm to you or your unborn baby is limited, and should not cause concern.

Pregnancy can be stressful anyway

Separate to the fear of being infected with COVID-19 is the fear and stress related to simply living through the pandemic while pregnant.

Pregnancy can often be stressful as lifestyle, relationship and income changes create challenges for families.

Pregnancy can be stressful at the best of times.
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Worries about the baby’s health are present in any pregnancy, but adding concerns of what infection would mean for the unborn child can exacerbate feelings of anxiety.

Before the pandemic, about 20% of women had a clinical anxiety disorder (for example, generalised anxiety, specific phobia) while pregnant.

We now have some early indicators of how the COVID-19 pandemic is affecting that statistic.

And when you add the pandemic into the mix

Canadian researchers surveyed nearly 2,000 pregnant women in April 2020 (in research yet to be peer-reviewed). They found 57% of pregnant women showed anxiety symptoms but 68% reported an increase in pregnancy-specific anxiety.

Only one of the 1,987 participants had a confirmed case of COVID-19, with another 25 cases suspected but not confirmed. So, for most participants, just being pregnant during the pandemic (without being infected) led to three times as many women being anxious during the pandemic than before it.

Pregnant women are also concerned about how the pandemic will affect their maternity care, including who can visit them in hospital and after the birth of their baby.

A review of pregnancy stress during previous infectious disease outbreaks, including SARS, MERS, Ebola and Zika, found that as well as feeling vulnerable, pregnant women were anxious about disruption to pre- and postnatal care, and exposure to treatments not fully tested in pregnancy.

We can’t avoid stress, but we can manage it

We know stress during pregnancy has been linked to a range of poor outcomes for the child, such as pre-term birth, being more susceptible to disease, and behavioural problems through childhood.

Post-traumatic stress symptoms in pregnant women following the September 11 attacks and various natural disasters have significantly affected both emotional and cognitive development in children later in childhood.

But there is good news. While we cannot avoid the stress that comes with the COVID-19 pandemic, we can manage it.

In fact, it’s not necessarily the stressful event itself that can lead to poor outcomes. It’s how a pregnant woman assesses the stress of the event and how she chooses to move forward that might determine what happens to her child.

So, if we can manage our stress and not let it overwhelm us, we may be able to avoid the negative consequences of stress in pregnancy with benefits right through our children’s lives.

Here’s what you can do

Social support is key for managing stress, but social distancing makes it harder to gather with the friends and loved ones who might typically provide that support.

Still, there are many online pregnancy support and birth groups targeted to particular stages of pregnancy. These could provide reassurance and a sense of belonging while the outside world looks different.

You can still exercise outside. But if you prefer to exercise at home, there are many online pregnancy yoga and pilates classes.

Yoga and pilates classes for pregnant women are available online.
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You can practise guided relaxation and meditation with an app. And if you can work from home, this might give you some much-needed flexibility.

You can also use local, evidence-based telehealth to access mental health care. There are also many free, online programs providing self-guided mental health support.

As long as the COVID-19 pandemic is here, with its accompanying uncertainty, we can best focus on limiting the long-term effects of stress on our mothers, babies and families.

Monique Robinson, NHMRC Early Career Fellow, Telethon Kids Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

7 tips to help kids feeling anxious about going back to school

Posted on May 31, 2020 by particularkev

Mandie Shean, Edith Cowan University

As COVID-19 lockdown measures are lifted, some children may experience social anxiety about the prospect of returning to school.

People with social anxiety may fear embarrassment or the expectation to perform in social situations, or worry exceedingly about people judging you poorly.

In certain situations, people with anxiety may find their heart beats quicker as adrenalin is released into their blood stream, more oxygen flows to the blood and brain, and even digestion may slow down.

These are helpful responses if you need to run away or fight danger. But social situations are generally not life threatening, and these physical symptoms can interfere with socialising.

People with social anxiety may fear looking silly, being judged, laughed at or being the focus of attention. For anyone, such experiences might be unwelcome but for those with social anxiety they pose an unacceptable threat.

Social anxiety in Australian children

One Australian report found that about 6.9% of children and adolescents surveyed have a diagnosed anxiety disorder, 4.3% experience separation anxiety and 2.3% a social phobia.

Social phobia (social anxiety) is more common in adolescents, whereas separation anxiety (intense anxiety over leaving caregivers, such as parents) is more prevalent in children.

These figures only account for those who have a diagnosis of anxiety. They do not include undiagnosed young people who experience high stress in social situations.

Not all children will be happy to be back in school.
Tom Wang/Shutterstock

Any recent prolonged absence from school may have increased social anxiety, as avoiding what you fear can make your fear become greater.

This is because you do not get to learn that the thing you fear is actually safe. Your beliefs about the threat go unchallenged.

Anxiety can also increase through what pyschologists call reduced tolerance. The more children withdraw from the situations that cause them fear, the less tolerance they have for those situations.

Anxiety can affect education

The educational cost for students with anxiety is considerable.

The research shows students with poor mental health can be between seven to 11 months behind in Year 3, and 1.5 – 2.8 years behind by Year 9.

That’s because these students experience more absences from school, poorer connection to school, lower levels of belonging and less engagement with schoolwork.

7 strategies to help overcome social anxiety

So what can children do to overcome anxiety as they return to school? Here are some useful tips.

deal with some of the physical symptoms. It is hard to think if your body is stressed. Use calming strategies like mindfulness or breathing exercises. Slowing your breathing can reduce symptoms of anxiety, depression, anger and confusion. Useful apps to help you control your breathing include Smiling Mind (iOS and Android) or Breathing Bubbles (Android only).
anxiety increases while using avoidance techniques such as avoiding eye contact, not raising your hand to answer a question, or not attending school. So the most effective way to deal with social anxiety might be to face it. Allow your child to have small experiences of social success – give their opinion to one person, start a conversation with someone they know – so they can learn to feel safe in these social situations.
fear and anxiety are normal and benefit us by helping us to respond efficiently to danger. Rather than read your body as under threat, think about the changes as helpful. Your body is preparing you for action.
while avoiding your fears is not the answer, being fully exposed to them is not the answer either. Providing overwhelming social experiences may lead to overwhelming fear and failure, and may make anxiety sufferers less likely to try again – or at all. Start small and build their courage.
supportive listening and counselling are less effective than facing your fears because these approaches can accommodate the fears. While you want to support your child by providing them with comfort and encouragement – ensure you also encourage them to face the fears that cause the anxiety.
you cannot promise negative things won’t happen. It is possible you will be embarrassed or be judged. Rather than try to avoid these events, try reframing them. Remember that that we all experience negative social feedback, and this does not make you silly or of less value. It makes you normal. Or, rather than see it as embarrassing, maybe it can be funny.
remember it is the “perception” that something is a threat – not the reality. Reasoning with your child to help them see your perspective may not change theirs. This reality only changes with positive real experiences.

Breathing Bubbles in action.

What we think is truth is often revealed as untrue when we face our fears. There is joy in social situations. Keep turning up to them.

Mandie Shean, Lecturer, School of Education, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus lockdown made many of us anxious. But for some people, returning to ‘normal’ might be scarier

Posted on May 26, 2020 by particularkev

Amy Dawel, Australian National University; Eryn Newman, Australian National University, and Sonia McCallum, Australian National University

Many Australians have welcomed the gradual easing of coronavirus restrictions. We can now catch up with friends and family in small numbers, and get out and about a little more than we’ve been able to for a couple of months.

All being well, restrictions will continue to be lifted in the weeks and months to come, allowing us slowly to return to some kind of “normal”.

This is good news for the economy and employment, and will hopefully help ease the high levels of distress and mental health problems our community has been experiencing during the pandemic.

For some people, however, the idea of reconnecting with the outside world may provoke other anxieties.

Social distancing and mental health

We surveyed a representative sample of Australian adults at the end of March, about a week after restaurants and cafes first closed, and with gatherings restricted to two people.

Even at this early stage, it was clear levels of depression and anxiety were much higher than usual in the community.

Surprisingly, exposure to the coronavirus itself had minimal impact on people’s mental health. We found the social and financial disruption caused by the restrictions had a much more marked effect.

Many people in our survey reported the restrictions also benefited them in some way. Around two-thirds of people listed at least one positive impact coronavirus has had on them, such as spending more time with family.

For many people, lockdown has been an opportunity to enjoy more time with family.
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Another positive thing we’ve seen is communities coming together in new ways. For instance, teddy bears have appeared in windows for neighbourhood children to find, with We’re Going On a Bear Hunt Australia connecting more than 20,000 followers on Facebook.

More than half of our survey respondents were hopeful “society will have improved in one or more ways” after the pandemic.

Adjusting to the ‘new normal’

Our findings show adverse events can affect mental health and well-being in unanticipated and mixed ways.

Because we haven’t experienced anything like the coronavirus pandemic in recent history, we simply don’t know how our community will readjust as restrictions ease.

Some people may feel particularly anxious about reconnecting. For example, people with social anxiety might experience heightened anxiety about the prospect of socialising again.

One of the main evidence-based treatments for social anxiety is exposure therapy. When social exposure is reduced, as has been the case over the last couple of months, social anxiety may flare up, making returning to social gatherings particularly daunting.

Meanwhile, people who fear germs, such as some people with obsessive compulsive disorder (OCD), might worry about re-entering public spaces.

Even people who don’t normally have these tendencies might share similar worries. Our survey found around half of Australians were at least moderately concerned about becoming infected with COVID-19.

People who experienced psychological conditions before the pandemic may be able to draw on skills they’ve learned through therapy to help them re-engage. But people without any prior experience of anxiety or depression could struggle more because they have never had to manage these conditions before.

Tips for people who are feeling anxious

Whether you have previously experienced anxiety or not, there are several strategies you can use to manage your worries around re-engaging.

One effective psychological approach to managing anxiety is cognitive behavioural therapy (CBT).

CBT involves learning about how your thoughts affect your mood, and developing strategies to manage problematic thinking patterns. Importantly, CBT can be effectively delivered online.

CBT might also include developing a social or germ “exposure hierarchy”. For instance, working up from seeing a few people briefly to longer interactions, with more people. There are some critical ingredients that make exposure therapy work though, so it’s important to get advice from a psychologist or follow an evidence-based online program.

If you’re feeling anxious about coming out of your isolation bubble, you’re probably not the only one.
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Mindfulness, regular exercise and getting enough sleep can also help manage anxiety.

If you or someone you know is feeling distressed, it may also be helpful to contact relevant support services in your area – many of which now have telehealth options.

These may include your GP or a psychologist, or community services like Lifeline, SANE Australia, or Beyond Blue.

Things are likely to change over time

The public health measures implemented to mitigate coronavirus risk have worked to stop the spread of the virus, but they’ve also disrupted the way we live.

There’s much speculation on what the future will look like, resulting in the “new normal” terminology. A key concern as we continue to navigate this new normal is our collective mental health.

Japan experienced a 20% decrease in suicides in April 2020 relative to April 2019. Yet predictive modelling raises concerns about suicide rates potentially rising after the pandemic recedes.

7 ways to manage your #coronaphobia

Posted on May 21, 2020 by particularkev

Jill Newby, UNSW and Aliza Werner-Seidler, UNSW

As we’re slowly moving out of lockdown, many Australians will be feeling anxious about going outside, away from the safety of home, and returning to normal life.

For most people, these coronavirus fears will be temporary.

But for some, being overly afraid of the coronavirus can have serious implications. People might avoid seeking medical care, isolate themselves from others unnecessarily, or be debilitated with fear.

Others have taken to social media under the hashtags #coronaphobia and #coronaparanoia to share their anxieties, some with humour.

If you’re anxious, you’re not alone. Our survey of more than 5,000 Australian adults during the peak of the COVID-19 pandemic found one in four were very or extremely worried about contracting COVID-19; about half were worried about their loved ones contracting it.

But how do you know if your fears of coronavirus are out of control? And what can you do about it?

Here are some signs

Your anxiety may be out of control if you notice:

your fears are out of proportion to the actual danger (for instance, you’re young with no underlying health issues but wear a mask and gloves to the park for your daily exercise where it’s easy to social distance)
the fear and anxiety is intense and persistent (lasting weeks to months)
it’s hard to stop worrying about coronavirus
you’re actively avoiding situations (for instance, places, people, activities) even when they’re safe
you’re spending a lot of your time monitoring your body for signs and symptoms, or searching the internet about the virus
you’ve become overly obsessive about cleaning, washing, and decontaminating.

None of these experiences alone are a problem. But when they occur together, are persistent, and negatively impact your life, it’s time to do something about it.

Are you cleaning the same place over and over?
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These seven tips can help:

1. reassure yourself, it’ll get better: for most people, the anxiety will get better as the threat of COVID-19 passes. If anxiety doesn’t go away, it can be treated

2. change your ‘information diet’: spending time reading alarming tales of the horrors of COVID-19 will probably increase anxiety, not reduce it. Instead, try spending time focusing on positive information, stories or activities that take your mind off your fears

3. think logically about the risk: coronavirus has led to tragedy for many families, and we acknowledge the risk and consequences of contracting coronavirus differs from person to person. However, keep in mind over 90% of people infected with coronavirus in Australia have already recovered. The number of cases is also still extremely low, with 7,072 confirmed cases to date out of about 25 million people

4. reduce the focus on your body: when we pay too much attention to our bodies, it can make us notice things we wouldn’t normally notice, which then makes us more anxious. Take your mind off your body by focusing on other things, such as positive, enjoyable activities

5. take things slowly, at your own pace: it’s OK to slowly ease back into doing things you used to do. Take a step-by-step approach, doing one activity at a time, so you feel safe, while slowly building up your confidence

6. channel your anxiety into action: it can help to focus on what’s under your control. Taking active steps to look after your mental health, by sleeping well, exercising, doing fun or relaxing activities, and staying socially connected can make an enormous difference to your mental health

7. get help from professionals, not Dr Google: try an evidence-based online program for health anxiety, seek advice from your GP, or a psychologist who specialises in anxiety.

Here’s what you can do to ease your anxiety about the coronavirus (Australian Academy of Science)

How about children?

Most children will be pleased to get back into their familiar routine and to re-engage with their peers and friends.

Australian research conducted with adolescents at the height of the pandemic found young people were most worried the impact of the restrictions on their education and friendships (more so than the health risk).

However, for some children, the transition back to preschool or school will be more stressful.

For younger kids, some initial separation anxiety from the family members they have been spending a lot of time with is to be expected and will typically resolve quickly.

A small proportion of children may be excessively worried about leaving the safety of home and in these cases, these tips may help:

1. have an honest and open discussion with your child: ask your child to share exactly what they are worried about. Address their concerns rationally and devise a plan with them about how they can start to face their fears in a manageable way

2. model brave behaviour: children pick up on our anxiety and fears, but also on our behaviour. Model brave behaviours to demonstrate that it is now OK to go outside, and it is safe. You can start with a walk in the park on the weekend together and then transition to attending school. Importantly, if you are feeling overly anxious about the relaxation in restrictions, it is important to address your own anxiety first, before attempting to address your child’s

3. get professional help: if your child remains overly anxious about going outside and this doesn’t resolve over a few weeks, seek professional support. The best place to start is with a GP or psychologist who specialises in anxiety.

Coronavirus mental health resources are available online. Help for adults is also available from THIS WAY UP, myCompass and
MindSpot. Help for kids and adolescents is available from BRAVE-Online, ReachOut, Kids Helpline and headspace.

Jill Newby, Associate Professor and MRFF Career Development Fellow, UNSW and Aliza Werner-Seidler, UNSW Scientia Fellow, Senior Research Fellow in Mental Health & Clinical Psychologist, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

No wonder isolation’s so tiring. All those extra, tiny decisions are taxing our brains

Posted on May 3, 2020 by particularkev

Ben Newell, UNSW

Anxiety, depression, loneliness and stress are affecting our sleep patterns and how tired we feel.

But we may be getting tired for another reason. All those tiny decisions we make every day are multiplying and taking their toll.

Is it safe to nip out for milk? Should I download the COVIDSafe app? Is it OK to wear my pyjamas in a Zoom meeting?

All of these kinds of decisions are in addition to the familiar, everyday ones. What shall I have for breakfast? What shall I wear? Do I hassle the kids to brush their teeth?

So what’s going on?

We’re increasing our cognitive load

One way to think about these extra decisions we’re making in isolation is in terms of “cognitive load”. We are trying to think about too many things at once, and our brains can only cope with a finite amount of information.

Researchers have been looking into our limited capacity for cognition or attention for decades.

Early research described a “bottleneck” through which information passes. We are forced to attend selectively to a portion of all the information available to our senses at a given time.

These ideas grew into research on “working memory”: there are limits on the number of mental actions or operations we can carry out. Think of remembering a phone or bank account number. Most people find it very hard to remember more than a few at once.

And it can affect how we make decisions

To measure the effects of cognitive load on decision-making, researchers vary the amount of information people are given, then look at the effects.

In one study, we asked participants to predict a sequence of simple events (whether a green or red square would appear at the top or bottom of a screen) while keeping track of a stream of numbers between the squares.

Think of this increase in cognitive load as a bit like trying to remember a phone number while compiling your shopping list.

When the cognitive load is not too great, people can successfully “divide and conquer” (by paying attention to one task first).

In our study, participants who had to learn the sequence and monitor the numbers made just as many successful predictions, on average, as those who only had to learn the sequence.

Presumably they divided their attention between keeping track of the simple sequence, and rehearsing the numbers.

More and more decisions take their toll

But when tasks become more taxing, decision making can start to deteriorate.

In another study, Swiss researchers used the monitoring task to examine the impact of cognitive load on risky choices. They asked participants to choose between pairs of gambles, such as:

A) 42% chance of $14 and 58% chance of $85, or

B) 8% chance of $24 or 92% chance of $44.

Participants made these choices both with their attention focused solely on the gambles, and, in another part of the experiment, while also keeping track of sequences of letters played to them via headphones.

The key finding was not that increasing cognitive load made people inherently more risk-seeking (tending to choose A) or risk-averse (B), but that it simply made them more inconsistent in their choices. Increased cognitive load made them switch.

The fruit salad or the cake? Well, it depends partly on your cognitive load.
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It is a bit like choosing the fruit salad over the cake under normal circumstances, but switching to the cake when you are cognitively overloaded.

It is not because a higher cognitive load causes a genuine change in your preference for unhealthy food. Your decisions just get “noisier” or inconsistent when you have more on your mind.

‘To do two things at once is to do neither’

This proverbial wisdom (attributed to the Roman slave Publilius Syrus) rings true – with the caveat that we sometimes can do more than one thing if they are familiar, well-practised decisions.

But in the current business-not-as-usual context there are many new decisions we never thought we’d need to make (is it safe to walk in the park when it is busy?).

This unfamiliar territory means we need to take the time to adapt and recognise our cognitive limitations.

Although it might seem as though all those tiny decisions are mounting up, it perhaps isn’t just their number. The root cause of this additional cognitive load could be the undercurrent of additional uncertainty surrounding these novel decisions.

For some of us, the pandemic has displaced a bunch of decisions (do I have time to get to the bus stop?). But the ones that have replaced them are tinged with the anxiety surrounding the ultimate cost that we, or family members, might pay if we make the wrong decision.

So, it is no wonder these new decisions are taking their toll.

So what can I do?

Unless you have had ample experience with the situation, or the tasks you are trying to do are simple, then adding load is likely to leader to poorer, inconsistent or “noisier” decisions.

The pandemic has thrown us into highly unfamiliar territory, with a raft of new, emotionally tinged decisions to face.

The simple advice is to recognise this new complexity, and not feel you have to do everything at once. And “divide and conquer” by separating your decisions and giving each one the attention it – and you – deserve.

Ben Newell, Professor of Cognitive Psychology, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Are you worried someone you care about is thinking of suicide? Here’s how you can support them from afar

Posted on April 28, 2020 by particularkev

Milena Heinsch, University of Newcastle; Dara Sampson, University of Newcastle, and Frances Kay-Lambkin, University of Newcastle

We’ve now been social distancing for several weeks. While these measures have allowed us to slow the spread of COVID-19, they’ve also upended our day-to-day lives.

If you’ve found yourself experiencing feelings of fear, anxiety, depression, boredom, anger, frustration or irritability, you’re not alone.

Older adults, health-care workers, people with pre-existing mental health conditions and people experiencing financial pressure could be particularly vulnerable to psychological distress at this time.

When feelings of psychological distress increase, suicidal thoughts and behaviours may also increase.

So how do we know when to be worried about someone we love, and how can we support them from afar?

Recognising the signs

During COVID-19, we may all be feeling more stressed than usual. That’s why we need to stay connected with each other online, on the phone and via text messages.

But it’s important we’re attuned to whether this extra stress and uncertainty is developing into something more for any of the people we care about.

Some warning signs for suicide might be easier to recognise when you can see a person’s facial expressions and gestures. But there are cues you can pick up on during text, phone or online communication.

Social withdrawal can indicate a person is at greater risk. Perhaps a friend or relative is increasingly difficult to contact via phone or text, disappears from social media or starts saying they just want to be alone.

A persistent drop in mood might be revealed on the phone by a flat tone of voice, talking less than usual or more slowly, and by shorter text messages or none at all.

You may be able to tell if a friend is becoming socially withdrawn by the tone of their messages.
Shutterstock

Some people might say things like “you’d be better off without me” or “there’s nothing to live for”, which suggest they can’t see a way out of their situation and may be thinking about suicide.

If you’re worried someone you know might be suicidal, reaching out and having a conversation could save their life.

Talking on the phone or online

Choose a time and place where you can talk openly and without getting interrupted. This might be challenging when whole families are at home together for extended periods. But these can be sensitive and confronting conversations and it’s important to protect the person, as well as people in your family or household.

You could start the conversation by asking your friend or loved one how they are. You might also let them know you’ve noticed a change in them: “you don’t seem yourself”.

Starting the conversation may look different if you’re online. Perhaps someone has posted a comment or image on social media that seems unusual for them, or which makes it seem like they’re thinking about suicide. If so, contact them directly by sending a private message. It’s OK to talk online, just not in a public forum.

Once you’ve started the conversation, ask directly about suicidal thoughts and intentions (for example, “are you thinking about suicide?”).

And be prepared they may answer “yes”. Then you just have to listen with supportive statements. Say things like “that sounds really tough” rather than “don’t be silly”.

Some people considering suicide might actually find it easier to talk online.
Jonas Leupe/Unsplash

Being at a distance can be an advantage

You might feel worried about having a difficult conversation on the phone or online, but this style of communication actually has some benefits.

People may feel more comfortable revealing suicidal thoughts, without fear of stigma, when communication isn’t face-to-face. And sometimes people find it easier to communicate via emoji, GIFs or images rather than having to find the words to express how they’re feeling.

Further, listening on the phone or via messaging gives us time to think about how to best respond, and to let our initial reactions pass.

This is important because negative reactions, like criticising or dismissing someone’s feelings, may make the person less likely to seek help and increase their thoughts of suicide.

Encourage them to get help

If you’re worried about someone and you think they’re at risk of suicide, offering help is important. Our research with people who had previously attempted suicide found although participants wouldn’t necessarily seek help, many said they would accept it if it were offered.

While talking with the person you’re worried about is an important first step, you may be able to guide them towards professional help. For example, they may want help to make an appointment with a GP or counsellor, or to call a crisis line.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Lauren Rogers, a research assistant at the University of Newcastle, contributed to this article.

Milena Heinsch, Senior Research Fellow, Centre for Brain and Mental Health, University of Newcastle; Dara Sampson, Academic Research Manager, University of Newcastle, and Frances Kay-Lambkin, Professor, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Reconnecting after coronavirus – 4 key ways cities can counter anxiety and loneliness

Posted on April 28, 2020 by particularkev

Roger Patulny, University of Wollongong; Jordan McKenzie, University of Wollongong; Marlee Bower, University of Sydney, and Rebecca E. Olson, The University of Queensland

COVID-19 has forced us into social distancing, isolation and quarantine. These conditions are likely fostering widespread anxiety and loneliness in our cities. However, they’ve also made the need for socially connected, vibrant public spaces obvious to all.

We offer four strategies for rebuilding social connectivity and emotional well-being in our cities, once restrictions are lifted.

Changing the emotional climate

Enforced distancing measures are probably changing not just our work, travel and family routines, but how we interact with others and how we feel about ourselves and our communities.

Loneliness is bad for your health and is likely on the rise. There is no guarantee the pandemic-driven shift towards more digital communication will compensate for the lost emotional closeness of in-person contact.

As loneliness becomes more common, it creates a change in what sociologists refer to as “emotional climates” – the collective feelings experienced and shared by most people within a given city or society. A “mass emotional event” like COVID-19 can dramatically alter the emotional climate. It’s so disruptive that it leads to a permanent change in everyday emotional states, expressions and social interactions.

COVID-19 has strong potential to make us not only lonelier, but more distrustful, fearful, anxious and angry. The emerging evidence of this includes: panic buying of goods; abuse and stigma of “risky” carers such as health workers; and potential increases in domestic violence and animal cruelty.

It has even been suggested we are collectively processing and moving through the stages of mass grief.

It’s important to remedy negative emotional climates with strategies to reconnect communities, allay fears and better prepare us for any future shutdowns. We can even aim to promote positive emotional climates and “kindness pandemics”.

4 ways to build better communities

COVID-19 is an opportunity to build on what we know and to learn from this situation. It’s possible to promote social and emotional well-being. We suggest four key approaches for building better communities that do this.

1) Design walkable, social, flexible public spaces

Recent work-from-home practices have reduced car traffic by up to 50% on arterial roads. However, they have also prompted cabin fever and a craving for exercise and social contact.

Cities and suburbs should be redesigned to support physical and social activity and mental health. We need a greater emphasis on cycle- and pedestrian-friendly spaces. There should also be renewed focus on building walkable town centres and neighbourhood high streets, rather than continuing with car-dependent suburban sprawl.

Recent examples of innovative and flexible use of space by business are inspiring. Whether cafes become corner stores, pubs sell takeaway cocktails, parks become gyms, or car parks become pop-up businesses, flexible use of space should become commonplace.

2) Integrate public and online spaces

Our new online communication skills can help us develop a better physical-digital interface for bringing people together.

Video conferencing is flexible and can enable long-distance connection and “work from home” hubs. However, social media platforms, such as Facebook, Meetup, WhatsApp or art-based apps like Somebody, are useful for organising physical meetings too. These can can help with community volunteering, socialising, or simply sharing guerrilla-garden herbs for local cooking.

A better physical-digital interface could help new jobs flourish in “interactive” creative industries that virtually connect isolated individuals. New art spaces could be established, putting connective digital infrastructure, such as audio-visual platforms, within physical spaces to help face-to-face and virtual audiences interact.

3) Provide quality housing

COVID-19 has exposed the vast variability in the quality of Australian housing. Many homes lack the space to accommodate work, study, relaxation, exercise and socialising, or spaces where people can seek privacy and quiet. Housing also varies in its access to fresh air, light, temperature control and healthy green spaces.

Designing future homes with these needs and features in mind should be a priority.

4) Build with different needs and stigma in mind

The impacts of COVID-19 will not be felt equally. Post-COVID-19 cities should take this into account.

COVID-19 has exposed the vulnerability of people experiencing homelessness. It has also greatly increased the risk of loneliness for the one in four Australians who live alone. This applies particularly to older Australians with a mobility impairment.

The pandemic has also highlighted the safety risks of centralised living arrangements like nursing homes.

We must prioritise the creation of housing that reduces isolation and promotes social connection.

Recent positive public conversations on social media and within the arts community on previously stigmatised emotions like loneliness and anxiety will help keep these concerns on the public agenda.

Roger Patulny, Associate Professor of Sociology, University of Wollongong; Jordan McKenzie, Senior Lecturer in Sociology, University of Wollongong; Marlee Bower, Postdoctoral Research Fellow, Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, and Rebecca E. Olson, Senior Lecturer, School of Social Science, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus: tiny moments of pleasure really can help us through this stressful time

Posted on March 28, 2020 by particularkev

Desirée Kozlowski, Southern Cross University

If I told you that last night I built a blanket fort in the living room, crawled inside with my cat, a glass of wine and my just-arrived copy of the New Yorker, would you think less of me?

After all, we’re in the midst of a global coronavirus pandemic. Borders are closing, people are sick, dying, losing their jobs, and locked in isolation. And there was I, playing – as though I didn’t have a care in the world.

Meanwhile, you might be reading this holed up at home, screaming with fury at those bloody hoarders. Or perhaps you’re on a train valiantly trying to keep 1.5 metres away from the next person, shrinking back as they cough and splutter.

Wherever you are, whatever you’re doing, whatever you think about the pandemic, the economy, or your compatriots, a tiny part of you knows you could do with a bit of pleasure right now.

The effects of sustained stress

When we’re first exposed to something stressful, like a deadly new disease, our body reacts with a cascade of small changes such as releasing adrenaline and other chemicals, and activating brain regions related to fear and anger.

In many cases those changes make it more likely we’ll meet the challenges we face.

But if the stressful conditions continue, and especially if we feel powerless to fix the situation, the consequences of the stress response increase.

Our risk of chronic diseases increases, immune function can be compromised, and we become more vulnerable to mental health problems.

We can feel depleted, disconnected, anxious and depressed. We can become fixated on negative thoughts and on looking for signs of threat. Sound familiar?

The good news is the effects of stress on the brain are reversible.

Pleasure in times of stress

It may seem too simple to be true but shifting our attention toward the small, everyday pleasures in our lives can offset the consequences of stress or negative events.

US researchers reported last year that experiencing pleasurable emotions, for example having interesting things to do, serves as a buffer between chronic stress and depression. So, among people with sustained, high levels of stress, those who reported more pleasurable moments were likely to experience less severe depressive symptoms.

Pleasurable experiences might even be of most benefit in times of stress.

We experience pleasure in a myriad ways. Perhaps one of the most potent of pleasures, and one that springs most easily to mind, is a lover’s caress.

But to maximise the pleasure in every day, we should look more widely, to a multitude of sources.

If we’re too busy reading those alarming headlines to notice the beauty of the sun setting outside our window though, it’s a missed opportunity for a moment of delight.

When I recently asked people on Twitter to share the things bringing them delight in these challenging times, I received hundreds of replies within a couple of hours.

Each one was a small vignette conveying a personal moment of simple pleasure. Gardens and dogs and children and nature featured strongly, and many people reflected on the added pleasure of recalling such moments.

Indeed, recollection and anticipation – along with relishing pleasure in the moment – are effective ways to maximise the value of positive experiences or emotions. We call it “savouring”.

Luckily, we can get better at savouring with practice. And the more we savour, the less stressed we feel. And that’s why I’m here.

If we increase the pleasure we experience, it can lift our psychological well-being. In turn, higher well-being is linked to better immune function.

It’s about boosting our personal capacity

My message is not to avoid the facts or pretend nothing has changed. It’s to intentionally build in moments of reprieve and restoration. It’s to turn your attention to what is still good and rich and fun – to really focus on those things.

This is how we can harness the protective power of small pleasures, for the sake of delight itself and to build grit and resilience.

So, there may never have been a better time to build a blanket fort, or to bring out a game of Twister, or to lie on your back in the garden making fantasy creatures out of passing clouds. Find excuses to giggle.

Making pleasure happen

In difficult, frightening times, no one is immune to worry; it’s a natural response. But what we can do is take steps to protect ourselves, as much as possible, from its physical and psychological ill-effects.

The challenge is to make this happen, to tear yourself away from analysing the COVID-19 curve and intentionally, systematically engineer more small delights into your day.

Do you like the sunshine? Then know when the sun falls on your balcony, in your garden or in the street near your place. Take a cup of tea or coffee with you and soak up the warmth.

Pets? Run, play, be silly with them. Eating a tomato? Plant the seeds and watch something grow, from nothing, because of you. Sing. Dance. Delight someone with an act of kindness.

Plan your opportunities for pleasure. Put them in your diary. Set your alarm for them. Commit to share them with others. Photograph them. Post them on social media or share them directly with friends and family. Anticipate them gleefully and reflect on them with delight. This is our time to be here. Savour.

Desirée Kozlowski, Lecturer, Psychology, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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