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Q&A: Maintaining Mental Health in the Time of COVID-19

Reina Juarez.

UC San Diego’s fall plan is continually evolving, informed by the university’s Return to Learn program. We invited students, faculty and staff to submit their questions on topics such as how to maintain mental health during a time of great uncertainty, ways to combat loneliness and what mental health support is available to students, faculty and staff.

To address several of these important topics, we spoke with Reina Juarez, Ph.D., director of Counseling and Psychological Services (CAPS) at UC San Diego.

Q. What is mental health and why is it important to maintain?

A. Mental health can be described as a state of cognitive, psychological, emotional and social well-being. This encompasses having the ability to manage and respond to the daily demands and vicissitudes of life, recognition of your own inner strengths, having meaning and purpose, as well as possessing an ability to contribute to your community. Said simply, it means savoring life regardless of your circumstances.

There is a connection between mental and physical health—the two cannot be separated. As humans, we are a sophisticated system; our thoughts and emotions are interwoven with our physiology and behaviors. For example, feelings of depression can result in a loss of vitality and energy, making it difficult to engage in behaviors and activities that would support well-being. Similarly, those who experience anxiety may have physical symptoms such as headaches, high blood pressure or stomach aches. Interestingly enough, improving our physical condition can benefit our mental health, from nutrition to exercise and restful sleep. When we take care of our bodies, we generate energy that allows us to function effectively and achieve goals.

Q. What are some of the most common emotions people are feeling about the pandemic?

A. We are in the midst of extraordinary times, and our emotions reflect this—from anxiety and grief to frustration and loss of resolve. These are all a natural reaction to our shared unnatural circumstances, a way to process the loss of a lifestyle that we took for granted. For many, stress has increased because the ritualistic markers that used to indicate when our work duties came to a close for the day, and our family or leisure time started, are not clearly delineated anymore.

What is also difficult is the loss of control; we can no longer predict how the day or week will flow with a sense of assurance. Worries do not end about how to balance work circumstances, finances and the heavy weight of isolation. Some feel a deep sadness for the lost time with aging parents, the void of not having the chance to say goodbye to loved ones and mourning without the comfort of in-person community. Others may be experiencing immense trauma, in particular our healthcare providers.

Q. What are three coping methods you would recommend?

A. I would recommend:

  1. Maintain perspective by continuing to educate yourself about how to safely navigate the pandemic. And know that you are not alone, we are in this together. There are resources and support systems to help you through this. We can all cultivate a positive mindset and find meaning in life even in the most miserable of circumstances.
  2. Be present and remember that nothing lasts forever. Our mind might engage in a lot of predictions because we need to have control and explanations, but many of them will not manifest. Focus on what you can control right now.
  3. Make time to give back and support others, because humanity as a whole is enduring the pandemic.

Q. Why is social connection important, and how can we overcome loneliness during this time?

A. Human connection is so very important from the moment we are born. We derive emotional sustenance and strength from our positive relationships. Loneliness accelerates aging, cognitive decline, affects the immune system and increases inflammation.

It is important to distinguish between social distancing and physical distancing. Our brain correlates social distancing with isolation, loneliness and disconnection. However, we can socialize in a safe manner through physical distancing, so long as we wear a face covering, meet outdoors or in a well-ventilated area, maintain at least six feet between each person and wash our hands often.

Q. Why is it so difficult to deal with uncertainty?

A. Our brains have been hardwired to predict and control as part for our survival. We want to succeed, and part of success is to feel confident and in charge. How we react to uncertainty is at the core of our well-being. We can react either with fear and anxiety, or another emotion like curiosity. We feel most comfortable when we have clarity, which dictates how we behave and make decisions.

There is no doubt that challenges like this help build resilience. It starts with acceptance of what is happening and being clear about what we can control, like cultivating positive mindsets and emotions and supportive relationships. For those with ongoing trauma or lack of resources, challenges like a pandemic can tax their system and may lead to break down rather than growth. Thus, it is important to take care of those who are vulnerable.

Q. What are signs that someone should seek guidance from a therapist?

A. My hope that is that we all know how we are in our normal state of being. When you begin to realize that you do not feel like yourself, or others begin to ask what’s going on, it is time to reflect and tell oneself the truth. And if we cannot do it alone, then it might be time to seek support from a mental health professional. Other signs include if your feelings and cognitions begin to interfere with your relationships with family and friends or begin to impact your work or academic productivity.

Sometimes signals can be more subtle. Perhaps you don’t find joy in activities that you used to love, or you begin to postpone your goals for no clear reason. There may be a feeling of listlessness or lack of vitality, or you find that past coping mechanisms no longer help. Alternatively, individuals may begin to engage in unhealthy coping behaviors such as higher utilization of alcohol and other substances, or fall prey to addictions like food, online gambling or shopping.

Even those who have been solid as a rock might have begun to feel anxiety and depression during the pandemic. Sometimes the depression is a manifestation of the compounded despair and anger that arise, not only from the COVID-19 pandemic, but from the many other issues going on at a local and global level, from racism to geo-politics and climate change. These are normal reactions, but sometimes you need a little more help than talking with friends and family. The stigma of mental health can be a deterrent, but there should be no shame in seeking out a mental health professional. In fact, the sooner the better.

Q. What services is Counseling and Psychological Services (CAPS) offering for students?

A. CAPS has transitioned to a virtual counseling center. We are fully operational, offering every service that we provided in the past. This includes televisits, educational workshops via Zoom, daily drop-in groups for skill building on topics like mindfulness, as well as a wide range of online applications in our iFlourish library. Programming outreach services for students can be requested via the CAPS website, and consultation services for staff and faculty can be accessed by phone during work and after hours.

All appointment requests start with a call to our office (858-534-3755) and an initial 30-minute telephone assessment to determine the best support for each student. We encourage students to call us—no issue is too big or small. Our CAPS Central Office at Galbraith Hall is open every day to ensure that if a student needs to be seen in-person, they will not be turned away. In particular, if a student is experiencing a crisis, we have urgent care available. We encourage students to indicate urgent requests when they call the office.

Q. Are there counseling services available for faculty and staff on campus?

A. Yes, faculty and staff can receive mental health support through the Faculty and Staff Assistance Program (FSAP). Services include confidential, one-on-one counseling via Zoom or phone, virtual educational workshops and remote support groups. Appointments can be requested online.

Have more questions? We invite the campus community to submit your inquiries online. A new Q&A with a Return to Learn expert will be published each Thursday in This Week @ UC San Diego for the next several weeks.