Mental-health providers offer tips for keeping a level head amid pandemic

In this new normal, where government directives and information about the COVID-19 pandemic seem to change on a dime and the economic landscape has transformed seemingly overnight, it’s easy to find oneself asking: how are we going to get through this?

While much remains uncertain about the pandemic — the duration, the long-term effects and the cure — local mental-health providers are happy to share a few strategies to help Flathead Valley residents navigate these uncharted waters.

Dr. Sara Boilen, clinical psychologist and owner of Sweetgrass Psychological Services in Whitefish, said people are being forced to adapt to the constantly changing situation quickly and noted many activities that help ease stress are the exact activities that have been deemed off-limits in order to reduce the spread of the coronavirus.

“We are social creatures. We come together to vent about things or to process things and sort things out. We eat out when we are sick of cooking or see our friends when we are lonely,” Boilen said. “Right now, all of those connections are very limited. Many of the things on most people’s wellness routines have now become off-limits, and that can be a real problem.”

In her eyes, there has been an evolution in how society has perceived the COVID-19 outbreak, beginning with a collective confusion and sense panic (i.e. toilet paper hoarding) followed by a great deal of uncertainty over how long the situation might last. Last week Gov. Steve Bullock extended the closure of public schools and imposed a stay-at-home order though April 10, where residents were instructed to remain inside as much as possible. Travel for essentials like groceries, medical appointments, outdoor activities and work at businesses deemed “essential” were permitted.

These measures, along with social distancing and hand-washing, are considered by health experts to be the most effective at reducing rates of infection. However, these restrictions have resulted in complete transformations of most people’s daily lives.

What’s more is that an end date has yet to be identified. Montana was among the last states to identify a case of coronavirus and a model produced by the Institute for Health Metrics and Evaluation at the University of Washington predicts the state will see a peak use of hospital resources for coronavirus on April 26. This prediction was calculated based on the dates of school and non-essential business closures, the imposition of the stay-at-home order and the lack of severe travel limitations.

Meanwhile, people are bracing for impact but are not sure when exactly, or if, it will hit, leading to prolonged stress.

“When our bodies perceive a threat, we prepare for our fight or flight response. We get hormones coursing through our bodies that prepare our response. When that threat is protracted, not immediate and not entirely clear, our system is activated indefinitely. That apprehension takes a real toll on our physical body as well as the mind,” she said. “This leads to fatigue, exhaustion and demoralization — people feel they can’t keep going at this pace.”

To cope with the undeniable uncertainty, Boilen recommends adopting five strategies for coping with stress and preparing another five in the event of a mental-health crisis or moments of intense anxiety. To minimize stressors, she suggested a range of social distancing-approved activities including: taking walks, baths, time with pets, outdoor activities, time with friends or putting together puzzles. Time with friends might mean a group video chat — or even happy hour — or something as simple as a phone conversation.

For times of extreme stress, Boilen advises people to do things that help ground them — stretching, taking 10 deep breaths or naming every color in sight can help ease one’s mind.

Patricia Greene Hall, a clinical psychologist with the Flathead Community Health Center, said the level of isolation one experiences can also impact the way they respond. She recommended monitoring news and social media intake, verifying the source of information related to COVID-19 and keeping to a routine as much as possible.

“Being isolated and being quarantined, unless you’re seriously ill there’s no reason you can’t go stand on your porch and get some sunlight,” Hall said. “It doesn’t mean you have to stay cooped up in your house with the shades drawn 24/7.”

She also stressed the importance of being kind to yourself during this already stressful time and setting reasonable goals, rather than ones that would add to existing stress. Instead of saying, “I’m going to rearrange my entire house,” divvy that large objective into manageable chunks, say a bedroom or single closet. And don’t forget to reward yourself for the things you do accomplish, she noted, like giving yourself the OK to binge on Netflix after completing a project around the house.

“I would just say it’s OK to be anxious. It is absolutely 100% OK to be anxious and a little nervous about what’s going on. The key point is to not let the anxiety override everything else going on in your mind to the point where it just paralyzes you,” Hall explained. “If you’re focusing on the death toll increasing you’re going to stay anxious but if you’re focusing on the people recovering, that’s a different picture.”

Hall has yet to see an uptick in new clients as a result of the pandemic, but said she’s observed heightened stress responses in a few patients with existing anxiety conditions. Boilen hasn’t noticed an increase either, but is anticipating one, and both providers have encouraged their clientele to take advantage of telemedicine appointments. Many providers around the valley are still taking new clients for telemedicine appointments such as North Valley Behavioral Health, Sunburst Mental Health and the Western Montana Mental Health Center, among others.

“People should not feel ashamed or embarrassed if they are not coping well,” Boilen said. “If you are still in your same set of pajamas from three days ago, you are not alone. These are wild times and we all have to have grace and compassion for ourselves and others as we figure out how to get through this.”

In response to increased need for mental-health services, the Montana Department of Health and Human Services is increasing funding to a variety of hotlines and programs to serve those affected by the COVID-19 pandemic. Last Wednesday, the state announced a $20,000 increase in funding for Mental Health America of Montana, which operates a behavioral health hotline, the Montana Warmline. The Warmline provides confidential emotional support by trained staff. Thanks to the funding increase, the Warmline is offering extended hours from 8 a.m. to 9 p.m. Monday to Friday and 12 p.m. to 9 p.m. on Saturday and Sunday and can be reached at 877-688-3377 or www.montanawarmline.org.

Due to increased call volume, the department also authorized an additional $75,000 to support the Montana Suicide Prevention Lifeline at 800-273-TALK (8255). Mental-health assistance is also available by text through the Montana Crisis Text Line, which can be accessed by texting “MT” to 741741.

Finally, $25,000 was added to Thrive by Waypoint Health, online cognitive behavioral therapy for those actively working to manage anxiety and stress.

“We continue to monitor and make adjustments as necessary to meet the needs of Montanans during this challenging time,” Department of Public Health and Human Services Director Sheila Hogan said. “While we are focused on limiting the spread of COVID-19 in our state, we must also not forget the mental-health needs of our friends and neighbors.” ■

Editor Mackenzie Reiss can be reached at editor@bigforkeagle.com or (406) 758-4433. Reporter Jeremy Weber may be reached at jweber@dailyinterlake.com.