The COVID-19 crisis has been extremely challenging for all of us.
The isolation, health risks, anxiety over loss of income, stress of working from home while doubling as full-time caregivers and teachers, and the overall uncertainty about the future are heavy burdens to carry. Mounting evidence points to a widespread increase in mental health issues, domestic abuse, alcohol consumption and substance use as we all struggle to cope with the fallout from a global pandemic.
But few among us bear the burden of the crisis more than front-line healthcare workers: the doctors, nurses, EMTs, aides and janitorial workers who are risking their lives to help the rest of us stay healthy.
These heroes are among the most at risk for issues like PTSD, substance use and even suicide. Faced with long exhausting work hours, the constant risk to their own health and that of their family, feelings of helplessness when they can’t save patients’ lives despite every effort, death on a scale many have never seen before, and the pressure of living up to being called a hero when the odds are stacked against them, is all unbelievably overwhelming.
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And, the risks are substantial. An NIH study using functional MRI scans showed that PTSD can have the same impact on the dopamine reward system of the brain as long-term use of methamphetamine. The effects are similar: nightmares, detachment, avoidance of triggers, guilt, panic, anxiety, depression, trouble sleeping—the list goes on. That means those we depend on most are being subjected to serious and chronic brain trauma. And the longer it continues, the more difficult it is to treat and the more guarded the prognosis.
Sadly, most medical personnel in the field today have received next to no training in self-care, mental health or addiction for their patients, let alone themselves. While there is a push to change that now, it won’t help those on the front lines of the crisis.
So, what can front-line workers do now to help cope and avoid long-term trauma?
Be aware of your own mental wellbeing. Mood changes, increase in anxiety or depression, feeling jumpy or easily startled, change in appetite or sleep habits, loss of enthusiasm for work or even being at home with your family are all warning signs that you need to take a break or step-up your self-care.
Turn off the news. When playing a significant role in maintaining a global pandemic, it can be tempting to want to see how it’s being portrayed. And with so much news coverage and information changing rapidly, it becomes overwhelming and takes away from the break you’re supposed to be taking when you do finally get to sit down and take time for yourself.
Take breaks when you can. Don’t be afraid to say you need to take a step back or ask for help from neighbors and friends. Something as simple as running errands or picking up groceries can go a long way toward alleviating your personal burden. And, people want to help, so don’t be shy about accepting it.
Don’t let social distancing become social isolation. Of course, you want to be safe and adhere to the distancing guidelines, but that doesn’t mean total isolation. Make time to video chat with friends and family, and reach out to colleagues to talk and share your feelings. You’re certainly not alone in your feelings, and your outreach may be exactly what someone else needed, too. Talking it over can help you both to cope better.
Get some exercise. Exercise has proven to elevate mood, energy levels, concentration and overall feeling of wellbeing. When you’re on your feet for a 12-hour shift, going for a walk or a jog may be the last thing you want to do, but there are plenty of other options. Yoga can be restorative for both the mind and the body, and strength training can help you to feel more empowered and in control. Simply doing a few bodyweight exercises like squats, lunges, pushups and overhead presses can get the blood pumping and help you to feel more energized and ready to face the challenge of the next shift.
Control what you can. So much of this situation is entirely beyond our control, and that’s especially frustrating for those who are typically the ones the rest of us turn to during a crisis to calmly take control and “fix” it. But spending time ruminating on all the things you can’t change is useless. Instead, shift your focus toward what you CAN change. What can you do today or right now? Maybe it’s taking time for self-care, participating in peer group chats or getting some exercise. Find something that’s within your power and do it.
Don’t get sucked into substance use. It’s become a sort of the running joke of quarantine that daily drinking is the new norm. The temptation to self-medicate with alcohol or drugs can be extremely powerful, especially when you see non-front-line colleagues having a drink during the workday or enjoying virtual happy hours with friends.
But, for those facing life and death crises on a daily basis, this can quickly become a very slippery slope. While it’s OK to responsibly enjoy an alcoholic beverage on occasion, be aware of the CAGE signs of chronic use:
- Cut back: Have you tried to cut back use without success?
- Annoyed: Do you get annoyed if someone brings up your using?
- Guilt: Do you feel guilty about using?
- Eye-opener: Do you need a drink to get going or before going somewhere?
An affirmative answer to just one of those questions would typically prompt a physician to recommend a patient for substance use evaluation. While you may not be at that point, it can happen quickly. And for healthcare workers, the temptation to hide a problem is great, considering the potential risk to licensure, practice privileges and overall livelihood.
When it’s in your nature to help others first before helping yourself, it’s easy to feel like bearing the burden is just part of the job. Some even wear it as a badge of honor. But, when putting others above yourself puts your own personal safety at risk, it’s time to take action.
As we’re told during the safety instructions on every flight: put on your own mask first, before helping others. As a caregiver, you must make your own health and wellbeing a priority in order to do the job you love. And, while it might be tempting to give up your own self-care to make others well, the truth is we need you to be well.
If you’re struggling with mental health issues, stress, addiction or suicidal ideation, help is readily available. We’re counting on you to reach out so that we can help the helpers.
Charles Smith is an addictionologist at the Recovery First Treatment Center.