For an increasing number of Covid-positive patients undergoing treatment in city hospitals, the disease has brought the added baggage of anxiety and insomnia. Prolonged treatment, loneliness and the social stigma attached to the disease are giving them sleepless nights. The anxiety has aggravated their existing illnesses and mental health conditions, if any, prompting experts to call for an urgent need to include mental health management in the Covid-19 treatment protocol. The city has already seen three suicides among Covid positive patients.
A doctor at Seven Hills Hospital said blood pressure and blood sugar levels in many comorbid patients have shot up. “Many are complaining of sleep deprivation. Patients seek attention by asking doctors to check their symptoms at regular intervals. There is also fear among the healthcare workers, who are being extra cautious in handling patients. This, too, is adding to the patients’ angst,” said the doctor.

Though patients with existing mental health conditions are being attended to via phone calls, a regular mental health check-up would help all patients. “Patients have access to information. They read about Covid-19 deaths going up every day. Many fear death, which is natural. Since many are in isolation wards, they feel lonely,” said another doctor.

Consulting chest physician VA Sajit Babu said symptomatic patients get worked up waiting for test results. “Testing positive itself comes as a shock to patients and their families. Thereafter, getting a bed in a hospital adds to their trauma. Unlike other illnesses where relatives and friends boost a patient’s morale, covid patients have to stay in isolation wards. Many fear being socially boycotted once they are discharged,” he said.

Psychiatrist Dr Harish Shetty said, “Besides the fear of the disease, people are worried if their housing societies will accept them or if they will end up infecting their loved ones. The biggest fear is that of death,” he said. He rued the lack of a mental health expert in the state task force. “The battle is not just between life and death. It’s also about giving confidence to those on the frontline,” he said, adding Covid warriors such as doctors and nurses must be debriefed.

Interestingly, Sion Hospital doctors believe the psychiatric morbidity of Covid-19 is not as high as they expected it to be. “Patients who came in the initial stages of the outbreak were more anxious. We have had patients becoming violent at the very mention of Kasturba Hospital. But that’s not the situation anymore,” said Dr Nilesh Shah, adding he saw mental health issues in less than 1% patients. “Patients who are not as aware about the disease are calmer compared to those who have read a lot,” he said.

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For most of us, life was on autopilot, with a planned structure. But now, with no need to report to work, most of us are spending nights either working, surfing the internet or watching OTT content

We loved the idea of a work from home scenario, the mere thought of having ample time on our hands, made us ecstatic. But little did we know that this freedom had the potential to mess with our daily routine and most importantly, our sleep cycles. For most of us, life was on autopilot, with a planned structure. But now, with no need to report to work, most of us are spending nights either working, surfing the internet or watching OTT content. Kavita Mungi, mental health counsellor, affirms, she says, “As there is no urgency or timings of attendance, even if one is working from home, it leads to a lethargic state of mind and body. There is no train/ bus to catch early in the morning or anywhere to go to. So, one may just stay awake late at nights binge watching their favourite shows. This, in turn, may result in a disturbing sleep- wake cycle. One has to also watch out for binge eating and drinking which may lead to a disturbing mental as well as physical health situation.”

But what can be done, though, is being aware of, and recognising these changes, and then acting upon them to improve the situation. The virus has not taken away hours from our days. What the virus has done though, is deleted our familiar programs.

Dr Shwetambara Sabharwal, clinical psychologist and relationship counsellor, cautions us, she says, “Let’s not be delusional and trivialise this experience, this is a hard U-turn and has shaken us to the core. We must understand why some of us are finding this newness hard to absorb and then make certain adjustments.”

Sabharwal explains that there are three dimensions to our existence that we need to deploy, all together, to adapt and survive”

1 Body: the body works on oxygen, water, food, sleep, and of course prevention of disease. Recognise its needs and the new reality. Use and nourish your body well, with good breathing techniques, healthy eating, hydration, exercise, sleep, and necessary precautions.

2 Mind: Break down your rigid perceptions of what a day and schedule “must” look like, that productivity is a consequence only of formal office hours, that housework is not work at all, and finally embrace and respect your new reality.

3 Soul: The most valuable hard lesson that we have been compelled to swallow during these times is that we are all weak, vulnerable, conquerable and in that, we have realised that we are one. That realisation is enough for the soul to be nourished. When we feel one with those around us, with nature, we act in ways that help and support our own being.

Tips to deal with an irregular sleep cycle:

1. Plan a sleep-wake schedule that matches your regular work hours

2. Exercise to stay fit and get adequate sleep

3. Eat healthy and at regular intervals

4. Avoid spending unhealthy hours on social media

5. Manage stress by working on it by keeping yourself busy, talking to people close to you or seeking help

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“Doesn’t it feel like the zombie apocalypse?” I recently asked my boyfriend. We were taking our daily sanity stroll when suddenly the sleep-deprived eyes peeking over surgical masks started to feel extra eerie. I may have even traumatized a small child in a window when I waved excitedly, forgetting a big black piece of fabric was covering half my face and I hadn’t bothered with concealer. Honestly, the lack of concealer is probably what drove the poor thing to run. The insomnia has been brutal lately.

I’m certainly not alone. Everyone I speak to, from my grandmother to Kaia Gerber, mentions how badly they’ve been sleeping. That’s because the current situation is a veritable perfect storm for sleeplessness, and that goes for sassy 80-year-olds and teen top models alike. 

“The biggest issue is stress and anxiety: worrying about your health, worrying about your job, worrying about your finances,” says Dr. Atul Khullar, medical director at the Northern Alberta Sleep Clinic and senior consultant at Medsleep. Then there are the changes to your routine. “Being more restrained, not being able to get out as much, less light, less exercise, worse eating habits—it’s just a hurricane of things that can disrupt sleep.” 

While we can’t control what’s going on in the world, there are some things we can do to help rest our minds and bodies and get that much-needed shut-eye.

MAKE SLEEP A PRIORITY

In our performance-obsessed culture, rest is too often undervalued, but it’s truly essential to our health. A chronic lack of sleep has been linked to a whole host of issues including heart disease, stroke, obesity and diabetes. “There are some studies showing that you’re less likely to catch things, including the coronavirus, if you get proper sleep because sleep deprivation weakens your immune system, even in the short term,” says Khullar. Poor sleep also hikes up stress hormones, which make it even harder to deal with everything going on on top of making us more testy and irritable. “Sleep is going to get your entire family in a better mood, in a better temperament,” says Alanna McGinn, sleep expert and founder of the Good Night Sleep Site. “We’re all stuck together, so we need to be as happy as we can.” 

STICK TO A SCHEDULE

With no commute or school run to worry about, it’s tempting to sleep in more and pop out of bed mere minutes before you have to be online. And since you don’t have to wake up so early, you might be going to bed later, too, falling into a Netflix black hole or buying overpriced throw cushions at midnight (just me?). But all of this can throw off your sleep as well as your energy levels throughout the day. “A lot of people don’t have the discipline to keep the structure, so we find people not keeping consistent bedtimes or sometimes napping excessively,” says Khullar. For McGinn, the first step is setting an alarm. “It doesn’t have to be as early as you would have woken up when you were going to work, but getting up at a more reasonable hour builds up more drive for sleep, which will help you fall asleep a lot better at night.” Regular exercise, including sanity strolls, also helps with that on top of promoting a deeper, more restful sleep.

MAKE YOUR BED SACRED

Both experts are adamant your bed should be for sleep and sleep only. “Protecting your sleep space provides a positive association between sleep and your bed,” explains McGinn. “Now, our bedrooms are becoming our home office and command centre, and that can make falling asleep even harder.” What happens is your brain no longer equates being in bed with just sleeping, so you lose that signal to wind down. “If you start doing many other activities in bed, you can get very strong behavioural insomnia,” warns Khullar. This is also why you shouldn’t lie awake for long periods. “We should be sleeping 85 per cent of the time we’re in bed, so if you are struggling with that it’s okay to get out of bed for 10 to 15 minutes,” says McGinn. “Do a quiet activity—don’t turn on every light or check your email, but a quiet activity in low light like reading or doing a puzzle—then get back into bed and try again.” 

OPTIMIZE YOUR SLEEP SPACE

There are plenty of small tweaks that can make your bedroom more conducive to sleep, especially going into the warmer months. Mornings are getting brighter, so incorporating blackout drapes can help keep your room dark. There’s also the matter of temperature. “The best sleeping temperature is usually a little cooler than people think—between 16 and 19°C,” says Khullar. McGinn suggests switching to more breathable bedding and moisture-wicking materials like bamboo, eucalyptus or linen. And if you sleep with a partner, don’t be afraid to customize your side. “You don’t need to have to have the same pillow, comforter and sheets,” she says. Finally, pay attention to how your room smells, too. Certain scents like lavender and chamomile have been shown to promote sleep, so don’t discount those trendy diffusers and pillow sprays.

IMPLEMENT A BEDTIME RITUAL

Much like a toddler, I find a bath and book a surefire way to get me to sleep. That kind of pre-pillow quiet time is actually key to telling your brain you’re about to go to bed, say the pros. “It can be 10 minutes or 40 minutes, but there should be some time where you don’t do any other activities except prepare for bed,” says Khullar. For McGinn, that means putting down devices and steering clear of all things stressful. “We need boundaries on what we’re absorbing with the news and the scary stuff that we’re bringing into our brains right before going to bed,” she says. You also want to limit screen time in the evening as the artificial light confuses your internal clock. That’s not to say all tech is bad, though. Things like meditation apps or relaxing podcasts can help get you into a calmer state. 

GIVE YOUR BODY A BREAK

Another important part of prepping for bed is what you put in your body. It’s important to avoid big meals at least four hours before bed so that your body is focused on sleep and not digestion. “A lot of people are turning more to carbs and desserts right now—please tell me I’m not the only one [laughs]—and if your body is not used to that, it might have a harder time metabolizing it,” says McGinn. She also suggests satisfying your sweet tooth earlier in the day rather than in the evening so that you’re not hyped up on sugar. Then there is the question of alcohol, which many of us might be consuming a bit more regularly than in pre-isolation times. “Alcohol is probably one of the worst things you can do for your sleep,” says Khullar. “It can put you to sleep, but that effect wears off quickly, and the sleep it gives you is artificial and not restful. Long-term, it damages your ability to sleep.” What about weed? “If cannabis is helping you sleep, then maybe there’s something else that you need to look at such as anxiety, depression or chronic pain,” says Khullar. “As a general rule, we don’t recommend people use anything to help them sleep without addressing it and getting assessed by a medical professional.” Many sleep clinics are offering virtual consultations right now, so if you try all these tips and still find yourself tossing and turning, don’t hesitate to reach out for help. From coping with the stress to staying healthy, you need your rest more than ever.

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You know the drill. You try to get a good night sleep, only to wake up at 2 a.m., contemplating all the doom and gloom of the pandemic. Your subconscious is doing a major data dump. A couple hours later, if you’re lucky, after checking Facebook, doing some online shopping and reading your favorite websites, you fall back asleep.

Jenna Jonaitis, a lifestyle, wellness and parenting writer based in Grand Rapids, tackles the issue in the The Washington Post in a story headlined: “Some of us have more time to sleep. So why are we so tired?”

She starts:

Since the onset of the coronavirus pandemic, I wake up most days already tired. Coffee is mandatory, and that wasn’t the case before. My husband is more sluggish too. We have increased responsibility, taking care of our toddler while still working full time from home. It’s also harder for him to fall asleep and harder for me to keep my eyes open in the afternoon.

This pandemic is exhausting, mentally and physically. Our worlds have shifted, and it takes emotional energy to cope with that. Health-care workers are spending long shifts in hospitals and care homes trying to keep patients alive. Other essential workers are pulling overtime in grocery stores, warehouses, fields, production plants and delivery trucks to ensure the country has enough food, toilet paper and face masks. At-home workers are doing their jobs and, in many cases, also caring for and educating children.

Rebecca Robbins, a postdoctoral fellow and sleep researcher at Harvard Medical School, tells Jonaitis that sleep challenges are totally understandable.The uncertainty of the pandemic, concern for others and ourselves, and the utter lack of control is a perfect storm for insomnia and sleep difficulty.

Lori Russell-Chapin, a professor of counselor education and co-director of the Center for Collaborative Brain Research at Bradley University in Illinois, says we’re worn down by this new lifetyle, the hyper-alertness while doing such tasks as grocery shopping and grieving the loss of a loved one from afar.

A study out of Wuhan, China, found insomnia was often the results of anxiety, depressive symptoms and fear of getting infected, economic-related stress, difficulty handling social distance restrictions and changes in daily life.

What to do?

Suggestions include getting exposure to sunlight, limiting caffeine, sticking to a sleep schedule and calming the brain through meditation and deep breathing. 

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TORONTO — Lily Francois battled insomnia for a solid week, waking up at 3 a.m., and then struggling to get back to sleep. So the 13-year-old from Cole Harbour, N.S.

TORONTO — Lily Francois battled insomnia for a solid week, waking up at 3 a.m., and then struggling to get back to sleep.  

So the 13-year-old from Cole Harbour, N.S., decided to switch things up, pitching a tent in her living room and camping out with her younger sister.

Like most Canadian kids, Francois said she’s felt the emotional toll of COVID-19.

“There’s some days where I’m fine and I feel pretty motivated to do things like clean up around the house, do my schoolwork, work out,” Francois said. “But sometimes it’s really hard. . . when you’re just stuck in your house and you’re doing the same thing over and over again.”

Most Canadian teenagers say they’re experiencing feelings of sadness due to the global pandemic, according to a survey released Thursday that sheds light on youths’ feelings, behaviours and attitudes.

The Social Impacts of COVID-19 on Canadian Youth web survey asked kids aged 12 to 17: How fearful are they of catching the coronavirus? How do they feel about online schooling? Who do they reach out to for information?  

“The feelings of anxiety and uncertainty, even though there is a mixed range of emotions, they’re still very high and prevalent,” Ashley Manuel, assistant director of the Association for Canadian Studies, which conducted the study in partnership with Experiences Canada and the Vanier Institute of the Family, said during an online news conference.

“And because mental health issues have kind of always been something that this generation has struggled with, they’re definitely more at the forefront during this time.”

The study found 72 per cent of girls reported feeling sad often or sometimes, while 55 per cent of boys did.

“I miss laughing, honestly. My friends and I would laugh all the time, we’d find something that was hilarious, and be hysterical over it,” said Chase Ellis, a 13-year-old from Toronto. “It’s very hard not being able to be with family and friends, that’s what makes me the most sad.”

Deja Lee, a 16-year-old from Surrey, B.C., said she rarely feels cheery, but said it’s more indifference than sadness.

“You just feel less motivation to do things when you’re in the same environment constantly, day in and day out,” said Lee, a top basketball player for her age in B.C. “I’d rather be out with my friends, so I kind of like developed this sense of, not loneliness, because I still have my family around me, but I’m disappointed in a way that I don’t get to see my friends and do the things that I usually do.

Canadian kids are also running out of ways to entertain themselves — 84 per cent of female respondents, and 85 of males reported feeling bored.

But feelings of joy were also reported, with 86 per cent saying they have “often and sometimes” felt happy since the COVID-19 crisis began. The number was slightly higher among kids aged 12-14 than kids in the 15-17 age group. 

“It’s interesting to see . . . a more nuanced understanding to what all of this means, as they are reporting feeling happy as well,” Manuel said. 

Visible minority and immigrant youth, and kids with disabilities are both significantly more fearful of catching the virus and more fearful of immediate family members catching it.

Fifty-two per cent of visible minority and immigrant kids said they were afraid of catching the novel coronavirus versus 34 per cent of non-visible minority kids. There was also a gap around the fear of an immediate family member catching it — 80 per cent versus 68 per cent.

And 74 per cent of kids who had responded that they were “very afraid” of catching the virus also reported they often or sometimes have a hard time sleeping.

“If I got it, I don’t know what I would do because then I would have to stay in my room, and do my school work and I wouldn’t be able to see my family, and go outside, which is what really is helping me in this — going outside when it’s nice out,” Francois said. “And also, my grandmother is older, obviously, and if she caught it, I don’t know what would happen, so I’m really worried about that.”

The study’s findings around school were concerning, says ACS’s president and CEO Jack Jedwab.

While almost all the respondents said they missed being in the classroom, the majority of them are doing less than four hours of school work a week.

“It’s an important takeaway in the sense that doing homework less often is . . . a trend to be concerned about when we go into the fall,” Jedwab said. “It could mean that it’ll be increasingly challenging for educators to keep our youth up to the necessary standard with respect to their education.”

Asked how many hours a week of school work they’ve done, half of the respondents reported two hours or less, the majority falling in the one-to-two hour range. Five per cent of kids in Grades 9 to 11 said they’d done none; 10 per cent of kids in Grade 12 or CEGEP said none.

“If you consider that relative to how much school work they typically get in a week going to school, that’s quite a drop,” said Deborah Morrison, president and CEO of Experiences Canada.

The Grade 12 and CEGEP numbers weren’t surprising, said Morrison, since “marks are already into universities and pretty much your school year is well done.”

But the low numbers in other age groups were worrisome, and suggest that online environments aren’t working for many kids.  

“So, if you’re doing less work, and the platforms aren’t intuitive for you and you don’t feel that you’re learning much, then I think we may have a problem going into the fall,” Morrison said. “And I know all of the provinces are already on this issue in working hard to figure out better strategies for online learning to bridge that gap.”

Morrison noted that while school work was going down, housekeeping improved by about 40 per cent.

“I’m sure parents are pretty delighted about that,” she said.

The study found that parents were the biggest source of COVID-19 information for their kids, and so Nora Spinks, the CEO of The Vanier Institute said it’s important for parents to keep those lines of communication open.   

“Ask (kids) questions. Share your own ambiguity around your feelings, so without terrifying them or scaring them at all, letting them know that some days you’re having a good time, and some days not so much,” Spinks said.

She suggested communicating around routines including dinnertime, and asking questions such as: “How are you feeling today? What are you most anxious about? What are you most excited about?”

The web study, conducted in partnership with Experiences Canada and the Vanier Institute of the Family, was conducted between April 29 and May 5, and had 1,191 respondents.  

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Having trouble to have a good night’s sleep? If yes, then read below to find out how some food items can help regulate your sleep patterns and help you to sleep well at night.

Are you someone who plans to sleep early every night, but are awake till 2 am? Do you feel sleepy throughout the day, but when it comes to bedtime, you are wake as an owl? If yes, then we know how you feel. Not getting enough sleep not only makes your next day less productive, but it also makes you cranky, angry and you tend to feel more hungry.

Enjoying a good night’s sleep is important for overall health, and it helps maintain mental stability and lower stress levels. And if you are planning to do something about it for a while, then don’t worry we’ve got you covered with this one. Read below to find out how these food items can help you sleep well naturally. These food items help in the production of hormones like melatonin and cortisol that are responsible for defining the body’s sleep habits and patterns.

Cheese:

Good news for all you cheese lovers, since cheese can contribute to a good night’s sleep. It is so because cheese is an excellent source of calcium, which is also known to release serotonin. So if you are having trouble sleeping, include more cheese in your diet, and it will increase serotonin production for battling insomnia!

Chamomile tea:

Chamomile tea is one of the best remedies for good night sleep. It contains a compound called apigenin that has sleep-inducing properties. It also boosts the immunity levels and keeps health in check.

Almonds:

Almonds are packed with magnesium and calcium, which help relax the brain and body muscles. Consuming a handful of almonds daily can help regularise sleep patterns, as it helps provide a high dose of melatonin, correcting the sleeping and waking up timings. 

Cherries:

Cherries contain melatonin, a chemical that controls the body’s internal clock to regulate sleep. They can be consumed in the form of juice or just as a fruit. Eat a handful of them an hour before bedtime to get a good night’s sleep. 

Warm milk:

This remedy is known to all. Research suggests that milk contains the amino acid L-tryptophan, which turns to 5-HTP and releases relaxing serotonin. It’s also high in calcium and other minerals, known to have a relaxing effect.

Bananas:

Bananas are packed with potassium and magnesium, which are known as muscle relaxers. They also contain the amino acid L-tryptophan, which gets converted to 5-HTP in the brain. The 5-HTP is converted to serotonin, which is a relaxing neurotransmitter.

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A lot of us are familiar with what insomnia is. It is a common sleep disorder that makes it especially hard for patients to fall asleep, stay asleep, wake up once or multiple times in the night and get back to sleep. A good night’ sleep becomes difficult to achieve and parents wake up tired. Insomnia can greatly disturb our energy level, mood, mental and physical health, work performance and overall quality of life. Even though the requirement for sleep varies from individual to individual, most of us need seven to eight hours a night to feel completely energized. But, many adults experience insomnia every now and then. You could be suffering from short-term or acute insomnia, which goes away in a matter of days or work. People suffer from acute insomnia due to stress or a traumatic event.

On the other hand, some people suffer from long-term or chronic insomnia. This insomnia may last for months at a stretch. Insomnia may also be a  result of some medical conditions or medications. Insomnia can be cured by lifestyle changes, medication and seeking the help of a sleep therapist.

Causes of insomnia

1. Stress about work, finances or family keeps our mind awake at night. This makes it difficult to fall or stay asleep.

2. Those of us who have an irregular bedtime schedule, an uncomfortable sleep environment, or stay online until late into the night may experience trouble sleeping.

3. As we age, we become restless. Minor inconveniences such as noises or other changes in our environment affects our sleep. Our internal clock often advances, which means we tend to sleep shorter hours than we actually need to.

4. Caffeinated drinks are stimulants that keeps sleep away. Nicotine in tobacco products can also interfere with sleep. Alcohol may cause you to feel sleepy but it hampers deep sleep and makes us feel fidgety.

Symptoms of insomnia:

1. Difficulty in falling asleep and staying asleep for long hours at a stretch. 2. Waking up too early and not feeling fresh upon waking up.
3. Daytime tiredness is accompanied with irritability, inability to focus, anxiety and an increased tendency of making errors.

Treatment of insomnia:

1. Keep your bedtime regular and limit your naps.
2. Avoid nicotine, alcohol, caffeinated drinks and other stimulating activities before going to bed.                                                                          3. Your doctor may recommend cognitive behavioral therapy for insomnia or CBT-I. This will help in controlling or eliminating negative thoughts and actions that keep you awake. You may also be prescribed medication to help you sleep better.

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Coronavirus led lockdown has brought lives and so many imperative things to a grinding halt. Sudden unprecedented changes, uncertainty and negativity have been affected us. Our mental health is gone for a toss and sleeping for many is now a task. However, one should anyhow focus on sleep as a lack of it can impact our health especially the immune system. And now, better immunity is important than ever. One can keep stress, depression, and anxiety and other mental health issues at bay by sleeping properly. 

Profound changes in our routines, disturbed circadian rhythm, depression, isolation, work, and household stress excess Screen Time are some of the reasons why you are facing hard sleeping soundly or taking time to fall asleep. We have earlier shared a few evening exercises and foot massage techniques to sleep well. And today we are sharing a no brainer yet effective breathing method which can make you fall asleep. You don’t need to do anything than breathing in this method. It is considered as a fool-proof method for better sleep. 

What is 4-7-8 breathing method?

The 4-7-8 breathing technique aka pattern was developed by Dr. Andrew Weil. He described this pattern as a “natural tranquilizer for the nervous system.”It’s based on an ancient yogic technique called pranayama, where one has to gain control over their breathing. When practiced regularly, it may help you to fall asleep in a shorter period of time. With the help of this state of deep relaxation, one can fall asleep faster. 

Because of deep breathing, we get more oxygen, and organs and tissues get a much-needed oxygen boost. It also regulates the fight-or-flight response we feel when we’re stressed. This is particularly helpful if you’re experiencing sleeplessness due to anxiety. And nowadays, due to lockdown, thoughts and concerns are at a peak.  So, when we focus on breathing our mind and body instead of worries get relaxed. At first, you may not see the results, however, with practice, you may see the effects. Do at least twice per day could yield the best results.

How to do it: 

One has to first rest the tip of your tongue against the roof of your mouth, right behind your top front teeth. 

Keep your tongue in that place throughout the practice. 

You can purse your lips while exhaling.

The first step ist to completely exhale through your mouth and make a whooshing sound. 

Then, close your lips, inhale silently through your nose as you count to four in your head.

Then, for seven seconds, hold your breath.

Finally, make another whooshing exhale from your mouth for eight seconds

Start with four breaths and then gradually work your way up to eight full breaths.

You can also follow this technique when you want to be in a  state of deep relaxation.

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Simple lifestyle choices can enhance mental health

Because of widespread unemployment and the closing of mental health clinics due to the pandemic, millions of individuals struggling with anxiety, depression, and insomnia do not have access to, or cannot afford psychotherapy or medications. These circumstances may continue for months or even years, depending on how soon effective antivirals and vaccines become available. This post is offered as a concise review of the mental health benefits of lifestyle changes for depressed mood, anxiety, and insomnia, including changes in diet, regular exercise, improved sleep, and a daily mindfulness practice.

Diet

Individuals who consume whole foods (as opposed to processed foods and fast food diets) are at reduced risk of developing depressed mood. For example, individuals who closely adhere to a Mediterranean diet, as well as traditional diets in Norway, Japan, and China, which are rich in vegetables and fish, have a 30% lower risk of developing depressed mood than those with the lowest rate of adherence to a Mediterranean diet.

Twelve essential nutrients have established mood-enhancing benefits. These are: folate, iron, long-chain omega-3 fatty acids (EPA, DHA), magnesium, potassium, selenium, thiamine, vitamin A, vitamin B6, vitamin B12, vitamin C, and zinc (LaChance and Ramsey 2018). Foods with the greatest antidepressant benefits include seafood, leafy greens, and cruciferous vegetables such as broccoli, cauliflower, cabbage, kale, and Brussels sprouts.

Some depressed individuals are deficient in certain B vitamins, omega-3 fatty acids, vitamin D, zinc, and magnesium. Foods rich in folate and B-12 such as whole grains and green leafy vegetables may be especially beneficial for depressed mood. Omega-3s and some B vitamins also have anti-inflammatory and neuroprotective effects on the body and brain, which are believed to enhance their antidepressant benefits. Diet also plays an important role in anxiety. For example, generalized anxiety is often associated with reactive hypoglycemia, resulting in acute anxiety symptoms. Individuals who have anxiety caused by hypoglycemia benefit from reducing sugar and carbohydrate intake, increasing protein intake, and reducing or eliminating caffeine. Excessive consumption of caffeine is also associated with an increased risk of anxiety. Many chronically anxious individuals report significant reductions in the severity of anxiety when they abstain from caffeine.

Finally, recent research findings show that the microbiome—i.e., the microorganisms that naturally populate the large and small intestines—causes beneficial changes in brain levels of serotonin and other neurotransmitters implicated in mood regulation. Research studies suggest that there is a link between imbalances in bowel microflora, increased inflammation of the mucosal lining of the intestines, and systemic immune dysregulation resulting in an increased risk of depressed mood. Findings of animal and human clinical trials suggest that probiotics have beneficial effects on both depressed mood and anxiety.

Exercise

Short-term and long-term beneficial effects of exercise on mood are mediated by increased brain levels of mood-elevating endorphins, dopamine, norepinephrine, and serotonin (Schuch 2016). Regular exercise may also promote increased neuroplasticity in certain brain regions, resulting in improved mood (Gourgouvelis 2017). 

Regular exercise including both aerobic exercise and non-aerobic strengthening exercise has established anti-depressant effects and less sedentary individuals have a reduced risk of both depressed mood and cardiovascular disease (Schuch 2017). Chronically depressed individuals often experience difficulties with thinking and memory, and regular aerobic exercise can significantly improve cognitive functioning in this population (Oertel-Knochel 2014). A meta-analysis of controlled studies on exercise used either as a single intervention or in combination with antidepressants found that regular exercise has beneficial effects on depressed mood (Kvam 2016). A systematic review of studies on exercise as an add-on therapy to antidepressants found that depressed individuals who exercise regularly have better response rates compared to individuals who take an antidepressant only (Mura 2014). Antidepressants and exercise probably have equivalent efficacy against moderately severe depressed mood (Blumenthal 2007).

Regular exercise improves sleep quality in depressed individuals who do not respond to antidepressants (Rethorst 2013). Improved sleep enhances resilience and day to day functioning because of the high prevalence rate of insomnia in chronically depressed individuals. In addition to its mood-enhancing and anxiety-reducing effects, regular exercise enhances self-sufficiency.

Both aerobic exercise and strength training improve anxiety when done on a regular basis (Paluska 2000). A daily workout lasting 20 to 30 minutes can significantly reduce generalized anxiety and may also reduce the intensity and frequency of panic attacks.   

Relaxation, mindfulness and mind-body practices

Relaxation techniques include sustained deep breathing, listening to calming music, and progressive muscle relaxation. Examples of mindfulness training include different styles of meditation and guided imagery. Mind-body practices include taijiquan, qigong, yoga, and other approaches that involve both the mind and the body. A regular meditation or mind-body practice such as yoga, may be as effective as antidepressants and cognitive behavioral therapy (CBT) for moderately severe depressed mood.

Relaxation techniques and mind-body practices also improve sleep quality in individuals with insomnia. Progressive muscle relaxation and sustained deep breathing are especially effective at reducing the time needed to fall asleep in individuals with chronic insomnia. Listening to relaxing music soon before bedtime can also help individuals with insomnia fall asleep quicker. Many individuals who have problems falling asleep because of chronic worrying report improved sleep with guided imagery. Individuals with chronic insomnia who use a cognitive-behavioral technique alone or in combination with a benzodiazepine or other sedative-hypnotic drug report that non-pharmacologic or combined approaches are more effective than medications alone.

Supportive relationships

Finally, I want to emphasize the importance of relationships. In addition to engaging in healthy lifestyle choices, supportive relationships with friends and family members can provide important buffers to day to day stresses and uncertainties that we will all face at this time of great uncertainty. Video calls or phone calls can be very heartening and encouraging even when shelter-in-place orders restrict us from direct contact with family, friends, and loved ones.

The post Lifestyle Choices for Good Mental Health During COVID-19 appeared first on MyMedicPlus.

COLUMBUS, Ohio — If you’re craving sleep these days, you’re not alone. At least 40 percent of Ohioans don’t get enough sleep as it is.

Missing out on sleep at least two to three times per week may be and indication that you’re struggling with insomnia. Doctors say the stress and anxiety caused by COVID-19 may be to blame for sparking the sleepless nights or making it worse.

Business owner, wife and mom Michele Rapp struggles with insomnia. 

“I mean, I’ll be asleep and then all of a sudden I’m like, I can’t turn my mind off.”

Up around 2:30 a.m. each day, she catches up on her favorite movies. Rapp can’t remember the last time she gotten good rest. She says the pandemic’s made it worse.

“Being so worried about all the people that I take care of and I’m responsible for their livelihood. That pretty much was the kicker for me.”

COVID-19 forced her to close up shop. With all of the adjustments and more coming to reopen soon, she’s mentally exhausted. 

“The stress of that, like I gotta sleep, I gotta sleep, makes it worse.”

Dr. Aneesa Das specializes in sleep medicine at Ohio State University Wexner Medical Center. She said at least 30 percent of the population in the U.S. has experienced symptoms of insomnia. And the COVID-19 pandemic has made sleeping much harder since regular work schedules and daily activities have been washed out. 

“Number one, we’re in isolation, so that can affect mood right and that can lead towards depression. Number two, we have increased stress and anxiety about what’s to come both financially and, and from an illness and health perspective,” said Das.

Since the pandemic started, Das said prescriptions for sleeping pills are way up. But if you’re wondering how to get a good night sleep, Das recommends checking your schedule.

“Even if you’re not going to maintain the same schedule you were when you were working, maintain a schedule. Pick a wake time and get up every single day at that same time. Number two, don’t go to bed until you’re tired. If you’re wide awake, don’t go to bed because you feel like I always used to go to bed, because now you might be sleeping in later,” Das said.

She also said you should get outdoors to keep your body clock in the right rhythm with sunlight. Exercise. And set time for relaxation. But don’t take a nap midday. That’s one thing Michele Rapp struggled with daily even before the pandemic. 

“I’ll come home and I’ll take what I call a medicinal nap, which is a good 20 to 25 minutes, or and then here’s the other thing is, I’m so tired after dinner, like around 6:30, 7:00 I’m out cold in my chair.”

So to settle her mind, she said, “I started building these little teeny, tiny houses.”

It doesn’t help her sleep, but it does slow her mind down.

“Part of my insomnia is all the worry. So, doing something like this that is so hyperfocused, I can’t think of anything else.”

Building tiny houses is a tedious process, but she said if she gets tired of doing it, she watches TV. Nothing else has helped. She doesn’t exercise right now because the motivation to do it isn’t there. However, she’s hoping that once she reopens her childcare centers and she can get to the gym, things will change.

Since we don’t know how long this pandemic will last, Dr. Das says it’s important to focus on one day at a time. If you suffer from chronic insomnia, there are resources for guided imagery and muscle relaxation exercises. For anyone struggling with short term or acute Iinsomnia, Dr. Das says you should know that it tends to resolve itself over time.

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It’s not easy to relax in the middle of the Covid-19 pandemic. But there are some simple tips and techniques that can help you get some shut-eye.

LIFE IN THE Covid-19 pandemic has taken on some unpleasant and unexpected contours. Time has lost all meaning. Dreams have become assailingly vivid. That is, if you’re able to sleep at all, which many people cannot. At least, not as well as they did before it felt like everything was unraveling, all of the time, with no end in sight.

“I am seeing a significant spike in insomnia at this time during the pandemic,” says Lisa Medalie, a behavioral sleep medicine specialist at the University of Chicago.

It might be useful to nail down our terms here. Insomnia isn’t just staying up late. It’s the inability to sleep—or to fall back asleep if you wake in the middle of the night—with no obvious impediments to explain it. Implicit in the definition, too, is that the deprivation negatively impacts your ability to function the next day. It’s acute when it lasts a few days or weeks; if it extends longer than a month, it’s considered chronic.

If this sounds like you, know first that you’re going through the same thing as a lot of people. And also know there are a few simple strategies you can deploy to get yourself back on track.

It is extremely understandable if you have cut yourself some slack during these sheltered-in-place times. Maybe your diet has gone a little snack-heavy. Maybe you shifted your work hours to make way for childcare or self-care. Maybe you stopped flossing. Only natural. But sleep is something worth preserving—even though that’s harder than it may sound.

“During times of increased stress, sleep is often the first biological system to malfunction,” says Candice Alfano, director of the University of Houston’s Sleep and Anxiety Center. A pandemic is stressful like magma is hot. In a recent online survey conducted by Alfano and her research team, the rate of respondents reporting “severe to very severe problems” either falling or staying asleep was double what they normally see.

That tossing and turning has real health implications. As neuroscientist and sleep expert Matthew Walker detailed in a 2019 TED Talk, sleep deprivation makes your brain slower, weakens your immune system, and increases the likelihood of all kinds of mental and physical woes as you age. “Sleep loss will leak down into every nook and cranny of your physiology,” Walker said in his viral presentation. “Sleep, unfortunately, is not an optional lifestyle luxury. Sleep is a nonnegotiable biological necessity. It is your life support system.”

Unfortunately, life amid Covid-19 disrupts that sleep in any number of ways. There’s the anxiety, sure, not just about the disease itself but about financial security, childcare, and all the other ancillary effects of a society in suspended animation. “If you’re not tackling those problems head-on during the day, then when it’s just you and your brain at night and there’s no distractions, all of those problems, all those worries, all those stressers are going to come bubbling to the surface,” says Medalie. “The thoughts are going to produce emotional responses, the emotional responses are going to produce more thoughts, and the realization that time has passed and you’re not sleeping produces anxiety.”

It gets worse. “The relationship actually runs in both directions,” says Alfano. “Even during times of low stress, sleep loss elevates next-day anxiety, potentially creating a vicious cycle.”

While stress contributes greatly to sleep woes, it’s not the only factor in play. Staying mostly at home makes for a more sedentary lifestyle than your body might be accustomed to, which can make falling asleep harder. You may be looking at your screen even more than usual, pulling to refresh for the latest Covid-19 tolls or mind-smoothing TikTok loops late into the night. While you do, the blue-spectrum light emanating from your phone tells your brain to stop producing melatonin, the hormone that regulates your sleep-wake cycle, also known as the circadian rhythm.

And while bedtime gets much of the focus when it comes to sleep problems, a morning without routine—there’s no office to report to, after all—can be just as detrimental. “A lot of people don’t realize that the wake-up time and getting out of bed and exposure to light is probably the most important thing that regulates our circadian rhythm,” says Jason Ong, a neurologist who focuses on sleep medicine at Northwestern University, referring to the biological process. “Your brain is confused about what time zone it’s supposed to be in.”

The circumstances wrought by Covid-19, in other words, seem almost specifically engineered to interfere with your sleep cycles. Fortunately, there’s plenty you can do to reclaim your shut-eye.

Let’s start with that looming existential dread, since it’s probably the most pandemic-specific contributor to your tossing and turning. The bad news is, you’re probably stuck with it, at least until a vaccine arrives.

You can still take steps to manage it, though, especially as night falls. And it starts with not doing anything at all. “Make sure you have a scheduled hour of ‘me time,’” particularly if you’re sheltering in place with others,” says Medalie. “Everybody needs at least one hour by themselves.”

How you spend that time is up to you. But as you get closer to bedtime, make sure it’s genuinely relaxing. ”Instead of watching or reading the news—most content is repetitive anyway—engage in quiet, calming activities under dim lighting, such as reading, talking with family or friends, or listening to music,” says Alfano.

This all might sound easier said than done. But small adjustments can make a big difference. Don’t bring your smartphone into the bedroom, for starters, or tablets or laptops or any screens at all. If you have a TV in there, consider jettisoning it. Alfanso suggests putting all your charging cords in the kitchen, and setting a reminder for an hour before bedtime to plug in all your electronics and bid them adieu until the morning. Old-school alarm clocks still exist! And some even have built-in light functions designed to help you sleep and wake up on a regular schedule. (WIRED recommends the Homelabs Sunrise Alarm Clock, but you’ve got no shortage of options.)

Northwestern’s Ong also researches how mindfulness techniques can improve sleep, especially for those with chronic insomnia. “It can be a potential tool to help reduce that vigilance, give your brain some signals that it doesn’t need to go into that fight-or-flight mode, or that if it does, here are some tools to help decompress, so that you have a more fair chance for your sleep system to help you fall asleep and stay asleep,” he says.

A simple way to start is to think of yourself as a trainspotter. (Presumably not one from the 1996 Danny Boyle film.) Much like a trainspotter observes railcars passing by from a distance, try to observe what’s happening in your mind without directly engaging with it. If you do find yourself boarding at some point, just get off at the next station. “As you do that, you will start to train yourself that it’s OK to focus on this present moment,” says Ong.

Apps also offer an entry point to anxiety-quashing meditation, although that complicates the whole “remove the phone from the bedroom” scenario. WIRED contributors have had some success with Calm, which offers a range of soothing sessions. Even Swiss Army workout app Peloton has a sleep meditation section, including at least one class specifically designed for the 3 am wake-up.

Getting good sleep involves more than just clearing your head. The experts WIRED spoke with all agree that clearing your bedroom is just as important. “The bedroom should just be a bedroom. Just a room for your bed, and maybe your dresser, and nothing else in there,” says Medalie. “Sleep and sex are the only two things that should happen in the bedroom.”

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