We are a group of psychologists who just launched a free mental health course to support people through covid19. Ask Us Anything about staying sane in a pandemic!

Is there an initial exam to see where people might sit so that materials can be sent according to how someone might be doing?

Hi!

The course we have built responds to the areas of need we saw emerging in our own practice, and those seen by other clinicians who were interviewed as part of the initial design research. Topics covered include handling anxious thoughts, information diet and the news, experiences concerning death and anxiety about death, effects of isolation and quarantine and more.

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We are conducting a piece of research in collaboration with academics from the University of Westminster and so if you do the course you will be given the chance to contribute some data in a secure and anonymous way.

This is a weird one for me.. where’s the line between sane and insane?

Are suicidal thoughts normal?

Do a good majority of sane people dislike most people they come in contact with?

That is a really good question, and one that people might take different perspectives on. Some people have tried to categorise mental health into different diagnose which have specific criteria for deciding whether someone has a mental health problem or not, however recent research suggest these diagnoses lack a scientific validity. Psychologists often criticise the way that diagnoses can pathologise distress, they point out that often the symptoms of mental health problems are ways that a person has learned to cope, in difficult environmental. A recent framework by psychologists is called the “Power, threat, meaning framework”, which suggests we ask each other not ‘what is wrong with you’, but instead ‘what happened to you’, if we are going to be able to more fully understand someone’s difficulties.

Suicidal thoughts are surprisingly common. There might be different reasons for experiencing them, for example as a wish to escape a difficult life situation, rather than an active wish to die. Lots of people experience and sometimes, they do not seem to cause people too much distress. However if the thoughts are causing someone distress, or if there is an intent or wish to act on those thoughts, that is when help and support is often needed.

The last question is an interesting one! It would be an interesting topic for a survey I imagine that everyone, those who are struggling with mental health difficulties and those who are feeling well and healthy, will vary a lot in whether they dislike or like the people they come into contact with. It will also probably depend on the people they come into contact with of course. I would say that it’s more of a personality thing, and than something to do with mental health. However when we are feeling very low or very angry, we might find that we notice the negative in people more than we normally would perhaps.

Lately, I've been feeling like shit. I haven't attended any of my online classes. I've skipped an assignment. And I hate myself for it.

When I was in the university, I felt motivated to do stuff. But now at home, I laze around all day. Don't do any chores. Don't study. Just lie on my bed all day. Is there something wrong with me? I just don't feel motivated to do anything. In fact I dread the idea that I'd have to take a class. I've been postponing it. I know I have to take the lectures. But I just don't want to. And it's not like I have anything else to do. I'm bored all day. I do t want to play games. I don't read. Don't watch movies. Just watch random videos on YouTube that I don't really like. Just killing my time.

I've always been lazy. Never bothered to learn anything new. Barely completed my class work on time. But somehow, and I don't know how, I still got decent grades. Managed to get into one of the best universities in the countries. Is there a tip, suggestion or anything that I can do to be less lazy? Something. Anything. Please?

I’m sorry to hear it’s such a tough time at the moment, it sounds really difficult/ I don’t know if it helps, but I certainly don’t think you’re alone. There is so much going on right now that lots of people are finding it incredibly hard to motivate themselves and are finding it very difficult to find routine. There is a similar question above about motivation that has some ideas about that, so check it out. Sometimes when there is a lot going on emotionally, one of the ways to deal with that is to mentally ‘tune out’ -boredom can sometimes be a by-product of this. We tend to distract ourselves with lots of things, which can feel easier and comforting, but after a while can feel frustrating and unfulfilling. It can be really tough to try new things, because it risks exposing ourselves and that can be really hard.

Sometimes when we find we’re staying in bed all day, our mood can really drop -I don’t know if this is the case for you. If so, reaching out for support can be helpful, for example talking to family and friends about how you’re feeling, or having a conversation with your GP about it. There is support out there and it can be really helpful.

One thing we suggest in psychology is to plan something small and manageable (preferably enjoyable) into your day for a certain time. Put it in your calendar and then say to yourself “I’ll follow the plan, not the mood.” Because it’s quite likely you won’t feel like doing it, but by ‘following the plan’, it may be that that little bit of activity lifts your mood, and gives you more energy. Routine is a huge thing for our wellbeing, so trying to get out of bed in the morning and having breakfast, though really difficult at first, can have a surprisingly huge affect on our mood and motivation.

[question] how can be a human being stress free after losing job due to COVID 19?

Ahh that’s a tough one, I’m sorry if this is affecting you. The reality is that some situations aren’t stress-free and in this case, it might be a question of how can we alleviate the stress a little, at least enough to be able to function.

I would recommend allowing yourself a bit of time to experience your feelings around this - it does suck and you are allowed to be sad/disappointed/angry. When you feel more able and practical, start making a list of things things you can do. You don’t have to start these right away, but it might make you feel a bit more in control if you know what steps you might want to take.

Finally - use the support around you! Whether it’s family, friends or local organisations, there are people willing to listen, empathise and help with practical things like finances.

Hei! I wonder if you guys have any suggestions for students who are struggling to keep motivated during this pandemic due to the reduced social contact and thus reduced feeling of belonging, as well as the general weigh down that this situation we are in causes some people. How can you stay focused on your studies while going through the pandemic?

This is a good question, the pandemic has certainly made it tricky to stay motivated for many people I think, and it can be particularly hard for students as assignments mean that there is a lot of self-motivation needed involved anyway. One of the main things I suggest to students is to try and keep a kind and compassionate attitude to yourself over this period. There may be lots of different things to adjust to, including online learning, living in lockdown with flatmates or on your own, worry about loved ones etc. -it’s a lot… Perhaps accepting the fact that you might be less motivated than normal, can help. You might find that your work isn’t as good as it would be, if you weren’t having to deal with the pandemic and everything that that brings -maybe that is ‘okay’ (I know it’s not ideal…).

Once we accept how we’ve feeling, we stop fighting it and then we can think about what might support us (e.g. a good rant to a friend, or a jog if we’re able to, or building a routine). This acceptance can sometimes make it easier to take those small steps. Breaking up the work into manageable chunks (even if that means 10 mins reading on an unmotivated day), can help. Some days will be better than others.

It’s very tough with the social contact at the moment, it can be really helpful to stay in contact with family and friends with video calls and taking advantage of the online community events, such as webinars, choirs, exercise classes etc. can help build a sense of community and routine (and might make academic work easier too!). Depending on your university, you might be able to contact your personal tutor too, to check in with them.

Should I feel guilty for not checking up on friends and family?

No one should or shouldn’t feel anything. When we set expectations for what our emotions should or shouldn’t be, we are doing ourselves a disservice and probably adding to our own distress.

Guilt, in particular, is difficult as it inherently criticises our actions in a way that will threaten our self-esteem. I think my most common piece of advice to people currently is to lower expectations they set themselves and be kind to themselves when things are tough.

If there is something you’d like to do (e.g. be in touch more with friends and family), try starting with something small and prioritise. Pick one family member, for example and commit to trying to contact them by a certain (manageable) point. I say “try”, because we never know what might come up - the important thing with aims is to give it a go and remember that all progress, no matter how small, can be built on.

How do you cut through the non stopped partisan commentary and get actual facts? Seems every "fact" has a political spin and we are stuck in the middle. This is causing tons of anxiety IMO.

If I may, could I reframe this from a psychological perspective? At the moment, there are many things about coronavirus that nobody knows definitively. Many times in life, we have to face uncertainty. Perhaps it’s sometimes ok not to know the answer?

Consider asking yourself

• Which facts do I need to know the answers to?
  
• Is it necessary to know the answer to this question to live my life safely and well?
• Can I live with being uncertain about some of this stuff?
• Can I leave the politicians to the spin and disinformation and get on with focussing on what’s important to me, focussing on the things that I value most.

But what If the answer coming up for you is that, actually it’s really important to get to the answer, and to do so right now?

I’d suggest finding which scientists and journalists seem to be most trusted by other scientists and journalists, and find out which scientists and journalists are best at synthesising communicating complex and sometimes contradictory research. Which are best at looking at both sides. And of course you can always look at the fact checking sites.

I have reached a point of suicidality where I absolutely need to get some sort of friendly human contact, so I'm breaking quarantine to see a friend and stay with her for a few weeks (she will also be alone, as her mother who lives with her is off to take care of a relative with cancer, and also needs the company because she doesn't do well with being alone). Everyone around me is actively encouraging this and so is everyone around her, but I can't help but feel oppressive feelings, not really of guilt since I don't think I'm doing anything wrong, but of like... fear of being shamed? I really feel like I'm putting on my own oxygen mask before helping others but I've already had a couple of people who know about this accuse me of being selfish or terrible. What do I do to counter these things? For the most part we've just mutually decided to keep the trip a secret as much as possible so no one knows about it. I'll be traveling entirely by car and not staying in any hotels etc.

EDIT: It's not illegal, we've checked travel restrictions etc for both our areas and every area I'll pass through and I'm fine legally speaking.

It’s really hard at the moment, as the rules are quite unclear and no one really knows what’s ‘allowed’ or not. In this situation, sometimes we have to use our judgement, and act as sensibly as we can, given the set of circumstances we are in, and it sounds like that is exactly what you are doing. Your feelings and current experience is confidential to you and you will probably only want to share that with the people you trust the most and are closest to you. My hunch is that if the people who you feel are judging you knew the full extent of what was at stake if you didn’t go to your friends, they would not judge you. They are not judging the full situation, they are judging only a part of it and so their assessment will inevitably be inaccurate. That doesn’t stop it being painful to hear however, but remembering they don’t know the full extent or even if they do know, they probably don’t fully understand, might help. The thing about life is that, unfortunately, we will never please everyone, there will always be people who will disapprove of what we do, and again, remembering that can help us put this into perspective.

Everyone is scared and out of sorts at the moment, maybe the people you discuss are highly anxious and therefore are saying unhelpful things. They might see it differently when things calm down. I hope going to your friends is nourishing for you.

Thank you for your question.

How do you cope with starting and building a business for 6 years only to watch it taken away because of something you can't control?

I am so sorry that you are having to watch this happen. What an incredibly hard thing to have to deal with. I sadly don’t know if there are any easy answers to your question. It is very hard to cope and right now I would be very surprised if someone in your situation said they were ‘coping well’. One thing to remember is that coping is a process, it’s not something we either do or don’t do. You are very early on in the process and I would imagine that you might currently be in shock. Once things start to sink in, I imagine that you might begin to experience grief for the business you have lost and other losses associated with that. Knowing that this grief will be a process, can sometimes be helpful, it will continue to change and you won’t always be feeling exactly as you’re feeling now.

Although it might sound strange, taking the pressure off yourself to cope might be helpful. You are allowed to feel devastated, upset and angry. It might be thinking about how you can support yourself in the best way you can right now, being kind to yourself, talking to friends and family, connecting to others in similar situations can give a feeling of solidarity and not being alone. The fact that we’re not in control of this devastation to livelihoods can be very difficult. Some therapies like Acceptance and Commitment therapy (ACT) can be useful and there are lots of resources on the internet that might be helpful. Sometimes accepting our feelings and the things that we are not in control of, and at the same time focussing on what we value in our lives can be helpful.

One of the team members just told me that they were going through a similar situation and suggested remembering that there will be a tomorrow, even if it doesn’t seem like it now. Things will change and its’ possible that the adaptability that you are having to engage in right now, might also give rise to new opportunities in the future that you can’t see now. She suggested contacting other businesses of a similar size to yours for peer support and solidarity can be very helpful. Wishing you all the best.

What is your advice for being quarantined with people that you do not necessarily get along with or who you tend to argue with a lot?

That sounds like a very tough situation to be in. I do not know your specific circumstances, whether you live with family or friends and what your relationship to them are so it is difficult to give specific advice. If you feel able to, could you talk to them about it? Tell them how you feel and what situations tend to upset you?

Communication is hugely important in all relationships in order to maintain the good bits as well as to problem solve when friction arises. It might be that they are unaware of how something is affecting you. Letting them know what causes a tense situation gives you a platform to problem solve from. If we let things that bothers us go unspoken they tend to build up and affect us even more. If you do confront the issue, a tip is to use so called “I statements” where you describe how you feel. For example say “when you do X, I feel Y” rather than “Must you do this”. Using “I statements” stresses how you feel about something rather than sounding confronting.

Before bringing it up, take a moment and think through exactly what it is you want to say and be sure that you describe how something makes you feel. Try to stay focused on a specific issue and avoid bringing up everything that bothers you about them as that can escalate into a full blown argument rather than a discussion. I know it is not easy confronting someone when there is a problem but as this is your living environment it is important you communicate how it is affecting you. Other tips is that you do things that you enjoy that does not involve the other person(s) such as reading in your room if possible, or that you create a space for yourself. If you have other people you feel connected to outside the house do make sure you speak with them on the phone/online to remind you that you have other people that you do get on well with. I wish you the best of luck with this.

For people who struggle with substance issues, will this be a big downfall for a number of people?

Also same kind of question regarding chronic pain sufferers, work takes our mind off of pain and gives life substance and reason, is it typical for us to see more flare ups due to less movement, and or more depression that comes with chronic pain. What can we do to not go batshit crazy when the pain is the only thing nagging you and its impossible to concentrate on a book or even tv show.

Great questions. Everyone is responding differently to the pandemic. Some people with substance misuse issues are actually doing better, as being at home is keeping them out of the way of temptation. Others are doing worse, as they still have easy access to substances and may be living with other people who misuse substances, or may be increasing their self-mediation for other issues such as anxiety or low mood.

We won’t know for certain until the research is in as to whether the corona-virus is making things worse overall for any condition, but sadly I suspect that on average the effect may not be positive. I know for certain that some people with chronic pain are finding the need to stay at home to be particularly difficult, as previous coping techniques, like going to the park are no longer possible.

The standard coping techniques that people have used before may still work, but may need some extra mental flexibility (and some might be neglected). Every person will have a different toolkit of things that work for them. A really important skill is being able to take a step back from one’s thoughts and feelings and not get too caught up in them.

• Some classic psychology questions to step back and identify your own pre-existing skills:
  • What would you advise a friend in the same position?
  • If you were to look back on this in 1 years time, what might you want to say to your present self?

I wish I had time to respond to this in more detail, but I hope that this helps. It may also be helpful to connect virtually with other people struggling with the same issues. I don’t know for sure, but I’d bet there are a lot of active forums for people suffering with chronic pain. Perhaps you could join together with other people with chronic pain and take part in the peer support group?

What's the psychology behind people who are clinging on and actively seeking out these conspiracy theories (like Plandemic)? From a purely psychological perspective, how do you educate these people without putting them off and making them defensive?

We don't have anyone who specialises in this field of research currently but more broadly, there is often some association to epistemic mistrust. Most of the time when we have doubts about anything, it points to some significant breach of trust perceived and this could be something that causes defences to go up.

People's past often causes them to fear the world and this can lead to people finding it understandably different to relinquish control to things/people/objects unknown or outward to themselves.

I think it's important to remember that fear is a big driver to mistrust and therefore listening openly and trying to establish what is contributing to people's opinions, what function the opinion has to them and why you feel they may be defensive is helpful. Before challenging them, try to gage whether they are also listening to you. They may not be in a position emotionally to attend to any other suggestions, highly threatened already and this could mean that this may not be the best time to pursue your argument. If however they seem ready to converse, using 'I statements' and leading with your rationals rather that commenting on theirs may be helpful to move a discussion forward.

You may also want to suggest that you both do some fact checking yourselves if they appear to be ready to engage in a discussion, reiterating that all views are to be respected and maybe you can check in and see if you are both seeking to understand the other or judge the other. The latter is often our subconscious protecting us so stopping, stepping away, looking back before going forward with this kind of talk is helpful to ensure that your truest intention is being acted out. If they are still defensive, they may not be ready or keen to be challenged or more importantly challenge themselves. I'd advocate respecting their wishes as unearthing a deeper sense of lack of control in them or triggering more fear could be more harmful than helpful for you both. Hope that helps!

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As for many of these questions, there is no correct answer. The first thing to say, is that there are always limits to what we can do to help someone. We cannot control how other people are thinking, feeling and behaving. It sounds like you are already doing a great job of supporting your friend; she knows that you are there for her, and that’s perhaps the most important thing a friend can do.

With regard to suicide, the general advice is not to be afraid to ask about it. There is a myth that talking about suicide makes it more likely. Psychologists believe that the opposite is true, talking about suicide makes it less likely to happen. Try to ask the question as if you are not afraid to talk about suicide. You could say something like: ‘you’ve previously told me how close you have come to suicide, is it ok if I ask you if you’re feeling suicidal now?’.

The same goes for not wanting to feel like you are interrogating your friend, just ask her. ‘Is it ok for me to be asking you these questions, I don’t want you to feel like I’m interrogating you, it’s because I care about you’.

As I said, there is no perfect answer, no perfect solution, and at the same time I hope you find this useful!

I work at a long term care residency in Canada, we have 39 cases at our place. I work as chef to cook all the food and help with certain things for the residents. All in ppe gear and whatnot. ... my dad is 81 yrs young, and he is at home, so after work taking care of over 180 ppl I go home to then take care of my dad (dinner, cleaning, laundry etc). After a 12 hr day, then coming home to another 4 hrs of more cooking and cleaning, I get exhausted. I don't mind at all to do everything because he's my dad (..context: mum passed away 6 months ago, as well as our doggo right before xmas..)

However, my mental state is constantly being berated by so many things. And I don't know how I can get through certain aspects. I know exactly how I'm feeling, what it means, and because of that I rationalize and just surpress feelings more. It doesn't help that I have a degree in psychology, or was a suicide cousellor for 2 yrs, or therapist afterwards and can rationalize things but with all this it's too close to home.

All the things I've learned, have been thrown out the window becuase of the fast progression of his deteriation, at this stage of life. Especially after my mum, pup, and shit going on right meow.

My question to you guys, is what would be a good coping mechanism to employ, dealing with such strong influences that make the mind more negative? ... I always try to look at the postive, but sometimes. .. .. ya know?... It's hard. Thank you doing the ama and hope to hear from ya

Hi there, thank you for your question. Gosh, it sounds like you are doing so much at the moment, with your job in PPE gear, which I understand can be very tiring to wear, and looking after your Dad, as well as being in grief for your Mum and your dog. It sounds like you’re so busy, it must be hard to find any time for yourself, and when we’re so busy (as of course you’re aware), everything is a lot harder to deal with.

I certainly can relate to the degree in psychology, practitioner experience that can sometimes mean we almost know too much theory! There’s sometimes the expectation that if you’re a counsellors, psychologists, practitioners etc, you should have all the tools and be ab le to sort things out. The truth of course is (as I’m sure you’re aware) that life is messy and a journey, and the theory and tools can help but we struggle and get into tangles just the same. You’re dealing with a lot right now, and giving yourself to feel upset and angry, tearful and not coping, might also be important. I don’t know if you’ve heard of Acceptance and Commitment Therapy (ACT), but it’s a theory we use in the Helpers tool a lot. It’s about accepting the feelings, rather than trying to change them, and committing to actions which reflect what we value in life. I really like this approach (though as you know everyone’s different), you might like to look it up?

In terms of a coping mechanism, I don’t know the full extent of your situation but from what you’ve said I’m wondering whether putting a boundary around a window of time, even if it’s small, to just focus on you, might be helpful. Maybe writing down your feelings in a journal and practicing being compassionate to yourself. Thinking about what you would say to a freind in your situation. Is there one small thing you can do a day, or week, which you enjoy, for example a puzzle, a bath, a walk, listening to your favourite tune that gives you a sense of nourishing yourself. Maybe it is okay not to see the positives right now, but to mentally note the things you value in your life, or imagine something you’d like to do when this intense period of time calms down. Contacting a friend and seeking support, or looking for peer support online (for example the Helpers tool but there are many forums) can be really helpful. Remember that you can only do what you can do, at work and with your caring responsibilities. You’ll be prioritising some things and some other things will have to slip in terms of standards, and that is more than okay. Sometimes, you’ll be grumpy with your friends and coworkers, that’s very normal. Sometimes you’ll feel an emotional mess, being kind to yourself at these times, rather than expecting yourself to cope in these incredibly difficult circumstances can be helpful.

What do you think it says about someone if they are actually enjoying this new way of life? I feel like all the normal anxiety-inducing shit things in life aren't there for me anymore. Now all that's left is some existential dread, but at least 80% of what made me stressed is gone.

Thanks for your question. I think you’ve already covered what it says-that things were pretty stressful before Covid-19. If this happens to be a break for you from some typical anxieties, I’m glad you’re getting some much needed respite. I wonder if this might provide some space for you to reflect on how, when things go back to some semblance of “normal”, you may have some opportunity to reduce some of the typical anxieties. Or, if potentially you could use this time, where you’re feeling less anxious, to really strengthen your strategies for coping with anxiety so you might feel more prepared to handle stressors when you need to again.

I've struggled in the past to make time for CBT ect. How would you suggest people structure their time for engaging? Set a time each day? Try to squeeze it in when you can? Set an alarm? All of the above?

Setting a new routine can definitely be tricky! And those are all excellent ideas for engagement. You could try to set aside time for CBT activities connected with something pleasant that is already part of your daily routine, to anchor it into your day. Also setting boundaries around the time you've set apart, such as letting others know that it's important that you take this short time for your well-being.

Also, you can take these activities bit-by-bit, there's no rule that you need to complete them all in one go. If shorter segments split up through the day work better for you, that's excellent!

Perhaps, reflect on some other habits that you've built over time-how did you go about achieving that? Are those methods something that you could adapt to building CBT into your routine?

I'd recommend experimenting with a few strategies and remember we're not aiming for perfection, just improvement 😊

Do you have any recommendations regarding when to hold memorials or funerals?

Gathering together to mourn is a really important healing experience, in my opinion. But there are limitations on group size and travel. What guidance would you suggest to bereaved family and friends on when to hold memorials/celebrations of life/funerals? (Assuming they are non religious and don’t have prescribed mourning rituals).

I am an officiant for memorials and celebrations of life, and have had a few inquiries. I generally am open to working with people to meet their needs within the limits of law, including virtual memorials. But some people are really lost and need guidance. Some suggestions of questions to ask would be welcome.

Thank you for this question, it’s a really interesting thought and how lovely for your clients that you can be so thoughtful and flexible. My first thought is that some people find it really hard to think and make decisions in times of grief, so perhaps it might be helpful to have some clear options that you can provide written down for people. They can take this away to think over, or discuss with others. Sometimes, with everything else that’s going on, it’s easier to pick from some choices rather than come up with a plan from scratch.

Secondly, I wonder if encouraging people to consider what’s most important for them in the memorial might help them to arrive at the most meaningful and “right” option for them and their loved ones? Often it’s not the practical arrangements that matter so much, but what they represent. If the family can think about what aspect of the memorial would be most valuable to them (e.g. that everyone is together, that a family tradition is observed, that there is a celebration etc.), then this might point towards certain options and or place less importance on other decisions.

What color is your toothbrush?

A lovely periwinkle blue

Hello! I have no diagnosed mental health conditions. I do not take any medications or supplements at all, not even birth control. I have a healthy diet.

I started having panic attacks last week, vomiting and difficulty breathing.

I cry a lot and have a hard time doing even what I enjoy doing.

Would this course help? Thank you so much for offering your expertise at a time like this.

Hi there,

Thank you for your question and I am sorry to hear that you have felt unwell lately. It sounds as if you have not experienced panic attacks before so I can appreciate how frightening it must feel for you. As your difficult symptoms started so recently I wonder if it was something particular happening at that time? If not, I would say that the unprecedented circumstances we all find ourselves in is more than enough to make anyone experience low mood, panic and anxiety.

Panic attacks are very unpleasant but not dangerous per se even if it can feel like you are about to collapse or “lose it” whilst you are having them. It can happen when we feel out of control or overwhelmed with pessimistic thinking - when everything feels insurmountably difficult. It might be helpful for you to read about panic attacks, their causes and also some coping strategies to manage them. Some of these coping strategies are called grounding techniques that offer ideas of how you can shift your attention away from the panic and anxiety onto other external things which helps reduce anxiety. Learning about panic attacks will make them feel less overpowering as you will know what is happening in your brain and body. Learning about what situations or thoughts bring on the panic attacks can also give you an idea of what exactly are causing them, which in turn can help you to confront and resolve it. It might be worth you reach out to your local mental health service to see if they can offer you further support or that you contact an online charity or organisation that can give you more tips on how to manage your difficulties.

I hope that the course we offer will be helpful for you. Some of our sessions focus on how the way we think can increase anxiety and low mood and it sounds like that might be useful for you. Meanwhile, I would recommend that you seek out self-help material and information on your experienced difficulties and that you contact services that could give you more support as it sounds as if it is very difficult for you. Panic attacks, anxiety and low mood is very common and even more so when we are undergoing changes or difficulties. The good news is that because it is so common there has been lots of research done on it and there are plenty of support and treatments on how you can manage them. I hope this answer is helpful and that you can reach out for further support - I also hope that you will find our course helpful!

Mom of 4 here. I've been at home for almost 7 years taking care of children full time. I'm aware that this time is traditionally not the most ideal mentally for the stay at home parent. The problem that I am having is regulating my emotions on the days when I am overwhelmed with kids 24/7, homeschooling and zero time for myself.

Before coronavirus my 2 oldest were in school, leaving me with the 2 toddlers which I could easily manage. I was even able to workout a few times a week. No more. Now it's 24/7 and most days I'm okay with that. There are days, however, when I do not want to do it, at all. Is there any CBT that I can practice to help me on these days? Usually those negative days devolve into utter chaos leaving me drained beyond belief then I feel guilty about not being a quality parent for my kids.

Hello! Thanks for reaching out. I am currently balancing my laptop on the edge of my knee with a sleeping baby between, so I can relate to the struggle! This is a huge transition-to double the amount of kids who are usually home and all the energy that entails. I can see that you’ve already noticed that negative thoughts impact those rough days and compound themselves by morphing into guilt. Having that awareness-of those negative thoughts is already a step in the right direction! So, what can you do with those thoughts/feelings? Here’s a link to a page that does a really nice job of explaining cognitive distortions-which may shed some light on some distorted thoughts you might be experiencing, and has a bunch of strategies you can try (with some worksheets too if you’re interested). I know with kiddos it can be hard to get the time to do longer strategies-so I’d encourage you to start with some of the quicker ones like progressive muscle relaxation or deep breathing to bring calm and interrupt that cycle of negative thinking to guilt. There’s tons of youtube videos with guided relaxations (there’s plenty for kids too if you want to do it together with them).

Pandemic-parenting is no picnic and you are doing this! My hope is that you’ll be able to find some space to be proud of yourself as well, because this is really hard. And the fact that you’re here, asking for resources to do an even better job, tells me that you’re already a quality parent.

**https://positivepsychology.com/cbt-cognitive-behavioral-therapy-techniques-worksheets/

What is a small, "effortless" habit everyone should practice to help during these times?

I appreciate your work, I'll sign up right after this comment!

Hi there,

Thank you for your question and for signing up - we hope it will be helpful for you.

To answer your question, that would differ from person to person and it is important to try a few different strategies to improve wellbeing that works for you. You are right in that starting with something “small” that does not take too much effort is a good idea as it can quickly feel overwhelming otherwise. Perhaps practicing mindfulness might be a good start for you. This is the practice of focusing your thoughts on the present moment. So for example if you are washing up the dishes, really focus on what you are doing such as the temperature of the water and how it feels against your hands, the smell of the washing up liquid, the sounds the water and the dishes make. Practicing to focus on the very present moment trains us in noticing when our thoughts race to things we cannot control, such as feeling sad about the past or anxious about the future, which tends to increase anxiety. Being able to stop our thoughts from racing and focus on the present instead can therefore be a good habit to build up.
Or perhaps you can go outside for a little while every day and whilst you are outside you can focus on what you can perceive through your senses such as what you can see, hear, smell, touch and really focus on that.

However, there are several types of mindfulness strategies you can try, you can find lots of tips and ideas on the internet.

Physical exercise can also be a good habit to get into. This does not need to be intense exercise, it can be gentle stretching from your chair.

Other habits you can try is to set up a routine where you do certain activities roughly at the same time each day. This is as routine gives us a sense of control which is especially important in these times of uncertainty.

Another idea is to set aside time a few times a week to reach out to other people, such as giving a friend or relative a call, as supporting others usually makes us feel good and also help us stay connected with other people.

These are just a few suggestions and I hope you find something that will work for you. Whatever your new daily habit will be, make sure it is something that feels manageable and meaningful to you. Remember that it can be difficult to set up new habits so give it some time if you feel it is not benefitting you straight away.

A lot of my coworkers are having issues mentally due to having to work from home and being around their families. The upheaval of routine has also causes a lot of anxiety. We have been creating calendars and goals as ways to give them some predictability as well as try to help them train themselves to work certain hours and avoid distractions. Next week we are introducing playing a game just before the meeting so as to provide a positive experience for work. Is there anything else we could be doing to make things better for them?

This is a really nice question, thank you. It’s great to hear that you are thinking of your co-workers, I’m sure they are appreciating that. Predictability and an opportunity to be a team in a less pressurised setting like a game sounds like a great start!

Something I have found quite useful recently has been having a space to share my stresses and concerns with my colleagues. Personally, I feel validated when other people have the same issues as me and I feel less alone with my feelings. It’s also a good way for people to share tips, or things that could be helpful, as well as to offload difficult thoughts and feelings at the end of a day, or week, so that I don’t take them home to my family life. Sometimes more practical changes are helpful, but at other times people just need to feel like they are being listened to.

On the listening topic too, how about inviting feedback on some of the things you’ve done so far? I’m thinking this because, while predictability is helpful, people might also value flexibility in this kind of situation where they are trying to balance work and home. Checking how your thoughtful strategies are being experienced might be a good way of gaging what is helpful for your colleagues and offer insights into further useful things.

Hi, thank you so much for doing this AMA!

I've been struggling with depressiin for a while before the whole covid-19 thing begun, and the quarantine is only amplifying my horrible thoughts and feelings. I want to talk to my parents about my mental health but have no idea how to begin, and it's getting harder and harder to keep myself motivated to even get out of bed in the morning. Do you have any tips on how to cope, and how to approach my parents?

Hi there, thank you for your question. I’m really sorry that you’re finding things difficult right now, it must be tough. I’m glad that you have parents you’d like to talk to about this though. Sharing how you feel with others can be a good step towards getting helpful support, but many of the young people I work with find this difficult, for different reasons.

Firstly, I wonder if there is someone in your life who’s easier to talk to? Perhaps if a friend, other family member, or a professional you are in contact with knew, they might be able to either give your parents a heads up, or help you think about how you (or you both together) could approach it. Alternatively, could you write something down for your parents to read? Or send them a text? Some things feel easier to write than to say.

Finally, sometimes I think people often get bogged down in language, too. They can’t imagine how to begin to start saying words like “depression” or “mental health” out loud. But perhaps you don’t have to use those terms, perhaps you can find a way of talking about your experiences that feels more comfortable. Something like, “I’m really struggling at the moment”, or “I’m feeling really bad” can offer ways of starting to explain what’s going on without coming straight out with scary terminology.

However it works for you, I would urge you to get the support your parents can offer. Sharing things can be a weight off of your mind and very often the thought of conversations like these are way, way worse than the actual conversation itself! Sometimes, parents know already, and are waiting for you to open up when you’re ready - it perhaps won’t come as the surprise you might think it will be. And you don’t have to do it all at once. Start by saying a little if you want to, and building up over time in different conversations. Good luck!

Family dynamics were always fucked up. And with lockdown it’s taking a toll on me and my mental health. And they are struggling too. But it’s empathy exhaustion I am feeling. How do I empathise with toxicity around and when everyone is hitting rock bottom?

Hi, thank you for your very good question. I have a feeling that many people reading this will empathise with your situation right now, I really feel for you, it is tough being in lockdown with all the family dynamics swirling around and the immense pressure that this can cause. The fact that you have the intention to empathise with the difficulty and with the family members that are driving you round the bed, is actually a big thing in itself, and my hunch is that on some level your family members will pick that up. It’s also okay not to feel okay about some things, you might feel angry sometimes, and that might be very understandable.

It’s of course difficult to give advice for this kind of thing because each family is so different. But when it all gets a bit much, taking your own space, even if the only time you can do this is going out for a walk on your own (if you’re able), can be so important. When we’re feeling down or angry due to family dynamics, thinking ‘what’s mine and what’s somebody else’s’ can be helpful. We get so wrapped up with each other it’s hard to know where we begin and where they end. If a family member is feeling triggered and you’re the recipient of their emotion, taking a mental step back from the situation and thinking ‘this is not mine to carry’ can be helpful. This might be their anxiety, or anger or sadness. Tuning into yourself, and thinking about what your part in it is, can help us feel less confused and overwhelmed by everyone else’s emotions and difficulties. In the helpers tool, we have a 5 minute daily check-in exercise every day. Something like this can be incredibly helpful. Just 5 minutes to take 3 deep breaths and ask yourself how you are doing can centre you in yourself, and help you have some sense of distance from the family dynamics. Then you are in a better position to feel empathy. First and foremost, if at all possible, have empathy and compassion for yourself in this situation (and if this feels impossible, see if you can kindly accept that you are struggling to have compassion for yourself right now). Maybe prioritize what you need to do for your own mental health (e.g. routine, chatting to friends, exercise) and acknowledge that this is a difficult time and you’re doing the best that you can.

US-based mental health professional here. This looks like an amazing resource!

I’m wondering about the group setup — does one sign up to facilitate a group and other people are assigned to that group, or do the groups just come together without a facilitator?

Thanks for the kind words!

We don't facilitate groups right now though that may change in future. People are encouraged to find people in their own lives or through social media. We have a subreddit ( /r/helperstools ) for this.

I have adhd and i don't have the motivation to do exercises on quarantine , how can i get some motivation?

Thanks for your question! A few people on here have been struggling with motivation, it seems to be a common thing in lockdown. The trouble with a motivation dip is that as soon as you start feeling unmotivated and stop doing things, the more tasks build up. And the more tasks build up, the worse you feel, which makes you feel even less like doing anything - it’s a vicious cycle. The good news is though, it can often work the other way too - when you start picking a few things back up again you feel good for doing them, which makes you feel a bit more motivated to tackle something else.

The main thing I think with low motivation is not to expect too much of yourself too soon. Start by planning a few key tasks, literally writing these down in a diary or calendar - people are more likely to do things if planned in advance, as opposed to just waiting until they feel ready. These tasks need to be small enough to be realistic - it’s no good promising yourself you’re going to go for a 10 mile jog everyday when you’re struggling to get out of bed at all. Seriously, start very small, preferably with things you enjoy and that fit with your own life values. And then keep going, building up when you feel more able. Make sure you celebrate your successes, no matter how small, and don’t give yourself a hard time if you’re not going fast enough, or doing as much as you think you should. It’s hard for everyone right now and we need to be kind to ourselves and lower expectations. Good luck!

Do you think that coping strategies are different for those sheltering alone vs those sheltering with others?

Great question! I think that the strategies that we will each find most helpful does need to be specific to our situation. For instance, those who are sheltering alone may find that they need to prioritise connecting with others, whereas those sheltering in larger families/groups, may find that they actually need to prioritise some time alone.

I think that being able to recognise and name how we are feeling allows us to reflect on which strategies might be most helpful for us. It’s important to adapt strategies to our individual situation, whether we are sheltering alone or with others. I think the important thing is to reflect on your current needs and seek out strategies that best fit your situation whether alone or with others.

Can antibiotics make you have mental health symptoms? I’ve been taking clindamyacin and have been feeling bad but I’m not sure if it’s related.

We don’t have any psychiatrists on this team right now to my knowledge. Medical doctors are generally (but not always!) better informed on the side effects of medications. Mood changes are sometimes associated with antibiotic use, and I believe some antibiotics are more associated with mood changes than others.

We do know that the body and the mind are highly connected, and that the gut can certainly affect how the mind works (ever been ‘hangry’?). It’s possible that clindamyacin could affect your mood and anxiety by affecting your gut. But that’s just speculation.

Another possibility is that you’re feeling bad for other reasons (coronavirus being one of them, but hormones, life events, isolation etc could also be the reason). I do suggest consulting the doctor who prescribed the meds if you’re still taking them and are worried about side effects. The advice is generally not to stop taking meds without first consulting the doctor (it’s important to take a full course of antibiotics).

What tips would you recommend for elderly people who live alone and are feeling depressed due to the impact of corona? As a district nurse I see quite a few clients who are depressed and very scared of corona virus.

This is really hard, thank you on behalf of all of us for doing what you do. I’ve seen how even the briefest of visits from someone like yourself can help older adults feel cared for and more connected to the outside world. If you’re really worried about their emotional wellbeing, do ask them if you can take back your concerns to their GP, or their main health professional if you’re not in the UK. It might be that they could benefit from a referral to mental health services.

If you don’t feel it’s at that level but you are still concerned, check out some local services who might be able to help. If you’re in the UK, for example (apologies for the UK-centric answer if not), Age UK might be able to help with practical and befriending support. Silver Line, too, is an advice and friendship line for older people. If you feel able to, you might like to gently suggest the importance of keeping connected to their families and friends however possible, maintaining healthy routines and looking after their physical health. Keeping themselves busy with projects, or household tasks (while still allowing time for rest and relaxation) can offer both distraction from worries and a purpose, or meaning for lockdown life. It’s nothing radical, but often it’s these basic things that are the first to be affected when we’re not feeling at our best.

Finally, make sure to leave proper time and space to look after yourself and debrief after work. These people are so lucky to have your professional time, but it’s really important to make sure that your wellbeing is a priority too.

Will this help with people who are stuck sheltering in abusive households, who may not have access to other resources? Are you aware of any resources for those people? Thankfully my situation is stable, but there are far too many people who are in a situation of abuse due to the pandemic.

I’m glad to hear that your situation is stable. This tool is not specifically designed for addressing abuse. We recognise that people in these situations may have quite limited access to other resources at this time, and there are some links to agencies on the Urgent Support page on the helpers.tools site. If you are aware of people who may be in a situation like this, we hope you’ll encourage them to reach out to these resources. As always, if you are concerned for the immediate safety of someone, it’s best to call your local emergency services.

Are you finding that this isolation time is unlocking pent up issues that were suppressed during normal life?

Hi, thanks for your question, that’s a really interesting insight. At times of stress, we often find that things we would normally find manageable, suddenly become really hard to deal with. It’s like we have a bucket, and life gives us lots of things to deal with, lots of worries and possibly past trauma or difficulties that fill up our bucket. But we have holes at the bottom of this ‘stress bucket’, that prevent the bucket from overflowing. The holes in the bucket might be ways of coping we’ve built up over time, like routine, social support, work, hopes etc. During the pandemic a lot of these holes in the bucket have been blocked -we can’t see our friends and family, routine has gone out the window, we might have lost our jobs. At the same time the amount of stress pouring into the stress bucket has increased hugely -we have a lot more worry, about loved ones, the future etc. So it’s unsurprising many of our buckets are overflowing.

At the same time, being isolated, as you say, means that we have a lot of time with our worries and pent up issues, and we don’t have the normal distractions to distract us from that. We also might not have people around to support us and to talk to about what’s coming up for us. So we absolutely might find that these issues become a lot more intense and difficult to deal with. A lot of the ways we normally ‘lock up’ issues, might not be working. Although this can feel very overwhelming and difficult and isolation is notoriously hard, it’s possible it might also be an opportunity to reflect and gently and kindly look upon the things that are coming up for us, maybe by journaling, or drawing for example. Maybe this might in a funny way be helpful for us. I always find thinking about spiritual hermits interesting -in ancient times (and also now), people chose to isolate in order to concentrate on their spiritual growth (which may look very different to each of us). When we are in forced isolation, I wonder if we can connect to the hermits attitude, and use this time to reflect upon our issues with compassion, it’s possible we might find ourselves growing and accepting ourselves a little bit more than before. However, I hope I don’t give the impression this is easy, it’s tough, and sometimes just acknowledging that is important. Reaching out to family and friends and seeking support for example online, can be really helpful.

How do I incentivise myself to follow through on my targets?

I have so many things that I want to do but I'm not doing as much as I want to.

I find myself going from "this is going to be great to do" to "f*ck it, nothing even maters anyway" pretty quick. It's a cycle from 'if nothing matters, then you might as well do it' to 'why do it if nothing really matters'

Thanks for your question! A few people on here have been struggling with motivation, it seems to be a common thing in lockdown. The trouble with a motivation dip is that as soon as you start feeling unmotivated and stop doing things, the more tasks build up. And the more tasks build up, the worse you feel, which makes you feel even less like doing anything - it’s a vicious cycle. The good news is though, it can often work the other way too - when you start picking a few things back up again you feel good for doing them, which makes you feel a bit more motivated to tackle something else.

The main thing I think with low motivation is not to expect too much of yourself too soon. Start by planning a few key tasks, literally writing these down in a diary or calendar - people are more likely to do things if planned in advance, as opposed to just waiting until they feel ready. These tasks need to be small enough to be realistic - it’s no good promising yourself you’re going to go for a 10 mile jog everyday when you’re struggling to get out of bed at all. Seriously, start very small, preferably with things you enjoy and that fit with your own life values. And then keep going, building up when you feel more able. Make sure you celebrate your successes, no matter how small, and don’t give yourself a hard time if you’re not going fast enough, or doing as much as you think you should. It’s hard for everyone right now and we need to be kind to ourselves and lower expectations. Good luck!

Hello, I’m someone who is considering a career in counseling/family therapy. How do you think this pandemic is going to change the future of therapy. Are we going to start seeing more virtual therapy as a regular option in combination with in-person? Would a therapist have the option to have mostly virtual appointments instead of in-person?

Hi, thanks for your question! It’s a good one and one that I know is largely being considered in the profession in my jurisdiction. Also, I should note that there are many differences between countries and jurisdictions - so I’d encourage you to search out professional colleges in your own area for answers.

Telepsychology, providing services by telephone or video chat, did exist prior to Covid-19, however was often used to provide access for clients who might live in rural/remote areas, or who might be housebound for various reasons. Prior to Covid-19, I was aware of many clinicians who offered telepsychology options as part of their practice, but I was not aware of anyone who solely practiced from a virtual platform. Since Covid-19, many insurance companies (in my jurisdiction) have increased their coverage for virtual services and if they leave those changes after Covid-19, I think that we will see an increase in virtual services that extend post-pandemic. There are some services, such as formal assessments, which are tricky to perform virtually, and after Covid-19, I expect clinicians will go back to in-person sessions for these and some other services. A clinician in my jurisdiction definitely has the option to have entirely virtual appointments, even before Covid-19, however, many clients were interested in having in-person appointments. I’m not sure whether the demand for virtual appointments will stay steady even after people are able to attend in-person again. It will certainly be interesting to watch how the profession evolves through all of this!

I find it really upsetting and almost disrespectful that psychologists are now telling people they might experience PTSD from being in quarantine. I’ve been hearing the term “quarantine PTSD” way more than I see appropriate.

I thought PTSD is supposed to be the result of something traumatic like sexual assault, or having to kill children in war. Not from having to be alone for a couple months without your favorite restaurant and friend. I could see how this would apply if someone lost some family members to the virus but beyond that I think using PTSD to describe quarantine really downplays and takes away from the gravity of the actual disorder and is disrespectful to the people who have it. This disorder fucks people up beyond belief and can make them a shell of the person they once were. Quarantine will not do that.

This is just my take but you guys are the professionals so what’s your opinion?

Thanks for your question. I appreciate your concern about the brevity of the use of diagnostic terms. We do want to ensure that diagnostic terms have meaning and that colloquial use does not detract from the serious nature of trauma disorders.

You are correct that PTSD is a result of something traumatic. The tricky bit is that it’s not possible to tell which individual will experience PTSD from any particular traumatic event. The examples you mentioned, sexual assault and war, are two extreme events where it would definitely be more likely for a person to experience PTSD. However, even in those cases we still have no guarantee about who will experience PTSD or how severe it will be.

I would draw a distinction between experiencing a trauma response and a long-term clinical PTSD, as you might have in mind. I think that it is reasonable to consider that some people will experience trauma from quarantine, as you mentioned. Not everyone, and not everyone to the same extent, but there are people who, for many reasons, will likely experience a trauma response from this. Whether they go on to develop long-term, clinical PTSD, will remain to be seen.

I think that the value in having a conversation about trauma and quarantine is to help people reflect on the idea that their thoughts and feelings may be affected by a trauma response and that there are actions we can take to address this. There are aspects to this pandemic that will shape us all as a cohort, but also many that we experience on a very individual level intermingled with our own personal histories. Again, I appreciate your concern that diagnostic language not be watered down and so lose its meaning for those who are facing suffering. However, I’d also encourage you to consider that many people have personal histories that may make them vulnerable to an increased trauma response due to this pandemic, and that many of those reasons may not be immediately apparent. Thanks again!

How does one deal with the lack of motivation and emotional damage this has caused? ive found myself sleeping through the day although i have so much to do, and ive become way too dependent on texting people and feeling hurt when they dont text me back soon enough because ik its very likely that theyre home.. this has kind of lead to me getting nearly all of my validation from people as well..

Lack of motivation is tricky! The trouble with a motivation dip is that as soon as you start feeling unmotivated and stop doing things, the more tasks build up. And the more tasks build up, the worse you feel, which makes you feel even less like doing anything - it’s a vicious cycle. The good news is though, it can often work the other way too - when you start picking a few things back up again you feel good for doing them, which makes you feel a bit more motivated to tackle something else.

The main thing I think with low motivation is not to expect too much of yourself too soon. Start by planning a few key tasks, literally writing these down in a diary or calendar - people are more likely to do things if planned in advance, as opposed to just waiting until they feel ready. These tasks need to be small enough to be realistic - it’s no good promising yourself you’re going to go for a 10 mile jog everyday when you’re struggling to get out of bed at all. Seriously, start very small, preferably with things you enjoy and that fit with your own life values. And then keep going, building up when you feel more able. And celebrate your successes, no matter how small - we often neglect to do this.

It’s likely that when you start doing more with your day again, you’ll be less reliant on others. Good luck!

You don’t use the term “toxic positivity” do you?

Hi There,

I wonder what that term means for you. If I take it to mean that all negative emotions are diminished, refuted, avoided or unacknowledged then I personally would not advocate this manner of coping. I would suggest instead that perhaps embracing all feelings as equally valid and worthy may be more healing in the long run.

I'd recommend sitting with the negative feeling, accepting that it's okay to feel it and after you have perhaps created some emotional space between it and you, re-observe the situation and see what you felt was negative about it and why. Then perhaps you can move to trying to piece together a plan of how to address the thing that is most taxing to you about that negative emotion rather than rejecting them. Negative emotions are a great indication that something doesn't sit right with us and although scary and overwhelming at times, if ignored could lead to further negative consequences to one's self. Hope that helps!

B.P. S.O. here. How do I squash delusions that develop from covid news before the delusions take over?
Her bipolar starts to run away with "The world is forever changing, this is the dawn of a new Era!" Type stuff.

Hi there, thank you for your question! It’s really tough right now both for people with bipolar disorder and their friends and family, so we’re glad you’re reaching out.

It’s hard to answer your question fully without knowing your S.O and the individual situation, but one thing I’m wondering about is how much the media might be influencing people’s thoughts and fears at the moment. Perhaps take a quiet moment to think with your S.O about how they might be being affected by the media at the moment - is she finding that certain stories or types of media are fuelling unhelpful thoughts or delusions? If so, she might want to think about how she can change her relationship with the media to help, for example by limiting intake. I’m not sure where you’re reading from, but do check out any local bipolar disorder organisations or support groups and speak with health professionals if either of you get really worried about each other. Remember your health is important too!

I don't mean to be insulting, but who are you? And are you qualified to be providing this service? I don't see anything in your post or website that addresses this issue.

Assuming you are though, keep up the good work!

It's a very reasonable question thanks for asking! I'm actually working on the team page right now.

We are a group of volunteers who have donated our time to build helpers.tools

There are about 13 people who have contributed. The majority of those contributing are clinical or counselling psychologists. That means that they have completed postgraduate training (most often at doctoral level) and are certified to practice as clinicians. Everyone answering questions in this thread falls into that category.

Some of the other team members are journalists or health technology workers. It's been great to have a multidisciplinary team and some of the push and pull from different perspectives has been instrumental in producing helpers.

I hope this answers your question!

I suffer from severe debilitating depression. If I were to die, how would I go about making sure my brain is donated to scientists? Although I feel there isn't hope for me, I'd like to at least be able to provide hope to others.

I’m sorry to hear that you are feeling so hopeless at the moment. Severe debilitating depression is incredibly difficult. I wonder what in your life has kept you going so far? Maybe it is a person, a pet, an interest, a hope. If it is possible, hold on to that. When depression gets very severe, the brain struggles to see things in the way it would if we weren’t depressed. This can lead us to suicidality when we would otherwise be able to see other options. If you don’t feel you are able to keep yourself safe at the moment, I would strongly encourage you to seek some support from your local healthcare professional, or from a crisis service in your country. Your doctor may be able to help you with possibly some medication as well as some talking therapies.

There are some crisis services listed at the bottom of the helpers urgent support page https://www.helpers.tools/urgent-support. It may be there is some help out there that you are not aware of yet.

I am a current fellow about to start my own practice within a hospital setting doing modified CBT for adolescents and young adults with ASD. Obviously, we are looking at this being a major issue when these kids go back to a traditional school setting and worrying about if this happens again. What resources or tips do you have for adaptive traditional CBT, visual or simplified resources, and other information do you have for adapting these traditional skills for working with such a specific population?

This is a great question. I currently work with young people who have autism and I do use CBT in my clinical practice. If you’re new to working with this population, I would definitely advise familiarising yourself with autism and how it may present in different young people. I’d also recommend getting some additional training in this area, including how CBT may be adapted to both adolescents in general and those living with autism.

For some starting tips, I tend to invest time in fostering a relationship with my clients, recognising that it may take people with autism longer than other people to get used to both therapy and therapist. It’s usually necessary to make practical changes too, for example perhaps having shorter sessions, being flexible with the room set-up, going at a slower pace and using lots of visual materials to help illustrate any explanations or shared formulations. Remember that people with autism may find it easier to grasp concrete concepts, so use lots of examples and visual cues to make things less abstract.

Clinical supervision will be a key tool, so make the most of this time to discuss anything that you’re struggling with. But remember to flag the things that are going well too to help build your confidence. This is a really fun and creative client group to work with - enjoy!

Hello! I feel like I can't breathe and I'm coughing once in a while. When I cough, I feel like there's something in my chest like pop pop pop. It's the same when I get a terrible cough. I don't have fever, no runny nose, no fatigue. I'm just worrying if this cough is Coronavirus? I'm sorry, I'm already paranoid and I can't explain it well. I know you guys are under psychology, but a confirmation of what I'm having is a big relief to my mentality. Thank you for the help.

Hi there. I’m sorry that you are not feeling well, and the worry that is causing. You are right, as psychologists, we are not able to confirm or diagnose your symptoms through this forum. I appreciate you reaching out, and I’d encourage you to keep reaching out by speaking with your local health authority about your symptoms.

Hi! Have you noticed people who claim to feel trapped? Such as they are in situations where they are in quarantine with less than ideal people or in places they'd rather not be in? What is your advice to these people? Thank you!

This is a really difficult situation, I empathise with anyone who is feeling trapped in difficult relationships or home environments. My first advice to anyone who is in an unsafe situation is: if you can, leave. Although social distancing measures are in place, health and safety is a priority and many countries will allow you to move if your safety is in jeopardy. However, things are sadly rarely that simple and people may feel unable to leave due to financial issues, childcare, fear, or a number of other reasons. In this case, I’d urge people to use the help of supportive friends, family or organisations to keep as safe as possible during this pandemic and beyond. There are a number of domestic abuse charitable organisations and helplines available across the globe (some are mentioned on https://www.helpers.tools/urgent-support), who can offer specialist advice and support - many of these have updated their websites and services in light of this epidemic. Contact these services where possible for individualised support, but at the very least make sure you know important helpline and emergency numbers in case they’re needed in a crisis. It might be helpful to arrange a safe word with family and friends and/or to keep your phone charged and on your person in case you need help in a hurry.

For those who are at least safe, but who are still living in a situation that is difficult for your wellbeing, it will be important to make sure you can get breaks from the difficult situation or relationship where you can. Make the most of your exercise or supermarket time, for example. Find a space in your house that you could go to for some time and space for yourself, make it as comfortable as possible. Day to day, it might help to keep up with healthy routines, look after your physical health and use enjoyable, distracting activities to keep your mind off of worries or stresses that are outside of your control. Don’t be afraid to get more help from health professionals if things get too much, and remember this won’t be forever.

Hello. In real, situation with pandemic didn't change my life actually. I don't talk to people much, also I'm being at home almost the whole day, it doesn't feel like it's changed really. My question is "how to live through pandemic if the pandemic is your whole life?"

Hi there, thank you for this question, I think that this is actually a question that quite a few people are asking themselves right now. Everyone is having such different experiences and reactions to the pandemic, sometimes the media only portrays certain experiences, and might highlight certain social narratives. This might make the many, many people, who are experiencing something different feel more isolated in a way.

For those who are already quite isolated, the pandemic might in some ways feel like a relief, as the pressure to engage is in someways reduced. It might also throw sharp relief on the question you ask. I wonder how you feel about it. It may feel okay to you, it’s a valid choice to live a more solitary and quiet life, even though our culture sometimes doesn’t appreciate this. As I suggested in another answer, some people choose to live solitary lives (for example spiritual ‘hermits’) and find it very fulfilling and enriching. Many people report enjoying the slower pace of things during lockdown and it might be that people start appreciating being at home now and living a quieter life.

There are many reasons as to why you live a quieter life. It may be that you have physical limitations that keep you at home or other circumstances. It may also be that you are not happy with your current circumstances, you might find the current situation is making you reflect on whether this is the life that you want. Giving yourself time to reflect on this question can be helpful, even if painful.

If you are feeling unhappy with your life, perhaps think about whether you want to take the step to seek some psychological support, or to join a peer support group. Right now might actually be a good time to experiment. It won’t be a quick and easy journey but a small step can make a big difference.

Hello! Thank you for your work. If one needs help but can't access their mental health team during the pandemic, what are measures they can take at home in the meantime?

Hi,

You are right in that it can be tricky to access your usual mental health services at this time. Many of them do still offer phone/online support however so it might be worth checking this with them. If they are completely closed, there are a lot of online support out there.

I would say it depends a bit on what type of difficulty you are experiencing. For example if you would like help with stress reduction it might be worth searching for guided meditation or mindfulness but there are also specific support and organisations for specific issues such as for OCD, eating disorders or people who have experienced trauma etc. If you search the net for specific support, suggestions of organisations should come up. I am not sure where you are based, in what country so I cannot give you specific recommendations.

There are also lots of self-help material out there such as books or apps that helps people manage common mental health difficulties.Many of these self-help books follow the model of CBT, cognitive behavioural therapy, which helps people noticing that the way they think affects the way they are feeling and teaches tools of how we can be more in control of our thoughts and thereby improve our mental wellbeing.

Other things you can do at home if you are not using any external source of online support or self-help books is to focus on things that makes you feel good such as engaging in a hobby that you can do from home, or to maintain contact with people you care about. It is also important that you try to stick to a routine when you are at home as routine gives us a sense of control which is especially important in these times of uncertainty.

How can a person with depression learn to get things done in this time of uncertainty, how can they start engaging in activities, and not do any self harm?

Thanks for your question! A few people on here have been struggling with motivation, it seems to be a common thing in lockdown. The trouble with a motivation dip is that as soon as you start feeling unmotivated and stop doing things, the more tasks build up. And the more tasks build up, the worse you feel, which makes you feel even less like doing anything - it’s a vicious cycle. The good news is though, it can often work the other way too - when you start picking a few things back up again you feel good for doing them, which makes you feel a bit more motivated to tackle something else.

The main thing I think with low motivation is not to expect too much of yourself too soon. Start by planning a few key activities, literally writing these down in a diary or calendar - people are more likely to do things if planned in advance, as opposed to just waiting until they feel ready. These activities need to be small enough to be realistic - it’s no good promising yourself you’re going to go for a 10 mile jog everyday when you’re struggling to get out of bed at all. Seriously, start very small, preferably with things you enjoy and that fit with your own life values. And then keep going, building up when you feel more able. Make sure you celebrate your successes, no matter how small, and don’t give yourself a hard time if you’re not going fast enough, or doing as much as you think you should. It’s hard for everyone right now and we need to be kind to ourselves and lower expectations. Good luck!

How much of the current mental health problem is due to the constant barrage of media outlets shouting at the top of their lungs "the world is ending, the world is ending"?

Do you think overall mental health would improve if people would turn off the tv/radio/social media?

Great question! If we think back to previous crises, often people were relying on a newspaper that they would receive once a day, or perhaps updates on the television or radio that might come a handful of times per day. Now, we can literally spend an entire day immersed in various media about this crisis. In addition to this, anyone anywhere can write anything and get it out for people to view-whether an expert on the topic or not.

I think that mindful and intentional consumption of media would have a great positive impact on us all (even after this crisis). I’m not advocating for complete abstinence from the media, after all, many people are using social media to connect with others, and we rely on the media to keep us apprised of public health information and orders. However, I believe mindful consumption requires paying attention to our sources and ensuring (as best we can) that we are taking in trustworthy information. And I think it also means setting boundaries on media consumption (for example, unfollowing people on social media whose posts increase anxiety at this time, or setting time limits on media consumption in a day). Noticing how the information we are taking in makes us feel is an important step to taking action to adjust our consumption to better serve our needs. If what we’re reading is a lot of the “world is ending!” type stuff-we’ll feel pretty awful, and this might be an indication that we could seek out a source that is providing a more measured take on things.

What is the scientific support you're using to deliver this course? What would be the key factors that enable it to help people in this emergency?

As a group of practicing psychologists, we typically use evidence-based practice and therapies in our day to day working life. For this tool, we’ve taken aspects of evidence-based approaches, like Cognitive-Behavioural Therapy and Acceptance and Commitment Therapy, to help people become more in tune with their emotional wellbeing and what might help when things feel difficult.

We hope that the tool's accessibility and its focus on common elements of the pandemic that people are finding difficult (e.g. isolation, anxiety and others) will make it useful to a wide variety of users.

In addition we are conducting a piece of research on the impact of helpers in collaboration with the University of Westminster. Even though we are taking well evidenced techniques we are presenting them in a new format the result of which is a new artefact which requires evaluation in and of itself.

Is this HIPPA compliant? I'd only want to divulge information about myself if I thought it would not be shared without my consent.

Thanks for the question.

HIPPA is an american law and our project is in the UK. As such we have not measured ourselves against its standard as part of our process. With that said I can assure you of the following:

• The only data you are required to divulge to participate is your email address.
• There is an opportunity to offer some data to our study. The study is progressing through ethics at the University of Westminster and all data will be handled anonymously to the standards of their ethics board. This activity is entirely optional and choosing not to participate does not affect your ability to access helpers.tools

I hope that answers the question to your satisfaction. If you still have questions feel free to send them to [email protected]

Is there something a psychologist unaffiliated with your project can do to help you?

Please do send an email to [[email protected]](mailto:[email protected]) and we can figure something out I'm sure.

Beyond that, feel free to take a look at the tool and spread the word if you feel it is a good fit for your context.

Why email as a platform for your free 6-week program and not an app or social media?

One of the key principles we designed the program around was accessibility. This meant the thing we made had to be:

• Free to use so as not to present any economic barrier
• Usable remotely so as to not require breaking any rules about distancing
• Usable with a modicum of technological savvy or equipment so that as many people from as many age groups as possible could use it.

This was why we settled on email as there are many people, especially older, who would not find or use an app.

Is this bit of research HIPAA compliant? Will users personal information or answers be sold?

Thanks for the question.

HIPPA is an american law and our project is in the UK. As such we have not measured ourselves against its standard as part of our process. With that said I can assure you of the following:

• The only data you are required to divulge to participate is your email address.
• There is an opportunity to offer some data to our study. The study is progressing through ethics at the University of Westminster and all data will be handled anonymously to the standards of their ethics board. This activity is entirely optional and choosing not to participate does not affect your ability to access helpers.tools

I hope that answers the question to your satisfaction. If you still have questions feel free to send them to [[email protected]](mailto:[email protected])

As a therapist myself, are there any resources you could share that could help me in working with my own clients? Because this is all so new, I’m having trouble finding trainings or material to specifically handle the challenges presented currently.

Thanks for your program, and thanks for opening up for questions!

Yes! The American Psychological Association has a comprehensive page dedicated to Covid-19 information and resources.

https://www.apa.org/topics/covid-19/

Is it captioned for the deaf?

There is no audio component, all the material is written. That said to get the best out of the course it is recommended to do parts with at least one other person so a deaf user would want to find someone who can do that alongside them.

First and foremost I would like to applaud your project and the well thought out and constructive answers to the many questions already asked in this thread.

As a fellow psychologist who has been tasked with assisting frontline staff with dealing with stress regarding covid-19, are you open to sharing the material that you use on the course? I imagine it would be a huge asset to structured group sessions.

Thanks for the kind words!

Send an email to [[email protected]](mailto:[email protected]) I'm sure we can work something out.