Psychologists Jonathan Gallagher and Dr Isabela Caramlau provide reassurance and advice on minding your mental health during the coronavirus.
These unprecedented times are difficult for everyone and can be particularly stressful for people living with a heart condition or those who have suffered a stroke.
In an effort to support you at this time we have teamed up with psychologists specialising in cardiology, Jonathan Gallagher and Dr Isabela Caramlau to provide specific reassurance and advice for people with heart disease, or who have had a stroke, on minding your mental health during the coronavirus.
Q1: Is it natural to feel anxious about the current COVID-19 crisis?
Yes it is very common to feel frightened and overwhelmed during these unprecedented times. Acknowledge your feelings, try to understand why you are feeling this way, and make sure someone you trust is available to speak with.
Q2: How do I know if I am experiencing abnormal levels of anxiety and may need to seek extra help?
In Ireland, many people live with anxiety, and it’s only natural that anybody’s anxiety levels would spike during a pandemic. A certain amount of anxiety can actually be helpful when it results in us taking appropriate safety precautions and self-care.
However, if increased anxiety persists and starts to significantly impact your day-to-day functioning, this is another matter. If you are experiencing sleep difficulties, loss of appetite, problems with concentration, unusual levels of irritability and overall feeling like your mind is racing all the time, you are probably struggling. As the first port of call you should contact your GP.
It is very common to feel frightened and overwhelmed during these unprecedented times.
.
Q3: I have been forced to cocoon because of my health and I am finding it difficult, can you please suggest some coping strategies I can use?
Stay connected. The physical and mental health benefits of social support are very powerful for people living with heart disease and the general population alike. These welcome social distractions (g. chats, jokes, videos) also help us to interrupt the flow of negative thoughts that can fuel anxiety.
Make a plan and identify what you can control just now. There will be lots of things you can still do and retaining this sense of control will boost your ability to cope.
Set daily goals: this might include things you have been meaning to do, but never got around to, or even learning a new skill or hobby.
Acknowledge any difficult feelings, try to understand why you’re feeling this way and seek support from others.
Accept that this is a difficult and challenging time, and that some level of anxiety is normal. Remind yourself that the current situation won’t last forever, but equally be prepared that it is unlikely to resolve overnight. Attending daily to your self-care will help you cope, even if it lasts for a few months.
Remind yourself of the benefits of self-isolation. This is a meaningful sacrifice that will protect both you and your community.
Focus on maintaining your health – another thing you can influence. Ensure that you take regular meals, adequate fluids and exercise daily. There are many approved online options to help you with a home-based exercise routine. Maintaining a regular sleep schedule will also help strengthen your immunity, manage your blood pressure and regulate your mood.
Remember to take your prescribed medications and adhere to any medical advice you’ve been given. A heart-healthy lifestyle also supports your mental health.
Acknowledge any difficult feelings, try to understand why you’re feeling this way and seek support from others.
.
Q4: I miss my grandchildren and I am worried about the impact all of this is having on their mental health – what can I do?
Take advantage of the phone and social media to stay in touch with your grandchildren. Listen to their concerns and answer their questions in an age- appropriate manner. You can still have fun too. Apps such as Caribu (www.caribu.com) allow you to read books and play games with them.
Q5: I suffer from heart disease and I am worried that I will become unwell – what can I do to stop worrying about my health?
Why wouldn’t you be worried about your health? We are in the middle of a pandemic.
To reiterate, social connection remains crucial here. The scientific evidence tells us that there is a consistently strong link between good social support and cardiac health. Heart patients with a good social network (≥3 people) have both increased survival and reduced hospital admissions. For patients living with heart failure, the emotional support provided by partners/ spouses in particular, is strongly linked with cardiac health.
Remind yourself of all the things you are doing to keep yourself well. Approximately 90% of the causes of heart disease are modifiable, so there’s lots you can do to influence your health. Adhere to the advice given by your cardiology team, and if you experience unusual symptoms please contact your GP. Remember that the hospitals are still open, and should you need to come in, it’s vital that you don’t delay. Not only is it safe to do so, you will likely be seen very quickly.
Worry Scheduling: If you are worried and anxious, consider scheduling your worry for a specific part of the day. It might sound strange, but people who struggle with worry are often asked to schedule their worry so that it doesn’t take over their day. Allow yourself a specific time each day to do all your worrying. When your mind wanders to worries outside that time slot, simply remind yourself that you have already scheduled time for worrying. Track with a journal (or even on your phone) the big and small worries you want to cover during your worry time. Compressing your worries into an hour (or less) each day helps you gain a sense of control over your worrying, and allows you to shift your attention to focus on positive, productive activities during the rest of the day.
Take any form of regular exercise you can manage just now, whether inside or outside the home.
.
Q6: I had a heart attack a few years ago and I am afraid that I might suffer another during the lockdown period how can I manage that fear?
Acknowledge your fear but try to take steps to manage it so that it only minimally impacts your life. Pay attention to your self-talk and remember: thoughts are not facts. Patients who adhere to medical treatment and adopt a heart-healthy lifestyle are much less likely to have a recurrent cardiac event. If this is you, remind yourself of everything you do remain healthy and well.
Make time to relax. “An anxious mind cannot exist in a relaxed body”. If you’re not already familiar with relaxation techniques, learn more! There are many scientifically proven options like diaphragmatic breathing, progressive muscle relaxation (PMR), guided imagery, mindfulness based stress reduction (MBSR), and others. You can find a wide variety of resources available from reputable medical sites, and there are even additional smartphone apps for meditation and other forms of stress management. Choose an approach that fits you, and make sure to prioritise time to relax. Regularly reducing your overall level of tension “steals the oxygen” from the fire of anxiety. When we’re physically relaxed, we experience less stress, tension, and it boosts our immune system.
Acknowledge your fear but try to take steps to manage it so that it only minimally impacts your life.
.
Q: What practical steps can I take to keep mentally healthy?
It cannot be overstated that we all need someone we trust to provide us with a safe space to talk about our concerns, feelings and what we need. Stay connected with family, friends, and neighbours by whatever means, even over the garden fence.
Get up every morning, take a shower and change into day clothes. Don’t stay in your PJs all day. Have a routine in place – make time for work, school, household chores, exercise, and self care.
Take any form of regular exercise you can manage just now, whether inside or outside the home.
It really is important to eat and drink as healthily as possible. A high-quality diet will support both your physical and mental health, and alcohol should be taken in moderation as it acts as a depressant, particularly if taken late at night. Even if you feel that alcohol helps you to nod off more easily, it unfortunately disrupts your sleep architecture, worsens low mood and, despite ‘losing the night’ can make you feel like you didn’t sleep the next day.
Although moderate coffee consumption does not appear to be strongly associated with cardiovascular health, you should consider limiting your intake just now if you’re feeling anxious, as it can make you feel more agitated.
Support available
The Irish Heart Foundation’s nurse support line is available five days a week. Anyone living with heart disease and stroke who has concerns or questions about the coronavirus can contact the nurse support line on 01 668 5001 or support@irishheart.ie.
The Irish Heart Foundation’s new heart support group is on Facebook. Anyone who lives with heart failure or another heart condition or has a family member living with a heart condition can join here: www.facebook.com/groups/heartsupportnetwork/
The Irish Heart Foundation runs 21 stroke support groups and 5 heart failure groups around the country. All these groups have moved to telephone and online support. For more information, see https://irishheart.ie/get-support/.
