How to Stay Sane While Staying Home
Date Published: April 7, 2020
With more than 90 percent of Americans under stay-at-home orders, Deborah Marin, MD, Psychiatrist and Director of the Center for Spirituality and Health at the Mount Sinai Health System, offers tips for safeguarding your mental health while social distancing. One piece of advice: Build structure into your day. “I've substituted my babysitting hours with FaceTime twice a day. It's on my schedule at 7:45 in the morning and 5:30 p.m.” Dr. Marin says. Listen for more tips.
From the Mount Sinai Health System in New York City, this is Road to Resilience. I'm Jon Earle. Each episode we bring you interviews with resilient people and scientists who study resilience. This is our third episode on resilience during the coronavirus pandemic, and we're going to use it to offer some useful tips to the more than 250 million Americans currently under stay-at-home orders. If you're one of them, and you're cooped up at home, you know how hard it can be to keep from going stir-crazy, or from getting so in your head that you can't find your way out. We know from the scientific literature that extreme isolation erodes our bodies and our minds, but even the milder kind that many of us are going through right now when we're apart from loved ones and we're walking through the same spaces again and again—it almost aches, doesn't it? On this episode, we're going to fight back with the help of my guest, Dr. Deborah Marin. She's a psychiatrist here at Mount Sinai, and longtime listeners might remember her from episode four, where she talked about faith, spirituality, and mindfulness. Dr. Marin covers a lot of ground in this interview, but I think for me the biggest takeaway is the importance of building structure into days that can seem to blur together. Even something as simple as that 12:30 office lunch you used to eat, bring it online. It helps. Anyways, here's Dr. Marin. I hope you enjoy it. Dr. Marin, Deb, thank you so much for joining us on Road to Resilience. Can you just share with us some of the concerns that you're hearing from your patients about how to kind of get through this very challenging time?
Dr. Deborah Marin:01:35
I take care of older folks. So a lot of them are already kind of socially isolated because they can't necessarily get around like they used to. But a lot of these people had routines that worked for them. Even going to the store was an event that was part of their day and their routine. So they're very concerned about actually being cut off from the activities they had figured out to work for them, and they're very worried about getting sick. They're also worried that—some of them rely on family members to care for them who can't come in. They're worried they won't get access to care. So a tremendous amount of immediate anxiety. I haven't heard worry about getting food necessarily, but definitely destabilization of normal routines and patterns of relationships.
Just to back up a little bit further, I mean, what does it like to be a psychiatrist right now? Are you feeling inundated?
Dr. Deborah Marin: 02:31
I don't feel inundated. I'm very lucky in that I have excellent people who work with me. I worry about my patients getting depressed who are not now. I worry about them getting more panicky. So I have worries for them, I don't have worries for myself. I have to be frank with you.
Let's go point by point. Can you just go through those and give me some of your bullet points that you find yourself saying to patients right now?
Dr. Deborah Marin: 02:56
Sure. Why don't we start with what the predictors are of issues with being isolated. I'm not talking about quarantine right now. I'm talking about isolation in general. When people are isolated, especially if their person-to-person ties are not there, they often feel they don't have a structure to their day. They can become bored and lonely. People that are isolated a long time actually can have worse health outcomes in terms of their mental health and even cardiovascular illness. So there are certain risk factors you worry about—older person, frail maybe some of these things. But there are definitely things that can work, and while we live in an age of being disconnected in many ways, there are so many opportunities to be connected, and if it's not going be FaceTime, because I know some people don't have a smartphone, it's a phone call, it's fine. I do think that finding virtual ways to be connected to your family, virtual ways to be connected to your community. If you are part of a reading group, I bet they're setting up something where people can speak with one another. If you belong to a synagogue or a church, I'm certain something is being set up. If you belong to other associations, find out what they can do. I think the other big part of social isolation is that the routine of being alone is different. There's no routine. You've lost the going to the store. You've lost preparing to go to church. You've lost seeing people. So building in a routine, some of which should be reconnecting yourself with people, but some of it can be done on your own, like finding meaning and purpose in things that maybe you haven't done recently. Reading a good book, if you can't go to the gym, do some things at home, set up a schedule to do things that maybe mimic—. For example, for me, I have a clear routine of going to work and coming home and seeing my family. So I've substituted my babysitting hours with FaceTime twice a day, and it's on my schedule so I know when it is. At 7:45 in the morning and 5:30 pm, I see Lily. That's how it works. Things like that. Predictability really can mitigate. I also think that some people have hobbies they haven't done in a while. They maybe haven't read a book. Maybe they are not comfortable with doing Kindle. Pick up the book off your shelf and read the book. Make time to do that. I definitely think self-care is very important. If you used to eat meals in a certain way, continue that schedule. And also pick projects that you want to do. I mean, I'm a knitter. I've decided I'm going to learn a new stitch.
Yeah, certainly rediscovering YouTube. If you haven't been on it recently, you can learn pretty much anything on YouTube.
Dr. Deborah Marin: 05:30
I do think making a schedule is very important though, and it may sound kind of silly, but most people like a schedule. Most people like predictability, and in this time of unpredictability, making your days for yourself predictable is extremely important. Another thing about isolation is, I think being connected is very good, but I do worry about people being over-connected with regards to the news. I lived through 9/11. I was a caregiver then, I was at a patient's home, had the TV on, I saw the building go down. I walked down Park Avenue, I saw a puff in the air, and you kept on seeing the buildings being hit over and over again. That's a great setup for some post-traumatic issues. So I would say don't bombard yourself. You have to stay abreast, so much news is being pushed to us. I think that's also an important thing to think about.
What would you say is an appropriate news intake?
Dr. Deborah Marin: 06:26
That's an excellent question.
Because I check it three times a day. I check it first thing in the morning. I check it at lunch. And then I check it— and I think this is the worst time to check it—before I go to bed.
Dr. Deborah Marin: 06:36
Yeah. I think first thing in the morning is what most people will do. It used to be open the paper and read it. Now it's open the phone and have the blue light on your face. I think midday is good. My worry about evening is that there are a lot of things that keep us from sleeping anyway, and usually evening time should be relaxation time. If you have to look at it in the evening, whatever you read—. Unless you get a beep on your phone—red alert, Amber Alert—nothing could catastrophic will have happened. If it did, believe me, someone is going to call you anyway. So I would think that maybe before dinner, if possible. Definitely not late into the night. The worst thing I think is some people that keep the news on to go to sleep. I really think that's a very bad idea. I think that's not a good plan because you need your sleep, and if this is going to rev you up at night and keep you awake, it's very bad for so many things: your physical health, your psychological health. That's one thing I would strongly recommend.
There was something else that you brought up that I thought was really smart and it's kind of like a 10,000-foot view of things. When you're talking to your patients, you said you tend to bring up the things that they've survived that they've been through and to remind them that this isn't your first rodeo.
Dr. Deborah Marin: 07:50
Yes. I think for older folks, they've been through a lot. They've seen a lot. Aging isn't for sissies, you know? If you've lived that long—I think that's the one thing that makes people resilient, by the way, is previous episodes where their life may have not been easy for them. And that actually is, believe it or not, early life, not trauma, but early-life challenges actually help people. So I know [Friedrich] Nietzsche says, "What doesn't kill you makes you stronger," but this is an environment that's very complicated. I do think that for people who've experienced something, if they made it through, they should think about that. It also helps to talk about situations in the past— how they banded together, how they did something—to remind themselves of how they did figure this out before.
Is there anything, maybe 9/11 comes to mind, for you in your life where you're like, "Yes, I've been through a crisis?"
Dr. Deborah Marin: 08:43
Yeah. 9/11, definitely. But I had other experiences. My parents were Holocaust survivors. My father had been in the camps. So my parents kind of—they didn't traumatize me, they didn't talk much about it, but I learned to be extremely grateful for what I had and I think that helped me a lot.
Dr. Deborah Marin: 09:00
I think also another thing about feeling better and being resilient, putting things in its place. Like problem solving, like making a schedule, finding ways that you know you're grateful for something that can shore up you're doing well. Pulling away is a bad idea. That's one thing I will
say. If you are in contact with people. Also, I think sometimes altruism comes out in these situations. People may have friends that they haven't been in contact with for a while. You know, people are connecting again now.
Yeah. I mean I've noticed just for myself, I've been in touch with my family every day, which is not something I can say for the rest of the month.
Dr. Deborah Marin: 09:36
I think it's a very good thing to do. I know that people who have not been church-goers are going more to virtual church than before. People are having online dinners with one another. They're just eating their dinner in front of the computer with other people, but they're doing that. I think it's a very important opportunity to combat social isolation.
Is there anything that we haven't covered that you want to make sure to mention?
Dr. Deborah Marin: 10:01
I think the one thing we didn't talk about is connecting with one's cohort. We talked a lot about people who are isolated because they may feel frail, you know, maybe a little older. I think connectivity for work is an important conversation. I've asked the site directors to make sure they meet every day with their staff in-person. If not, have a video conference, use Zoom. I think it's helpful because you know the water cooler chats, whatever you want to call them, they're gone. So I think it's not a bad idea for coworkers who used to even do that, like, if they know they had lunch every day at 12 o'clock, maybe they should check in.
Oh, I like that.
Dr. Deborah Marin: 10:40
I think that may be a good thing. Because workplace relationships vary a lot, but I know that I have folks who work for me who are working from home, and it's an adjustment. These two people worked next to each other. They had a working relationship, they got along with each other. So I think that's an important thing, too.
I like that a lot. I'm going to try that one.
Dr. Deborah Marin: 11:01
Okay. Let me know how it goes.
I will. Dr. Marin, thank you so much for making the time to talk. It's been a real pleasure talking with you, and be well.
Dr. Deborah Marin: 11:13
You too. Take care.
Dr. Deborah Marin is the Blumenthal Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai. She's also Director of our Center for Spirituality and Health. Road to Resilience is a production of the Mount Sinai Health System in New York City. It's produced by Katie Ullman, Nicci Hudson and me, Jon Earle. Lucia Lee is our executive producer. If you enjoyed this episode, please leave us a rating and review on Apple Podcasts or wherever you're listening. It helps other people find the show and keeps us resilient. Thanks. That's all for this episode. Thank you again so much for listening. We'll be back very soon with more episodes and until then, stay safe and be well.