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Tips for Preventing Depression While Social Distancing

Daughter visits mother during quarantine on other side of glassThe challenges of isolation and loneliness have become apparent over the past several months of social distancing. Not only are we physically separated from our friends and extended families, but we’re concerned about their health and wellbeing as well as our own. We may be juggling childcare, homeschooling, and our own work. Or we may be wondering how we’ll support ourselves through this. We may know those who are sick, or who are high-risk, or who are essential workers putting themselves at risk for our sake. We may have lost people close to us. And we may feel powerless to do anything.

The situations that we find ourselves in can be overwhelming, and can contribute to low mood, irritability, and other potential depressive symptoms. If these symptoms persist and severely impact your day-to-day functioning, it can be a good time to check in with your doctor or a therapist. Many providers have moved to telehealth during this time, so it’s possible to connect to extra support. But if you just notice your mood dropping a bit or you feel a bit unmotivated, you may want to try out new strategies to prevent further depressive symptoms or bounce back from these moments of low mood.

First of all, it’s important to acknowledge that this is a time of adjustment and loss. Many of us will experience normal mood fluctuations such as low mood and sadness related to the loss of life the way it used to be. As with any loss, reactions will come and go, and feel different from day to day. Being gentle with yourself and others is important for maintaining mental health. For example, focus on “good enough” instead of “perfect” or “how I would usually do this.” Think of tasks that help you to feel productive, need to be done, and give you joy, and engage in a mix of those things. Let go of getting everything done. When you do achieve something, celebrate it.

It’s also important to remember that every person is different and will have certain strategies that work better for them in maintaining mental health. Different circumstances and situations will call for different approaches. Consider this a time of experimentation: try new strategies, but don’t be afraid to give them up and use others if they don’t work for you.

Social support from family and friends can help to prevent symptoms of depression. The lack of close personal contact during this time of social distancing is a challenge and can lead to feelings of isolation and loneliness. While we may not be able to interact with one another in the ways we’re used to, there are plenty of ways to stay connected.

If you’re lucky enough to be social distancing with your family, take some time out to connect with your kids or spouse. Even small moments of connection can improve your mood. When it comes to technology, find what works best for you, whether it’s virtual parties or one-on-one chats with a friend. While social media is one way to connect, it may be less helpful than picking up the phone and calling or FaceTiming. And just as in life before, know your limits. Having time to yourself to recharge is still important, and if you’re feeling Zoom overload, it’s perfectly okay to say no to a virtual happy hour.

When you’re interacting with others or when you’re alone, don’t forget to notice the good or joyful moments — that can do a lot to improve your mood. Did you have a good laugh about something silly with your family? Did you get a sense of satisfaction from completing that puzzle that’s been sitting in your living room for years? Notice when those moments come up and what you’re doing, and look for opportunities to engage in more of them. Along those lines, you can start tracking three good things or three things that went well each day. In addition to writing these three things down, write what made them go well or what caused them. Research has demonstrated that doing this daily for a month can help to improve your mood and increase happiness.

Repetitive negative thinking can contribute to depressive symptoms, so it can be helpful to take time to notice thoughts that are connected to feelings of sadness, anger, fear, and other emotions that bring your mood down. Once you notice these thoughts you can make efforts to reframe them or focus your attention on more helpful ones. If you notice that a bothersome thought keeps coming up, see if you can switch it up. For example, “I’ll be stuck at home forever” could be turned into, “I feel stuck right now, and this is a temporary situation. I’m looking forward to seeing my dad after this is over.”

Taking care of your physical health can have a strong effect as well. You may see a lot of runners and bikers out in your neighborhood these days, and they’ve got the right idea. Exercise has been found to be effective in preventing depression. Just engaging in something active can help — check out streaming yoga or old-school Richard Simmons videos. Take a walk around your house or challenge yourself to a stair climb. It doesn’t matter what you do as long as you get moving, and your mood will likely improve as a result.

Though it can be hard to put down your phone or turn off the news, getting enough sleep (but not too much) can help keep your mood stable and make it easier to roll with the punches. If you’re having difficulty sleeping, work on improving your sleep hygiene. Start preparing an hour before bedtime by turning off screens, doing some relaxation, and clearing your head.

Finally, remember that it’s not about never feeling low — it’s about bouncing back from the low mood. Honor the fact that this is a difficult, sad, and anxiety-provoking time. Remind yourself that social distancing and staying at home are temporary. Think of other difficult times in your life and what strategies you used to get through those times. If we are mindful of our thoughts and intentional about the strategies we use throughout the day, we may be able to maintain good mental health — despite all of the challenges we’re facing.

Further resources:

Katherine R. Buchholz, Ph.D., is a postdoctoral research scientist working on depression prevention research at the Wellesley Centers for Women.

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Guest — Eva Williams
I recently felt on myself what depression is. True, this was accompanied by my menopause, which began just before quarantine. And ... Read More
Thursday, 18 June 2020 17:15
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Social vs. Physical Distancing: Why It Matters

Social connection and social distancing during COVID-19 coronavirus pandemicThis article was originally posted by Amy Banks, M.D., on April 12, 2020, on her Wired for Love blog on Psychology Today.

To protect ourselves, our families, and our communities from the devastation of the coronavirus health experts are strongly encouraging everyone to “socially distance” — to stay 6-10 feet away from other people.

I am concerned — not by the strategy but by the way people are enacting it. The few times I have ventured out to a grocery store or for a walk around my neighborhood, I've seen people not only keeping distant from one another but also seeming afraid. They pass each other on the street or in a store without looking at each other or exchanging greetings.

It’s as if we were each locked in a personal bubble that no one can enter. The threat of COVID-19 and the stress it induces can understandably cause individuals to become terrified and myopic — to turn inward in an attempt to stay safe. While a week of that may be more stressful to some than others, months of this type of social isolation is dangerous. Research clearly shows us that our physical and emotional health and well-being are dependent on loving relationships and physical touch. To weather this pandemic, we need one another.

Weeks ago, my colleague and friend, Roseann Adams, LCSW, recognized that the national strategy of social distancing was a double-edged sword. She identified that social distancing can be a threat to all of us as it leads some people to socially isolate potentially causing further stress and, over the long haul, impairing our bodies’ immune system. In fact, strict social distancing may set us up for other illnesses.

Within the first few days, she was encouraging people to physically distance with social connection. Differentiating physical distance from social distance acknowledges the virus’s malignant ability to be transmitted from person to person but also acknowledges that the virus has no power over our ability to support and nurture one another in this time of extraordinary threat.

Think about the power of social isolation in society. Solitary confinement is considered the worst punishment a human can receive. In fact, most civilized communities consider it a form of torture. The physical and emotional toll it takes over time includes a worsening of mental health issues, an increase in self-injurious behavior and even suicide.

Isolating individuals is perhaps the most common first step domestic abusers use to gain power and control over their victims. He or she begins to control who you can see, where you can go, what you can wear. When a person violates the rules set by the perpetrator the punishment is harsh and swift.

Social distancing, as it has been presented, can feel like that. In fact, in my work with trauma survivors during this time, I have heard people describe feeling trapped and threatened again. That is not sustainable. Becoming socially isolated may keep the majority of us alive, but not well.

By naming the national strategy as physical distancing rather than social distancing and emphasizing the need for human connection we can stay safe from the virus but also hold onto the heightened need we all have for one another right now. Each of us needs an extra dose of being seen and held within our connections during this extraordinary time. Perhaps now more than ever we must be intentional about giving our neural pathways for connection a workout.

In fact, we need to go out of our way to make eye contact, wave, move, or loudly say "hello" from behind the mask. This gives our smart vagus nerve and our mirror neurons a workout. Literally, the sound of a friendly voice and seeing the eyebrows of another person raise in greeting stimulates your social engagement system, which in turn sends a signal to your stress response system to stand down. Those moments of interaction may make the difference in the long run as to how we, as a society, survive the pandemic.

The human nervous system is amazingly adaptive. Our brains will adapt to social isolation over time, but the burden of stress the isolation causes will lead to long-term health problems. As a society we will not be well at the end of all of this — not because of COVID-19 but because of the message we take in that being with others can be dangerous.

That is why each of us must do our part to not only stay physically six feet apart and to wear masks but also to go out of our way on the street, in the grocery store, through FaceTime, Zoom, or whatever platform you can use to reach out to one another. We all must know that nurturing the relationships we have and reaching out to others who may be isolated is as essential to surviving the pandemic as physical distancing.

Let’s add another important directive to our national policy of containing the coronavirus — to reach out each day to three other people — to check in on them, simply hear their voice, or share the pain or joy of the day. This is a wider strategy to not only survive the pandemic but to keep our humanity alive.

Amy Banks, M.D., is a senior scholar at WCW and founding scholar of the International Center for Growth in Connection, which began as the Jean Baker Miller Training Institute at WCW. Dr. Banks has spoken throughout the U.S. on the neurobiology of relationships and is the co-author, with Leigh Ann Hirschman, of Four Ways to Click: Rewire Your Brain for Stronger, More Rewarding Relationships.

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To stand by in such moment of crisis.....is something all we need....great choice of words...liked it
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Right now the whole world is struggling with Corona. The whole world is looking for a cure for this virus, but until it can be sol... Read More
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Preventing Depression in Young People

This policy brief originally appeared in the Spring/Summer 2016 Research & Action Report from the Wellesley Centers for Women as part of the multi-media series Advancing the Status of Women & Girls, Families & Communities: Policy Recommendations for the Next U.S. President.


Depression is Prevalent but Prevention Programs Are Limited

According to the World Health Organization, depression is the leading cause of disability worldwide—it is the most common psychiatric disorder in the U.S., and is particularly common among lower income populations, and among women beginning in adolescence. The average age of onset for depression is 15, and about 20 percent of all people will have experienced an episode of depression by the end of adolescence. Youth depression is associated with a host of negative and long-term consequences, including poorer school performance, difficult peer and family relationships, increased risk of substance abuse, and poorer functional outcomes in adulthood. Of particular note is the connection between youth depression and suicide. Although not all people who commit suicide were depressed at the time, depression and suicidal behavior are indeed linked. Suicide is a tremendous problem in the U.S. and is the second leading cause of death among American adolescents.

Although depression is among the most treatable of all mental illnesses, and although we have evidence-based treatment approaches for depressed youth, the reality is that only about half of all depressed children and adolescents ever receive treatment, and only about half of those who do receive treatment actually improve as a result. Nearly all of those who recover from depression will experience a subsequent depressive episode within a few years. Specifically, 40 percent of youth who have experienced a past episode of depression will relapse within two years, and 75 percent will relapse within five years. This means that a typical 15 year-old who develops an episode of depression, if she is fortunate enough to receive treatment and benefit from it, will experience another depressive episode while she is graduating from high school and transitioning to adulthood.

Although nearly one in five young people experience an episode of depression by the end of adolescence, treatment protocols for youth depression only help about half of those they target, and relapse is common and debilitating. Funding for depression prevention efforts is limited, and preventive programs are difficult to access.

Promising Prevention Efforts

Youth depression is a problem of major proportions, affecting millions of children and families and interfering with children’s social, emotional, and academic functioning. Although evidence-based treatments for youth depression have been found to work well, treatment resources often are difficult to access. Most adolescents who recover experience relapse, and the long-term consequences of youth depression are significant.

Recently, promising research has suggested that depression is among the most preventable of major mental illnesses. We now know of strategies that work to prevent youth depression, including providing cognitive behavioral interventions to adolescents at high risk and helping youth to strengthen social relationships. Based on this research, many European colleagues now encourage a focus on preventive efforts for youth at risk for depression. Although funders and policymakers in the U.S. support preventive efforts for medical concerns, such as healthy eating and exercise to address heart disease, prevention, unfortunately, is often overlooked in mental health. Researchers, policymakers, and practitioners should focus attention on identifying youth at risk for depression, providing evidence-based preventive interventions to at-risk youth and families, and assisting at-risk youth in accessing preventive and/or treatment resources, as needed.

Approaches & Recommendations

Recommendations for enhancing a focus on the prevention of youth depression include:

  • Increase use of depression prevention interventions by increasing funding for research. Although several depression prevention interventions have been found to decrease the onset of depressive symptoms or disorders among at-risk youth, such programs are still not readily available in community-based mental health settings, and many practitioners do not know how to implement evidence-based protocols. More funding is needed for large-scale effectiveness trials that examine ways of disseminating evidence-based interventions in real-world settings and for large-scale trials that compare the efficacy of different evidence-based programs for different populations.
  • Attend to family processes that influence depression risk and that promote depression prevention. Research suggests that parental depression is a significant risk factor for depression onset in youth, and that family processes both maintain and may help alleviate depression. Policymakers, funders, and practitioners must attend to the important role of families in identifying and supporting youth at risk for depression who are appropriate for preventive efforts. In addition, interventions to prevent youth depression may benefit from a focus on enhancing family understanding of youth depression, improving parenting skills, and also on addressing parental depressive symptoms that may affect the efficacy of interventions targeting at-risk youth.
  • Integrate youth depression prevention efforts into places where youth are most readily accessed. Efforts to prevent youth medical concerns are an established focus of public health strategies, resulting in, for example, vaccinations from physicians and auditory screenings Integrate youth depression prevention efforts into places where youth are most readily accessed. Efforts to prevent youth medical concerns are an established focus of public health strategies, resulting in, for example, vaccinations from physicians and auditory screenings at school. Unfortunately, routine screening for depression and suicide risk is generally overlooked both in primary care and in schools, although these are the places that youth are most readily accessed and serviced. Policymakers, funders, and practitioners must support additional training for school and medical personnel in identifying at-risk youth, evaluating youth for mental health concerns, and connecting youth to appropriate mental health services. Additionally, research is needed to evaluate primary care and school-based depression prevention interventions, so that, when at-risk adolescents are identified, evidence-based depression prevention services are readily available in locations that are comfortable and accessible to those in need.

Tracy Gladstone, Ph.D. is an associate director and senior research scientist at the Wellesley Centers for Women as well as the director of the Robert S. and Grace W. Stone Primary Prevention Initiatives, which focus on research and evaluation designed to prevent the onset of mental health concerns in children and adolescents.

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Views expressed on the Women Change Worlds blog are those of the authors and do not represent the views of the Wellesley Centers for Women or Wellesley College nor have they been authorized or endorsed by Wellesley College.

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