As the coronavirus continues to upend our lives, local therapists are adjusting to an intense new era. They’re still on the job even if they’re sitting at home instead of an office, talking to a patient via Zoom or Skype.
“We are working. In fact, we’re as busy as ever,” said psychologist Katherine Nguyen Williams, an associate clinical professor at UC San Diego who treats children, their families and college students.
In an interview, Nguyen Williams talked about what she’s seeing – plenty of stress and anxiety, but also actual relief among some patients whose burdens are being lifted, at least for a moment. She highlighted strategies to help us cope, and she offered tips to parents about how to help their children get through this tough time. “Kids do better,” she said, “when their parents model resilience.”
How are your patients with depression doing?
We’re definitely seeing a significant uptick in their severity of symptoms. It’s especially concerning because one of the treatments for depression is essentially getting outside.
Part of depression is staying home and isolating because you don’t want to do anything. You don’t talk to friends, and you don’t do things that are enjoyable to you. Now, people are being told we need to stay home, and we need to isolate.
What do you tell these patients?
We really have to think outside the box. Call up friends on Zoom, Skype, Snapchat or Instagram Live and chat for an hour or two. Or, like some of our younger kids, play video games where you play with each other remotely.
Another strategy is to engage in activities that make you feel effective and make you feel good. We help our patients to identify any kind of hobbies or activities that they may have put aside in the past and haven’t had a chance to get around to.
How do you help patients who are experiencing a lot of anxiety?
We talk about focusing on today as much as possible. What can we do today that can help us to stay present? We’re seeing a lot of resources about mindfulness things like visual guided imagery and progressive muscle relaxation that help people feel calmer.
How do you help kids become mindful?
Kids love digital screens, and there are great age-appropriate videos about mindfulness. One of them features an ambiguous animal – a monkey or a frog – that shows kids  how to do what’s called Five Finger Breathing. It’s essentially a mindfulness technique to help slow down the kid’s breathing.
When kids get anxious with thoughts like “There’s a virus coming” or “Grandma’s going to die,” their heart races, and their breath gets really shallow. This causes them to feel even more anxiety, and kids can hyperventilate and continue to feel anxious. One very quick and easy strategy is to teach them how to slow down their heart rate and to have deeper breathing diaphragmatic breathing so that they can feel in control of their own bodies. That way they don’t panic, and they don’t go into fight-or-flight mode.
What about people with social anxiety who don’t want to be around people in the first place?
I’m actually seeing a decrease in some of their anxiety because they’re no longer being forced to go to school or to be in situations that make them anxious like soccer or karate class. Their social anxiety has decreased significantly.
How are kids with conditions like ADHD doing now that they’re stuck at home?
Surprisingly, some of these kids are doing better at home because they aren’t required to follow routine. If you’re highly distractible and impulsive, for example, it’s difficult to have to do your assignments at the same time that everybody else does. Now you’re home, and it’s just one-on-one teaching with your parent, you have more time, and you can do it maybe after a nap or after you have lunch. And if you don’t finish your assignments, you could go outside and run around and come back and finish them.
On the other hand, you may have kids who are being disruptive and disrespectful with their parents, who are trying to manage their own stress.
What can parents do to help their kids during this difficult time?
Kids do better when their parents model resilience.
Let’s say you’re a parent who’s really freaked out because your spouse is going off to the hospital and exposing himself or herself to danger. Or you lost your job or you’re now you’re being told to do your work from home and it’s highly stressful.
Model your coping skills. Tell them that “Mom’s feeling really tired today. I want to make sure I get good night’s sleep tonight.” Or “I’m going to go for a walk or take deep breaths now because it helps me to feel better. It helps me to calm down.”
With my four kids, I’ll do progressive muscle relaxation and some deep breathing. I tried to get them to do that with me yesterday, but only two joined me. But that’s OK. The other two kids know that if you’re feeling stressed out, there is a coping strategy — something that you can do to make yourself to help yourself feel better.
For them, it might be something different. But at least they can see that Mom is doing something.
What should we all watch out for in terms of our own mental health?
Keep an eye out for any new or worsening of behaviors or symptoms that impair functioning. For example, if you’re anxious, is your anxiety getting so bad that you’re losing your appetite, or you’re not able to sleep or focus on school or work? That’s when you need to get help.
During this crisis, mental health therapists are considered essential services. A lot of therapists are providing telemental health [services via phone or video such as Skype and Zoom]. Many insurance companies have now agreed to pay for these sessions, and some therapists are volunteering their time.
We are working. And, in fact, we’re as busy as ever.