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“Your health is paramount”: The mental health of health care workers during COVID-19

Stanford mental health experts offer tips for handling the uniques stressors faced by health care workers treating patients during the coronavirus pandemic.

"I don't want to get this virus. I'm young, but young people still get the virus," began the first call-in comment from a health care worker participating in a Stanford Medicine webinar on anxiety and caring for COVID-19 patients.

The comment was one of many from approximately 600 participants in a recent video conference moderated by Tait Shanafelt, MD, Stanford Medicine's chief wellness officer. Shanafelt, along with three mental health specialists from the Department of Psychiatry and Behavioral Sciences, offered tips and advice for health care workers providing care during the COVID-19 pandemic. 

"This reaction is normal," Shanafelt said, in response to the participant's comment. "If there is one take-home from this webinar, it is that you can let go of anxiety about anxiety. It's a common response, and there isn't something that is wrong with you."

Health care workers, often independent to a fault, can find it extremely difficult to ask for help, said psychiatrist Mickey Trockel, MD, PhD.

Despite this independence, though, they're not immune to added pressures of the pandemic -- both on a personal and professional level, the experts told their audience. Health care workers, too, worry about their families, about getting sick and being quarantined. They, too, face social isolation and fears about the future. 

"All of this worry can lead to feelings of guilt," said psychologist Cheryl Gore-Felton, PhD. "This can lead to moral distress, resulting in lower efficiency and contributing to a lack of sleep."

Accepting that it's normal to feel anxious and stressed in times of overwhelming situations can help prevent such emotions from spiraling out of control, she said, adding, "Remember: Your health is paramount."

Psychologist Debra Kaysen, PhD, said that early reports from a study of health care workers in China, where the pandemic first began, showed that 50% experienced symptoms of depression and anxiety; one-third suffered insomnia; and 75% reported distress. Those most at risk of suffering these mental health issues were workers on the front lines, such as nurses.

Skills to help navigate the mental health landmines include knowing when to turn off the news, when to schedule a break, and when to take time off to watch a movie, read a book or exercise. Talking to others about worries, or learning self-calming practices, such as mindfulness meditation, also can help, the experts said -- though they acknowledged that finding time away can be difficult, with so many competing demands.

"Even just take the time to take a deep breath," Kaysen said. 

Questions from participants ranged from how to control anxiety to how to deal with the stress of being at work while loved ones are at home. They also asked for tips on how best to talk to patients with the disease and their family members, all of whom struggle with their own anxiety.

"Speak slowly," Gore-Felton said. "They may be so anxious in the moment that they can't take in all the information. Answer questions as accurately as you can. And listen."

Participants also asked how to deal with feelings of helplessness and grief from witnessing the suffering of severely-ill patients. 

"These are common feelings," Gore-Felton said. "They're similar to the feelings of helplessness in war time. But you just being there tells me about the empathy that you have. That's a powerful thing for patients. What you're doing is not nothing. It is something very valuable."

The webinar was part of an ongoing series on coping with COVID-19, sponsored by Stanford Medicine's psychiatry and behavioral sciences department and its WellMD Center. More resources for health care workers can be found here.

Photo by Ani Kolleshi

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