Mental Fitness During a Pandemic – PediaCast 458

Show Notes 

Description 

  • Parents and children have many feelings these days, including anxiety, anger, depression and disappointment. These are normal responses to our new reality. We explore the feelings and share practical tips for weathering the storm. Gina McDowell, clinical counselor with Big Lots Behavioral Health Services, is our guest. We hope you can join us!

Topics 

  • COVID-19 
  • Coronavirus Pandemic 
  • Mental Fitness
  • Mindfulness

Guest

Links 

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 1: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone. And welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from my house in Columbus, Ohio. 

It is Episode 458 for April 1st, 2020. We're calling this one "Mental Fitness During a Pandemic".

Our pandemic coverage continues this week as we, the inhabitants of planet Earth, billions of us stay home as we try to flatten the curve and prevent our healthcare systems from being overrun and in the process, hopefully, save millions of lives. 

0:01:13

That effort is working better in some places than others. New York City and Italy and Spain are impacted tremendously right now, and our hearts and prayers are extended to you along with families everywhere, in every city and state and country that has experienced loss from this terrible disease. 

Now, we have been chronicling the COVID-19 pandemic on PediaCast for a while now. We started back in Episode 455. That episode was called COVID-19: What You Need to Know. We talked about the  SARS-CoV-2 virus, really some science in that one, we explained exactly what it is and what it does in the body. And then, we also explored COVID-19 disease. So, if you want sort of a foundation of what's causing the pandemic, what causes the disease, be sure to check out Episode 455.

0:02:08

And then, in 456, we talked about social distancing or really, I'd like to call it physical distancing, because we can still be social through digital means as we are quickly learning. But we talked about social distancing, the concept of what that is, and how that relates to flattening the curve and why that is important. We covered the in Episode 456.

And then, in 457, we just talked about our new routine as parents and families and what it means to stay home, what does life look like. And some of that you know, what it looks like from very up-close personal experience. But I think it's good to hear how does it look for others and then you can say, "Hey, we really are all in this together. It's not just our family who's going through this."

And I'm making a collection of all of our COVID-19 pandemic episodes in a playlist over on SoundCloud, so you can find all of them together in one nice bunch. Of course, if you subscribe to the podcast in your player, you'll have all of them because they're all back-to-back episodes. But just trying to make it easy for you to listen to all of the content that we are producing related to COVID-19 disease and the current pandemic. 

0:03:20

This week, we are going to consider mental fitness in the wake of this pandemic. And I toyed with calling this mental wellness, but the problem with that is we are not mentally well right now. And that's an okay thing to admit, it's okay that we are not well. 

Mental wellness many not really be achievable at this moment in time. But what we can do is strive for mental fitness, even as many of us and our children and families are being squeezed from every direction. There is uncertainty and anxiety from the disease itself, as we worry about the health of our family and loved ones. 

Many folks have lost jobs or worry that we could soon lose a job. We're stuck at home, sometimes in less than ideal situations. For some folks, it may even be a dangerous situation. Food and supplies may be dwindling with fear to go out and get more. Bills are due.

0:04:17

Our children are restless. Many are scared and asking lots of questions that we ourselves may not know the answers to or how best to explain. 

So, it's a lot of pressure, right? In a matter of just a few weeks, our world has literally been turned upside down. So if you are feeling worried, anxious, uncertain, angry, outraged, confused, disappointed, depressed, or pretty much any other feeling, including several at the same time or waffling between them from one hour to the next -- I know I do that often -- let me encourage you by saying you are not alone. 

In fact, there is no normal response to a situation like this. We are literally making it up as we go along. And you, moms and dads, you are doing a great job, even when you don't feel like it. You're doing great. You are the rock of stability that your children need, even when you don't feel stable. There you are, not giving up, marching on with the most important job in the world, being a parent. 

0:05:19

So today, we're going to focus on mental fitness, how can we become more mentally fit as we deal with these emotions and feelings and the actions that kind of flow out of these feelings during this COVID-19 pandemic. We're going to chat with Gina McDowell, she a licensed professional clinical counselor with Big Lots Behavioral Health Services here at Nationwide Children's Hospital. 

And we're going to talk again about these feelings and ourselves and then our kids, how to best respond to them in a healthy way. We'll talk about routines and maintaining relationships and supporting those we love and practicing the very important job of self-care. 

So that's all coming your way shortly. First though, our usual important reminders. It's important for us to protect our family and our loved ones from COVID-19 disease. And you can do that by following just a few very simple instructions. 

0:06:14

You really want to pay attention to your local public health officials and what they are telling you to do and following those directions. And those will be available at their website or their social media platforms.

Here in Central Ohio, we are following Columbus Public Health, Franklin County Public Health, and Ohio Public Health. And it's easy to find the websites and have just all the directions that we in Central Ohio should be doing. And wherever you are, make sure that you look up what your public health officials are recommending. 

We want to be washing our hands frequently. Soap and water is preferred. Alcohol-based hand sanitizers will work in a pinch. But you want to make sure you lather for 20 seconds. Do it always, 20 seconds is going to be your best bet. And pick a song that will last that long. We're provided some examples for you in past episodes. 

0:07:06

Be sure to cough or sneeze into the inside of your elbow or tissue. Throw away the tissue and then wash your hands. And teach your children to do that as well. Always wash your hands after you cough or sneeze and avoid touching your face with unwashed hands.

Clean and disinfect commonly touched household surfaces every single day with a disinfectant. And that includes countertops and tables, doorknobs, light switches, sink faucets, and toilet handles. Remember, if you don't have any symptoms, you could still be shedding the virus and so, it is important to clean those surfaces.

Absolutely no physical contact with at-risk folks, even again if you were seemingly healthy. And by at-risk, we're talking about those who are over the age of 60, folks with heart disease, lung disease, cancers, the immune system problems, and regardless of their age if they have those chronic health conditions. 

0:08:04

So you want to stay physically apart, especially from at-risk folks. But remember even if you are around people who are not at risk, if you have very mild symptoms or no symptoms at all, and you give the virus to them, and they're healthy, they're young, they also have no symptoms, but then they give it to another person who then gives it to someone who is at risk. So, you really do need to stay apart and maintain physical distancing at this time with pretty much everybody except those in your household. 

But we do want to use digital technology to check in with our loved ones, our friends, our co-workers, family. Keep them company. Find and meet their needs as best as you can because we are all in this together. And as much as we want to beat coronavirus, we also want to stamp out loneliness and anxiety and depression to our best ability. And connecting with people is certainly one way to do that. So those are the most important ways that you can protect yourself and your family and your loved ones from COVID-19 disease. 

0:09:07

Now, what do you do if your child gets sick? If they have mild symptoms, even with fever that's just there for a couple of days, rest, fluid, fever reducers are going to be important. But if you are worried, if your child has a really high fever, it's been there for more than a couple of days, your child is a young infant, any concern, I always say if your mom and dad radar goes off, like "I'm really worried," don't sit at home and worry about your child's health. Call your child's medical provider for guidance. 

And if you don't have  doctor, often, your nearest children's hospital probably has a referral service. You could also try contacting your local health department. They may have an idea of who could use for primary care. And lots and lots of doctors now are turning toward telehealth as a way to still maintain distancing but get you and your family the medical health that they need. 

0:10:01

A couple of other reminders before we move on to our interview. Don't forget, you can find PediaCast in all sorts of places. We are in the Apple Podcasts app, Google Podcast, iHeart Radio, Spotify, SoundCloud and most mobile podcast apps for iOS and Android.

Reviews are helpful wherever you listen to the program. We always appreciate when you take a moment to share your thoughts about the show. And we love connecting with you on social media. You will find us on Facebook, Twitter, LinkedIn and Instagram. Simply search for PediaCast. 

If you have a comment for the program or a topic you'd like us to discuss, it's easy to let me know. Just head over to pediacast.org and click on the Contact link.

Also, I want to remind you the information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call or contact your doctor. 

Also, your use of this audio program is subject to PediaCast Terms of Use Agreement which you can find at pediacast.org. 

Let's take a quick break. We'll get Gina McDowell connected with the studio and then we'll be back to talk more about mental fitness during a pandemic. That's coming up right after this.

0:11:09

[Music]

Dr. Mike Patrick: Gina McDowell is a licensed professional clinical counselor with Big Lots Behavioral Health Services at Nationwide Children's. She's here to talk about mental fitness in the wake of a worldwide pandemic which is keeping billions of people across the planet at home, and yet the job of being a parent does not stop. We just have to add the stress on top of everything else. 

0:12:08

She's going to walk us through the impact of that worry and how we as parents can best respond. But first, a warm PediaCast welcome to Gina McDowell. Thank you so much for joining me remotely today. We are social distancing.

Gina McDowell: We are social distancing. Thank you so much for having me. 

Dr. Mike Patrick: Yeah, really appreciate you taking the time to talk with us. I think this is something that parents have really had to figure out how to do this sort of on their own. And they've already been doing it for two to three weeks. And one of those things is just how, what are best practices for approaching this whole pandemic and talking with young kids about it? 

I mean, they have lots of questions. Parents have already fielded these questions. How should we really engage our kids in talking about what's going on in the world? 

Gina McDowell: I think that's a great question. And you're absolutely right. We have these conversations with our kids because they've been impacted by those change. But parents definitely want to be mindful of how they approach this conversation with younger children. 

0:13:12

There can be a significant amount of information released about COVID-19 and there has been, you know, depending on if your child's on Internet or watching TV, whatever it might be, but depending on the developmental level for that child, they might be able to understand all of it. They're kind of seeing how we're reacting though and knowing that their routines have all been disrupted and a lot has changed. So, it's really valuable to have this talk.

Having said that, I think parents will first want to think about what it is they like their children to know and what they want to accomplish with that conversation. I recommend making a list of topics that you want to cover with your child ahead of time and then figure out how you might be able to break those down in a way that they will be able to understand depending on their age and developmental level.

0:14:01

So, for example, when we're trying to explain social distancing to a pretty young child, that can be a hard concept to explain why we're doing this when we haven't done it before. So that might look something like, "There's a really achy bug going around and our family's going to do our part to help fight it and keep everyone healthy. So, for a little while, this might mean that we want to make sure we stay at least two arm's length away from each other so germs can't be spread." So that might be a way to explain that two feet rule and why we're doing this for a younger kid. 

The goal of this conversation should be to provide kids with the basic information about COVID-19 and how to stay safe, while leaving out some of those scarier details that might not be necessary depending on their age. 

It's probably helpful as well to talk with kids about how their routines will be changing so they know what's coming. This will help them prepare when they aren't able to return back to school or have their usual playdate, things like that. 

0:15:02

Dr. Mike Patrick: And this is an ongoing conversation, right? You don't want to make that list of topics and like "Let's sit down and talk for half an hour," but really kind of just as things sort of organically and naturally come up, sort of try to hit those things over the course of a period of time. 

Gina McDowell: Absolutely. I would say updates or brief check-ins, I think always also checking in with them giving the opportunity to ask you questions or share their feelings about how things are going, how they're feeling about the situation. You might not know all the answers to their questions and that's okay. 

They kind of gives you an idea of where they're at and where they're coming from. So I like the idea of kind of doing these check-ins and giving updates as needed. Like, "You know what, we're actually not going to be able to go back to school after, about that."

Dr. Mike Patrick: Yeah, absolutely. And how you're feeling about it. 

Gina McDowell: Yeah, give kids that safe space to talk about what they've experienced throughout all of this and the stressful time and let them know that that's okay. 

0:16:00

Dr. Mike Patrick: So, what you've described is kind of the best-case scenario if you could start this at the beginning of the pandemic. So now that we're two to three weeks in, there's going to be some parents out there that like, "I lost my cool." Like, "I maybe told them more than I wanted to and maybe I scared them," or, "Maybe there's more anxiety now in the family."

I guess the good thing with young kids is that they're pretty resilient, right? 

Gina McDowell: Yeah.

Dr. Mike Patrick: But what can parents do it they feel like they've already maybe crossed that line and didn't do it in the best way?

Gina McDowell: I think what they could start off by doing is with the information that they've given is really checking with the child's feeling and emotions, where are they at? Are they feeling really really anxious? Are they feeling really scared? 

And I would think, first thing, validate that. Validate that, let your kids know that it's okay to feel whatever they were feeling. And then kind of start to start to shift things a little bit, help kind of guiding them to that positive aspect. 

0:17:02

So maybe even something like, "Hey, what are the positive things about being able to stay home? What are some benefits of being able to stay home?" 

And then, I think when it comes to identifying activities and things that kids can do, let them be part of the brainstorm process. And I think it really just shifts the mindset little bit. It provides a little bit of instruction too and that's good right now. 

And I think it's important for parents to remember to remain calm. If we start to panic, they're probably going to follow suit. So if we can remain calm, if we can reassure them that, "Hey, we're going to get through this together," and then start to shift that mindset about what's the positive part of this, what are we grateful for today? And help kids kind of shift fears in that way.

Dr. Mike Patrick: Yeah, that's really good advice. I mean, kids are pretty forgiving and what happened a week ago, especially if you change the tone of the conversation can really change things. 

Gina McDowell: Absolutely.

0:18:06

Dr. Mike Patrick: That's great. Now, for the older kids who are going to have a lot more questions and they're going across information in ways that you may not even know about through the Internet and social media and whatever they're watching. But they're also going to have feelings of anxiety and depression and really being upset about all of this from multiple angles. What's that best way to engage with our older kids and teenagers?

Gina McDowell: I think you're exactly right. They are exposed to more information because of the Internet because of peers and just being in the media altogether. I think those conversations with teens might look a little bit different. I even looked at some of them might even be a little bit of myth-busting information they may have heard. 

I would say those conversations I want to know, what is it that you've heard? What is it that you know and how are you feeling about that? And let's talk through that. So those are going to be a little bit teen led. 

0:19:09

I think as a caregiver, you can make sure that you're aware of the facts yourself. So if there are things that come up and let you know, you can kind of say, "Actually, here's what I've read on the CDC website," or whatever that might be. So, giving teens some hard facts that they can look into.

I think with the teens, validation is going to be really, really important because the thing with them is too, that it's not even just being out of school but they're not able to see a lot of their peers. Some of them have had major school events that are canceled, proms and things of that sort. And that's hard, that's really really hard.

So, for your teen, I would say more -- I know you mentioned this before -- more of an ongoing conversation. Checking with them and I would say keeping them in the loop about the updates that are going to impact their schedules and their routines. And it might even lessen some of that anxiety about the unknown because that's where a lot of our anxieties come from. We just don't know it.

0:20:11

So being able to kind of give them those updates as you get them and then giving them that space to process. Create that space that they can tell you, "You know, yeah, I'm really mad about this." I get it, I get it.

Dr. Mike Patrick: And allowing them to have those feelings. 

Gina McDowell: Absolutely, absolutely. 

Dr. Mike Patrick: What are some of the other feelings that, so I mentioned anxiety. I mean, there may be depression. What other feelings are normal or not just for kids but for all of us?

Gina McDowell: All of us?

[Laughter]

Dr. Mike Patrick: To have right now?

Gina McDowell: I actually read something. I saw something the other day that said there is no right way to feel right now. And I thought that hits the nail on the head. I don't think we can even define what would be a normal reaction right now. I'd say, there's probably a good deal of anxiety like we said, around the change and the information that we might be seeing, and the media. 

0:21:05

I think there's some sadness and a little bit of grief for a loss of our normal routines and the things that do help us cope on a daily basis. Little irritability, we're stuck inside a lot more, distanced from friends, things like that, both the parents and children. 

Disappointment, I see a lot of things that are canceled and things we aren't able to do. And we might even in kids see a little bit of an increase in some behavioral concerns due to several things, but significant disruption in routine and structure, or even boredom, when I've exhausted my list of activities for the day.

You might even see some of that. The point there is that no two children are really going to react exactly the same. So, it's important to give that space to process those thoughts and feelings and see what's going on for that kid. But those are some of the things that I would imagine we see but there's no right way to feel right now. 

[Laughter]

0:22:05

Dr. Mike Patrick: Yeah. And I love that you would tie that to behaviors that we see because sometimes we don't really know how to express our feelings, and especially feelings of anger and disappointment. We may not even realize that those feelings are there, but we still act out through those feelings.

And so when your kids are really acting out and not acting like their normal selves, and as a parent, you're pretty anxious about everything that's going on, and the fact that you can't provide what you want to provide for your children, you  could see that conflict could really well up easily.

So, I think, as you said, give each other space and have a lot of forgiveness for behaviors right now, right?

Gina McDowell: Absolutely. I think, because I think parents are probably guilty of this just as much right now when it comes to behaviors because I could see even as adults, our routines have been shifted. And adults are feeling really overwhelmed right now for everything that they're having to jumble since school is out and daycare might be close and those types of things.

0:23:11

So, parents are probably even a little bit more irritable now and maybe, yeah, a little more than usual. They're finding it a little more difficult to remain calm and possibly a little more slide these days just because there's such height in stress levels. I think you're right, it's just a matter of we know that this is a product of a really highly stressful time. Just being aware of that. 

And I was talking to somebody the other day, and I say, you know, everybody, most people are going to have some things that they're like, "I shouldn't have said that or I wish I would have handled that different."

This can be nice family activity, actually. At the end of the day, have everybody give maybe a couple feelings words, how they're feeling today. Like what we're your main feelings for the day and maybe having a little bit of accountability in there. So, what's something that you did really, really well today, you handled really well? And what's something that you want to work on and improve tomorrow? 
 
0:24:11

And I think that's really nice for kids and parents to be able to do because that also models like, "Hey, you know what, we're not perfect and we're all under a lot of stress right now. And we're not going to be better tomorrow." 

Dr. Mike Patrick: And maybe get an idea from the child's point of view, like what did you perceive that I did that you liked today? What did I do that you didn't like, and how can we maybe change things? So, I think I love that, like a little family meeting at the end of every day I think is a really good idea. That's fantastic. 

A lot of kids went into the pandemic with anxiety, depression, ADHD, just pre-existing mental health stuff that then you add a pandemic and we have to stay at home and our routines are changing on top of that. Talk a little bit about those kids who are already maybe seeing a counselor or a psychiatrist or they're on medications, and things aren't working out well at home. What additional things do parents need to know for those kids? 

0:25:13

Gina McDowell: I mean, definitely, keep up with your services right now. I think that that's really important. I know a lot of things are shutting down so there's been confusion, and still, "Well, am I still be able to receive my mail home services or meet with my counselor or psychiatrist?" whatever it might be. But reach out to that, to your provider, and talk with them a lot of places have been shifting to telehealth in order to continue providing and serving families and the community for that reason. If we were working through something prior to this, this could definitely help.

So, come up with a plan with your provider, with your child's provider. This might be a nice thing, a nice thing for your child to work through with their counselor and potentially you too as a caregiver depending on their age. But just coming up with even a plan of like what are some coping skills that I can use throughout the day? Chances are they've worked on that before and identified some things that work.

0:26:12

So, what are the things that I can do when I'm feeling afraid and anxious, sad, fearful, whatever it might be. So, I think really working with your provider to develop a good toolbox of coping skills in the event of a mental health crisis. So something that goes beyond what an outpatient, what outpatient visit might entail or be able to handle. 

Know what your resources are for any event of a crisis. We do have the Franklin County Psychiatric Crisis line that is available 24/7, should you need to consult with a mental health professional. Children can call it. Parents can call it. And they can help guide the decision on what to do next based off of what you report.

0:27:02

Also, if you are in the area, if you are in the Columbus area, we have the Psychiatric Crisis Department at our Big Lots Behavioral Health Pavilion that serves as type of urgent care for mental health needs. So that is open 24/7 as well. If you're outside of the area, nowhere nearest emergency room is, then there is always 911 during the crisis. So just know what the resources are. 

Dr. Mike Patrick: What sort of crisis would lead someone to want to take their kids for immediate help like that to, like the Psychiatric Crisis Department that we have here at Nationwide Children's or a local emergency department? So, what sort of things are we talking about?

Gina McDowell: I could see the main things that we see is if we've reached the point at home that your child is a potential harm to themselves or others. And if you feel like you are not able to keep them safe or they feel they're not able to keep themselves safe, that's when we want to reach out for help and we want to get them into the right services and get them to the right place. We can get them help and we can get them safe and stable and work through that crisis. I would say that's the biggest thing that we would.

0:28:15

Dr. Mike Patrick: And it is okay, right, to talk about these things, especially with our older kids to talk about "Hey, do you have thoughts of depression? Have you thought about hurting yourself? Have you thought about ending your life because of all of this?" And talking about that in an open and transparent way is not going to put those thoughts into the kids' head, right?

Gina McDowell: Absolutely not, the literature show that it does not. And we talked to parents about that a lot. We're actually doing more harm by not asking. Just because we ask, that does not put the thought in the child's head. So by asking these questions, we can intervene early, so that these aren't slipping through the cracks. And we're not getting to the point of a crisis that might be something that they may be able to handle at home or work with our outpatient provider on that.

0:29:04

So absolutely asking those questions. And when we ask them as parents and caregivers, if we're comfortable doing it, our children will become more comfortable with having those conversations, too. So, you're actually increasing your chances that your child will come to you then if they start experiencing those types of feelings and thoughts.

Dr. Mike Patrick: Yeah, great points. For those who are in the Central Ohio area, I do want to point out that just recently our Big Lot Behavioral Services, that Pavilion opened, and we do have that Psychiatric Crisis Department. I'm going to put links in the show notes for this episode, 458, over at pediacast.org, so folks can find that easily. 

One thing I think it is important for parents to understand is that if you're going to take your child to the emergency department for mental health or behavioral reason, if they do have an injury that would need to see a medical doctor... So maybe they have tried to hurt themselves or maybe they swallowed something or have cut themselves, so they have lacerations, then you want to go to the regular emergency department if there's a medical issue. 

0:30:10

If it is strictly behavioral or mental health related, then you would want to use that Psychiatric Crisis Department at the Big Lots Pavilion. And again, I'll put links in the show notes so folks can find that. 

Those who are not in Central Ohio and you're just not sure where to go, obviously, your nearest ER is a possibility. But we also worry that there could be COVID exposures as a possibility in an emergency department. And so, I would encourage folks to reach out to your child's doctor. And they're going to know what resources in your particular area are available. 

And so many primary care providers are switching over to telehealth options now, just so everyone can stay distant but still get the help that you need. And they may be able to do it for you the mental health, telehealth services that you may not even know is available, but because your doctor is seeing all sorts of other kids with the same problems, they will have an idea where to refer you to, right? 

0:31:06

Gina McDowell: Absolutely. And I think that's a really good call out to "We're going to the emergency department right now." There's risk for a lot of exposure. So your child's doctor might even be able to refer if they're in a different county, be able to give you information on the local crisis line that they would utilize or where might be the place to take your child in that area, if there is a mental health emergency. So, I think that's a great point.

And also, if you start noticing that there are symptoms happening already, reach out to see what are the outpatient services that are available in your area because like we said, a lot people are still seeing, they're still taking patients. They'll be switching to telehealth but try to of intervene as soon as possible, as soon as possible. 

Dr. Mike Patrick: And if you do go, if you really have to go to the emergency room, call ahead. Let them know that you are on the way, because they may have a door that they want you to go through where there aren't sick folks. Each place is going to have their own protocol for getting folks in. But this is a time of our lives right now when we definitely want to communicate when we're going anywhere. 

0:32:15

Gina McDowell: Absolutely. Absolutely.

Dr. Mike Patrick: We had talked a little offline before we started the interview about things that families can do. You talked about like a family meeting at the end of the day, but what's some other sorts of routines and activities that will really help families get through this time? It's a time to be creative, right? And what works for one family is not going to necessarily for another. But what are some ideas for helping families through this?

Gina McDowell: I started with routine. I think it's extremely important for families to establish a routine because this can get a sense a structure during this time of rapid change when all other routines have been completely altered. Some families may feel overwhelmed by trying to figure out how are they going to manage time and all of that. Creating daily schedules can actually help organize time and task for the day, relieving a little bit of that anxiety and stress. 

0:33:10

Schedules are going to look different for each child and each family. They're going to vary depending on the developmental level. But caregivers can work in time for schoolwork as well as other activities throughout the day to keep your child engaged. Having a daily schedule also gives them as the opportunity to plan ahead for these activities instead of having to come with some ideas on the fly. 

I think having a mix of fun educational activities and some downtime is usually a good idea. Remember, kids are feeling a good amount of stress as well. And so, any opportunities for children to come back with any of their peers virtually, that might be a nice way to coordinate with other parents. I've seen some really creative ideas online that parents are using FaceTime and things like that. It's pretty neat, so allowing their kids to be able to still stay connected with their peers.

0:34:06

But Nationwide Children's Hospital actually have a blog post that I believe they're going to share. And this has several ideas on how to keep kids busy and engaged throughout this time. But the bottom-line is we'll get creative with this, have fun with it, and engage your child in the brainstorming process. I think that can actually be not even just fun, but also very effective because it gets them thinking too about "What do I want to do with my time?" 

Even though this is a really stressful situation, we can use it as an opportunity to explore new things and then some great connections within the family. 

Dr. Mike Patrick: And the schedule doesn't necessarily have to be concrete week after week after week. Maybe even at the end of the week, have a meeting and what works well this week? What are we going to change for next week? And mix things up a little bit. And I love having the kids have some say in what the schedule's going to look like, too. I mean, obviously, there are boundaries in things that we have to do but letting them have a say will ease some of the anxiety and stress from their point of view as well.

0:35:13

One of the ones that I love was that I came across, and I mentioned this in the episode last week, but in case folks haven't heard it was they had a list of things that kids need to do, like their schoolwork and their chores and all those things. And then they have like Monopoly money. And for each of those things that you do, you earn the money.

And then for the fun things, the entertainment stuff, then you could spend your money, I thought that was kind of a fun way to make sure you're doing some productive stuff and some fun stuff and kids get to make choices based on what they want to pay for. 

Gina McDowell: Exactly, what a great... I think that's great because again, choices are really good because there's not a lot we can control right now. And so, if kids are able to be able to choose from this list, they're kind of like... I saw somebody with a menu that they had created, like a menu of different things and fun activities that they could do throughout the day. 

0:36:03

And I think just giving kids the opportunity to say like, "Yeah, this is what I would want to use my fun time for today." And it gives parents a little bit of ease too, because I know parents, a lot of them, are juggling working from home as well. And so being able to work on those pieces too when having to fit in your own things throughout the schedule. So, I think you need to be strategic about it.

I'm going to have links to several resources in the show notes. You had mentioned from our 700 Children's Blog, How to Keep Kids Busy and Connected at this time during COVID-19. There's also a blog post called How to Talk to your Kids About COVID-19 from 700 Children's. I'll put links to both of those. 

And then, the American Academy of Pediatrics, their site healthychildren.org, they have a couple of interesting articles, one is called Working and Learning from Home During the COVID-19 Outbreak. And another is Talking to Children about Tragedies and Other News Events, which is an article that have there from past events, like mass shootings and things like that. But also, they've tailored it to the COVID-19 crisis. And so, that's another one just to get you some helpful hints in terms of talking to kids.

0:37:17

I want to pivot away from our children for a moment. And we sort of mentioned this a little bit at the beginning of our time together. But there are normal feelings for us as parents, but not only do we have to help our kids work through their feelings, but it's important for us to work through our feelings as well. What are some of the things that are normal for us to be feeling right now?

Gina McDowell: I know the same statement applies, that there's no right way to feel. I would say, I talked with a lot of parents, and the most common things I'm hearing are that anxiety I'm feeling really overwhelmed because parents are trying to process also just everything going on in general. And that would be unknowns and kind of waiting for the next update. But on top of that, trying to figure out this whole new schedule for their families. 

0:38:11

So, I'm hearing a lot of anxiety and a lot of feelings of being overwhelmed. But also, some feelings of sadness and almost mourning the loss of life as we had it, so feeling some of that. But what's interesting is that I've also heard a lot of feelings of gratitude -- and I can say this for myself, too -- a lot of feelings of gratitude for this additional time with family at home. That we're on the go a lot, and many of us are on the go a lot and this is kind of making us have this family time at home.

And so, I will say that I have experienced that myself. And I think it's really great to be able to look at those positive emotions because a majority of what we're experiencing right now is just great pretty challenging emotions and really difficult emotions to process. 

Dr. Mike Patrick: Yeah, it's like Dr. Jekyll and Mr. Hyde. 

0:39:03

Gina McDowell: It is. It is.

Dr. Mike Patrick: There's like joy and you see the positives that will out of this on the other end. And yet, there's just horribleness too all at the same time and it just kind of flip back and forth sometimes between the two. And then, there's the whole financial aspect which a lot of kids... So, we have the same anxieties and stresses and worries that our kids have, and then you have to add folks losing their jobs on top of that and how am I going to pay my bills? And that can make the anxiety and stress even more. 

But one thing is a lot of us really are in this together. I mean, there are just so many people that are losing their jobs that we can't still be social at a distance especially with social media and FaceTime. And it's really important now to not only connect with the folks that are inside of our home but to do so digitally as much as we can with the people that we care and support them outside of the home too, right? 

Gina McDowell: Absolutely. I imagine this briefly, but things are really challenging for adults too, especially if you developed a good set of coping skills. That might include going to gym or meeting new friends for dinner or going and grabbing a coffee, things like that. That's been taken away. 

0:40:17

And we hear social distancing, social distancing, and actually I explained the other day, it's not social distancing, it's really physical distancing. We want to keep up social aspects as much as possible because it's a great coping skill for us. Having a strong support system is important for our mental health regardless of COVID-19 or not.

So, I think, you know, use the technology, this amazing technology that we have now, so things like FaceTime and Zoom and things like that. I've seen lots of really creative stuff like having virtual game nights. I actually have my own virtual coffee date with a friend the other day and Saturday morning. And it was nice to just catch up and to just be able to have that interaction. 

0:41:08

And so, I think the biggest thing to remember is just because we are having to stay at home a little bit more and isolate ourselves does not mean we have to physically isolate ourselves. That doesn't mean we need to socially isolate ourselves from our friends and family. 

Dr. Mike Patrick: And self-care is important, right? I mean, we really need to take time out for ourselves, what does that look like from a parent standpoint?

Gina McDowell: Also, I think work this into your daily schedule because if you don't, chances are, it probably won't happen. I can talk about self-care for days. But this is something that even in our regular routine, sometimes we kind of put in the back burner because we have a lot of other things that we have to take care of. 

Right now, self-care is so important. That might be working in an online yoga class. A lot of places have gone virtual and have ton and ton of things online now. That might mean as a family we go, and we take a walk around the block or maybe you and the dog take a walk around the black. Take your bike out for a bike ride, something like that.

0:42:14

So, I think whatever it is, whatever works for you, reading a book, meditating, work in at least 10 to 15 minutes of that a day. Because it's just as important as us taking care of others. And we are a better parent, we are a better friend, we area a better spouse, we are a better employee when we take care of ourselves. So, I think just keeping that in mind and finding what really works for you. 

Dr. Mike Patrick: Do it for an hour if you can.

Gina McDowell: Oh, yeah. 

Dr. Mike Patrick: I mean, 10 to 15 minutes at a minimum, right? 

Gina McDowell: At a minimum. I would say an hour, I just know that if I say an hour a day, I'd create some... but...

Dr. Mike Patrick: I need an hour. I need hour. 

Gina McDowell: Yeah, I personally, yeah, I need an hour. 

0:43:01

But if you get your family together and go for a walk around the block, you know what, what you thought was going to take 15 minutes, it might be an hour. And it's fresh air and sunshine and an activity, all these things that we know boost up mood, lower our stress levels, things like that. So, if you can work it an hour, absolutely. 

Dr. Mike Patrick: A term that's flying around now is mindfulness. What is meant by the word mindfulness?

Gina McDowell: I love mindfulness. My favorite thing.

Dr. Mike Patrick: Mindfulness, so if you look at the definition of mindfulness, it's really focusing on one thing in a moment without judgement. But I think, when we think of mindfulness, generally speaking, people kind of like picture of the yoga post that I'm sitting cross-legged and meditating. And yes, that's absolutely mindfulness. 

But really, you can make anything mindfulness. So, it's being able to remove that attention on anything else going on and focus on one thing in the moment. So, for some people, it is meditating, it is yoga. Some people, it's going for a run. It might be a crossword puzzle or getting lost in a book, things like that. 

0:44:13

So, you can really truly turn anything into a mindfulness activity if you're willing to pause for a moment. And try to just acknowledge that those other thoughts are there and then just slip them on the shelf for a minute. And when you take that walk, notice the colors of the tree, and the colors of the sky and like the smell in the air and what it feels like. Notice those things and it turns into mindfulness. And that's where you really going to get that great self-care.

Dr. Mike Patrick: Yeah. It's like when you're eating a meal and instead of just chewing it up and swallowing it, like you taste it, you let it sort of linger in your mouth a little bit before you swallow it.

Gina McDowell: Exactly.

Dr. Mike Patrick: We need to do that with life. 

Gina McDowell: We really do, we really do. And it's so funny, we think about there's times we're on that, I'm very intentional, like I'm going to take my walk today and I'm going to intentionally be mindful. 

0:45:06

And it's so funny the things that I noticed even though it's the same path that I take all the time. And the things that we miss because our mind is somewhere else at the time. We're thinking about other things. 

So that time, we really give ourselves that mental break and become mentally fit. It's just work in those times throughout the day that we can do that. And that might not mean you do it once a day. That might mean I'm going to take 10 to 15-minute break from my work and I'm going to go find some sort of mindful activity to practice. And those little breaks are what really going to keep us going and keep us mentally fit. 

Dr. Mike Patrick: If you need a little, if you need a little push into mindfulness, I do have a couple of apps that I would recommend to just help you get some ideas and guide you on your way. And I'm not getting any kickback for mentioning this, I want to make that clear. But there are ones that have helped me and my wife as we've gone this last two or three weeks. 

0:46:09

We actually got introduced to them through our work because we have wellness programs, and so we have gotten some emails about these.  One is a site called Ten Percent Happier.  And they have a coronavirus sanity guide. They have a website, a blog, a podcast, an app. And they're offering free access for healthcare workers during this time. So, I'm going to put a link to Ten Percent Happier in the show notes for this episode, 458, over at pediacast.org.

And then, the other one is Headspace. And they're also offering free support during the COVID-19 crisis. They have a website, a blog, an app, and they have some interesting things there as well. And I'm sure that there are others that are out there. But Ten Percent Happier and Headspace are a couple that I've had personal experience with and have found helpful. So, we'll put links to those in the show notes. 

And then, we also mentioned another thing that's going to be important is to arm yourself with good information. There's a lot of sensational stories out there. There's a lot of ways that statistics are skewed to cause certain reactions and to get more viewers and more reads and headlines. And so, you really do want some good sources of information. 

0:47:17

Of course, the Centers for Disease Control and Prevention, the cdc.gov is going to be a useful site to get really good information. Also, your local health department, so here, Columbus Public Health, Franklin County Public Health, and the Ohio Public Health. And of course, our public health officials have just been so wonderful in all of this. But check, wherever you live, check your local public health department. 

And then, we've done three COVID-19 related podcast prior to this one. The first one is What You Need to Know, Episode 455. Another one on social distancing, which really is physical distancing, not social distancing and flattening the curve. That was Episode 456. And then Our New Routine was last week, 457. We're talking mental fitness this week. 

Next week, we're going to cover physical fitness and exercise with some of our sports medicine folks here at Nationwide Children's, so stay tune for that in the coming week. And I'll put links to all these things in the show notes, so you can find them easily. 

0:48:14

All right, well, Gina McDowell, we just thank you so much for stopping by today. Tell us very quickly about the Big Lots Behavioral Mental Health Services here at Nationwide Children's and that new Big Lots Pavilion that we have.

Gina McDowell: Yes. So, I'll start with the Pavilion because I think the Pavilion kind of serves as a symbol for what we are trying to accomplish for Behavioral Health Services. But the Big Lots Behavioral Health Pavilion just opened  up on March 10th and it's amazing. We have lots of levels of care within the Pavilion. Nine stories high, we have things built in that are meant to enhance mental wellness. 

So even things like outdoor play spaces for children that are staying in the Pavilion that, you know, they can get fresh air, get sunshine, those sorts of things. And it has courtyards for families because it's just stressful for the families. They're experiencing crisis, too.

0:49:11

So, the Pavilion really serves as this cornerstone in our efforts to break stigma around mental health. It's funny because it's mental fitness this week and then talking about physical fitness next week. And they're so interchangeable, right? Physical and mental health, they're so connected.

So, our aim is to break the stigma around mental health. And as amazing and huge and beautiful as the burden is, it's interesting because it actually only contains 9% of our behavior health service fund. And so, the majority of services actually continue outside of the walls of the Pavilion. And we have multiple programs, levels of care, outpatient services, as well as community-based services, psychiatry. 

0:50:06

We have an inter-professional team of folks that work throughout  Big Lot Behavioral Health Services. And so, we are just really dedicated to the treatment of not only the children but the families as well and helping them help and cope and just work through whatever it might be.

Dr. Mike Patrick: We're very proud it is the largest free-standing building dedicated to mental health services for kids. And if this crisis was not going on, we would be talking about it. And it would be like, "Hey, look at what we have. This is a great place." 

But what the pandemic has done is instead of highlighting  what we've done and saying, "Yay, me," we're actually using what we've done, right? I mean, what better time than during a worldwide pandemic to really serve the mental health of children and families with this fantastic program that we have in this new pavilion. Not that we will wish a pandemic on people.

[Laughter]

Gina McDowell: No.

Dr. Mike Patrick: But it really is useful at this time. 

0:51:13

Gina McDowell: I mean, we're just really proud of it and we're just so grateful that we've been given this opportunity to open a building that is dedicated solely to helping mental health clients. And so, we're just really, really proud and grateful. And can't wait till we get more time to spend in it once we can go back to normal routines. 

Dr. Mike Patrick: Yeah, in the same room with all of us together.

Gina McDowell: Yeah.

[Laughter]

Dr. Mike Patrick: All right, well, Gina McDowell, licensed professional clinical counselor with the Big Lots Behavioral Health Services at Nationwide Children's Hospital. It's been a pleasure. And again, thank you so much for stopping by and visiting with us. 

Gina McDowell: Thank you so much for having me. 

[Music]

0:52:27

Dr. Mike Patrick: We are back with just enough time to say thanks once again to all of you for taking time out  of your day and making PediaCast a part of it. Really do appreciate that. 

Also, thanks to our guest this week, Gina McDowell, licensed professional clinical counselor with Big Lots Behavioral Health Services at Nationwide Children's.

Don't forget, you can find PediaCast in all sorts of places. We are in Apple Podcasts app, Google Podcast, iHeart Radio, Spotify, SoundCloud, and most mobile podcast apps for iOS and Android.

Our landing site is available at pediacast.org. You'll find our entire archive of past programs, show notes for each episode, transcripts for many of them if you'd rather read through the content, our Terms of Use Agreement and a handy contact page to ask your questions or suggest topics for future programs. 

0:53:12

Reviews are helpful wherever you listen to PediaCast. We always appreciate when you take a moment to share your thoughts about the show. And we love connecting with you on social media. You'll find us on Facebook, Twitter, LinkedIn and Instagram. Simply search for PediaCast.

Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy, stay home, and stay involved with your kids. So long, everybody.

[Music]

Announcer 1: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

2 thoughts on “Mental Fitness During a Pandemic – PediaCast 458

  1. Hi,
    I am a graduate student pursuing my master’s degree in social work, and I just wanted to say that after listening to this audio cast, thank you!

    This is so informational for not only parents but for those working with children and having family/friends with children during this pandemic.

    I will be continuing to listen!

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