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Accept grief amid COVID-19 pandemic

Here are four suggestions that can help people to cope with current events.

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Photo by Megan te Boekhorst from Unsplash.com

As the COVID-19 pandemic upends life as people know it, changing daily routines, limiting social interactions and shaking their sense of safety, a  mental health experts from US hospital Cleveland Clinic’s Mellen Center is stressing that it is perfectly acceptable to feel sad about all of it.

She points out that grief is a natural response to loss – whether it is the loss of a loved one, or the loss of a sense of normalcy.

“We are experiencing a lot of disappointment right now — in both small and big ways — and grief is going to be a factor,” says clinical health psychologist Amy Sullivan, PsyD, ABPP.

“It’s really important that we process this and stay connected to other people in safe ways,” she adds.

Regarding how people should go about dealing with all of these difficult and unexpected feelings bubbling up, she says there is no right or wrong way. However, she offers four suggestions that can help people to cope with current events.

1. Look through the lens of grief and process emotions

She says that the stages of grief can provide a helpful framework for navigating these complex emotions. Experts recognize these stages as denial, anger, bargaining, despair, and acceptance. However, these experts also know that people do not step neatly from one stage to the next in this exact order, she says.

“Grief can come in waves and change on a very regular basis. Our feelings can change on a daily, or even an hourly, basis,” she explains.

Dr. Sullivan adds it is normal to go from feeling despair one day to anger the next.

“The first thing we need to do is to recognize that it is normal to have these waves of emotions that are happening on a regular basis,” Dr. Sullivan says.

Next, she says, acknowledge the loss whether it is knowing or losing someone with COVID-19, losing jobs, missing friends or family.

“Those are all very sad, difficult things for people to manage,” Dr. Sullivan says.

“Feel what you are feeling — whether it is being overwhelmed, anxious, powerless or anything else, it can help to identify and name these emotions,” she advises.

“It can be quite powerful to sit with those feelings for a few moments — to really recognize those emotions and normalize them,” she says.

However, she advises people to set a time limit on this, suggesting they give themselves five minutes to feel that emotion, and then move on to something that they know is a positive coping skill for them.

“It is important for us to accept where our feelings are at the moment and process through them, and then move into a more positive position of acceptance,” she says.

She says this can be done by identifying their own best coping mechanisms

“This is a time when people need to become innovative and develop their own individual sense of coping that works for them during this time,” she says. Examples might include deep breathing, mindfulness exercises, journaling, talking with another person, or going for a walk.

“If it comes to a point where someone cannot handle these feelings on their own, they need to seek mental health help,” Dr. Sullivan says.

2. Fight the urge to disengage

Dr. Sullivan stresses that staying connected is a powerful tool for coping during hard times. Whether that comes in the form of video chatting or sending a good old-fashioned letter, staying in touch with family, friends, neighbors and coworkers can help people to keep a positive attitude, she says.

She adds that many trained mental and behavioral health professionals are currently seeing patients through virtual visits, so that if people are having trouble coping, this could be a solution.

3. Focus on what can be controlled

Dr. Sullivan says that when there is so much uncertainty about the future, it is easy for people to get carried away, playing out the worst-case scenarios in their heads, for example worrying about themselves or someone else getting COVID-19, or wondering if things will ever get back to normal.

“Anticipating negative events can bring a sense of anxiety or fear,” Dr. Sullivan says.

She advises that, instead of agonizing over the things that cannot be known or controlled, people should be aware of what they do have control over. For example, they can choose how much news or social media they consume in a day, and they can decide what they eat. She recommends being mindful about these choices, and focusing on staying in the present.

4. Be open to joy

Lastly, Dr. Sullivan advises people  to find joy and gratitude in the small things, like a video chat with family members, or the rush of fresh air when they open a window or step outside. She adds that if they are under a lockdown order, they can find ways to appreciate the opportunity to step back from the hustle and bustle of everyday life and being home.

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Natural therapy shows promise for dry-eye disease

Castor oil has been proposed as a natural product that could offer a safe, effective and easy-to-use alternative to existing therapies.

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Researchers at the University of Auckland are running a trial of castor oil as a potential safe and natural treatment for dry-eye disease following a successful pilot study.

While exact figures aren’t available for New Zealand, in Australia, it is estimated dry-eye disease affects around 58% of the population aged over 50. Advancing age, menopause, increased screen time, contact lens wear are just some of the risk factors for developing dry eye disease.

Blepharitis is the most common cause of dry-eye disease, accounting for more than 80 percent of cases. It is a chronic condition with no known cure.

“Currently, patients are left grappling with symptoms of dryness, grittiness and, in some cases, watery eyes that feel uncomfortable impacting on their quality of life and work productivity,” says doctoral candidate and lead clinical investigator Catherine Jennings.

Current treatments, such as antibacterials and anti-inflammatories, are generally unsuitable for long-term use, due to significant side-effects and potential for antimicrobial resistance.

“Often patients are left feeling helpless when attempting to manage a chronic condition,” Jennings says.

The current trial is of a product containing cold-pressed castor oil enhanced with mānuka and kanuka oils applied using a rollerball attached to a small glass bottle.

“The previous pilot study, conducted by our research team, was unique in its use of castor oil in such an application on the eyelids, with the product not known to be used anywhere else in the world for treating blepharitis,” says Jennings.

Castor oil comes from a flowering tropical or subtropical shrub from the species Riccinus communis. It has been used therapeutically for millenia, including more recently in eye cosmetics and eye makeup removers.

In the pilot study, 26 patients with blepharitis were treated with cold-pressed castor oil over four weeks. They had measurable improvements in symptoms, such as reduced redness of the lid margin, decreased thickening of the eyelid, and a decline in bacterial profusion, as well as reduced eyelash crusting.

Building on the success of the pilot study, the research team is now engaged in the more extensive double-blinded, randomised and placebo-controlled study. They are aiming to recruit 92 participants and generate robust scientific evidence for clinicians.

The ultimate goal is to sustainably improve quality of life for this large group of patients using a natural, safe and effective product, principal investigator Professor Jennifer Craig says.

“Castor oil has been proposed as a natural product that could offer a safe, effective and easy-to-use alternative to existing therapies,” Craig says.

“My hope is this study will produce evidence-based guidance for clinicians with regard to offering castor oil as a possible management option for patients suffering from blepharitis, so they continue to enjoy a great quality of life, read the books they love, be productive in their work environment and enjoy other visual hobbies.”

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For epilepsy, yoga may be good for your mind

People who did yoga were more than four times as likely to have more than a 50% reduction in their seizure frequency after six months than the people who did sham yoga.

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For people with epilepsy, doing yoga may help reduce feelings of stigma about the disease along with reducing seizure frequency and anxiety, according to new research published in the November 8, 2023, online issue of Neurology, the medical journal of the American Academy of Neurology.

“People with epilepsy often face stigma that can cause them to feel different than others due to their own health condition and that can have a significant impact on their quality of life,” said study author Manjari Tripathi, MD, DM, of All India Institute of Medical Sciences in New Delhi. “This stigma can affect a person’s life in many ways including treatment, emergency department visits and poor mental health. Our study showed that doing yoga can alleviate the burden of epilepsy and improve the overall quality of life by reducing this perceived stigma.” 

For the study, researchers looked at people with epilepsy with an average age of 30 in India.

Researchers measured stigma based on participants’ answers to questions such as: “Do you feel other people discriminate against you?” “Do you feel you cannot contribute anything in society?” and “Do you feel different from other people?”

Researchers then identified 160 people who met the criteria for experiencing stigma. Participants had an average of one seizure per week and on average took at least two anti-seizure medications.

Researchers then randomly assigned participants to receive yoga therapy or sham yoga therapy. Yoga therapy included exercises in loosening muscles, breathing, meditation and positive affirmations. Sham yoga consisted of exercises that mimic the same yoga exercises, but participants were not given instructions on two key components of yoga believed to induce a relaxation response: slow and synchronized breathing, and attention to the body movements and sensations during practice.

Each group received seven supervised group sessions of 45 to 60 minutes over three months. Participants were also asked to practice sessions at home at least five times a week for 30 minutes. They tracked seizures and yoga sessions in a journal. After the three months of therapy, participants were followed for another three months.

Researchers found when compared to people who did sham yoga, people who did yoga were more likely to reduce their perceived stigma of the disease. People who did yoga had an average score of seven at the start of the study and an average score of four at the end of the study, while people who did sham yoga had an increase from an average score of six at the start of the study to an average score of seven at the end.

Researchers also found that people who did yoga were more than four times as likely to have more than a 50% reduction in their seizure frequency after six months than the people who did sham yoga.

In addition, people who did yoga were more than seven times more likely to no longer have seizures than those who did sham yoga.

There was also a significant decrease in anxiety symptoms for people who did yoga versus people who did not. They saw improvements in quality of life measures and mindfulness.

“These study findings elevate the need to consider alternative therapies and activities for people with epilepsy facing stigma,” said Tripathi. “Yoga may not only help reduce stigma, but also improve quality of life and mindfulness. Plus, yoga can be easily prerecorded and shared with patients online using minimal resources and costs.”

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Eating a vegan diet could reduce grocery bill 16%, saving over $500 a year – study

Total food costs decreased in the vegan group by 16%, or $1.51 per day, compared with no significant change in the control group. This decrease was mainly attributable to savings on meat, -$1.77 per day, and dairy, -$0.74 per day. Changes in purchases of other food groups (e.g., eggs and added fats) also contributed to the observed savings.

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Food costs decrease 16% on a low-fat vegan diet, a savings of more than $500 a year, compared to a diet that includes meat, dairy, and other animal products, according to a new analysis from the Physicians Committee for Responsible Medicine published in JAMA Network Open.

“We knew that a vegan diet significantly reduces your risk of conditions like heart disease, diabetes, and obesity—and now we have proof that opting for beans instead of beef will also lead to significant savings on your grocery bill,” says study co-author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee for Responsible Medicine.

The research is an analysis of a Physicians Committee study in which participants were randomly assigned to a vegan group or control group. The vegan group was asked to follow a low-fat vegan diet consisting of fruits, vegetables, grains, and legumes, while the control group was requested to make no diet changes. Calorie intake and food costs were not limited for either group.

For the food cost assessment, the participants’ dietary records were linked to food price data from the U.S. Department of Agriculture Thrifty Food Plan, 2021.

Total food costs decreased in the vegan group by 16%, or $1.51 per day, compared with no significant change in the control group. This decrease was mainly attributable to savings on meat, -$1.77 per day, and dairy, -$0.74 per day. Changes in purchases of other food groups (e.g., eggs and added fats) also contributed to the observed savings.

These savings outweighed the increased spending on vegetables, +$1.03 per day; fruits, +$0.40 per day; legumes, +$0.30 per day; whole grains, +$0.30 per day, and meat and dairy alternatives.

The findings support previous research showing that a plant-based diet provides more cost savings than one that includes animal products.

In addition to the cost savings, the study found that a low-fat vegan diet resulted in weight loss and improved body composition and insulin sensitivity in overweight adults.

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