Mental Health Experts Help Us Navigate Year Three of the Pandemic


Everyone has modified. We don’t know what COVID-19 will throw at us subsequent. Or when. We’re nonetheless fighting how we really feel about work, reaching life stability and referring to different individuals whilst we glance ahead.


That’s the broad evaluation from Honolulu psychological well being specialists we requested to assist us navigate the remainder of 2022 as we mark May as Mental Health Month. The consensus: Many of us really feel fragile, worn down by the widespread results of the COVID-19 pandemic—lingering well being issues, loss and isolation—layered on high of unrelated psychological well being issues we had earlier than. There is a few excellent news: Although we are able to’t flip a swap that turns off our nervousness and stress, specialists say we’ve change into extra resilient, which makes us higher in a position to deal with no matter comes subsequent.


Resiliency permits individuals to regulate to setbacks slightly than being overcome by them, says Sondra Leiggi Brandon, who serves as vice chairman of affected person care, behavioral well being and pharmacy at The Queen’s Medical Center. “Resiliency is also about finding your strengths when challenged and we’ve all been forced to do that in many ways the last two years,” she says.


And extra individuals are discovering extra methods to get assist. “Mental health treatment is no longer about laying on a couch and discussing your feelings,” Leiggi Brandon says. “You can access treatment from your home using telemedicine, or through your phone via an app, or even text someone for help. Treatment has expanded and evolved with technology.”


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Dr. Jason Keifer, Brain Health Hawai‘i. Photo: Joanna Salazar, courtesy of Jason Keifer

At Brain Health Hawai‘i, Honolulu psychiatrist Dr. Jason Keifer noticed an upswing of sufferers who survived the virus solely to undergo devastating results on their psychological well being from lengthy COVID. “This is a population of people who have issues from their toes to their brain,” Keifer says. They search therapy for melancholy however are getting extra far-reaching outcomes by a hyper-personalized use of transcranial magnetic stimulation, or TMS, he says. The TMS approach was first authorised in 2008 by the Food and Drug Administration for melancholy and obsessive-compulsive dysfunction.


“Many of the patients living with long COVID are struggling with brain issues such as brain fog, memory loss, depression and other issues,” Keifer says. He says his clinic may help them by adjusting a weekly TMS prescription primarily based on mind mapping, which may assess what’s taking place within the neural community and discover irregularities in mind rhythm. The approach can determine each situation and effectivity, Keifer says, to find out what could also be inflicting signs or dysfunction. And he’s discovered that assessing and treating the mind may help the place standard drugs and discuss remedy haven’t “because COVID can injure the brain, causing a concussion-like state.”


At Queen’s, docs are seeing a variety of sufferers, some in therapy, others discovering assist by journaling, mindfulness and meditation, with apps for stress discount, cognitive strategies for nervousness, even group remedy, Leiggi Brandon says. She recommends the Yale happiness course, the Headspace app for meditation, and the cognitive behavioral remedy app MindShift CBT for nervousness reduction.


Help for various ages and levels


Experts remind us that everyone’s completely different. “I think it’s important for people to remember that we’re all going to adjust to these various transitions and stages differently and that we need to give each other grace for being at different stages,” Leiggi Brandon says. “You might be ready to throw off your mask and go to a house party. I may not be because I want to be more cautious.”


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Sondra Leiggi Brandon, The Queen’s Medical Center. Photo: Aaron Okay. Yoshino

Each side of our lives advantages from psychological well being consciousness. With youngsters, participating with them and creating social connections can provide them a protected house to share their emotions, she says. Teens might not all the time need to divulge heart’s contents to you, however might go to a trusted grownup. Partners must take time to interact and reconnect to assist one another and to nurture their relationship. A boss can provide time in conferences for individuals to socialize and employers can spend money on wellness applications.


Leiggi Brandon additionally shares a small approach that may provide massive outcomes: “Take time in the day to recognize three good things that have happened to you … like I found a good parking spot today,” she says.


It doesn’t price us something, we are able to do it on our personal or with youngsters or companions from keiki to kūpuna. The payoff? “Just focusing on the positive and being able to recognize these little wins that we have throughout the day has shown to be as effective as taking an antidepressant as far as mood goes,” Leiggi Brandon says. “Isn’t that incredible?” Whether it’s the 5-year-old who took residence the category bunny for the weekend, your co-worker’s nice sport of pickleball, or that good cup of espresso you brewed this morning, the little issues add up “to retrain our brain to focus on the positives,” she says.


And sure, the wrestle is actual. There are nonetheless waitlists for remedy and indicators of neighborhood wrestle. Nationally, suicide charges proceed to rise in various teams, Leiggi Brandon says, “and senior men are now the No. 1 group of people who commit suicide.”


Battling Burnout, Finding Hope


At Mental Health America of Hawai‘i, program director Mestisa Gass sees hope and indicators of resiliency coupled with a surge in individuals in search of psychological well being companies. “I think the surprising takeaway for some is that while we are moving toward a more stable and safer way of interacting again there continues to be high levels of compassion fatigue, burnout, stress and grief,” she says. While we’d have anticipated merely reduction and happiness, many individuals really feel exhausted, she says.


“Businesses have been contacting us about the high levels of burnout and fatigue being reported by staff. I am hearing people say, ‘It’s getting better, why don’t I feel better?’”


Gass worries about youngsters and teenagers who’ve missed a lot: interplay with mates, days of college, months and even years with out in-person studying, commencement ceremonies, sports activities, play dates, and time with family. She factors to a U.S. surgeon basic’s report citing widespread misplaced entry to psychological well being care, social companies, revenue, meals and housing. That report estimates, as of June 2021, greater than 140,000 youngsters within the U.S. had misplaced a dad or mum or grandparent caregiver to COVID-19.


While basic psychological misery amongst younger individuals was on the rise earlier than the pandemic, since then signs of tension, melancholy and different psychological well being problems have elevated as nicely. The federal report paints a regarding image:

  • Recent analysis masking 80,000 youths globally discovered that depressive and nervousness signs doubled in the course of the pandemic, with 25% of youths experiencing depressive signs and 20% experiencing nervousness signs.
  • In early 2021, emergency division visits within the U.S. for suspected suicide makes an attempt have been 51% greater for adolescent ladies and 4% greater for adolescent boys in contrast with the identical interval in early 2019.
  • Negative feelings or behaviors comparable to impulsivity and irritability—related to circumstances comparable to ADHD—seem to have reasonably elevated.
  • Reduced in-person interactions amongst youngsters, mates, social helps, and professionals comparable to academics, faculty counselors, pediatricians and youngster welfare staff made it more durable to acknowledge indicators of kid abuse, psychological well being issues and different challenges.


Learning to press reset


“We’re not the same people that we were two years ago,” says psychological well being advocate Kathleen Rhoads Merriam. She works as a state psychological well being supervisor in Windward O‘ahu, where clients, staff and all those they work with in the community have endured a difficult time yet responded with inspiring resiliency. “We have all gone through something really traumatic. That doesn’t imply that we’re higher or worse however we simply actually are form of completely different.” Some of our problem-solving expertise and social expertise bought rusty, Merriam says, “so take time to reflect how you’re feeling.”


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Kathleen Rhoads Merriam, Mental well being advocate. Photo: courtesy of Kathleen Rhoads Merriam

More social gatherings, crowds and shifting expectations can carry a mixture of pleasure and uneasiness. “We don’t know how to party with each other like we used to,” Merriam says. “It feels like I’m breaking a rule.” To assist counter these emotions, she suggests that folks attempt paths to wellness that really feel proper now. Get shifting, whether or not it’s strolling, becoming a member of a category on-line, on the gymnasium or pool. Go to a farmers market and take a look at cooking some meals you don’t normally purchase. Make these physician appointments and get these checkups that you simply’ve delay. Maybe you need to attempt reconnecting with outdated mates or discover new hobbies. Volunteering could be a good method to keep centered. “Helping others is also a way of helping ourselves,” Merriam says.


If checking the information, scrolling by social media, even your e mail can derail you, then create your personal quiet instances with out notifications or alerts. Merriam expects it should take time to gauge the long-term results of the pandemic on workplaces. Some of us fortunately returned to on-site work, whereas others fully modified their careers. “Some have thrived, some are just going through the motions,” Merriam says. She hopes we are able to embrace what we’ve discovered. For her, one takeaway is “I’m not going to double-book anymore; I’m going to have more family time.”


Shifting out of survival mode


Clinical psychologist Bart Pillen has spent 4 a long time working with households and now serves as chief of behavioral well being at Hawai‘i Pacific Health. “The way that families are impacted has been very traumatic,” Pillen says. “It’s been a prolonged thing, wave after wave—of not just COVID, but wave after wave of loss, of disruption for school and work and family and the economy.”


During two years of trying over our shoulders, we’ve leaned right into a hyper-aware survival mode designed to maintain us out of quick hazard. Pillen provides an eye-opening factoid to assist clarify how our our bodies reply: “We see threats in three-one-thousandths of a second while it takes us about 20 to 30 seconds to see something positive.”


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Bart Pillen, Hawai‘i Pacific Health. Photo: courtesy of Hawai‘i Pacific Health

After two years of fixating on the following risk, wave or variant on the horizon, it’s simpler to know why we’re somewhat twitchy. “That’s a lot of anxiety practice to undo,” Pillen says, however we are able to do issues that make us really feel higher—climbing, singing in a choir or enjoying mahjong. And every of us can proceed precautions that make sense, from washing our fingers and getting flu photographs to nonetheless utilizing masks when it feels proper. “You don’t just stop something that has been healthy, but you update it and you adapt it to the new circumstance,” he says.


Pillen says it’s necessary to maintain open traces of communication with members of the family of all ages. He factors to 2 components proven to assist households work nicely collectively: their means to adapt to completely different conditions, and people who preserve a way of cohesion, that we’re all on this collectively.


While many people are conscious of the struggles that may include post-traumatic stress dysfunction, Pillen notes analysis that reveals 20% to 30% of these studied after a traumatic occasion went the opposite method and skilled post-traumatic development. “They have a greater appreciation for life. They don’t take things for granted. They value relationships,” he says, and a few of these are responses that we are able to domesticate.


Spotting indicators and assist teams


All our specialists remind us to look at for indicators of hassle in these round us: temper swings, issue sleeping, urge for food shifts, persistent nervousness, melancholy and different sudden modifications. “Please, please, please, pay attention to each other and notice a change in behavior,” Pillen says, whether or not it’s an grownup who’s consuming extra or spending much more time enjoying video video games, teenagers who’re extra argumentative or a scholar whose grades have plummeted. If you discover these modifications in a liked one, ask them how they’re doing, discover out if they’re comfy speaking with you, or should you may help them find somebody to speak to.


As government director of the National Alliance on Mental Illness Hawai‘i, Kumi Macdonald offers training, consciousness and advocacy to these in want and their households. “We have more support groups for people with mental illness, classes for mental illness, and those are always full.”


Macdonald can also be inspired by the wide selection of strategies and coverings which have change into out there in recent times. Beyond the mind stimulation that Keifer practices, she says eye motion remedy has confirmed to be one other efficient method to deal with trauma. The apply of EMDR, or eye motion desensitization and reprocessing, was developed in 1987 and includes a therapist main a affected person by eye actions whereas recalling segments of traumatic experiences to ease these reminiscences.


Macdonald is heartened to see sufferers receiving entry to a wider array of what’s now referred to as complementary and different medication. Increased protection of those remedies by medical insurance coverage—together with Chinese medication, acupuncture, Polynesian therapeutic, chiropractic and therapeutic massage remedy—has opened the door for extra individuals, Macdonald says.


“I remember 30 years ago, I had acupuncture done and a medical doctor laughed in my face, ‘Oh, you’re one of those hocus-pocus people,’” Macdonald remembers. Now, she sees extra integration of homeopathic remedy and respect for different practices. For instance, a most cancers affected person who’s going to chemotherapy may also incorporate tai chi, meditation or acupuncture, she says.


And connecting just about stays a strong instrument. “We can see people we normally can’t see and a lot of our support groups are still on Zoom” as a result of not everybody has easy accessibility to assist teams, together with these on the Neighbor Islands or in additional distant communities on O‘ahu. “So it is a blessing,” she says. Yet when Macdonald pondered another virtual national convention, she realized how much she missed the entire experience of flying to the mainland to see colleagues and hear experts in person: “I’m on the display all day, all evening.”


Which modifications stick with us?


Virtual instruments additionally modified the best way individuals collect to wish. Nationwide, in-person church-going plummeted since 2020. At First Presbyterian Church of Honolulu, senior pastor Dan Chun feels grateful for all these within the church neighborhood who tailored, helped each other get by tough instances, and embraced on-line know-how when individuals couldn’t meet.


Dan Chun Mental Health

Dan Chun, First Presbyterian Church of Honolulu. Photo: Courtesy of Dan Chun

Before the pandemic, 1,100 individuals repeatedly confirmed up for his Windward O‘ahu church companies every week. But stay-at-home orders and concern of the lethal virus made it unattainable to fulfill in-person for months. Chun and the workers labored to attach individuals just about, by way of residence computer systems and telephones. As the pandemic went on, the variety of individuals tuning into companies climbed, Chun says.


By March of this 12 months, the typical variety of individuals livestreaming companies had risen to 1,200, however solely about 280 individuals confirmed up in individual, whilst mandates and limits eased. “Our services have been seen in all 50 states and 46 countries,” Chun says, marveling at that international attain whereas questioning what number of will need to preserve tuning in remotely. Compounding the uncertainty and nervousness about what may come subsequent, individuals should still really feel offended about inflation, politics, local weather change, masks mandates and vaccines, or might merely be weary of such a protracted stretch of stress.


Chun says new approaches could also be wanted within the coming months. They embrace constructing breaks into our calendars to supply time and house to recuperate, being intentional about assembly individuals in individual, in search of out some invites whereas declining others. He suggests useful mantras comparable to: “Don’t doubt yourself. You did the best you could. Don’t give up.” And Chun thinks firms can take into account giving all staff one other week of trip with pay to acknowledge those that have labored exhausting by troublesome instances.



— Kanoe Enos



How the neighborhood responds


Okayanoe Enos is a co-founder of ‘A‘ali‘i Alliance which works to improve the lives of Hawai‘i residents through systemic change. Like the other specialists, he’s felt neighborhood nervousness rising. “Everybody’s waiting for the cue, for the collective sigh of relief,” Enos says, “and I don’t know if we will ever really get one.”


Kanoe Enos Mental Health

Kanoe Enos, ‘A‘ali‘i Alliance. Photo: Courtesy of Kanoe Enos

Nationally, research point out about 30% of staff don’t need to return to the workplace full time in the event that they don’t should. Workplaces are evaluating the advantages of assembly in individual towards some great benefits of distant work: for staff, no commute and fewer cash spent on fuel and parking, and for a lot of industries, elevated flexibility, a instrument to assist retain staff, enormous price financial savings on workplace house. “I for one would not want to go back to a job that demanded me to work from the office 40 hours a week,” Enos says.


With a background in social work, he worries that the final two years have normalized catastrophes to the purpose that we really feel “everything is a potential brink of doom.”


In the information, we see struggle, pure disasters, case counts. On O‘ahu’s North Shore, a home tumbles onto the seaside after a long time of abrasion. The challenges of every day existence get more durable: “The price of gas is going up, housing is bananas and I think folks feel that crunch,” Enos says.


As these day-to-day challenges put on on, Enos worries that our neighborhood may change, for the more serious. “My greatest hope is that we don’t turn on each other,” he says. “Because I think that’s what makes us different, is that we’ve learned to sort of cohabitate with folks with the concept of aloha in its most genuine form.”



Mestisa Gass Mental Health

Photo: Courtesy of Mestisa Gass

Tips to Help Us Now

  • Realize how you’re feeling is regular, many individuals are feeling that method.
  • Take issues at your personal tempo. Re-entry nervousness and languishing could make it troublesome to take pleasure in reengaging socially so discover a tempo that’s comfy for you.
  • Reach out to your assist system. Call or textual content your pals and family members, particularly these you haven’t been in a position to see due to bodily distancing.
  • Continue to make use of self-care and coping expertise to enhance or preserve psychological well being.
  • Choose 5 minutes every day to apply mindfulness: Sit within the solar, take deep breaths or hearken to the sounds round you.
  • Engage and improve your senses. Take a brand new path throughout your stroll, add minimize flowers to your kitchen counter, attempt a brand new candle scent or hearken to enjoyable music.
  • Try to not evaluate your expertise with different individuals’s experiences. We are all therapeutic in our personal method and the easiest way to heal is the best way that works for you.
  • Accept that you will have low vitality or unhappy days as you progress ahead and it’s OK to not really feel OK. If you’re feeling you want skilled assist, know that it’s out there and there’s no disgrace to find assist and the instruments it’s essential to really feel higher.


Source: Mental Health America of Hawai‘i’s Mestisa Gass.



How to Find Help

  • For free assist, name Hawai‘i Cares—previously the Crisis Line of Hawai‘i—at (800) 753-6879 or textual content ALOHA to 741741. Professionals workers the road across the clock daily.
  • In disaster, name the National Suicide Prevention Lifeline toll-free at (800) 273-TALK (8255) 24 hours a day, seven days every week. The service is confidential and out there to anybody.
  • A nationwide 988 hotline is scheduled to launch July 16 to strengthen community-based disaster response by offering a three-digit quantity that’s simpler to recollect, just like 911 for emergencies. The new system is designed to supply a nationwide community of native disaster facilities fortified by nationwide backup facilities to reply calls and texts.
  • The Trevor Helpline is a nationwide 24/7 hotline for LGBTQ youths, (866) 488-7386.


More Local Resources

  • Mental Health America of Hawai‘i has data on apps, video coaching, printable supplies and social media hyperlinks.
  • National Alliance on Mental Illness Hawai‘i contains data on assist teams and courses.


Take a Free Course

  • What began out as Yale University’s hottest in-person class has advanced right into a free on-line class referred to as “The Science of Well-Being” that greater than 3.3 million individuals have tried.


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