fitness

Self care for mental health in a pandemic

A couple of weeks ago I wrote about looking after your mental health and well being during the pandemic. Since I work a lot in the area of mental health wellness and policy, I try to live the practices I learn about to manage everyday stress.

One of the things I have been sharing with friends is the need to grieve the loss. Our way of life has changed, and most likely, permanently. What happens in the next few months and after that is anyone’s guess. Some people may find Elisabeth Kubler-Ross’s stages of grief – denial, anger, bargaining, depression, and acceptance — a useful way to process all the feelings.  Also, regardless of how I have listed them here, it’s not a linear process.

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The pandemic, though, is not everyday stress even if we are feeling it every day. I thought you might be interested in some of the things government agencies in Canada and elsewhere are offering to help. I’m quite glad to see the variety of material as we have had to deal with a lot of stigma when it comes to mental health and illness.

The relative openness about mental well being is a positive thing we should recognize and is an important part of the WHO’s recent updates. Their focus these days is on emphasizing that physical distancing does not mean social isolation. They also recognize the importance of building psychological resilience. I hope some of the links that follow are helpful to you.

The public health system in England has come up with 14 things you can use to protect your mental health.  Here’s a super-condensed version:

  • Consider how to connect with others
  • Help and support others
  • Talk about your worries
  • Look after your physical wellbeing
  • Try to manage difficult feelings
  • Manage your media and information intake
  • Get the facts
  • Think about your new daily routine
  • Do things you enjoy
  • Set goals
  • Keep your mind active
  • Take time to relax and focus on the present

For the science-minded among the readers, here’s an interesting article looking at what we have learned from past epidemics. The authors focus on what we can do better going forward and why we need to also apply psychological first aid when working with people in our communities during this time. The article considers the impact on providers as well as people in the community. They write:

The outbreak of pandemics has a potential impact on the existing illnesses, causes distress among caretakers, and affected persons and leads to an onset of mental symptoms among the young or old, which is possibly related to the interplay of mental disorders and immunity. In order to avoid the mental health effects of the COVID-19 infection, people need to avoid excessive exposure to COVID-19 media coverages, maintain a healthy diet and positive lifestyle, and reach out to others for comfort and consolation that the situation will soon be contained. Everyone should maintain a sense of positive thinking and hope and take personal or group time to unwind and remind the self that the intense feelings of fear, panic, and anxiety will fade. Additionally, seek information from reputable government sources for information and avoid the spread of erroneous information on the internet.

The Mental Health Commission of Canada has put together a website offering evidence-based information and links from across the country. Their focus is on providing information you can trust: “In times of high anxiety and stress, it’s more important than ever to safeguard your mental wellness. That includes stemming the tide of non-essential information (my emphasis) and paring down your news consumption.”

Another Canadian site comes from the Centre for Addictions and Mental Health. They offer a variety of coping strategies to deal with the stress and anxiety you and others may be feeling. What I liked about the site was their recognition that not all tools will work for everyone equally: “Some might apply to you and some might not – or they may need to be adapted to suit you personally, your personality, where and with whom you live, or your culture. Please be creative and experiment with these ideas and strategies.” CAMH also recognizes that a key factor driving ur fear, anxiety and stress is the uncertainty that underpins our lives today with respect to the virus.

I hope you find the material in the selected links helpful. Remember to connect to people you care about, to look after yourself, to take time to focus on the good in your life and to wash your hands and take appropriate precautions. Be well, stay well.

MarthaFitat55 lives and works in St. John’s Newfoundland and Labrador.

accessibility · disability · fitness · illness

Disability, Fitness, and COVID-19

by Jane S

Sometime in February, when it became clear that coronavirus wasn’t just going to be an outbreak limited to China and its neighbors, I got a lot more serious about going to the gym.

The logic was simple. I have cerebral palsy, a disability known to make pneumonia more dangerous by causing habitual shallow breathing, which reduces lung capacity. Less lung capacity means less reserve if you contract pneumonia. But this can be modified by exercise. As long as I was doing a lot of aerobic activity, my risk of severe illness should be about the same as that of a physiotypical 30-something.

Since avoiding the risk of infection entirely was impossible (even if I could have stayed home all the time, family members go out), it made sense to focus on harm reduction. Better a somewhat higher risk of an unpleasant illness than a lower risk of a dangerous one.

In March, my options for physical activity began to narrow. I stopped going to BJJ class because it didn’t seem like a good time to be getting into people’s faces. A week or two later, when students were sent home at my university, the rock wall was shut down. My main fun activities were gone — an unusually rainy March precluded outdoor cycling — but I could still exercise, maybe even train for a birthday challenge. Then, on March 15, my city ordered all gyms to close.

It’s an odd feeling when your main tool for staying healthy gets taken away in the name of public health. I felt a loss of control, combined with anger on behalf of others who would be harmed more than me. I could plunk down a hundred dollars on a mini-bike to use at home and set up Skype sessions with my trainer — not perfect but better than nothing. But that’s financially out of reach for many. Some people with disabilities need exercise equipment that costs thousands of dollars. Others can only swim. It wouldn’t have been too hard to set up designated fitness centers for such people, but no one thought of doing so. Even physical therapy offices closed.

The idea that an important aspect of pandemic preparedness is being overlooked is not just my intuition. Julie K. Silver, the Associate Chair of Physical Medicine at Harvard Medical School, writes in a BMJ opinion piece that it is crucial “to recognize that strategies that might help slow the spread of disease and perhaps reduce its overall incidence (i.e., social distancing and sheltering in place), could have the unintentional and harmful effect of decreased physical activity and contribute to cardiopulmonary deconditioning. In particular, the elderly, who are most vulnerable to pulmonary complications from coronavirus, may exhibit a decrease in their baseline cardiac and pulmonary fitness that could substantially impact their outcomes and increase morbidity and mortality.”

Some of the very people most at risk from COVID-19 — the elderly and those with heart disease and diabetes — are the ones most harmed by inactivity. And that doesn’t even begin to take into account questions of maintaining overall health and physical function. How many older people will become frail, possibly suffering fractures or losing the ability to do activities of daily living? How many will die from this?

There is still an opportunity to maintain vulnerable people’s health during this time. Some can take advantage of exercise videos or routines available on TV or online, or exercise outdoors while maintaining necessary distance. For others, cities and medical centers should try to provide individual or small-group telehealth sessions (hospitals may be overwhelmed, but the skills of physical therapists aren’t immediately relevant to treating COVID-19 patients) and set up in-person facilities for those for whom this is not enough. Getting through the pandemic with a minimum of harm to individuals and society will require a comprehensive approach that includes everyone.

Jane S. is an ecologist who teaches mathematical biology. She enjoys climbing, Brazilian jiu jitsu and any activity that involves thinking with your body. She also gets a kick out of using her powerchair to move heavy objects.

canoe · cycling · fitness · hiking · illness

Riding my bike and moving beyond bargaining

Last week, like many of us, I was bargaining.

Sure, #StayAtHome and #WorkFromHome but I can still ride my bike. I can still take walks with friends. I love the outside. It won’t be that bad. I was imagining canoe camping holidays even. Repeat: It won’t be that bad. I was still thinking about me and my life, not exclusively but my plans revolved around making work at home work for me, the daily work of my leadership role in the university, family responsibilities, and seeing how much of my exercise routine I could keep.

I blogged about that here and here and here.

And then I read this, To tackle coronavirus, walk – and act– this way by André Picard in the Globe and Mail. Who is André Picard? His official bio says, André Picard is the health columnist at The Globe and Mail and one of Canada’s top public policy writers. His latest book is MATTERS OF LIFE AND DEATH: Public Health Issues in Canada.”

To me, he’s the person whose voice I respect the most on matters of Canadian health policy. We were young journalists working together for Canadian University Press and though our careers have taken us in different directions, I’ve always found his voice to be wise and compassionate. You know you have those people in your life, who if they speak, you listen? André Picard is one of those people for me. His column was my wake up call.

André writes,

“People who are not sick and not recent travellers, can circulate freely. They can go for a walk. But should they? Ethically, is it right to go for a walk when we are being asked to keep our interactions to a bare minimum?

“We also have to start thinking seriously, and preparing ourselves mentally, for how long this could go on, and how long we can tolerate a new normal. Right now, we’re still in the bargaining phase: It’s okay to go for a walk, right? It’s okay to take the kids to the park, isn’t it? Are these attempts to eke out a little bit more normal in these extraordinarily abnormal times just a bargain with the devil?”

“In Canada, we’re on the brink of being too late to prevent those dire outcomes. It’s time to bring the hammer down, to move from polite entreaties to practice social distancing to firm orders to do so. This must be done with absolute clarity and a singular message. It doesn’t feel like time for a casual walk, or casual talk, anymore.”

In the past week, I went from thinking riding solo was okay to watching France, Italy and Spain ban recreational cycling. Why? Because if you get a mechanical failure, who is going to pick you up? Is that trip essential? Because you might have an accident and land in the hospital and you absolutely do not want to be taking medical attention away from a COVID-19 patient.

This week I’ve watched Nova Scotia moved to close all parks and ban recreational hiking. You can hike from your home only now. I just read that the UK is allowing people one bout of outdoor exercise a day. You can’t run in the morning and ride in the afternoon.

We’ve all watched people home from work taking over beautiful remote locations. Wales and Banff were both swamped with tourists. Go home, say the people who make these remote places home. We only have enough food supplies for locals and there isn’t room in the hospitals if you get sick. In my part of Ontario cottage country residents who aren’t year round residents have been asked to leave. The emergency rooms only have a few beds.

The world is getting smaller, fast. It’s time to stop bargaining and face the task at hand head on.

But it has its good moments, my smaller world. We took part in a neighbourhood art scavenger hunt today and drew a turtle to place in our window for local children to find.

I really appreciated these words from friend and award winning author Emma Donoghue about making a life in small places.

So there’s one focus right now and that focus is getting through this pandemic without overly taxing our health care system so it doesn’t collapse. We’re doing this so we won’t have sick people unable to get a respirator because they are all being used. I watched a thing last night about a 72 year old Italian priest who gave up his respirator to save a younger person. I don’t want doctors and patients to face those choices here.

Flattening the curve is a group project that requires our full on effort and attention. Today the Premier of Ontario announced (finally!) that all non-essential businesses are closed for two weeks. I hope that got everyone’s attention though I wish he’d done it two weeks earlier.

We are in this one together. We need to stay home, yes, but we also need to support vulnerable people and our essential workers. That’s nurses and doctors but also transit and grocery store workers.

But what about our mental health? Surely there is some need for exercise.

I think that’s right but what’s the smallest-cost-to-others way you can accomplish that? In places like France, Italy, and Spain you can still ride your bike to the grocery store. It’s recreational cycling that’s banned. You can still walk your dog. You can run within 2 km of your house.

We’re not there yet and if we all work together now maybe we won’t get there. I’m past bargaining but I’m still hoping. And me, I’m riding inside on my trainer in the virtual world of Zwift. When it’s nicer I will ride outside but short distances near my house, I think. Long rides are for later.

fitness

Prioritizing your mental fitness

Almost 20 years ago, I attended a workshop on self-care for front line workers. It was not long after 9/11, an event in which I spent a lot of time helping people stay calm in the face of great uncertainty.

The workshop leader gave us all a great piece of advice. She said, remember the airplane directions: always put your own mask on first before helping others.

In these days of great social change, when upheaval is the new currency, when the lack of a routine or the imposition of a new one with working from home or coping with job loss seems like a burden you cannot attempt to carry, or when the social distance required for public safety has started to unravel the threads in your personal safety net, it can be really easy to forget your own needs.

I have struggled with making physical fitness a priority in the past. I found making a schedule, committing to training, and blocking out the time as fixed were strategies that helped me make it happen.

Part of that was fear that I couldn’t keep up, that I was too unfit or incapable of actually doing the moves required. Part of it was also the expendability of women’s time when there are already so many demands from other sources: child and/or pet care, home care, elder care, work priorities, community responsibilities etc.

It came home to me a couple of days ago that the impact of keeping away from people generally and minimizing social contact when carrying out essential errands also required me to focus on maintaining mental fitness.

It’s easy to get overwhelmed by the news in our communities, or from places around the world where we have family, friends and colleagues also facing similar fears, concerns and challenges. Over the past week, I have talked with friends and colleagues about managing the stress created by meeting the guidelines for protecting ourselves, our loved ones and our community from COVID-19.

We are not alone in this. In case though, you find asking for help challenging, especially when it comes to building up your mental wellness and fitness, I took a look to see what is out there to help.

The WHO has prepared a comprehensive document you can use to develop your own mental fitness plan. It outlines issues and options by category, from health workers on the front line and those in isolation to caregivers of people with dementia and elders. It has a list of guidelines for the general population:

  • Acknowledge the global scope and be empathetic to those directly affected
  • Minimize watching, reading or listening to news that causes you to feel anxious or distressed (set a specific time of time day to gather information so you can avoid a constant stream of data;
  • Seek information only from trusted sources to take practical steps to prepare your plans and protect yourself and loved ones
  • Protect yourself and be supportive of others. Assisting others in their time of need can benefit the person receiving support as well as the helper.
  • Find opportunities to amplify positive and hopeful stories and positive images
  • Acknowledge the role frontline carers play to save lives and keep your loved ones safe.

The American Foundation for Suicide Prevention has shared specific strategies to help maintain mental wellness (slightly edited here for length and repetition):

  1. Separate what is in your control from what is not. There are things you can do, and it’s helpful to focus on those.  Wash your hands.  Remind others to wash theirs. Take your vitamins. Limit your consumption of news.
  2. Do what helps you feel a sense of safety. This will be different for everyone, and it’s important not to compare yourself to others. Make sure you separate when you are isolating based on potential for sickness versus isolating because it’s part of depression.
  3. Get outside in nature–even if you are avoiding crowds. Take a walk. (My note: Or if you don’t want to go far, sitting outside your door or next to an open window so you can feel the fresh air on your face and see sky, trees etc are always helpful.) Exercise also helps both your physical and mental health.
  4. Challenge yourself to stay in the present. When you find yourself worrying about something that hasn’t happened, gently bring yourself back to the present moment.  Notice the sights, sounds, tastes and other sensory experiences in your immediate moment and name them. Engaging in mindfulness activities is one way to help stay grounded when things feel beyond your control.
  5. Stay connected and reach out if you need more support. Talk to trusted friends about what you are feeling. If you are feeling particularly anxious or if you are struggling with your mental health, it’s ok to reach out to a mental health professional for support.  You don’t have to be alone with your worry and it can be comforting to share what you are experiencing with those trained to help.

This image offers some great things you can do as a reminder.

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Image shows a poster with a number of coping strategies. Created by Carie Stephens Art, TheCounsellingTeacher.com

Some things I am doing now include:

  • jotting down key accomplishments in my diary (can be whatever it means to you — for some that could be getting washed and dressed; for others, it can be walking their dog; remember you do you)
  • checking in regularly with my circle of friends
  • setting aside a chunk of time to do something that makes you happy (I’ve been watching cute baby — human and animal — videos before bedtime)
  • creating an asset map of things I have in my life
  • normalizing my routines (some are the same and some are new, like handwashing as soon as I get in the door of my house after a grocery run and wiping down all surfaces)

This website offers a great collection of strategies: from meditations and music to journaling and mindfulness activities. How about you? What are the things that you are doing to look after your mental fitness? Be well, stay well.

— MarthaFitat55 lives in Newfoundland, getting her physical and mental fitness on in multiple ways.

fitness · illness

Sam’s 7 part social distancing fitness plan

You’ve all heard the case for social distancing and the need to #FlattenTheCurve. Like many people I’ve said goodbye to the gym for now. I’m not going to group yoga classes either. Which is sad because I’ve come to love our local studio’s restorative yoga with live music class. But you don’t have to read too many articles like this to think maybe working out at home is a better idea.

So for the foreseeable future I’m either working out outside or at home. Here are my options:

1. Yoga with Adriene: I like doing yoga at home even though Cheddar likes to take part and often gets in the way. Usually I do Yoga with Adriene so it’s Cheddar and Benji, the yoga dogs. I’ve also downloaded the DownDog yoga app on the advice of a colleague and friend.

2. Indoor cycling: I love Zwift and the Bike Shed is my one concession to exercise not at home. I’m riding my own bike there though and there’s lots of space between the people riding. Mostly it’s just me and Sarah there. This month I’m going to do some more Swarm rides.

3. TRX at home: I love the TRX classes at the university but in lieu of that Sarah is moving her TRX to Guelph and we’re installing an anchor in the ceiling so we can use it here. I’m not sure what app or routine I’ll use. Advice? I do my best work with people talking and telling me what to do. Here’s a list of 44 amazingly, effective TRX exercises.

4. Kettle bell: I used to love the kettle bell routines at CrossFit. I even bought my own but since I was doing classes I didn’t much use it. And then I lost it in the move. Two years later it still hasn’t turned up and so I bought I new one. (I know, now I’ll find the old one.) I’ve downloaded a few kettle bell apps.

5. Dog walking: I can’t walk much these days but I still love walking Cheddar in the woods. There will definitely be some walking in the woods with dogs.

Dogs in the woods: Cheddar and Emilie

6. Outdoor riding. The season is almost here. If I’m outdoors and not near other people, riding is definitely I thing I can do. There are some great tips here: Cycling during coronavirus. (If running is more your thing, here is the running version.)

7. Plank challenge: You can read about Sam and Cheddar and the plank challenge.

What are you doing? What are you not doing? How are you handling these strange and scary times?

fitness · illness · weight lifting

Fitness in the time of pandemics: Working out alone or together, at home or at the gym?

It feels selfish to be writing about fitness from the perspective of staring down a possible pandemic, but I confess when I think about home quarantine from my self-interested point of view, exercise is one of things I think about. It’s not just keeping my fitness I’m worried about, though there is that. Working out and movement feel like they’re central to my emotional health and mental well-being.

That’s not all I think about of course when it comes to the possible coronavirus pandemic.

Over on Twitter, I think about covid-19 from the perspective of an academic administrator.

I worry about it a lot as a humanitarian crisis.

I worry about it as a problem for society when I have friends tweeting about cheap airfares. I think there’s an obligation to do all that we can do to slow down transmission of the virus. Likely that means staying home.

As a feminist philosopher, and as a human being, I worry about how quickly people move to say that covid-19 isn’t that dangerous because it’s only really a threat to the elderly and those with underlying conditions. What does that say about which lives we value?

I like this reframing.

I worry about political systems, especially south of the border, and the need for affordable health care, paid sick leave, and testing.

Lots to worry about but I like it that’s there’s some practical things we can all do to prepare.

Again, I like the framing this piece on preparing for pandemics as a pro-social action offers us.

“Be ready? But how? It seems to me that some people may be holding back from preparing because of their understandable dislike of associating such preparation with doomsday or “prepper” subcultures. Another possibility is that people may have learned that for many people the disease is mild, which is certainly true, so they don’t think it’s a big risk to them. Also, many doomsday scenarios advise extensive preparation for increasingly outlandish scenarios, and this may seem daunting and pointless (and it is). Others may not feel like contributing to a panic or appearing to be selfish.

Forget all that. Preparing for the almost inevitable global spread of this virus, now dubbed COVID-19, is one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind.”

But back to fitness. And back to just thinking about why I might do if I had to spend stretches of time isolated from others.

I take it there’s no reason not to ride my bike out alone in the world. I can carry my own snacks. While big races are being cancelled, there is no reason not to ride outside of big crowds, assuming I’m not actually quarantined.

There’s also Yoga with Adriene and walks in the woods with Cheddar. Both will be just fine even if I’m staying at home more to avoid public gatherings.

I’m not sure what I think about working out at the gym, especially the student gym though. And I’m not sure what I think about yoga in the close quarters of the studio.

Lots of photos of walking in the snow with Cheddar and a bonus friend’s dog. Hi Emilie!

I also belong to a 24 hour discount fitness club. Maybe I could go there and take disinfectant wet wipes, wash my hands often, and work out there in the wee hours? I’m not sure. I’m considering buying a set of dumbbells for home use.

A gym, Photo by Mark Bertulfo on Unsplash

Certainly we’ll set up our home TRX.

Here’s the fitness routine of quarantined racing cyclists!

What are your thoughts about the gym in times of avoiding crowds and germ-y surfaces? I’m still thinking this through. I’d appreciate your thoughts.

If you’re still thinking about what all of this means for you, I recommend following Helen Branswell on Twitter and following STAT news on coronovirus. Normally that’s behind a paywall but it’s free now for that topic only. Also give The Coronavirus isn’t going away a listen.