Our mental health is often the most challenging issue in a crisis; testing times often bring up fears, insecurities and genuine uncertainties or perhaps needs we didn't realise were so key to maintaining normal function let alone enjoying life. 
 
I've had the poem "If" by Rudyard Kipling on my desk since a brush with significant anxiety back in 2017. I was burnt out, having worked in a toxic prison environment for years while receiving death threats to myself and my family from drug dealers whose medication I stopped (due to their misuse of prescription meds and organised crime rings trading meds for profit). Eventually I took 2 months off, had some counselling and left that job where I had felt indispensable but unprotected and under resourced. Some reflection resulted in resigning and a move to an exciting new role in a supportive environment where I set up remote GP services, which in turn led me to setting up my own private medical clinic with a team which now uses the same agile methodology to provide video GP, video Clinical Psychology and Menopause consultations which under more normal circumstances would be face to face unless our clients are travelling. 
 
The poem "If" harks back to a time of Empire and 'British stiff upper lip', (Kipling grew up in colonial India) but speaks of contending with doubt and uncertainty, holding your core beliefs when all around are awash, dealing with setbacks, challenges and disasters, discerning truth and taking the plunge headfirst into a high level new venture while keeping your feet on the ground. 
 
These principles speak into the situation we find ourselves in, under the threat of Coronavirus but we know that underpinning good mental health are the habits of a lifetime, not just holding your nerve. 
 
I've heard a lot in the recent climate of mental health awareness about "resilience" from management experts and people on the ground alike; to me true resilience is tested and refined in the fire of repeated challenge. Challenge brings threat and opportunity; too much threat and we are overwhelmed; too much opportunity and we burn out. 
 
So here is some food for thought as always is under my favourite four headings:Body, Mind, Spirit and Relationships to underpin keeping your head... 
 
 
Spiritual 
 
Find your why and the rest will follow; purpose and value systems add meaning to what we do; tune up yours to optimise your spiritual wellbeing. 
Reflecting on my own mental challenges, my faith is one of the most powerful resources I draw on; believing in a God who cares deeply about the world and joins us in suffering and uncertainty really helps when you look around and ask "why?" 
Even if you are unsure if a higher power or God exists; sorting out what you believe and refining your worldview and belief system will help you to act with more certainty in times of crisis as you may be more able to follow through on logical values. 
My personal values as a doctor come from my belief in the sanctity of life; that every being has been created for a purpose and is valuable and a part of the plan, thus I believe we should protect the weak, uphold those who need help and speak up for those who have no voice or who are oppressed by others. I have found myself most fulfilled working with vulnerable people groups such as prisoners, the homeless, people with mental health problems and at the other end of the spectrum highly stressed business people who need support to continue performing at a high output without disintegrating at light speed. 
 
Physical 
 
- diet is key to maintaining good mental health - alongside plenty of fresh fruit veg and fish /meat in moderation consider supplementation for optimum function 
- magnesium can help anxiety and improve sleep, vitamin D is often depleted in stressed people and zinc is great for immunity; a good multivitamin and probiotic regime may prevent some of the causes of Alzheimer’s and chronic disease but also has mental health benefits as below: 
- probiotics aim to improve absorption of food through optimising your microbiome; this can also increase serotonin release from your gut and increase immunity, promoting improved all-round health 
- Aim for a daily exercise with a mix of variable high intensity aerobic (today trampolining in the garden with kids), load bearing (eg gardening), and low intensity (eg walking) 
- Meditative exercise such as Pilates Yoga or stretching seems to help with reducing anxiety calming the mind and relaxing the body 
- Avoid sugar and processed foods which will spike energy and can accentuate an emotionally crash 
- Reduce alcohol and stimulants as these leave a rebound effect both in physical terms of energy and mood/anxiety crash while disturbing sleep 
- avoid excess medication; dont stop without advice but if you are using a lot of over the counter medication reduce and keep it for when you really need it 
- use of substances is not advised as many have harmful mental health effects such as paranoia, increased anxiety and psychosis 
 
Mental 
 
- try to start and end the day with gratitude remembering what you have and reflecting on why you are of value and why your actions matter 
- follow a regular routine - some will need this more than others, however some expectations for the day will help you relax and focus 
- practise kicking negative thoughts out of your head by challenging them with logical thinking - what evidence is there that the negative thought is true? 
- if you find yourself checking media more often try to set yourself key times when you will do this e.g. twice a day for relevant updates 
- try a digital detox if you are overstimulated to alerts, emails and notifications and put away devices at mealtimes and bedtimes 
- listening to soft music or relaxing natural sounds like rain can help relax the mind and proven to reduce blood pressure and heart rate 
- being around water and nature can calm the mind, even if it's a fishbowl, pond or growing plants in the home - see green and breathe 
 
Social 
 
- we were built for relationship to other humans, animals and the environment - stay connected to maintain positive social links and wellbeing from them 
- a working timetable is helpful but make sure if you are working from home you check your workstation is set up to avoid problems of poor posture 
- pets are proven to reduce stress (if you are not allergic that is!) and also help moderate behaviour and offer activity and comfort in times of loneliness 
- singing is proven to improve wellbeing through endorphin release - even in the safety of your own shower - belt out your favourite tunes today 
- volunteering is good for mental health (be careful in the coronavirus crisis that your well-meaning efforts do not spread the virus by keeping distance) 
- many spend more time at work than any other activity so work life integration is key in balancing priorities in the fast lane; decide how much of your life will be work, focus on observing and maintaining healthy boundaries - especially important when working from home to build quality time into relationships 
 
If this all rings a bell please see our other blog posts. If you would like to investigate your personal health further, you can book a consultation with Dr Sinclair who specialises in an integrated approach to health, stress and burnout management, aiming to help busy people perform better and find lifelong health and happiness. 
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