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Melanie Cole (Host):  During the COVID-19 pandemic, there's been a marked increase in people seeking treatment for mental health conditions. What are the signs and symptoms to look for? If you think someone, you know is struggling with a mental health issue, what steps can you take? Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And I implore you to join us, as we discuss the signs of mental distress in family, friends, coworkers, and what you can do about it. Joining me is Dr. Ijendu P. Korie. She's a Psychiatrist in the Behavioral Health department at Henry Mayo Newhall Hospital. Dr. Korie, it's a pleasure to have you join us today. What an important topic we are really discussing here. People Are all sorts of things at this time. Some strange, some things they've never felt before. How has the pandemic exacerbated existing mental health issues and what kind of stress are we sort of globally experiencing right now?

Ijendu P. Korie, MD (Guest): Thank you for having me, Melanie. I have seen a whole lot of mental health related issues that are directly and also indirectly linked to the pandemic. And it is very heartbreaking when it affects us in a way that we have never known before. And it appears as though we were so unprepared to meet the need of our communities. One of the things that I have noticed is severe clinical depression. I have also noticed a lot of anxiety. And I've noticed decompensation in people who already had a history of mental illness, but who are now returning to us worse than they were before. The dimensions are very, you know, they're multi faceted to say the least but there is a lot of impact that COVID-19 has had on the mental health of our communities and globally as well.

Host: I agree completely. So, let's jump into red flags, signs of anxiety and depression. I mean, as we've said, this is kind of going on around the planet, but there are certain red flags and markers that would signal that we're not handling this very well for ourselves. We're not handling it in a healthy way. And these signs of mental distress can be quite damaging. So, what are we looking for and what should we be looking for in ourselves and in our loved ones?

Dr. Korie: So, one of the things I would like to say, you know, at the get-go is to make sure that we have the right perspective regarding mental illness. And that's an education that can never happen enough. When we see someone who has say breast cancer, say stage three, we usually respond with a lot of empathy, without any stigma. Whether it's us having it or others having it. However, it's so happens that mental health issues over decades and generations have a lot of stigma, either even directed from the person who is affected or from the people or the community around them. So, the perspective I'm talking about is for everyone who is listening to remember that the brain is an organ. If we are empathic, toward other illnesses like breast cancer, for example, if we don't have blames for the person who's suffering it. If we have nothing but empathy, it is the same way that we should approach mental illness. Because again, like I said, the brain is just an organ and just like the patient who is suffering from brain cancer or even breast cancer, for example, need some type of chemotherapy and some type of response immediately from experts.

That is the same way that if someone has mental illness, it's that organ the brain that also needs some psychopharmaceutical approach or therapeutic approach. But we should try to give the brain the same type of respect and empathy that we give other organ. So, that said, if we have the right perspective, then we will be able to find in ourselves the right responses, or even be ready to seek out those signs that you're asking about.

So, dive into the kind of signs, having prepared us to have the right perspective. If we have a friend or a family member who we know how they have always behaved or their baseline and we begin to notice that there is a significant immediate change in their mental status, or a subtle change in their mental status, that's a red flag and I'll give examples of what I mean. Like someone who is often talkative and conversational, who is now so quiet and you know, not wanting to converse or engage. Someone who is always out there with us or with family, or even calling on the phone and asking how we're doing. And now they are very quiet.

They're not answering phones or someone who was rather mellow and level in their mood, but now has become very talkative and, you know, erotic and having these abrupt new goals that probably don't add up to the match that we know about them. These are some red flags. It could go either way, but it's basically a change from baseline. That is something that we should look out for and respond with empathy, as I had mentioned, immediately to see if we can check in and actually see, you know, what's going on with that person.

Host: Well, thank you for telling us that and also about the stigma, because sometimes it would seem that because of the stigma that's been around for so many years in mental health and in the mental health world, that some people may be reluctant, and certainly now with COVID, people are more reluctant to seek help. I know because I'm going through it in my own family. So, it is something that people don't always want to do. So, thank you for mentioning that Doctor. Now let's talk about what we do, if we see this, I mean, I have seen this in someone that I love and now I'm trying to be empathetic. It's a little frustrating, but I'm trying to get them the help that I feel they need. What are we supposed to do Doctor, if we see these things that deviate from the norm of this person, what do we do?

Dr. Korie: Okay. So, the first thing to do is to make sure that you get yourself in a non- judgemental inner self. And I'm talking about the person who's trying to help, trying to intervene. So, we have to start with ourselves. You have to check yourself and just make sure that even before you try to intervene that you take a non-judgemental pose a posture either in the way that you approach the person or even within yourself, because sometimes being judgmental is usually even unspoken more than spoken. So, when you make sure that you have centered yourself, to that point where you are completely nonjudgmental, you're most likely to be more successful because your approach again is going to be nonjudgemental. So, you can approach the person in that nonjudgmental way.

Even from just a casual conversation and say, how are you doing? And what's going on? I've been thinking about you, you haven't called me for five days. That's very different from what had been, you know, what the case has been and reassuring the person that you are not going to judge them no matter what they share and then probably helping that person lose the stigma they might actually be having on themselves. I have personally had to educate a lot of my patients, not to think that it's their fault, that they have severe depression or even schizophrenia so that they can see that there is a huge environmental factor, like COVID-19, something that we've never seen before or other environmental factors and a genetic disposition that adds up to this illness, none of which is their fault. So, once you're able to help the person to feel unjudged by you and themselves, it's usually will help them open up. Once they open up and you see that they are willing to listen to you, even if you have to try multiple times, then you can begin to suggest to them that there are a lot of resources out there. And that it's okay to get help. It's okay to reach out to professionals who will be able to guide them through the process of getting help. It's okay to take medication if a professional thinks that you need it. It's okay and it's actually beneficial. So, that will be the first step to take.

Host: Great advice. Really great advice. Now, one issue that I think has come to light during this pandemic, and it's such an unprecedented time Doctor, minority populations, underserved communities face a disproportionate mental health burden, especially during this pandemic. I would like you to speak for just a minute to other providers that are listening to this, to people that love someone that they feel is suffering from a mental illness that may be in one of these communities and what we can do to help them. Or how you want providers to reach out and see if we can kind of all come together because this is facing all of us, but certain people are really carrying a heavier load.

Dr. Korie: Thank you so much, Melanie, for bringing this issue up. Because COVID-19 itself has affected minority communities disproportionately compared to others. And as a result, the mental illness or mental illness related things have also affected these communities more than other communities. One of the things that I've noticed through my practice is that because minority communities who are also unfortunately less privileged in terms of their socioeconomic status, have been unable sometimes to access mental health resources because they don't have health insurance or have health insurance that is so limited in the services that they can receive.

So, working on our health care system, such that the insurance types that are carried by these individuals does not shortchange them from receiving the help that are already available, but unfortunately, available to only those who have the "good insurance" or those who have the money to afford it, I think is very paramount so that these people will be able to you know, access the help that they need.

Host: Dr. Korie, as people would like to get help, or they have a loved one that does need to speak to a professional, what's happening with COVID now, how are you using Tele-health? What are you doing as far as visits to help people at this time?

Dr. Korie: That's a great question. So, actually COVID-19 has brought out the beauty of virtual visits. It's something that was not used very much before COVID-19, but with COVID-19, psychiatrists are able to offer regular virtual visits through Tele or a video visit, usually for the initial visits, it's absolutely important that you can visualize the patient for your initial evaluation, but even subsequently, should a patient need to talk to you, the patient has the resources of calling and you can do a quick evaluation and get the patient the help they need right away. So, that is safe. As you do not need to expose yourself or even leave the comfort of your home. And treatment is not interrupted. Medications can be refilled, therapy sessions can happen. So, Telehealth has really enhanced our ability to care for our patients like never before.

Host: Well, and it would help to break down some of those barriers and make mental health care more accessible for the underserved communities. So, while we're talking about this, many of us are being isolated at home. It's impacting all parts of our lives. What would you like to tell us about your best advice for lifestyle and behavior? You've spoken about treatment. You've spoken about stigma. You've spoken about red flags. Now tell us as a psychiatrist, what would you like us to be doing to help support our mental health? Whether it's lifestyle related or reaching out, Zooms, exercise, whatever it is, give us your best advice.

Dr. Korie: My best advice at this time will be talk about it. Talk about it, normalize it. Our mental health needs to be normalized. Let's be willing to talk about our own mental health to people in our community and be willing to listen to their own mental health issues without judgment. I think when we make this a conversation without stigma, then we'll be even able to share resources. We'll be able to reach out to each other without feeling like we're doing something that we're not supposed to do. And kind of wrapping up this very important advice that I hope that people will be able to imbibe. It goes back to the thing that I was talking about at the beginning. If someone has breast cancer, we will not contain that. The brain is just as good an organ as the breast is, we need to give our brain and our mental health, the respect that it deserves. Talk about it.

Host: What great advice really, that just gave me chills and it's something that's so important that we all do. Thank you so much, Dr. Korie for joining us today and for more resources and information, you can visit the National Alliance on Mental Illness This email address is being protected from spambots. You need JavaScript enabled to view it.. If you feel overwhelmed with emotions like sadness, depression, or anxiety, or feel like you might want to harm yourself, please call the national suicide helpline at +1 800-273-8255, 24/7. They can help you.

That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. If you have concerns about COVID, we encourage you to check the Henry Mayo This email address is being protected from spambots. You need JavaScript enabled to view it. and click on the virus link at the top of the page for more information. Please share this show with your friends and family on social media. We're learning from the experts at Henry Mayo Newhall Hospital together. And I think that it does take a village. We can all help each other through this. If we learn those red flags and we know where to turn for help. I'm Melanie Cole.