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Michael Carrese (Host):  The major disruptions caused by COVID-19 have most of us feeling some level of anxiety but for many people, anxiety can become a serious daily struggle. Board-Certified Psychiatric Mental Health Nurse Practitioner Andrew McGill from Southwest General Health Center’s Oakview Behavioral Health Services is here today to explain how natural remedies can help people regain control. This is Southwest General Health Talk. I’m Michael Carrese. And Andrew McGill, perhaps we can start by getting a general overview of anxiety and the different ways it can affect people.

Andrew McGill, CNP (Guest):  Anxiety is a normal response that our bodies and mind can have in terms of to change or any type of stressful stimuli. So, for instance, if someone were to say they are selling their house and they are moving; it’s a stressful change, it’s a positive change but someone can begin to feel anxious about it. For the most part, anxiety is a normal response. But having said that, anxiety can become troublesome when we’re not coping with it in a positive way or normalizing kind of how we’re feeling and being able to live our daily life how we want to.

You could break it down into kind of a more cognitive anxiety where we find like our mind is racing, like a subjective feeling like we can’t slow down our mind. Our thoughts are just kind of jumping from one thing to the next or we could have more of a physical anxiety where patients will tend to say they have something like an upset stomach, they feel their heart pounding, their hands get sweaty, they get physical manifestations of like panic when anxiety gets very high. And obviously, you can have kind of like a mixture of the two. So, for the most part, that’s how I would describe anxiety.

Host:  Yeah it can be on a scale as you say. You don’t have to be having full blown panic attacks to have a problem with anxiety.

Andrew:  Absolutely not. No, absolutely not. You could have a chronic kind of just baseline angst that just kind of puts you – makes you feel uncomfortable more often or patients sometimes they can have these sudden spikes of panic like an anxiety response where we maybe feel not anxious and then something will occur and then we feel like we’re losing sense of control and you can have a sudden like burst of anxiety or panic. But yeah, absolutely, there are definitely different manifestations of it.

Host:  And is there a typical way that it starts to interfere with your life or make things difficult? Does it interfere with eating well or being able to go to work or are there any kind of telltale signs?

Andrew:  I mean anxiety presents differently in different people, but what I tend to see is like challenges with our sleep would be a big one. So, maybe like just difficulty winding down. We find like we might get like kind of like revved up later in the day or just difficulty kind of winding down, not being able to turn our mind off and what that may manifest in or a patient may come in and tell me something like I don’t fell too bad but when I go to lay down at night; I just can’t turn my mind off. And they may be thinking about what if scenarios at night. So, like to put it into perspective with COVID-19 going on, maybe they have a child and the child has to go back to daycare and they just find themselves repeatedly ruminating about what if my child gets sick from another child, what if this happens and it can really be a slippery slope where things kind of get out of hand. The train comes off the track fairly quickly. So, I would say sleep disturbances is a big one. A lot of times patients will say they physically don’t feel well so like upset stomach, their hands get really sweaty, they feel like their chest is beating fast or tight and poor focus is another kind of big one that I tend to see. Like because of these racing thoughts that we can have, it’s difficult to really control our cognition, maybe challenges at work being productive, staying on task. Just because it’s like our mind is going in different directions and it’s very difficult to hone in on a specific task sometimes.

Host:  So, as you were saying at the beginning, it’s perfectly natural to be worried about different life circumstances, COVID-19 obviously as I was saying at the beginning has caused so much disruption and people are obviously feeling anxiety in a general sense but we’ve seen reports now that prescriptions for mental health conditions are up 25%, antianxiety prescriptions alone are jumping almost 40%. What do you make of that?

Andrew:  I would say it definitely doesn’t surprise me. I think that humans tend to be creatures of habit and clearly COVID-19 is a big break and breach into our normal traditional lifestyle that everyone has been living. They are stuck at home. We’re removing a lot of positive coping skills or mechanisms that someone might engage in to keep themselves mentally healthy and because of that, it can leave us with a sense of just not being able to relieve that anxiety and people are kind of reaching out for help. And thankfully so. I mean medication can be helpful especially in kind of acute crises situations. It also isn’t always necessarily the number one ideal choice but it’s another way to kind of help yourself feel better.

Host:  So, let’s talk about some natural ways, some steps we can take to reduce this problem. What’s on the top of your list?

Andrew:  Yeah, I have a number of things that I always like to preach. I’m going to run down a list of just diet, exercise, socializing is a big one especially that I’ve been trying to discuss with patients in this kind of stage of life that we’re in now. Things like yoga, meditation, therapy, huge one, like music therapy, sleep hygiene, getting outside, getting some like quality sunlight and fresh air and also limiting our exposure to some of these anxiety provoking news reports that we can – I mean it’s clearly it’s important to stay informed but at the same time, you could very easily kind of dive head first in and really fixate on all of the negative things going on. And I think that can definitely be overbearing at times.

Host:  Well and if you combine two of those things, watching news or consuming news late at night before you go to sleep; probably not good for sleep hygiene.

Andrew:  No. Absolutely. No. You can tend to like I said, just very much so fixate on some of these negative things that are going on and like I said, if we’re removing some of the positive things that we’re doing. I’m quarantined, the unfortunate nature is that due to regardless how you feel about it, clearly health providers felt it was necessary to keep everyone safe and that but there are things like so for instance, exercise. If gyms aren’t open and you are forced to stay home, it’s going to be pretty hard to exercise. Or socialization can be challenging when we were being forced to quarantine. But at the same time, there are ways around that or kind of something is always better than nothing. So, trying to do it in a healthy manner whether it’s a phone call, video chat, doing specific exercises at home, yoga, things like that.

Host:  Yeah, it can be small steps. You don’t have to join the gym. You can walk around the block.

Andrew:  Absolutely.

Host:  You mentioned yoga a couple of times. What do you like about that?

Andrew:  Yeah, so yoga and meditation, any type of like calming time that we can set aside to really just hone in on focusing on our body is awesome in my mind. It can increase like body awareness. It promotes like kind of identifying where – what areas our body can have tension in and then working on relieving those spots of tension through increased awareness. So, like working on breathing techniques to making sure that we’re not becoming like short of breath or hyperventilating like patients can when they get anxious. It gives us a much better sense of control. So, really finding like okay, I’m feeling maybe a little anxious and I feel like my chest is tight, I’m going to take some deep breaths, I’m going to do these stretches and really focus and hone in on relieving this anxiety myself. And that’s very empowering. It gives – it’s an increased sense of control, sense of self confidence and just focus. It kind of gives the person the keys to the car. They are better able to self-promote and advocate for themselves rather than having to rely on anything else.

Host:  Yeah, that’s a great way to look at it, that I do have some control over things, I can break it down, I can do a little bit to help myself. But if you get to a point where you think you need help and particularly in your case, how could listeners learn more about getting in touch with you or scheduling an appointment?

Andrew:  Yeah, I would say in terms of when is the right time to seek help for medication or how you do that. The answer is it’s always going to be different for each person. Sometimes we can tend to wait until things kind of boil over until we feel like we can control everything and then in a snap of a finger, something happens or maybe a snowball affects multiple things happen and we can feel like man I need help like pronto as opposed to maybe – I mean ideally, we want to engage in these things first and try and manage them without medication. It’s always the best option. Kind of preventatively. So, I always will recommend like therapy prior to medication. But the unfortunate nature is it’s not always that simple. Sometimes patients may hit a breaking point to where they are saying heh, I need some serious help maybe both medication and therapy to really get things back on track. And that’s always an option. We want to meet our patients where they are at and help them in any way with it, we can. So, what that would look like you call some form of like a mental health care provider, I mean that would be myself and then we would – what it involves is like a an hour long assessment in which we just sit down, talk. I get to know the patient. Really figure out what’s going on, how I can help them and goals of treatment. So, like everyone’s is going to be different. So, like maybe it might be getting back to working fulltime or maybe it might be if we’re feeling really down, it might be heh I want to be able to enjoy doing this again. I used to enjoy it, now I just don’t find that I get enjoyment out of it. So, we have some type of target like what are we trying to accomplish with medication or therapy or whatever it may be.

Host:  Yeah, that makes sense to have some goals. And specifically, to reach you folks can call 440-816-8200 or they could also visit the website which is  www.swgeneral.com. Andrew McGill, a Board-Certified Psychiatric Mental Health Nurse Practitioner has been our guest today. Thank you so much for spending time with us.

Andrew:  Yeah, sure thing. Thank you very much for having me. Always love to discuss mental health and how we can really just focus in and bring more awareness to it. It’s always a – it’s a hot topic nowadays, very important.

Host:  Really important and best of luck with your work. If you found this podcast helpful, please share it on your social channels or you can check out the full podcast library for additional topics that may be of interest to you. This is Southwest General Health Talk. I’m Michael Carrese. Thanks for listening.