You don't need to act like everything is OK

By Francine Deschepper

It has been just over two months since the world-wide COVID-19 pandemic necessitated extreme social distancing and self-isolation here in Canada. Each day, while I count myself lucky that my family and friends remain healthy and out of harm's way, I know thousands cannot say the same. And I feel guilty admitting I fear for my economic future when there are others whose loved ones are sick, or alone, or fighting on the front lines in hospitals, care homes or grocery stores. One of my close ACTRA Maritimes' friends lost his mother in a care home recently. It is heartbreaking to think about what he is going through.

Another colleague told me they would like to have their anti-depression medication increased but they are afraid to go see their doctor right now for fear of exposure to the virus. And then there is my friend whose husband works in an oil sands site north of Fort MacMurray, which is experiencing a COVID-19 outbreak as well as flooding, and, as a result, she has been on her own for two months trying to home-school two young children while worrying about her husband's well-being as well as the fact that her three upcoming theatre jobs have been cancelled.

Just because we're actors, doesn't mean we have to act like everything is OK.

Then, just as we were coming to terms with our new reality, an unimaginable tragedy occurred here in Nova Scotia and we added a new sense of horror to our growing, daily distress. With it all becoming too much for some of us to endure, I reached out to my friend Dr. Ron Fraser (Psychiatrist at McGill University Health Centre) for some reassurance and good advice. Here are his words of wisdom:

"By and large, human beings are social pack animals. Historically, we've always had to belong to some sort of family unit or tribe to survive. An important part of human society is inter-connectedness, and this has been severely disrupted over the last two months. So, people should realize it is not unexpected that current circumstances would be extremely trying and at times distressing. In fact, it would be rather atypical for individuals to smoothly adapt to our present situation. Personally, the COVID-19 crisis has separated me from my family and, like everyone else, I find it to be an increasingly difficult situation with each passing week. What began as a sort of bizarre break for people has now become rather frightening in duration and the novelty has long since worn off.

For many people, it can be extremely reassuring to simply give themselves permission to feel bored, lonely, sad, angry, frustrated or vacillating between all of those.

First and foremost, I think it's important to distinguish between mental reactions and mental illness. It is important to accept it's normal and expected that we each would have mental reactions to finding ourselves and our loved ones in such a stressful situation. For many people, it can be extremely reassuring to simply give themselves permission to feel bored, lonely, sad, angry, frustrated or vacillating between all of those.

I think as much as possible, it's important to try and have a structured routine. Go to bed at the same time each night (ideally before midnight) and get up at the same time each day (ideally by 8 AM). Try not to get into a pattern of staying up all night and sleeping all day, which we know profoundly changes our REM sleep and predisposes us to depressive and anxiety symptoms thereby making a bad situation unintentionally worse. No screen time before bed! Read an old-fashioned book or magazine instead.

Try to eat three meals a day with a relatively balanced diet even if comfort food is profoundly tempting. Shower! Dress like an adult. Don't fill the empty time with increased substance use. When you fall short of this and stay up ‘til 5 AM watching Netflix in your underwear while eating chicken wings and pizza in a drug-induced haze, don't beat yourself up, but instead make a renewed commitment to get back on track. And certainly you can make Saturday night your "reward myself for surviving quarantine for another week" night.

Pursue your hobbies and maybe develop new ones or rediscover old ones. If you're fortunate enough to have a yard, make use of it. Plant something. Try to do an hour of physical activity every day. It can be as simple as taking a walk. Try to alternate activities - start your day with a walk, then answer your e-mails and read the news, have a Zoom lunch date with a friend or a group of friends, connect with family, perhaps do something kind for an older adult, rediscover old books or films that brought you joy in the past.

Don't impulsively adopt a pet – they are a lot of responsibility. But you might offer to walk the neighbour's dog. If you are quarantined with other individuals, try to eat dinner together, maybe have group activities such as board games or puzzles. Just remember, doing nothing is always easier than doing something, and never healthier. You will need to push yourself. There are specific challenges if you're in isolation alone, particularly with loneliness and boredom, and other unique challenges if you're in isolation with others. Almost everyone I know is commenting on how difficult marriage is under these circumstances.

Anyone with children may feel like they're the worst parent in the world, alternating between feeling woefully inadequate and being angry and frustrated. Add to this the significant financial stressors people are experiencing and you find you have a situation that, for many people, is genuinely overwhelming and causes them to lie awake at night.

Finally, I think the thing most distressing for people is the profound sense of having no control and complete uncertainty about what lies ahead. Even working in a tertiary care hospital where presumably I have access to solid up-to-date medical information, the situation changes every 48 hours and in many ways I know less now than I did six weeks ago in terms of what to expect. This lack of control and uncertainty generates tremendous anxiety for many people, particularly when their well-established routines have been completely disrupted and none of us have any idea when life may begin to return to normal.

Anxiety is meant to keep us safe from danger, but if it becomes debilitating, such that we are unable or unwilling to leave the house, then obviously that's problematic.

It's normal for people to have negative emotions, it's part of the complex human condition. Anxiety is meant to keep us safe from danger, but if it becomes debilitating, such that we are unable or unwilling to leave the house, then obviously that's problematic. So, if you find your low mood or heightened anxiety has become your most frequent mental state, this may be something about which to be concerned. If you are finding other behavioural changes, such as changes in your sleep (either not enough or too much) or your appetite (again either not enough or too much), these can also be warning signs you're not doing well.

Generally, if you are experiencing any sort of functional impairment; if you find you're not able to leave your bed, invest in your needs such as preparing meals or brushing your teeth and showering, these are other warning signs that can be of concern. Similarly, we may not be cognizant of these signs and for this reason it's important to pay attention to the feedback we’re receiving from those around us. If your loved ones are giving you feedback of concern, you should take this seriously.

The other concerning thing we're seeing is people are significantly escalating their use of alcohol and drugs as a way to self-medicate and numb themselves. Obviously, people do this because it's a pretty effective short-term strategy, but it's a spectacularly poor long-term approach and inevitably can create more problems than it solves. If you find your substance use has significantly increased, or if others express concern about your substance use, this is something you should take seriously.

If you feel genuinely overwhelmed and are unable to cope with your mental state, it's important to get the appropriate resources and assistance.

Certainly, there are lots of online options and resources people can access from the safety of their own home. However, I can't stress enough the importance of going beyond online resources if the situation warrants. If you are having thoughts of harming yourself or others, or if you feel genuinely overwhelmed and are unable to cope with your mental state, it's important to get the appropriate resources and assistance. Online resources may simply not be adequate and you may require professional intervention.

Many communities have mental health crisis hotlines and it’s important to remember healthcare services have not ceased to function and can be accessed if needed. Unfortunately, people seem to be avoiding the hospitals, emergency rooms and family doctor offices at all costs, which is understandable. However, an unintended consequence of this is serious non-COVID-19 conditions are being neglected and left untreated. If you're having crushing chest pain, please go to the emergency room! A heart attack will kill you just as definitively as coronavirus.

Please don't neglect your mental health out of fear of this pandemic. We do not want people going to health centres needlessly, but at the same time we definitely do not want people avoiding health centres when needed and neglecting their own mental and physical health conditions. Take your mental health and wellness seriously and seek whatever assistance you might need."

ACTRA, in conjunction with AFBS, recently announced enhanced services available to ACTRA members through HAVEN Helpline and LifeWorks by Morneau Shepell. Online counselling, resources, webinars and videos are available through the LifeWorks platform, which can be accessed through the web or by downloading the free app (available in both the Apple App Store and Google Play). To join LifeWorks please email actra@actra.ca to get your log-in details.

Support through LifeWorks by Morneau Shepell

What is the novel coronavirus? (10 minutes)
Webinar: Emotional Well-Being During the COVID-19 Pandemic (25 minutes)
Webinar: Talking to your child about Covid-19 (25 minutes)

Well-being Wednesdays (via Facebook Live)

Visit the LifeWorks Facebook page to join Well-being Wednesdays! Weekly topics include mental, physical, social and financial well-being. Recordings of past sessions will also be saved to the Facebook page.

WellCan™

Created by Morneau Shepell, WellCan™ is a free collection of digital resources to support the mental health of all Canadians during COVID-19. Through the growing collaboration of organizations, WellCan™ addresses challenges brought on by COVID-19 through an extensive database of information. There are a number of toolkits, articles, tips and infographics available on the WellCan app. The free app is available on Apple and Android devices. For desktop access, visit wellcan.ca

Mental Health Awareness Month

May is Mental Health Awareness Month. To help bring awareness to this important aspect of total well-being, Morneau Shepell launched a new microsite, A stable mindset in an unstable world, within its LifeWorks platform. Through videos, infographics and articles, the microsite explores: What is Headline Stress Disorder; How to protect your mental health while staying informed; and Real-life tips to manage anxiety.

Did you know, depending on your level of insurance, you may have coverage for mental health counselling services through AFBS? Log-in to your account to see if you qualify. UBCP/ACTRA members can visit www.calltimementalhealth.com where you’ll find a complete list of services available from both AFBS and MBT as well as other supports.

Additional financial and well-being resources can also be found on ACTRA’s dedicated COVID-19 webpage.

Mental Health & Wellness Resources:

Anxiety Canada
Calltime Mental Health
Canadian Mental Health Association
Ending Violence Association of Canada
ShelterSafe
WellCan
Wellness Together Canada

Addiction Specific Websites:

In the Rooms 
The Daily Pledge
My Recovery

Francine Deschepper is a Halifax-based actor, Past President of ACTRA Maritimes, and an ACTRA National Councillor.

Dr. Ronald Fraser, MD, CSPQ, FRCPC is the Associate Professor of the Department of Psychiatry at McGill University Health Centre. Dr. Fraser is the Head of Inpatient Detoxification Services, Addictions Unit and Director of Extended Care Borderline Personality Disorder Clinic.

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