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The ABC's of Re-entry "Getting back out there" OAC Health Talks feature Dr. Pashby

To watch Dr. Pashby's OAC Health Talk covering the ABCs of re-entry, go here:

The ABC’s of re-entry.

I keep hearing people say:

“The pandemic is coming to an end”.

“We’re nearing the finish line.”

“The end is near.”

But the way I see it, we’re actually at about the halfway point of this crisis, psychologically anyway. The first phase of COVID was fear, anxiety, and grief as lockdowns ensued with the death tolls rising. Phase two, with its vaccines, re-entry stops and starts, and efforts at establishing a new normal is heading straight at us.

As one phase morphs into the next, we should take a moment to acknowledge what is going on. I’ve been calling it the mid-pandemic crisis as a way to capture the nuances of this moment. Like the ‘mid life crisis’ we are used to hearing about, this time represents one of transition. As more vaccines are distributed, we inch closer to a new phase of life. In this next phase, seeing friends and family, giving and getting hugs and even sitting in meetings may feel fresh, new, and exciting.

But also possibly terrifying.

Because alongside this freedom comes increasing emotional complexity. Turns out, transitions aren’t quite so simple. Psychologically speaking, transitions are often marked by surges in anxiety and sometimes depression brought on by a tendency to reflect and judge our past selves. We tend to lose perspective over time, and now we’ve lost perspective and a year.

See, for most of us, pandemic life was and still IS hard. Responding to an unpredictable threat like the COVID-19 pandemic evokes the stress responses – which have many serious physical and mental health consequences. The APAs newest survey reported some brow raising statistics: over 40% of Americans gained weight (an average of nearly 30 pounds), a quarter of Americans increased alcohol consumption to cope with stress, and almost 50% have delayed or canceled medical care in the past year.

What these statistics tell us is that this past year has been really, really hard. And yet many of my patients are reflecting on the last year with a sense that they didn’t pandemic well enough. They didn’t lose weight, get fitter, or clean out the closets. And time and again I hear my patients admonishing themselves for what they achieved, or didn’t, during the past year. It’s like there is a gold medal for making the most of pandemic life.

In response to the number of patients I hear expressing fear and self-blame as we inch towards normalcy, I created a framework to help think about these next steps.

I call it the ABC’s of re-entry.

The A’s of re-entry are: Acknowledge, Accept and Address both physical and mental health. First, acknowledge that in addition to the prolonged stress from COVID-19, real life continued as well. People lost loved ones, lost jobs, had babies, relapsed. Life didn’t care that COVID was here. As such, acceptance that the road to healing will be slow and bumpy is critically important to set realistic expectations. This path forward is not going to be linear. Finally, re-entry brings the need to address both physical and mental health. To do so, show up. Show up to your doctors, your therapists, your friends, family, community or other support network, and show up for yourself. The more you show up with your pandemic scars, the more you will see that you are not alone.

The B’s of reentry are: your Brain, your Body and your Behavior. All have been impacted by the pandemic and all will need some attention during reentry. Your brain has been flooded with stress hormones, greatly increasing your chances of experiencing anxiety and depression. Your body may have gained weight, may be stiff and achy from sitting in front of screens, and may have lost mobility during the many months of COVID. And your behavior has almost definitely changed. Whether you have found yourself drinking more alcohol, eating more at night, sleeping at odd times, or doom scrolling more than ever, you are going to have to pay attention to these new habits and make some changes to support the physical and mental health you deserve to have post-pandemic.

Finally, the C’s. They are: have Compassion, Create routines, and Choose wisely. First, let me help you regain some perspective. You are still living through the worst public health crisis in over a century. You weren’t supposed to earn a new degree, lose weight, or write a novel. You were just trying to survive. Trust me. That is how the human brain works. You were in survival mode for the past year. And it’s not over yet. Please, give yourself some grace and practice self-compassion. Next, proactively create some new routines that will support your physical and mental health. If you haven’t already, create a routine that includes daily self-care, no matter what that looks like for you. Walks, baths, reading a book, meditation. There is no perfect routine out there, so do what works for you. Finally, choose wisely as you re-enter. You don’t have to go back to things the way they were. Many of my patients have commented on how they do not wish to return to life as it was pre-pandemic. The rushing to and fro, the long commutes, and the endless to-do lists piling up. Re-entry is an opportunity to make choices about how you spend your time. Choose wisely.

You can watch the full talk on OAC's youtube channel by clicking here:

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