These very helpful tips from clinical psychologist Desiree Dickerson, offer great advice and I have been using them myself over the last few weeks as my sense of resilience feels increasingly frayed too! In addition, I have added information on herbal medicines and homeopathy that I find particularly useful in my clinical practice. When our minds are consumed by the spread of the coronavirus and its impact on our health, loved ones, employment and the economy - how do we maintain our own mental health and well-being and that of our community? Hope you find it all helpful, best wishes Dr Sally x

1. Manage your expectations

This is unlikely to be the writer’s retreat that you have long dreamt of. The suggestion that periods of quarantine might bring unprecedented productivity implies we should raise the bar, rather than lower it. Do not underestimate the emotional load that this pandemic brings, or the impact it will have on your productivity, at least in the short term. Difficulty concentrating, low motivation and a state of distraction are to be expected. Adaptation will take time. Go easy on yourself. As we settle into this new rhythm of remote work and isolation, we need to be realistic in the goals we set, both for ourselves and others in our charge.

2. Proactively manage your stress threshold

Try to lay a solid foundation for your mental health and well-being by prioritizing your sleep, and practise good sleep hygiene (for example, avoid blue lights before bed, and maintain a routine around your sleep and wake times). Eat well (be conscious that you might be inclined to lean on alcohol, or other indulgences, to manage stress - this is understandable, but potentially damaging in the long run). Exercise: it will lower your stress levels, help you to better regulate your emotions and improve your sleep.

3. Know your red flags

One way to manage moments of distress is to identify key thoughts or physical sensations that tend to contribute to your cycle of distress and feelings of being overwhelmed. Our thoughts ("Why can’t I concentrate?"), feelings (frustration, worry, sadness), physical sensations (tension, upset stomach, jitters) and actions (such as compulsively checking the latest COVID statistics) each feed into and amplify these negative emotional spirals. Addressing one aspect of this loop by, for example, actively reducing the physical symptoms (I use box breathing: breathe in for four counts, hold for four, breathe out for four and hold for four, then repeat) can de-escalate the cycle and help you regain control. Journaling or writing can be a very helpful way of connecting to your feelings and emotions if you find this difficult.

4. Routine is your friend

It helps to manage anxiety and will help you to adapt more quickly to this current reality. Create clear distinctions between work and non-work time, ideally in both your physical workspace and your headspace. Find something to do that is not work and is not virus-related that brings you joy. Working in short bursts with clear breaks will help to maintain your clarity of thought.

5. Be compassionate with yourself and with others

There is much that we cannot control right now, but how we talk to ourselves during these challenging times can either provide a powerful buffer to these difficult circumstances or amplify our distress. Moments of feeling overwhelmed often come with big thoughts, such as "I cannot do this," or "This is too hard." This pandemic will cause a lot of stress for many of us, and we cannot be our best selves all the time. But we can ask for help or reach out when help is asked of us.

6. Maintain connections

Even the most introverted of us need some sense of connection to others for our mental as well as our physical health. Many working groups have created virtual forums where you can contribute or just sit back and enjoy the chatter. Staff teams have instigated virtual coffee groups, online book clubs and co-working spaces where you can work in the (virtual) presence of others. We are in social isolation, but we need not feel alone. Reach out to those who might be particularly isolated.

7. Manage uncertainty by staying in the present

Take each day as it comes and focus on the things you can control. Mindfulness and meditation can be great tools. This will probably be a stressful time for all of us. By embracing good mental-health and well-being measures, and by relying on others when necessary, we can protect ourselves and those around us.

Calming and uplifting herbs….

Herbal medicine can be a very effective and gentle way to ease anxiety, stress and to calm the mind and aid sleep. With restorative actions on the nerves, and a normalising action on our adrenal glands many herbs can really support and aid the body in times of stress. My favourites to calm anxiety are passionflower, oatstraw, verbena and valerian, and these can also be used to help with sleep. Used as a herbal tea or tincture, they need to be taken regularly to be effective.

Ashwaganda - is another of my favourite herbs, with a relaxing and calming action it normalises and reduces cortisol, a stress hormone, and therefore reduces the harmful effects of stress on the body while aiding sleep, energy and immunity. Taken as a capsule, tincture or traditionally as a powder before bed.

Bach Flower Rescue Remedy - is a wonderful first aid remedy for shock, fear and panic – just place drops under the tongue, it can be used for everyone, including the young and old. Or try Aconite, my favourite homeopathic remedy for acute fear, palpitations, anxiety and panic. I would recommend a 30C dose taken as often as required until symptoms settle. Other homeopathic remedies which could be indicated are:

Arsenicum album - useful when someone is pacing to and fro, fretting over what may or may not happen, anguishing over their health and that of family members, and needing company. Chilly and thirsty for sips of water, they may feel worse at or after midnight. They can be controlling, very fussy and critical, particularly when in ill.

Calcarea carbonica - is a remedy for home birds who need security. They also worry about their health and their family. They crave stability, protection and dread disaster. Anxious when things are left undone or not going according to plan. They need order in the home and will tidy and clean if stressed or make lists. Anxiety may manifest as anger, envy, hatred, withdrawal, unresponsiveness, despair or indifference.

Lyopodium - is for anxiety due to a severe lack of confidence. The person may have an emotional swagger but are easily intimidated by anyone perceived as more powerful. Responsibility in work or relationships can create debilitating anxiety and fear of failure, which may manifest in irritability, digestive complaints, and claustrophobia.

Phosphorus - is for bright-eyed, sociable, loving and empathic people. When frightened, they are excitable, suggestible, "spaced out," easily vexed and in need of reassurance. They gulp cold water (but then either vomit it or get nauseated by it) and are much worse at night.

Pulsatilla - is for sensitive, easily upset people who need a great deal of consolation and reassurance and are as changeable as an April day. They tend toward childish rumination and pouting if they don’t get the attention and emotional security they crave, quickly becoming fearful of rejection. Dependent on others for reassurance. Worse in warm rooms, being covered in bed, and after eating rich foods; better from fresh air, mild exercise, and consolation.

All remedies should be taken at 30C dose and every 2 hours for 4 doses, then just as needed until symptoms reduce.

For poor sleep I would also recommend Nutriadvanced Magnesium glycinate – take 2- 3 capsules before bed. And the wonderfully gentle and sedating herbal teas like limeflower, passionflower, lavender and oatstraw

For chronic poor sleep I also use melatonin which is prescription only, but one of the most effective options for re-establishing a good sleep routine.

Tearfulness and low mood

With many people in very difficult circumstances at present it is normal to feel tearful and low; mindfulness, journaling and connecting to friends or family can all help. If this continues or leads to hopelessness, a feeling of being flat or withdrawn, or suicidal thoughts it is important to seek professional help. If you are very concerned about yourself or a family member, your GP or local mental health crisis team should be contacted.

Depression can cause poor sleep, tearfulness, feeling irritable, lack of motivation, early waking, changes in appetite, unexplained aches and pains, lack of energy and continuous low mood or sadness.

Herbal medicines and homeopathy can certainly be useful and effective in lifting mood, for milder cases you can use my tips below, but for more serious problems a 1-1 consultation with Jules or myself to create a tailored prescription is recommended. Exercise and mindfulness are always helpful. St John’s Wort is a well-known and effective herbal medicine which can help lift the mood and is taken as a tincture or capsules ideally. It cannot be taken with some medications, including the oral contraceptive pill, warfarin, digoxin, some antidepressant drugs, indinavir, cyclosporin, theophylline, HIV medication and anti-epileptic drugs.

Other herbs I find very useful in low mood are damiana, lemon balm and verbena. Lemon balm makes a delicious herbal tea, infuse 1-2 tsp of fresh or dried herb and infuse for 10 -15 minutes. Drink 3 cups a day for a medicinal effect.

Don’t forget that depression may also be caused by low Vitamin D, low thyroid function and hormone imbalance. 1000iu / day of Vitamin D is a good maintenance dose for most adults, but to get immune support for coronavirus too I would recommend a higher dose of 3-5000iu/day.

Homeopathy

Classic remedies which I find incredibly useful in treating depression are,

Natrum muriaticum - this is for the classic "stiff upper lip" people who are deeply sensitive but often shut down emotionally. They tend to withdraw and can’t express their feelings, can be very self-critical and find it difficult to cry. They may be silent with grief after a loss. They are fearful of tight, narrow spaces, anxious at night, worried about robbers, and secretly terrified of being humiliated or rejected. Anxieties are often cloaked by migraines, tingling in the extremities, palpitations, insomnia, and isolation or feigned indifference.

Sepia - is a wonderful remedy for women. She will be very tired, have fatigue, irritability and low mood. Feeling tearful, worn down and fed up this remedy is for women who have lost their joy. They are irritated and resentful to their husband and children, want to be alone yet also feel lonely. She can be spiteful and vents this on her family, and is often worse just before her period or ongoing through menopause.

Grief

Losing a loved one is never easy, but grieving is a part of normal human life. I find the 5 stages of grief very comforting, knowing that these feelings are natural and allowing yourself to feel them and express them is very important in coming to peace with what has happened. You may feel the first 4 stages in any order, and can move between all of them in a day, or feel more than one at the same time; this is completely normal. Grief can occur from any loss, including loss of a business, a relationship or identity, and the process will occur in just the same way. Self- compassion is key, and understanding what is happening can make the process easier to bear.

Homeopathic remedies commonly used to ease grief are Natrum muriaticum and Ignatia.

Ignatia - is for acute, recent grief or loss. It suits sensitive, refined, and heartbroken people who are repeating to themselves, "I just can’t believe it, I can’t believe it..." They may be hysterical, averse to consolation, defensive, sigh frequently (as if to ground themselves back into their bodies), and experience radical mood swings—bursting into tears or laughter.

Natrum muriaticum - is for the classic "stiff upper lip" people who are deeply sensitive but often shut down emotionally. They tend to withdraw and can’t express their feelings, can be very self-critical and find it difficult to cry. They may be silent with grief after a loss. They are fearful of tight, narrow spaces, anxious at night, worried about robbers, and secretly terrified of being humiliated or rejected. Anxieties are often cloaked by migraines, tingling in the extremities, palpitations, insomnia, and isolation or feigned indifference.

In addition, I often use herbal medicines, and find this wonderfully supportive -verbena, rose and hawthorn are my favourite herbs used as tinctures.

The five stages of grief:

1. Denial & Isolation

The first reaction is usually to deny the reality of the situation. "This isn’t happening, this can’t be happening," people often think. It is a normal reaction to rationalize our overwhelming emotions. Denial is a common defence mechanism that buffers the immediate shock numbing us to our emotions. We block out the words and hide from the facts. We start to believe that life is meaningless, and nothing is of any value any longer. For most people experiencing grief, this stage is a temporary response that carries us through the first wave of pain.

2. Anger

As the masking effects of denial and isolation begin to wear, reality and its pain re-emerge. We are not ready. The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family. We may feel guilty for being angry, and this makes us angrier.

Remember, grieving is a personal process that has no time limit, nor one "right" way to do it.

3. Bargaining

The normal reaction to feelings of helplessness and vulnerability is often a need to regain control through a series of "If only" statements, such as:

• If only we had sought medical attention sooner…
• If only we had tried to be a better person …

This is an attempt to bargain. Secretly, we may make a deal with God or our higher power in an attempt to postpone the inevitable and the accompanying pain. This is a weaker line of defence to protect us from the painful reality. Guilt often accompanies bargaining. We start to believe there was something we could have done differently to have stopped this happening.

4. Depression

There are 2 types of depression that are associated with mourning. The first one is a reaction to practical implications relating to the loss. Sadness and regret predominate this type of depression. We may worry about finances and the practical aspects of the loss. We may worry that, in our grief, we have spent less time with others that depend on us. This phase may be eased by simple clarification and reassurance. We may need a bit of helpful cooperation and a few kind words.

The second type of depression is more subtle and, in a sense, perhaps more private. It is our quiet preparation to separate and to bid our loved one farewell. Sometimes all we really need is a hug.

5. Acceptance

Reaching this stage of grieving is a gift not afforded to everyone. Death or loss may be sudden and unexpected or we may never see beyond our anger or denial. It is not necessarily a mark of bravery to resist the inevitable and to deny ourselves the opportunity to make our peace. This phase is marked by withdrawal and calm. This is not a period of happiness and must be distinguished from depression.

Coping with a loss is ultimately a deeply personal and singular experience — nobody can help you go through it more easily or understand all the emotions that you’re going through. But others can be there for you and help comfort you through this process. The best thing you can do is to allow yourself to feel the grief as it comes over you. Resisting it only will prolong the natural process of healing.

We do stock all of these supplements in the online Orchard Barn shop, and also hold a full dispensary of homeopathic and herbal medicine including dried herbs and tinctures. Some of these can be bought as over the counter ready-made remedies, or you can consult with myself or Jules for a tailored herbal or homeopathic prescription.

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