There is a common saying that people do not appreciate what they have until it is taken away from them. I think it is safe to say that this year has made this sentiment quite clear. The pandemic caused by Covid-19 has killed more than 1.4 million people so far globally. The quarantine has brought economic hardship, loss of jobs, significant social isolation, and increased stress. As a result, both anxiety and depression have become more prevalent. Rioting issues and the elections have compounded the problems further. One survey looking at the mental health impact caused by the pandemic was conducted by the World Health Organization (WHO). Stress, anxiety, and depression significantly increased and there was a greater need for mental health services; however, because of the quarantine, 93% of countries worldwide had a disruption in mental health services. These 2 opposing issues made it clear that attention was needed to address the mental health consequences.

We have all been impacted in one way or another, but some have certainly had to deal with these stressors to a greater degree. This includes health care providers, first responders, those who have been infected with Covid-19, those with chronic medical conditions, seniors, and those who already suffer from a mental health issue. Those in racial and ethnic minority groups were also felt to be at greater risk. Seniors living in a nursing care or assisted living facility may suffer from isolation and the inability of seeing family members for extended periods.

It is important to recognize what the signs of stress are so that you can be proactive and address them if they are present. Some signs include increased concern about the health of oneself or a loved one. Financial burdens may increase sadness and stress. Changes may occur in your sleep or eating patterns. You may notice you become more irritable easily. Sometimes people attempt to self-medicate by increasing alcohol, tobacco, or drugs. Look out for increased consumption of these products in yourself and your loved ones. Many medical conditions may worsen with stress. Examples include high blood pressure, diabetes, atrial fibrillation, and acid reflux.

The following are some simple things that you can do to help relax and address stress:

• Stop and take 5-10 deep breaths a few times a day. Listen to the sound of your breathing

• Make sure to get some physical exercise with the goal of 30 minutes daily

• Take advantage of the great Florida weather. I refer to it as sunshine therapy. Spend at least 15 minutes outdoors daily in the sunlight. Whether it be a simple walk, sitting and people watching, or just reading a book in your lanai, you would be surprised at how much better you may feel with time in the fresh and bright outdoors

• Focus on proper nutrition. Try to eat more fruits, vegetables, healthy protein, and whole grains. Watch out for saturated fats and high carbohydrate-rich meals which may make you feel tired

• Listen to calm uplifting music

• If you have a pet, spend time playing with them daily

• There are Apps that you can install on your smart phone or iPad which have calming sounds such as rainfall or ocean waves hitting the shore

• Limit the news that you watch as the recurring negative news is not helpful

• Watch comedies in place of serious dramas to help make you laugh

• Because of social isolation, it is even more important to keep in contact with family and friends. Try to participate in facetime or zoom calls on your phone, iPad or computer

• Do simple activities that relax your muscles such as neck exercises, hand massages, or taking a bath

• If you cannot see your physician in person, consider a telehealth visit where your medical conditions and concerns could be addressed

We all lead busy lives but remember how important it is to find time to relax and to work on your own self-care. You will be of no use to others if you do not focus on yourself first. Please reach out to your primary care provider if you feel down or overwhelmed despite trying the above techniques. Stress and depression may aggravate many chronic medical conditions so do not dismiss signs of their presence. Vaccines for Covid-19 are right around the corner and will help us deal with this novel virus. There truly is light at the end of this long and stressful year. If you become very down and do not know where to turn, the National Suicide Prevention Hotline is always available by calling 1-800-273-TALK (8255). Please remember that you are not alone.

Dr. Sciavolino-Day is a primary care physician specializing in internal medicine. Please visit www.drsciavolinoday.com to learn more about her concierge practice in Naples.