KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show on WAMU 88.5. Welcome. Later in the broadcast it's Kojo For Kids. We explore how kids are coping with the stress of 2020 and what can be done to help. But first, these are unquestionably uncertain and difficult times. So today we're taking a break and a breath to check-in on our mental health as we head into a long pandemic winter.

KOJO NNAMDIAnd we'd like to hear from you. What have you been doing to guard your mental health? How are you feeling now that the results of the election are in? How do you take care of your own mental well-being? Joining us now is Dr. Mary Alvord, Psychologist and Director of Alvord, Baker & Associates. She also teaches at George Washington University School of Medicine and Health Sciences. Dr. Alvord, thank you for joining us.

MARY ALVORDThank you for having me.

NNAMDIWe're eight months into a global pandemic with cases spiking across the country. It's been a year of racial reckoning and protests against police violence and systemic racism. And we face ongoing uncertainty as a sitting president refuses to concede vowing to fight the results of the election. What are you hearing from people about how they're responding to all of these stressors?

ALVORDOh, excellent question. You know, there are even stresses beyond these in terms of the economics and school being virtual or hybrid and working from home. So what I'm hearing is, you know, the broad band of how people are coping or not coping. And many and most are coping with some very helpful ways of responding to the stress and not thinking of everything all at once, because I think if we think of all of it at once it's quite overwhelming. And to just chunk it into smaller parts and focus on what we can control and what can we do about those things.

NNAMDIWell, for much of D.C. and this region there was an atmosphere of celebration this weekend after a long divisive election. It was finally over. The president-elect vows to bring unity and a return to decency. How much has this outcome affected people in your view in the Washington region?

ALVORDWell, what I have seen and what I've heard is for the most, it's bringing hope. And I think that's what, you know, the country needs as a whole. I'm also well aware and hearing of people that they are conscious that it's not everyone and that we do want unity. We don't want to have sides of we say this and you say that. And not having some sense that we can negotiate and we can compromise and that we can in fact be the United States of America.

NNAMDILet's talk about joy for a second. What did you think when you saw people dancing in the streets?

ALVORDWell, I love dancing. So music is always uplifting and, you know, you could just see the unleashing of people feeling like there's some sense of closure. Although, you know, listening to the news today, it's not complete closure. So we will hope for closure very soon. But I think music and dancing just unleashes those emotions we all need to chill out in different ways and celebrate. Celebrate our causes.

NNAMDIDr. Alvord, since the pandemic began there have been several studies and polls that point to a rise in anxiety and depression. What can you tell us there?

ALVORDWell, we certainly see that and as you pointed out, the studies are showing the depression rate has tripled and the anxiety rate has -- I don't know what the figures are, but they have increased significantly. The American Psychological Association recently released a survey on stress and they polled peopled nationwide. And regardless of affiliations the stress level is at an all-time high. And what I'm very excited today is that we can talk about some of the things that we can do because mental health is so critical to our well-being. It's not just physical health. It's everything.

NNAMDIYes. For people who are already experiencing depression, anxiety and obsessive compulsive disorder, what has this age of COVID-19 meant for them?

ALVORDWell, I think for many it has increased health anxiety, because, you know, we're seeing people needing to follow the science and be careful in washing hands. And for so many it feels like, well, we were right to be this anxious, and so it takes away a little bit in terms of the reality of moderating how we do it. How do we balance our anxiety with the realities of taking precautions but not going to the point where it's really interfering with our lives?

ALVORDAnd those who are depressed -- you know, with depression the worry is that there is increased isolation, which of course makes it all that much worse. You know, we talked about in the beginning of the pandemic and still this term social distance and I have never quite understood that because for me and people I talk to in the profession it's really we want physical distancing, but we want social connection. And that helps with anxiety. It helps with depression. It helps with not feeling that you are alone in all this.

NNAMDIYou recommend many strategies for coping with stress. Let's start with your own thoughts. What is self-talk and why is it so important?

ALVORDWell, self-talk is something we don't always think about, but we are constantly thinking to ourselves in our minds. And when we become aware of that we can really use that to be our friend. First acknowledge, are we criticizing ourselves? Are we, you know, really thinking negatives thoughts? Are we thinking retaliation? You know, what is that self-talk, because what we've learned is that our thoughts are so powerful and we can challenge them so that they are moralistic, you know, and we don't always have to act on them. We can be -- have very angry thoughts towards someone, but we don't have to act on that.

ALVORDWe can problem solve and think, Okay. I'm really annoyed with this person. They did X, Y, Z. What can I do? Is the relationship worth keeping? You know, how are we going to either compromise or make amends. So self-talk is just -- it feeds into then our emotions because if we think, I'm so overwhelmed. I can't handle this. What am I going to do? Then we sort of get stuck or we start avoiding. But if we think, Hey, I can try. I get help. You know, I can do something else. I've done it before. Then you move forward. So it really is this interaction between thinking something and then taking action. And also it affects our bodies.

NNAMDIWhat about our emotions? How do we find calm, but also acknowledge the reality of our feelings?

ALVORDWell, you know, feelings are feelings and we are all justified in having our feelings. They are our personal feelings, and they can be, you know, validated by others. And we have to learn to sort of tolerate I think distressing emotions, so that we don't act on them in negative ways and so that it doesn't impact us also in a physical way. So, you know, right now so many people are not okay. And I've been saying it's okay to not feel okay, right? It's just--

NNAMDIMm-hmm.

ALVORDThen what do you do with it. And, you know, acknowledging that goes a long, long way. And, you know, we have a lot of strategies to sort of sit with those feelings and then accept them and then decide what we're going to do with them.

NNAMDIYou, to come the body and the mind, you narrate a progressive muscle reaction. I'm wondering if you might walk us through a brief version of that exercise right now.

ALVORDSure. I'd love to. So this is called progressive muscle relaxation and there have been much research on how much it promotes mental health, calm and also physical health, because the mind and the body are connected. So I will ask people to get into a comfortable spot, and I guess it's going to be hard if you're driving and listening. But at least perhaps you can listen to the steps and then do them elsewhere, you know, once you're in a stationary place.

NNAMDIYes. Indeed, if anybody is driving or operating any heavy machinery they should first safely stop whatever they're doing, but go ahead, please, Dr. Alvord.

ALVORDRight, right. Or listen to it and try to do it later. So I'll lead you through a brief progressive muscle relaxation. What I'd ask you to do first is just take a really deep breath in and hold it to the count of five, two, three, four, five. Slowly breath the air out. And now I want you to take your right hand and make a fist as tight as you can and you're going to notice as you tighten it what those muscles feel like.

ALVORDSo part of this exercise is learning what you're muscles feel like when you're tense and anxious verses when you're relaxed. So hold it, hold it really tight till it hurts. And now very slowly, very slowly release the hand. You may feel a tingling sensation or a warmth. Your fingers may feel very stiff. And this starts giving you an idea of what your body feels like when it's so tense.

ALVORDNow bend your arm at the elbow without tensing your hand and tightening your biceps and your whole arm without your hand and hold it. And then very slowly relax, and as you do just really be mindful of the differences between that tense state and the relaxed. As you learn to do the exercise, you'll get better at distinguishing those feelings and then be able to do it.

ALVORDSo now let's move over to the left hand and do the same. Hold it. And then slowly, slowly relax. And just to move along we won't do the left arm. But let's bring your chin to your chest.

NNAMDIWell, I'm afraid we're about to run out of time in this segment. So I'm going to ask people to hold for a second. And you'll do the next exercise when we come back. I'm Kojo Nnamdi.

NNAMDIWelcome back. We're talking with Psychologist Dr. Mary Alvord. And she was -- as we took that break taking us through progressive muscle reaction. You were about to move to, I think, the chin.

ALVORDYes, the neck because as adults we stress so much in our necks and then we get headaches, so just take another moment and just keep noticing the difference between how it feels. So everybody just please put your chin to your chest as close as you can and you're going to feel some of the tension down the spine and hold it. And then very, very slowly bring your head up. So the key also is to do this slowly so that you can really hold the position. And we'll just do one side of the neck now. Put your head as if you're touching the shoulder and you might feel that pulling on the other side of the neck. And, you know, how much you feel that tension gives you an idea of perhaps how much stress you're holding on to, and then just slowly, slowly bring your head up.

ALVORDSo progressive muscle relaxation encompasses all the major muscle groups. So we don't have time to do it on air today. But there are plenty of recordings available. You know, I have one on a CD and it takes you through your face and your stomach, your chest, your legs and your feet. So all important because if we're stressed we don't think as clearly. And this is one nice relaxation exercise to do. And the nice things is you don't have to do all the body parts at once. You can really learn which of the body parts you stress out. Where does your tension fall? So many of it also falls in our abdomen and our stomachs.

NNAMDIHere now is Larry in Oxenhill, Maryland. Larry, you're on the air. Go ahead, please.

LARRYYeah. Well, you know, like many people we've had a very difficult summer. And I've been pursuing a lot of mental health help through an intele-doc, you know? It's been free in New York City and right now I'm in Maryland. But, yes -- I mean they do a lot of checklists and they make sure that you're on track and not too stressed out. And they're very quick to try to prescribe you medications. But I found a lot of great support from just friends and walking and meditation and just the stretching exercises, you know, progressive muscle relaxation. Those things have been very helpful for keeping me on track and just walking away from some of the sources of the anxiety and just taking a time-out that way. So I appreciate this show today. It's been very helpful. It's reminding me of what to do.

NNAMDIAnd, Larry, we appreciate your call. And Dr. Alvord, Larry's call reminds me that relaxation and meditation apps were already popular, but downloads have surged since the start of the pandemic. Can those be useful?

ALVORDThey're extremely useful, because I think, you know, so much of what helps us be resilient and cope is focusing on the things that we can control. Accepting the things we can control. But then also doing something about what, you know, is bothering us. And in the age of technology there are wonderful apps that are researched by the Veteran's Administration. I think it's the Center of Technology and they have a mindfulness app, a mood coach app. They even have a COVID app. But they have them for breathing.

ALVORDSo I think it's loading our toolboxes, right? Just like Larry said. There are so many different strategies that we can use, the mental strategies, the physical relaxation strategies as well as taking action.

NNAMDIWell, in our next segment we'll be doing Kojo For Kids where only kids are allowed to call in. But in this segment we heard from a parent who says, The holidays will be very different now because of travel and gathering restrictions. How do we address the sense of loss our children will feel, because of this on top of the loss they are already feeling by not being in school and not being able to do the regular things kids do? You will probably get this question to from a kid on Kojo For Kids, but you may want to respond to this parent.

ALVORDI think we had our first little trial with Halloween. First, as I said, we need to acknowledge the grief and the loss. They're on so many different levels. They're not seeing their friends. They're not able to go away. They're not able to see many relatives. So first and foremost validate that it is really hard. But I think you can also say and part of this is being resilient this gives us an opportunity to create some new ways to celebrate. You know, during Halloween I had a table out. Spread out candy with a little sign Take two. And kids walked by took their candy and we could from a distance see them with their costumes on. And many kids actually reported that was more fun, because they had little gatherings, you know, with distance, little pods.

ALVORDSo I think how do we take these circumstances and make them into opportunities to think outside the box and think a little differently and perhaps start new traditions.

NNAMDIHere is Kiani in Fairfax, Virginia. Kiani, you're on the air. Go ahead, please.

KIANI(unintelligible) So what I was talking about with stress and anxiety that whenever these things happen remember Allah and that will heal your heart. And that's where most have these anxieties. And in the era of this COVID-19 it is just everybody cannot go close to each other. And that's how things are. So we have to go back to faith. Go to that church. Go to that synagogue. Go to the (unintelligible) and maybe we can't go there also, but read the text and get some solace, you know, from the creator.

NNAMDIOkay. Dr. Alvord, how can faith help in this situation?

ALVORDWell, we also know from the research on resilience that faith, which does not have to be necessarily linked to a specific religious organization or religious domination, but I think spirituality and values and a sense of what are our values, what are our morality, what is important to us and how can we have faith that plays an important role in many people's lives. And I think in all people's lives in terms of values that we set up.

NNAMDIFor those who are considering finally seeking a therapist, what would you recommend as a first step?

ALVORDWell, I think, you know, if you're comfortable with your internist, if you have a primary care doc that would be one place to start to get some recommendations. And then all the state like psychological associations have referral help so you can call. There are also hotlines if somebody feels more in crisis, but the hotlines can also direct you to some resources.

NNAMDIOkay.

ALVORDAnd then really network.

NNAMDINow to close out this segment with adults, I'm wondering if you might lead us through a final brief visualization. We only have about a minute and 30 seconds left.

ALVORDOkay. I'll try to keep track on this. So everybody, again, if you are driving or heavy machinery please don't do this right now, but you can do it later. And take a very deep breath in and then slowly breath out. You can go wherever you want. I would like you to find a space in your mind that you can go to, which is relaxing free of stress and think about the temperature of the air and how it feels on your skin. What colors do you see? And what sounds do you hear or would you like it to be silence? You can choose this to be however you want.

ALVORDBecome aware of smells. And what surrounds you. And you can decide if you want to be in this place yourself or bring one or more people there, and what would you do? What I love about visualization is it's in our mind and it's with us always.

NNAMDIYep. I've visualizing some great scenes right now. We're going to take a short break. When we come back it will be Kojo For Kids. We take calls from kids only, but our guest will still be Dr. Mary Alvord. I'm Kojo Nnamdi.