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COVID-19 and the Toll on Mental Health

Dr. Robin Smith, best known as the Therapist-in-Residence for The Oprah Winfrey Show, provides tips on dealing with social isolation

Robin Smith

Courtesy Nick Onken/AARP

Dr. Robin Smith:

So when we feel disconnected and isolated, and I again want the audience to understand this, there's nothing wrong with you. There's something wrong with the pandemic. And that's just so important for us to know. It's not me. It's not my weakness. It's not my age or whatever, it's the fact that this pandemic just knocked everyone down and out.

Mike Ellison:

The COVID-19 pandemic has put the spotlight on another public health crisis that has existed for a long time: social isolation.

According to a study conducted by AARP Foundation with the United Health Foundation, two-thirds of adults reported experiencing social isolation and high levels of anxiety since the beginning of the pandemic. The study is called “The Pandemic Effect: A Social Isolation Report.”

Talking to us today about its impacts and how we can take care of ourselves is Dr. Robin Smith, psychologist and author. You might know her best as the therapist-in-residence for the Oprah Winfrey Show. We'll hear some suggestions that she gives to those who may be hurting from social isolation.

Hi, I'm Mike Ellison with An AARP Take on Today.

Welcome to Take on Today, Dr. Robin.

 

Dr. Robin Smith:

Thank you. I'm happy to be with you and be with your audience.

Mike Ellison:

We're happy to have you. So let me ask you this, let's first identify what social isolation is. How do we define it? And how can you tell if a person is experiencing social isolation?

Dr. Robin Smith:

There's a difference between social isolation, and sadness or loneliness. Social isolation is something that is ongoing. It is not just a feeling of sadness or a feeling of being disconnected. It's a sense of being overwhelmed with those feelings. And here's the big word, often feeling paralyzed. A part of this journey is to understand that we were not prepared to navigate the world without contact. Yeah. Completely abnormal.

Mike Ellison:

So we're dependent beings, right?

Dr. Robin Smith:

Yes we are. Yes, we are. So when we feel disconnected and isolated, and I again want the audience to understand this, there's nothing wrong with you. There's something wrong with the pandemic. And that's just so important for us to know. It's not me. It's not my weakness. It's not my age or whatever, it's the fact that this pandemic just knocked everyone down and out.

Mike Ellison:

Yes, yes. That is a really important distinction that I'd not thought about. Let me ask you this as a follow-up now. We've all been physically distanced for over a year now. How would I know if I'm experiencing social isolation myself? If I'm looking after other people and I'm worried about them, but we can sometimes ignore ourselves. So how would I, or our listeners, know if they too are experiencing social isolation?

Dr. Robin Smith:

There is an assessment that I'll talk to you abo in a moment that the AARP Foundation and United Health Foundation galvanized and organized to help people assess whether or not they, or someone they love, is experiencing social isolation. So you can go to Connect2Affect.org and you get to take it. It's free. There's no scary stuff there happening for you or for the other person. It's a way to actually answer that question. You know, am I just sad, or has my sadness and my lack of connection with people become more of a phenomena in my life?

So one of the ways other than taking that assessment, which again, I suggest everyone go and do. It's just good information to know how we're navigating the world or struggling with social isolation. But something else is to ask the question, how much contact am I having with people? Not physical contact, but how much contact? Am I zooming? And I know we're all zoomed out. Am I writing letters, or talking to people on the phone, or have I withdrawn? Have I withdrawn? Does it feel like being with people is too much work?

Mike Ellison:

Oh man.

Dr. Robin Smith:

You know, because we're navigating so much emotionally just to survive the day. I mean, do we have our mask? Have we washed our hands? Are we separated enough? And did we take any risks we shouldn't have taken? I mean, all of those things. How are we paying our bills if we still have a job? If we don't have a job looking for a job. If we are older adults, have we connected with our children or grandchildren? So by the time we do all of that, it's hard to have energy to engage. And so that's one of the questions we can really ask ourselves. Have we kind of quietly dropped out?

Mike Ellison:

You're hitting close to home there, Dr. Robin. You referenced this assessment. And I just wonder if just offhand, you might be able to give us some thoughts about how you would advise those who are experiencing social isolation. How would you advise them to manage their anxiety or other effects that they're experiencing as a result of this pandemic?

Dr. Robin Smith:

Normalize how abnormal everything is. And that might seem like, okay, is that really going to help? It is going to help a lot. It's going to help to know that if we are asking the wrong questions... I often say to people I'm coaching, I'm working with patients, whomever. I say it to myself too, because I talked to myself, talk myself through things. The truth of the matter is we can find a right answer to the wrong question. Okay?

So we can find the right answer to the wrong question. So one of the things we need to do, given what you've just asked, is we need to make sure we are asking the right question. And the right question isn't why can't I handle this like my neighbors? Why are other people more positive than me? Why do I seem so depressed and other people have found a way?

Two points. One is that a lot of people because of how we've been raised and we don't have a lot of examples around vulnerability and power, that being vulnerable is a part of being empowered. We've learned the opposite. We've learned that if I'm vulnerable, I'm weak.

Mike Ellison:

That's right.

Dr. Robin Smith:

That's not true. That's a lie.

Mike Ellison:

Especially for men.

Dr. Robin Smith:

Especially for men and especially for Black and Brown men, especially for Black and Brown men. So part of it is to deconstruct that lie and recognize that if the problem is not me, Dr. W E B Dubois said, "How does it feel to be a problem?" And he was asking something because then he goes on to talk about. "I'm not the problem, but what does it feel like if someone thinks I am? And I don't know that I'm not the problem."

So if someone thinks that the pandemic and their response to the pandemic has to do with a lacking in them, instead of that there is something sick and ugly and awful about the pandemic that rendered all of us weakened whether we tell the truth or not. And scared, whether we tell the truth or not. And wondering whether or not... I remember one night my throat started feeling like it was hurting, and I couldn't breathe. And I was sure that not only do I have COVID, but I have COVID, and my airway is going to close up and I'm going to die. I didn't have COVID. My airway didn't close up. But how many times have all of us wondered, is this it?

And so part of this, when you say what can someone do? Normalize all of your feelings. So if you feel anxious, you'll say, "Of course I feel anxious. How could I not? I'm in a pandemic." I mean, over 500,000 people in America have died. I mean, I think that would make one anxious or depressed.

Mike Ellison:

That's correct. And especially if you're responsible for other people, or if you're self-employed, or all these other things. So the baseline from which we start to even evaluate, am I okay? If it was here, the listeners can't see it, but I'm using hand gestures. But if it was sub sea level at one point, we're now starting from mountaintops in terms of all the pressures we're all facing and managing right now.

Dr. Robin Smith:

Right, and so how do we know we're doing okay? It's when we make our steps and our successes, small steps. Not these gigantic things that all of us don't usually accomplish. But if we make small obtainable goals. Like, you know what, I haven't called anyone and maybe no one is really calling me and that doesn't feel good. So today I'm going to make a decision to reach out to one person, either by phone or text, and make a scheduled appointment to hear a voice, maybe see a face on FaceTime or zoom, and let somebody say how you be, how are you? And maybe I can tell a bit of the truth that this has been rough.

Mike Ellison:

What about our listeners who are the Dr. Robins of their personal professional circles, right? They're used to being caretakers and they can present the facade of strength and confidence and stability. And the minute they're alone, they might be in the corner in a fetal position. How do you advise them under these circumstances?

Dr. Robin Smith:

No, I love that. Thank you so much for that question and the invitation to surface our humanity. Mine, and all the other caretakers who are out there wearing the badge that says, I'm the one. And I wrote in preparation to talk with you today, remember to check on your strong friends. Remember to check on your strong friends, because it is the strong people, the people like me who are giving advice, who if they haven't found their own permission to be human, and to be fragile, and to be resilient in the midst of all of this, they will end up in the fetal position and feel shame for their humanity.

And so one of the things I would invite anyone who is taking care of children or elderly people, older adults who are taking care of their older adult parents. So we have people who are older adults who have older adult parents, and they are trying to figure out, and trying to be connected with their own children and grandchildren. So what do you do?

And this is where, without judging yourself or the other, really it's to do what you said, which is to tell someone after you've told yourself and given yourself permission, that how you are practicing self care is to limit how much. And it could be how much time you spend watching television, or watching the news, or listening to things that are depressing. And the time you are using to fill that with, maybe music you love, whether that is classical, or hip hop, or some of both. That you're figuring out how to fill your time in ways that restore you.

So I think caregivers need to figure out what does self-care look like real time to refuel your own tank?

Mike Ellison:

Yeah. I mean, I so appreciate you talking about the small victories, because to be completely forthright, we have a lot of business and entrepreneurial experts out there saying now's the time to start a business. Well, starting a business of any kind is one of the most challenging things anybody can do when the circumstances are perfect. In the middle of a global pandemic when you're just trying to like brush your teeth and look presentable for yourself.

Dr. Robin Smith:

It's big business, actually. I mean that's part of what sells. And it is why we crash and burn. It is why we crash and burn, because there is something about the small victories that just doesn't feel sexy enough. It just doesn't feel like people are going to sign on for that. And what I know for sure is they will, because the part of all of us that is so overwhelmed, that is trying to figure out how to put one foot in front of the other, is relieved actually, when we hear someone in my position say, "Slow down."

India Arie has an older song and one of the lines is, "Slow down. You're moving too fast. You've got your hands in the air and your feet on the gas. You're about to ruin your future running from your past. You better slow down, baby." And so this moment of COVID-19, all of the deaths, all of the illnesses, all the fear, the loss of income, the loss of identity. That's a whole other thing. I mean, like who we were before this pandemic. Who we were as people. Who we were as workers. Who we were in our relationships. People then ended up quarantining with people that they basically call a spouse, but they hadn't really had to be with that person for a long time. Parents were asked to educate their kids.

I mean, just too much. And so this slowing down message, I believe, and the self-care message, I believe is the greatest liberating gift that I can offer the world right now. Just to slow down.

Mike Ellison:

You touched on something also about how men are especially expected to be just Ironman and superheroes and not vulnerable, and especially Black and Brown men. And so I was going to ask you, social isolation affects so many older adults. But it's not even across the board. And there are disparities among cultures when it comes to isolation. Some cultures are much more familiar and social than others, and they suffer in the West normal circumstances, let alone a pandemic. Can you speak to that a little bit?

Dr. Robin Smith:

I can. And I want to also talk about gender with women, because one of the things that the research is showing is that women, particularly 50 and over, are more depressed, feeling more depressed, more overwhelmed, more anxious, less motivated. That makes sense. Doesn't it? That I would have less motivation if I'm trying to navigate. And because so many women 50 and over are the caretakers of parents and children. And at times we're also seeing a lot of women having to leave the workforce. So there has been talk about identity loss. I'll talk to you in just a moment about identity theft, and not credit cards, but again, who we are, who we thought we were.

But one of the things I that the research showed is that, this is hard to believe every time I'd share it, that obesity and smoking 15 cigarettes a day, that social isolation is worse. That's the research. That's not Dr. Robin making something up. It's a game changer.

Mike Ellison:

So you already have people concerned about underlying conditions as it relates to COVID, and now we're finding that those underlying conditions are being exacerbated by the social isolation.

Dr. Robin Smith:

Yes. That is correct

Mike Ellison:

And so we've got to find ways to connect with people safely. So you were going to speak to gender and also cultures. So is it once again, like in Latino cultures that are very familiar or every culture, I don't want to single out one. But are you finding disparities among certain cultures because of this isolation?

Dr. Robin Smith:

Absolutely. So the Hispanic community absolutely has a higher incident of both COVID diagnosis and COVID deaths. They also have a higher rate of depression, and anxiety. Because how they are connected to each other, what is part of their culture and their value system has to do with gatherings, family gatherings. So when they are cut off, not just from their family of origin, but from extended family, we have seen that the incidents of how social isolation is impacting the Hispanic community is higher. It's higher than it is in the White community.

The same can be said for the Black community who also use their social networks as ways to keep themselves robust. And so when that is gone, there is a fragility that shows up in higher numbers. That is not to say, and you already said this, that White people are not suffering. That Asian people are not suffering. Of course they are, from social isolation and the ways in which depression manifests itself. But it is seen in higher rates and it is being underserved.

So not only is the social isolation higher in Black and Brown communities, but there are less resources. And let us talk about poverty. That's the other piece of this. Poverty in and of itself is an isolating factor. It keeps people from access. Access to good medical care, good mental health care, good housing accessibility. So what we know is that the rate of poverty, no matter what the age is, is off the chart for social isolation, and even higher for communities of 50 and over where there is poverty. And unfortunately, that community is growing. That community around poverty is growing.

And I want to say this too. Sometimes older adults can blame themselves. They can feel like maybe they should have done something better to be prepared for this. You know, “I should have stayed in better contact with my grandchildren. I should have gone to the birthday parties or traveled across the country when I could, and I didn't do it.”

And so I also want to caution every person who is listening, regardless of age, but if you are 50 and/or older, or you know someone who is in that age category, reach out to them and begin to speak kindness and appreciation for all the contributions that older adults do make. Their contributions and their limitations. And sometimes maybe they're blaming themselves, and maybe they're blaming themselves because they've got some younger people in their lives who don't see their whole story. And so I just want to remind us as we've come today to speak grace, to our older adults who are in our lives and remind them of how much they still have to offer, because somehow they made it. They made it through a lot of things

Mike Ellison:

Dr. Robin, thank you so much. I'm personally grateful, and on behalf of our audience, we're very grateful for your wisdom and your insight, and your honesty and transparency. Thank you so much.

Dr. Robin Smith:

Thank you so much. Be well. Take good care

 

Outro:

To take the isolation assessment, visit Connect2Affect.org – that’s connect, the number 2, affect, .org.

And if you want to learn about how a NASA astronaut trained to deal with social isolation before he spent a year aboard the international space station...check out episode 108. It’s called “How on Earth Do I Deal With Social Isolation?”

If you liked this episode, please let us know by emailing us at newspodcast@AARP.org

Thanks to our news team.

Producers Colby Nelson and Danny Alarcon

Production Assistant Bianca Trotter

Engineer Julio Gonzales

Executive Producer Jason Young

And, of course, my co-hosts Wilma Consul and Bob Edwards.

Become a subscriber on Apple podcasts, Google Play, Stitcher and other apps. Be sure to rate our show as well.

For An AARP Take on Today, I’m Mike Ellison.

Many people are suffering from anxiety and depression as a result of feeling social isolated due to the COVID-19 pandemic. Dr. Robin Smith — The Oprah Winfrey Show's Therapist-in-Residence — says that social isolation was common among older adults even before the pandemic. This week, she gives her best advice on how to tackle the problem.

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