The pandemic has been a profoundly difficult time for people and their mental health, says Dr. Samantha Meltzer-Brody, chair of the psychiatry department in the UNC School of Medicine.
Throughout her 21 years at Carolina, she’s maintained a strong focus on mental health. Meltzer-Brody also chairs the UNC Center for Women’s Mood Disorders, and she is the founder of the UNC Health Well-Being Program and serves as its executive sponsor.
Meltzer-Brody became department chair in October 2019, shortly before the pandemic began in March 2020, and she says she’s been running fast since then. And so has her department, she says, including her “outstanding and hardworking colleagues who have been extremely busy responding to the substantial mental health needs of the pandemic.”
She adds, “I think 2021 looks a lot better than 2020. We have a COVID-19 vaccine and we’re much more hopeful as we march ahead. That’s really important and we’re grateful for that.”
Meltzer-Brody spoke during the May Employee Forum meeting. What follows is a condensed version of her remarks in a question and answer format.
What’s your sense of how employees are feeling now?
I think most of us feel like we’re trying to drink out of a fire hydrant. There’s extensive fatigue, and yet we’re all supposed to be continuing to press ahead. For those working in universities, it’s this relentless pace that we have to get back to something that resembles usual business very quickly.
None of us knows what shoes someone else is walking in. There’s no way we’re all just going to go running into the new academic year without making sure we’re recharging our batteries.
I think we all just have to acknowledge the huge toll the pandemic has taken. We need to be good to ourselves, invest in our own well-being and acknowledge the many stressors that people face.
What are some warning signs that signal stress might be excessive and overwhelming?
If you start having difficulty thinking clearly or having decision-making paralysis or can’t remember anything, that’s a sign of excessive stress. Other signs might be a lot of anxiety, hostility, frustration, irritability, sadness and feeling like you’re just becoming more reactive. Some people can start withdrawing from others or feeling like they can’t support anyone, like complete compassion fatigue for all of it, or they may begin using substances as a way of coping.
We are seeing people who are obstinate and refusing to follow rules. And people just have decided they’ve just had it with the entire pandemic. It’s not that we can’t appreciate what that feels like, but it becomes disruptive in the workforce when we see people who are coping with things by going off the rails.
People may also experience physical symptoms, such as tension headaches, gastrointestinal issues, the inability to relax or to sleep, nightmares, flashbacks and other symptoms. If you start having these symptoms and they continue, I encourage you to seek help.
Can you share an example of how someone may know when they are experiencing excessive stress?
When we feel stressed, we often start behaving differently. For some people, it may be feeling more irritable and quickly losing patience with family, friends or co-workers. Others may experience feelings of anxiety and worry and/or have physical symptoms of stress, such as headaches, jaw clenching, neck or back pain, or other symptoms.
I think it’s important for us to know and look for our own warning signs. We have to take care of ourselves first. You can’t do your work if you’re not taking care of yourself first.
How do people know when they need help?
People functioning at optimal levels feel well physically, mentally and spiritually. They feel in control, are calm and motivated. As people experience mild and transient distress or impairment, they feel irritable, anxious or down, less motivated. They may also have difficulty sleeping, have muscle tension and are not having fun.
When people no longer feel like their normal selves, they may show signs of excessive guilt, shame and can feel out of control. This is when we start taking things seriously.
It’s important to note that all of us have been on any part of this significant stress spectrum over the course of the last year. I’d ask everyone to check in on where they are now, and depending on how you are, get help if you need it.
How do we keep going?
There is a great body of literature on how to foster resilience and manage stress and traumatic experiences. Research from the Center from Traumatic Stress shows that it’s important to make sure that we keep up our confidence to move forward. We have to maintain trust in our peers, our leaders and our mission — or else it gets very hard to move forward. We have to have hope and to believe in our own self-worth and self-respect. We have to figure out how we’re going to find purpose in what we’re doing at any given time. These things can be hard. And we have to be intentional about what we are doing.
I encourage employees to talk as a group about what you can try to do to make things a little better, even in small ways, and to talk about having compassion for yourself and others.
The COVID-19 pandemic has been terrifying. Most people who want to be have been vaccinated now and hopefully, many other people will be willing to get a vaccine soon. But, we also have to acknowledge that there are the other adversities people are dealing with: health disparities, systemic racism, economic issues, food scarcity, psychosocial impact, disruption of plans, worsening underlying physical and psychological conditions.
The pandemic has also been difficult for parents. We have to acknowledge the impact on our employees with small children as well as teens and adolescents, and just how profoundly challenging this pandemic has been. And many people are also taking care of and supporting older family members and trying to do their jobs.
How can people adapt to all of these changes?
Psychological resilience refers to adapting to the challenges of life and maintaining mental health despite exposure to adversity.
We may not be naturally born resilient, but we can learn helpful ways to improve resilience. Using that framework for thinking about resilience allows us to develop skills to be more resilient.
Working at a university is being in a service industry. We’re serving and giving without getting to refill our tanks. We can start feeling deprived and then people get compassion fatigue. We all want to do great with our work, but that can lead to people pushing themselves to a point of being exhausted, perhaps thinking they’re invincible or they’re somehow more in control than they are.
There are no easy answers, but it is so important to make you and your well-being a priority. Be good to yourself, and be kind to yourself.
What role does connecting with other people play?
Compassion is often an antidote for needing to connect. How can we prevent people from being isolated and form connection? That can be restorative and energizing, particularly when there’s been so much lack of connection because of social distancing and not seeing people.
How are you working to be resilient?
Part of creating a resiliency plan is to set priorities, create action steps and then carve out time to do them. Exercise is a very important part of my self-care routine. While it has been disrupted over the course of the pandemic, I have always tried to take daily walks with my husband, family members or friends. During the work week, a 30- to 45-minute evening walk was hugely therapeutic and it was so important to be outside. Walking is meditative. It’s physical activity and a time to talk and connect with others. I have also joined friends for online yoga each week.
What mental health resources are available for employees?
The UNC department of psychiatry also has a number of resources. Don’t be shy about calling us.