Covid-19 Series. Q+A with WWTW Mental Health Therapist

Over the coming weeks and months, our experts will take over our official Twitter page to answer your questions about mental health, veteran support and general well-being. In our latest Twitter Takeover, Emma, a WWTW Mental Health therapist answered your questions across a range of topics including starting conversations with vulnerable people, coping during isolation and how to create structure for your day.

1.      Veteran specific support

Q. Hello just wondering if you have any advice for families who might be seeking to reconnect to veterans and whether there is advice you can give to them in terms of monitoring anxiety and stress?

A. Useful question, thank you. If you or your family member is a veteran, local areas often run veteran meet-ups/breakfasts. Also, connect with veteran charities like Walking With The Wounded, they will have services to bring the veteran community together. Monitoring anxiety and stress is important I agree, you can use an anxiety diary such as this one to track thoughts, feelings and behaviour, or alternatively using your own diary and journal.

Q. One of our veterans has taken to sleeping on his sofa downstairs - I think he should sleep in his bed to break monotony of being in one room - is it okay for him to do this?

A. Thought provoking question. Yes, you could encourage this veteran to explore sleeping in different environments, maybe then ask him to note the pros and cons of sleeping in each different room to see which works best for him. I would also check in regarding any intrusions/nightmares, are these present? Sometimes changing a sleeping area can be related to attempts to try and avoid experiencing a nightmare.

Q. Like-minded people with shared interests is one way to reduce any stresses as the conversation tends to move away from our worries. Talking really does help. Do you all find this to be true with veterans?

A. Great question, I think you are right, it really is good to talk. In my experience, veterans may find it difficult to talk about their experience for fear of triggering further distress, or due to shame and in the short term it can feel safer to not talk about things. However, what we know in Psychology is that avoiding our thoughts and feelings only keeps us stuck, it maintains our distress and we don’t move forward in the long term. Please do reach out if you are struggling with emotional distress. I’ve seen great support from veteran to veteran with fantastic empathy in the community, in addition there are civilians and professionals here for you too. Talking is the start to a better future.

2. Mental Health

Q. What advice would you give to anyone experiencing more anger and frustration than normal?

A. First to pause, reflect and identify. We refer to anger as an umbrella emotion easily seen externally in our behaviour, however, often underneath internally there are other emotions usually present. Is the person feeling anxiety, guilt, sadness or any other emotions?

Once emotions are identified the person can work through self-help materials, here’s some that cover a range of emotions. Additionally, further support can be sought by visiting their GP/other services such as TILS.

Q. Are there things you should never do while helping a person is having a panic attack? What are the signs of that person is having a panic attack?

A. Please see below for the signs of a panic attack and what to avoid doing:

Thoughts & emotions: worst case scenario thoughts (overestimate the severity & likelihood of event), thoughts regarding ability to cope (underestimate ability to cope and resources available to help) leading to anxiety.

Bodily symptoms; increased heart rate/palpitations, fast shallow breathing, light-headedness, nausea, tingling, a feeling of disconnection from surroundings or self (dissociation).

What not to do; don’t stigmatize or indicate it’s a weakness/to ‘just snap out of it’ (instead listen, empathise & help), don’t panic with the person (transference can occur) try to stay calm while helping (use your own support afterwards to self-care).

Q. A friend of mine is having a ‘panic attack’ while on the phone, I can’t visit them because of Covid-19, what can I do to help them?

A. Great question, thank you. Please see the hints and tips below on how you can support someone experiencing a panic attack:

1. Remind the person they are safe and this will pass.

2. Encourage them to slow breathing; breathe in for count of 4 through nose, pause for 2, out for 6 mouth (count with them to help).

3. Help the person to the ground, bring them back to their surroundings.

4. Get them to name 5 things they can see, 4 things they can touch (get them to do this), name 3 things they can hear, to smell 2 things and to taste 1 thing.

Q. I have heard that smells that remind you of something happy can help. Is there anything in that?

A. Great question, thank you. Yes, smells can trigger negative or positive memories. I love the smell of rhubarb; it reminds me of growing it in the garden when I was a child! Using smells that relate to positive memories can improve your well-being; try it out see how you feel!

Q. Before the lock down I was out running pretty much every day, since lock down announced although it’s allowed I’ve lost all motivation last run I felt guilty for being out, weird I know, any tips to help with this? Each day I delay my run and don’t do it

A. Try the 5-minute rule. Set a goal of doing an activity, but reassure yourself you only do it for 5 minutes. If after 5 minutes you want to stop, you are free to do so, but you are more likely to then carry on. Further information on the 5-minute rule is available here…Most people I see report this as very effective and I use it myself.

Also, list the positives of the activity for both the short and longer term, the mind often focuses on why we don't want to do things rather than why we do! Good luck, you can do this!

Q. I am sleeping OK but wake at 4 am every morning, which is not the norm. I am dog-tired all day. What to do?

A. First, I would think about when this started was it linked to a stressful time/event that requires processing. Secondly, explore how you are feeling when you wake, can you return to sleep easily? If not get up for 15 minutes do light non-stimulating activity. e.g. reading/relaxing music before returning to your bedroom. Hopefully this would help you to return to sleep. If such continues for 2 weeks or more, it may be helpful to contact your GP. In the meantime, here is a sleep guide for you. 

Q. How can we try to keep our thoughts positive during lock down when toxic, negative thoughts are often taking over?

A. I am sure you are not alone with experiencing these thoughts and feelings. Firstly, we can practice gratitude, naming 3 things we are grateful for each day to remain positive.

In addition, we can work with our negative thoughts by taking a step back and acknowledging our irrational thoughts are thoughts, rather than reality, here’s a video with a technique for you.

Q. Several of our veterans with Project Nova are saying that they are having really weird and vivid dreams currently is this being reported elsewhere?

A. We don't have any particular data/statistics, however I can say I have noticed more people reporting this occurring during this time which makes sense as the function of dreams is that they help you store important memories and things you've learned, get rid of unimportant memories, and sort through complicated thoughts and feelings - particularly the last one at the moment, we have a lot to process!

Q. During the period we are in does it help to try and have a routine for the day / week that will give you some structure?

A. We know in psychology to improve mood it is important to have a routine/structure. Particularly with activities that promote a sense of achievement, closeness to others (remotely at present!) and enjoyment. Physical exercise too has proven benefits for our mood.

Q. How is it best to ‘check in’ with friends and family? Asking ‘are you OK?’ seems a bit lame!

A. So, for some variety could we try 'tell me about your week' 'how are you feeling' 'how are you doing?' I agree they are quite similar, its tough!

Q. Do you have any tips to help to start a conversation with a friend or relative if you're concerned about their mental health?

A. If you want someone to open up to you it can help them feel safe and understood if you share your own feelings (past experiences) to normalise. If they don’t respond first time, ask again, explain you are there for them and are willing to listen they are not alone.