This is the besthealth podcast brought to you by wake forest Baptist health in partnership with MedCost today. Everyone welcome back to the latest episode of the best health podcasts, Justin Gomez here from wake forest Baptist health, um, talking, uh, with another really great special guest today, dr Steven Scoggin, easy associate vice president of behavioral health and the interim chair for the department of psychiatry and behavioral medicine, um, through Wake Forest Baptist Health and also an assistant professor with the department of psychiatry and behavioral medicine. So are we gonna talk today about, um, some of the stress and anxiety factors around COVID-19 and Coronavirus and, um, just how that might be impacting our lives. Welcome, dr Skogen. How are you doing sir?
It's good to be here. Justin. Thank you for having me.
Absolutely. Um, so Dr Scoggin, he is the associate vice president of behavioral health, um, and the interim chair for the department of psychiatry and behavioral medicine, uh, here at wake forest Baptist health. Um, so he has a lot of insights and wisdom to impart on us as we talk about, um, you know, the, the stress and anxiety with, with finding our new normal with coven 19 and Coronavirus. Um, so thank you for, for being here, Dr Scoggin. And um, before we get started, if you just want to give a brief welcome and introduction, um, a little bit about yourself and, and um, you know, what, what your day to day. Uh, I won't say normal routine cause none of us have had a normal routine lately, but I know what your day to day has been like lately.
Well, as Justin said, I've been, um, uh, here with the medical center in actually a number of roles for the past 19 years. Um, here in the department of psychiatry. My background is training that acts as a psychotherapist. So that's what I spent a lot of my time doing in my, in my career until I got into administration. And am I being interesting to the listeners that I'm also ordained clergy, theologically trained, um, have a divinity degree and have a actually, uh, pastor, uh, churches too. So I bring kind of a, a multi-perspective of bio psycho social spiritual perspective to the work I do on a day to day basis concerning the day to day. Recently there's been, uh, no, no day the same. We're trying to, uh, do the adequate preparation that we know to do for our, uh, uh, patients and folks in the community who we know this is going to hide their, their, uh, we as providers are trying to manage our own stress and anxiety so that we can bring a sense of, uh, uh, calm, uh, to those we're trying to serve. But, uh, we're human as well. And so we're having to manage our own stress and anxiety, uh, as well as providers kind of if you will walk in to talk and practicing what we try to convey to our patients on a daily basis.
Yeah, that's a great point. Dr Scoggin. Um, and before I dive in here, I just want to remind people listening, um, just to make everyone aware that, um, this podcast, along with all of our other coven 19 Coronavirus related podcast will be available on our, um, Coronavirus resource page on our website. So anyone can go to wakehealth.edu/Coronavirus and they'll find a [inaudible] of information about, you know, uh, clinic, uh, updates, visitor restrictions, uh, symptoms, um, when they get tested, how to get tested, um, plus a lot of additional resources such as these podcasts and, um, FAQ [inaudible] and all kinds of really good and reliable information. So, um, we'll add this podcast to, to that page. Um, and it'll be up there for people to use. Um, so, and I, I'm glad you brought up the, the multifaceted multidimensional, um, approach, I guess as a baseline if you want to talk to us about what, uh, what do we do when we feel the stress and anxiety, uh, when we have a kind of an external, um, factor, uh, change. So much of our lives such as no, COVID-19. You know, I, I hear that, you know, humans, we, we like some sort of structure and routine and that's been turned upside down lately. So what is our body emotionally, physically, spiritually, what is happening to us, uh, when stress is going on in our bodies? What's taking place?
It's a great question. Uh, Justin, let me, let me attempt here too, to kind of break it down and normalize stress and then move to this period we're in, which is a little excessive and creating more stress for all of us. So, so stress affects you every day. You may notice symptoms of stress when you discipline your kids, you, uh, having a busy day at work, you're managing your finances or you're coping with the challenging relationship. Um, stress is everywhere. And while a little stress is okay, some actually some stress is actually beneficial. Too much stress can wear you down and make you sick both mentally and physically. So the kind of, if you will step to manage stress, you can't control that. You certainly can manage stress is to know the symptoms of stress. But before we jump in there, Jay, uh, Justin, let's look at what is it, what are we talking about here? Stresses the body's reaction to harmful situations.
situations that may be real or perceived or if we could say, imagine. So we're doing a lot of, if you will, anticipating imagining what this coven 19 outbreak may mean to us, both physically, financially, emotionally, and spiritually. Sure. So when you feel threatened, a chemical reaction occurs in your body that allows you to act in a way to prevent injury. That's what happens to your body. A chemical reaction is released, specifically adrenaline and cortisol. And we call this the fight your body. Either preparing to fight or flee Tonka or to fight during a stress response. And I've actually had this today with some, uh, situations. Your heart rate can increase. Your breathing kinda quickens. You might short breath, your muscles tighten up, your blood pressure can arise because you're getting ready to act on something. So that's kind of what, what stress is. It's this Nepal chemical reaction takes place. Adrenaline and cortisol are released and they kind of rev you up getting you ready for what's getting ready to happen if you stay in that state. Justin sick. What I mean by, well you can get physically sick coronary artery disease, stroke, digestive issues, just to name a few.
Yeah, yeah, I've heard of, you know, I've been talking with a couple of my friends and you know, more than one have said that they haven't been getting great sleep lately just because of this stress. You know, and some of it might be realized and, and some of it we might not realize necessarily is happening in our body, is that right? Some of them might kind of be under the surface of the water a little bit.
Yeah. That's why I was trying to name what these normal reactions to stress are in, in your body so people can, you know, if they start feeling like their, their breath is short and they may have a cough that think, Oh my gosh, I may have coven 19 it could just be stressed. Yeah,
yeah, exactly. That's a good point. Um, so, you know, you mentioned fight or flight is kind of what maybe some of us have heard over the years of how we, we we react. Um, so I guess of us feel like we have to, when the stress is happening, we have to do something. Um, we have to react in some way. Um, so in your experience in the years that you've, you've helped people, you know, what are some of the ways that they've shared with you that they react, um, and, and what have you shared with them about how they can react in a, you know, there's probably a healthier way, healthy ways to react and maybe not so healthy ways to react.
Let's just talk about ways that people respond to stress. That we won't put a value on it if they're good or bad. They're just normal ways emotionally that we respond to this sentence sense of feeling threatened. Our body goes on high alert, but emotionally what might happen? Well, we might feel a little more agitated. We're kind of short with those around us or more frustrated or a little more moody. We might start feeling a little overwhelmed, like we're losing control. We might have some difficulty relaxing. So you mentioned sleep interruption, very typical, uh, difficulty relaxing, quieting. You can't quiet your mind, you can't think straight. You start feeling kind of bad about yourself, low self esteem, you feel lonely, worthless. And then if this persists, you can feel depressed. Again. I want to normalize that these are normal responses to stress, which we call anxiety now to the other.
I think part of your question is maybe what can one do when they start feeling these things in their body and their mind and they start noticing that they're, they're uh, reacting in, kind of agitated, frustrated, uh, hopeless wise. What can one to, well, first thing that I would name is acknowledge that you feel the way you do. Yes. A psychiatrist once said, dr Carl Yan, what we resist persists, which is another way of saying what we try not to feel takes on a life of its own. It persists. So just naming that you're scared, you're uncertain, that you're afraid of a variety of things, losing your job, your retirement, uh, whatever it is that scaring you to name that because this is a time of great uncertainty for all of us. Um, but what I would encourage folks to think about that what is going on externally, don't confuse that sense of uncertainty, which we all have with what might be true of what's going on internally within you.
So there's what's going on externally, coven teens, what do we actually have influence over? So dr Stephen Covey had actually taught us a lot about leadership, uh, known for his book, the seven habits of highly effective people. And he used to talk about it this way. We have two circles. We live with them on in, on any given day. One is the circle of concern. It's all the things just in that, that concern you and me, world hunger, the coven died, teen virus, our finances, our kids being out of school. We could go on and on with those concerns. And then there's what he calls the second circle, the circle of influence. What are those things that you have have influence over? The more you can exercise your influence muscle, like doing something, the more it can decrease all the concerns that can, that actually at a time like this could consume an overwhelm.
Someone. Some very specific things I'd suggest that we all consider during this time of uncertainty is we're getting bombarded by the media. Yeah. Whose intent is good to keep us well-informed. I'm, I'm telling everyone, pick one or two trusted media outlets, Hume in the morning, in the evening, but not before I, for you go to bed at least two hours before you go to bed, get caught up 1530 minutes max and then shut down from the media. Infomania can uh, can be very stressful right now. We get a lot of conflicting reports about what's going to happen. So take control over, over ingesting them, the media that you're ingesting right now. That's great advice. Um, uh, second thing I would, I would suggest is try to stay focused as much as your mind will allow you in right now. This moment, the here and now, and you might ask it, and this may sound counter-intuitive, what not am I losing from this?
But what am I, could I actually gain from this uncertainty and unusual time? Hmm. We have, if we are going to be sheltering in here in Forsyth County, uh, I am told, uh, very quickly our mayor and other, uh, County officials are going to invite us to, to shelter in [inaudible]. What might we gain from that? Like, uh, extra time with our, uh, family opportunities to make our life better? Uh, we're to have time to maybe to learn something new that we haven't had the time to do because of our work lives. Uh, I think there's a, it's a, it's a two edge sword from, uh, anticipating what may happen to try to stay focused just in the here and now. The present moment is really all we have and to look at what the opportunities are for us in this unusual time that we're living in. Yeah.
So that's interesting. So we can, you're saying just to try and say actual cognizant of what our mind is working on. And I guess it can so easily drift off to, you know, three days from now, a week from now, a month from now, and without us maybe even realizing that we're doing that. Right?
Yeah. And all of us are thinking about what I call the what ifs. We're all saying, what if this, what if that, yeah. Some of us bind and I'm one a that I'd count myself in this group. I kind of try to bind my anxiety in, in a stress by, by planning as if I had some control over what's going to happen in the next few days or, or mans. But that helps me feel like I'm in control. But when people live in the what if world, what if this, what if I lose my job? You know, what if, uh, I can't go back to war, what, there's an endless list of what is, I would say try to in ask yourself then what if you just stay in? What if, and you don't move cognitively to then what? You're just staying in this perceived world of anxiety and stress versus, okay, if I lose my job, then here's what I'm gonna do.
Sure, sure. Well, um, that, you know, brings up a really interesting point, dr Skoggin you know, as we're talking through, um, you know, how to stay focused and, and manage, um, the stress and anxiety. Um, one thing that you've just mentioned was this shelter in place, possibility that already a lots of Americans are dealing with and here locally we might be, we might be dealing with as well. So, you know, social distancing doesn't mean I like actually isolating and not having any sort of communication with other human beings. Right. That's, you would, you would encourage, um, staying connected, wouldn't you?
Oh, absolutely. We're, we're social animals. We, we, we, we're, we're wired to be connected, uh, and it's, uh, inviting us to stay connected in some new and creative ways. You know, can we stay connected in, in digital platforms and, and find ways to, to connect emotionally and intimately over a digital platform. I can tell you, I have a, a group of friends that I, I raised my children with four other couples. We got on a group FaceTime and just were with one another on Sunday night and where we S we, we, it was so good for us cause we laughed and released some endorphins and our off things that we said, yeah we, we need to do this on a regular basis during this time. So yeah, when you're, when you're social distancing that you well said Justin does not mean socially isolating yourself.
Yeah. I, yeah. You know, if you are start kind of down the cycle of, of just being off by yourself and not having another human interaction of any kind that can, that lead to, you know, some, some issues that could lead to, you know, depression or anxiety, the cadet kind of fuel that type of thinking.
Yeah, absolutely. When, when we're helping folks who are struggling with depression and if you will, normal times, we really encourage them to stay, stay connected to those social supports because as you lose a perspective, when you're depressed, uh, you're not motivated sometimes to want to be around other folks with the key is, uh, that they stay connected even if they don't want to because many, I think rally actually many of our elderly who could get pretty socially isolated, uh, during this time and we know just the social connection would be extremely helpful to them.
Yeah, that's a great point. Um, I do want to also just touch base real quick, you know, as we're talking about, um, what this new normal looks like for all of us with work being adjusted, school being adjusted for kids, our social interactions being adjusted. You know, there's, there's different personality types. You know, there's type a, there's type B, there's this, you know, the Enneagrams now what type are you and you know, I think some personality types, they all have their, their benefits and, but some are traditionally, I guess maybe less flexible than others. Um, or less kind of go with the flow. Can you give us just your thoughts on, on, you know, how we should be flexible or adaptable during this, this very unique time and, and, and not, uh, again, one of my old coaches used to say, you know, don't sweat the little stuff. Yeah. Well easier said than done. Yes.
I would name a, and I think you're alluding to Justin, all of us are different and we manage, we all have different styles about how we manage stress and anxiety. And so all of us are different. What I would say is, uh, as, as we enter into some uncertain times, we need to stay grounded in the things that we know about ourselves and those around us. We've already talked about the social, uh, I'm getting more into to some, some if you will, coping strategies and how to better manage this. I just a, and I do this regularly anyway, but I've certainly found myself doing it more on a, on an hourly basis is just really deep dive formatic breathing, uh, dive formatics a fancy word to say. It's really saying, breathe from your belly, take deep breaths regularly. And often you say, well, that, that sounds like a very simple thing to do. You'd be surprised if you take very deep diaphragmatic breasts, hold it and let it out. How it clears your brain in mind. It has a, it has a neurological effect. So I would say deep breathe, deep often and, and, and deeply, um, during this time.
Okay. And then, you know, you mentioned earlier that you also do have a theological background and or ordain, so you know, people, uh, that have, uh, practicing faith or, or participate, um, in a faith, uh, group or community here. Um, you would probably just encourage them to, to stay connected with that faith community.
Yeah. To stay grounded in what, in what, uh, what, what feeds you spiritually? Uh, I've, I've participated, uh, this past Sunday in two virtual, uh, uh, services over the internet and found that to be actually enriching and, and, and comforting. So, yeah, whatever your faith tradition is, I hope, I hope folks can draw from the, the deep well of faith that will help sustain them spiritually during the time. Like this is what's not a typical and what is a, sometimes the spiritual response when you're traveling through them, certain times you feel kind of pretty helpless and your life has lost meaning. That's where spirituality and, and, and wonderful spiritual practices come in, have a contemplative prayer, a mindfulness, uh, as well as just the more traditional things of, of scripture reading than prayer.
Yeah. Well that's, that's definitely encouraging. And, and you know, as we wrap up, Dr Scoggins with this besthealth podcast, I know a lot of us can use, you know, all the encouragement we can, we can get right now. So, um, this has been just so helpful and I, I know you're really busy, so I appreciate you taking the time and talking, talking with us today.
Just a final word, Justin, to remind folks. Uh, we are, we are very resilient people. We have been through, uh, natural disasters before [inaudible] and I actually epidemics before in this country. The H one N one is the one that comes to mind most quickly in 2009. And that whatever you're feeling or thinking, remember that feelings and thoughts are transient. They're not necessarily reality. Feelings and thoughts come and go. So think of whatever you're the, whatever they're gripping you right now. It's, it's not permanent. It may feel permanent, it's going to stay with you, but it, it, uh, those things are transient.
Yeah, that's a good word. Dr Scoggin and I, I appreciate that and I hope our listeners, I appreciate, um, the nuggets of wisdom you share today with us. And, um, I'll remind the listeners, um, if, if you need, um, to reach out, uh, there's, we have a good, um, network of providers and counselors, uh, on our website, wakehealth.edu, um, and also through faith health and see, um, or you can call seven one six week. Um, if you feel like you need to reach out to somebody. And also a reminder, just the, the coven 19 updated information from wake forest Baptist health can be found at wakehealth.edu/Coronavirus, um, including all of these helpful podcasts are, or what we hope are helpful podcasts for, for all the listeners out there. So Dr Scoggin, um, I know you've been busy and I appreciate it and um, you know, hopefully we'll be able to catch up soon and talk about, um, you know, kind of the next phase as, as we're moving out of this unique time.
Thank you for what you, uh, you're doing through these podcasts. Uh, Justin for our community. Thank you.
All right sir. We appreciate it and thanks to all the listeners out there, um, for checking out this episode and, um, till we till we try it again, I encourage everyone to please be well, thanks for listening to this episode of the best health podcast brought to you by wake forest Baptist health. For more wellness info, check out wakehealth.edu and follow us on social media, Wake Forest Baptist Health, the gold standard of healthcare.
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