Dr. Chaabo Addresses Diseases of Despair in COVID Fallout / Stress Awareness Day, Nov 3

[Dr. Hani Chaabo pictured during medical school (left) and today (right) — shared as evidence of how stress management plays a role in overall health and happiness.]

Among the many serious impacts of the long COVID pandemic are the mental and emotional issues — sometimes called ‘Diseases of Despair’ — that came in its wake. With this week’s observance of Stress Awareness Day (the third Wednesday of each November), we invited one of our wellness experts to discuss the continuing stresses associated with COVID.

“Just as we were not equipped to deal with COVID, we were really not equipped to deal with the pandemic of mental health issues that followed,” said Dr. Hani Chaabo, a family practitioner at RRH Rural Health Clinic.

“Anecdotally, we have definitely seen an increase in mental health issues — among adults and especially in teenagers,” said Dr. Chaabo. “Closing our schools and sending everyone home was difficult for everyone — teachers, students and parents. We saw a rise in anxiety, depression and stress across all age groups.”

Eighteen months after the original quarantine, kids are back in schools, many establishments have reopened, and most activities have resumed with some modifications.

During the height of that isolation, many crisis-stabilization units, emergency rooms and urgent-care centers were overwhelmed with patients who were struggling. While some of that acute strain may have waned, Dr. Chaabo acknowledged that healing from the events of the last year and a half may go on for some time

“The first thing people should know is that if your mental and emotional state are affecting your day-to-day life — work, relationships, children, spouse — that is an indicator that it’s time to seek professional help.” He said that can begin with a trusted counselor or therapist, or by requesting a referral from your general physician.

“Primary care doctors are the gatekeepers of the medical system,” said Dr. Chaabo. “When you need help, that’s a good place to start. Even if your physician is not trained for providing the treatment, they can often detect the signs of mental-health strain before you are aware of it.”

Sometimes, if you catch the early warning signs, there are coping techniques that can help you manage your own wellness.

“Let’s say you have noticed little things like feeling irritable when you come home — a place that should be a sanctuary. If you’re feeling impatient with your family, feeling agitated by something that is usually comforting, that is an early sign of anxiety.”

During emotional exhaustion and burnout, the settings and activities that are normally soothing or nourishing can become triggers.

“When you feel your mind is on overload, pause and spend some time re-focusing and re-framing your thoughts. Think about all of the things you are grateful for.”

Dr. Chaabo offers a stress management clinic for local patients. One trend he has noticed is that when people are under increased strain, they forget about their own achievements, accomplishments and comforts.

“Train your mind back to get back to a more pleasant ‘thought cloud.’”

Even five minutes of meditation can bring about increased mindfulness. “This just means paying complete attention to the present moment without judgement.”

Individuals reach a heightened state of “mindfulness” by anchoring themselves to the present moment. “If you are washing the dishes, attune yourself to all the senses of that activity. I say ‘without judgment’ because all have a voice in our heads that wants to say whether something is good or bad. Move away from that voice. It will have a calming effect on your nervous system and your mind.”

Mental health management extends beyond your mind and into your physical health, he said. “If you’re not eating right, not sleeping right, not tending to the aches and pains of your body, that can contribute to your mental-health challenges. Your body is like the infrastructure that can set you up for success or failure.”

Good nutrition, restful sleep, stretching and other exercise will contribute to your success.

The doctor is effective only when he himself is affected. ‘Only the wounded physician heals.’

— Carl Jung, “Memories, Dreams, Reflections”

Dr. Chaabo acknowledged that his interest in integrative medicine, which takes into account all aspects of health, strikes a very personal chord.

“Although I still occasionally struggle with anxiety, my issues were more serious about 10 years ago. I was obese, I had regular panic attacks. That’s a struggle for anyone human being, but by my first year of residency it was debilitating.”

The key to managing his own mental wellness — back then and through today as a physician during a pandemic — began with meditating each morning.

“I started with meditating just five minutes per day — channeling all the strength and positivity in my life into those moments. It changed the way I saw and related to myself, changed my diet, changed the way I exercise. And those five minutes eventually stretched into a longer period of time,” said Dr. Chaabo.

“I think what helps me the most is being aware of what’s going on internally. We tend to live in the stream of what is happening to us, being pulled one way or another by those tides. ‘Mindfulness’ is like a platform that allows you to stand and observe what is around you without being moved by it. It is an incredibly liberating experience.”

Having that skill allows you to navigate even painful and difficult experiences that trigger your pain. “No one acts out because they want to, there is always a backstory.” But now, instead of creating his own story, he pauses and listens.

This happened recently, when a patient began a visit by yelling expletives. “I could almost feel the panic welling up, but I started breathing through it and said, ‘You’ve got this.’ We navigated the encounter and what began as something disturbing became a moment of triumph.”

The patient ultimately apologized, and opened up about what had triggered him. “We found a resolution and shared a beautiful moment together.”

Dr. Chaabo said that now that the world is opening back up, it’s time for people to find safe ways of re-engaging.

“Isolation is one of the major driving factors behind anxiety, depression, burnout, insomnia. We have seen evidence that a sense of community is very important in protecting us from developing these conditions.

“In many ways, the pandemic has pushed us to our limits. Many people have had experiences that are completely awful. But for some, there is a blessing in disguise.”

That key lies in renewing and strengthening relationships with the family, friends and support systems. “Many of us have experienced the benefits of being forced to lean on our loved ones,” said Dr. Chaabo.

“As creatures of habit, ‘isolation’ has become the new routine for some people. But it should not be permanent. Reconnecting with your family and your community is an important step toward health.”