CONVERSATIONS: ‘We are all suffering some level of loss’

During the pandemic and stay-at-home order many people have struggled with mental health issues such as depression, sadness, grief and confusion.

Credit: Shutterstock

Credit: Shutterstock

During the pandemic and stay-at-home order many people have struggled with mental health issues such as depression, sadness, grief and confusion.

Coronavirus threatens more than our physical wellbeing — local experts say it impacts our mental health as well.

That is particularly true in the Dayton region, a community that continues to recover from the impact of 2019′s Oregon District mass shooting, 15 tornadoes and a long list of other tragedies.

Beth Esposito, Samaritan Behavioral Health’s president

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Beth Esposito, Samaritan Behavioral Health’s president, said the region may not be in the middle of a health care crisis, but demand for help in coping with the stresses of these trying times is high.

“What you’re in the midst of seeing is an increase in mental health symptoms across the board. Those who already experienced it, are experiencing an exacerbation of such symptoms,” she said during our virtual town hall last week, Dayton Daily News Community Conversations: Handling the Hard Times. ”Your typical person who may not have been experiencing anxiety or stress at the level they have recently in the last six or seven months are suddenly experiencing that and that’s a new feeling for them.”

The video of the panel discussion can be found on the Dayton Daily News Facebook page and on our website at bit.ly/DailyDaytonDailyNewsHardTimes.

Edited excerpt from the hour-long conversation moderated by Dayton Daily News Editor Jim Bebbington and Community Impact Editor Amelia Robinson are below.

Besides Esposito, other panelist included Julie Manuel, Kettering Behavioral Medicine Center’s clinical program manager; Lisa Balster, Ohio’s Hospice’s director of patient and family support services; Dr. Brian Merrill, OneFifteen’s assistant medical director; and Dr. Mary Beth DeWitt, Dayton Children’s Hospital’s director of psychology.

QUESTION: Many families have decided against holding large holidays gathering out of fears of spreading spreading the virus. How does one cope with not being able to celebrate in-person together?

Mary Beth DeWitt,  Dayton Children’s Hospital’s director of psychology

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MARY BETH DEWITT: “We need to remember what the focus of the holiday and the celebration is.

Thanksgiving, for example, is a time to be thankful. So focusing on what we’re grateful for and what we’re thankful for and not focusing on what we’re not.

We have to acknowledge how it’s different and how that’s unfortunate, but (try) to focus on gratitude and what we are happy to have. We do still have our relationships. We can connect to those family members in virtual ways or creative ways. Sometime how we frame things in our minds and how we collect our thoughts can be very helpful in our coping.”

Dr. Brian Merrill, OneFifteen’s medical director

Credit: William Jones

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Credit: William Jones

DR. BRIAN MERRILL: “I know that it’s not nearly the same to have a conversation with somebody on an iPad as it is to have it in person, but that’s the hand that we’ve been dealt this year.

If you are going to get together, it’s nice bonfire weather right now. Maybe we’ll be lucky enough to have that for the next month. You can be outside, wearing masks, doing hand sanitizer and all the things that we can talk about. But it’s going to be a really, really big challenge to not be connected. Maybe the solution is smaller groups so that you can maintain distance, but 20 people in your house for Thanksgiving dinner is just a really, really bad idea.”

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BETH ESPOSITO: “I think having the mindset that you can really have a full holiday experience is going to be different and beginning to allow yourself to think of it from a different perspective.

I think of those people in abusive situations where it could escalate during these holiday times, thinking ahead and trying to have a safety plan or a safe room where you can go in the situations as things do get tense. "

Q: How does one balance the guilt and feelings of selfishness for wanting to do fun thing when so many suffer through illness and/or hardship?

Julie Manuel, Kettering Behavioral Medicine Center’s clinical program manager

Credit: Lee Ann Yahle

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Credit: Lee Ann Yahle

JULIE MANUEL: “(It is) the sense of the loss of our normalcy and sense of loss of time.

I don’t think that it’s been quite as apparent to us as a society that we were so structured. So you go to work, you come home, you get the kids to practice, you eat dinner, you come home, you do the homework, you put him to bed.

You just have all of these things lined up, and then when things kind of take a screeching halt, it’s like, oh my gosh, now what do I do?

All of the things that we normally do are completely now disrupted. But I think that for the majority of us, we do feel selfish because we still want to go out and do those things. And I think it’s a fine line of balance of just trying to figure out what can I still go out and do that I can safely do.

Being creative with those things that you can go out and do. Being outside in the woods going for walks. Taking pictures. Taking your dog for a walk. Volunteering. Making a meal for a neighbor. (There are) all sorts of different creative ways to still get out and have structure, but yet do it safely while in quarantine and social distancing.”

Q: The pandemic has had a big impact on teens. Fifteen students in Mason City Schools were taken to hospitals for suicidal thoughts within three weeks. What should parents be looking for with their children when it comes to suicidal ideology?

MARY BETH DEWITT: “The first thing we have to do is start to have conversations with our kids, and with our loved ones in general, about how this is impacting us and how difficult it is.

It’s OK to recognize that we are all suffering some level of loss and not as extreme as those who are directly affected and ill. Suicidal ideation occurs very, very commonly in children, unfortunately. Unless we start that conversation and look for those symptoms, then we’re going to have difficulty identifying it.

Kids may not be as likely to come to us with these concerns and so it’s important to begin that conversation. Our process has been stable, but we do see a high amount of children that do have suicidal ideation.

We do like to get them help preventatively and intervene early in order to prevent problems from occurring. Sometimes parents are afraid to have that conversation with the kids because they don’t want to talk about sensitive topics. It’s very important for us to know how our kids are thinking and feeling about things.”

Lisa Balster, Ohio’s Hospice’s director of patient and family support services

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LISA BALSTER: “It seems important that adults not try to pretend for children that things are easy for (adults) all the time. We all have our grief and pain from all of this situation.

The message can’t be, ‘I’m going to smile at you, but I’m going to go in the back bedroom to cry and have my pain.’

As parents and role models for children, we have to show them: ‘Look I struggle, too. This is part of being a person. But guess what? We can deal with it. We can deal with it.’

And I think with the suicidal ideation, a lot of times that really what makes that so much worse is isolation, which is our root core issue right now.”

BETH ESPOSITO: “Asking a child if they are having suicidal thoughts (is not) going to make things worse.

You’re not putting that in their mind... Inquiring is very powerful. It doesn’t create the problem and helps it.

Brutal honestly. Have you thought about harming yourself? Have you done anything to harm yourself? Are you thinking these thoughts? Just going walking alongside them, and then taking it from there. Reaching out to school counselors that are so incredibly in demand right now at all schools, whether it’s virtually or in person. Getting that referral to help in the moment.”

Q: How do we check in on people - seniors in particular - when we can not see them in-person?

JULIE MANUEL: “Right now, my mother-in-law’s in a nursing home. We have been going to the windows to visit with her almost every day, as much as we can. We’re also asking her to send us pictures. Send us pictures of yourself. Send us pictures of your room so that we know that you’re OK.

Send us pictures of what you’re eating, drinking. We want to make sure that we’re trying to check in with them as much as we possibly can. If we can’t physically do that, maybe having a neighbor or friend, or another loved one that we can have someone check in. Balancing our anxiety of not being too anxious about our loved ones, but also making sure that they are being cared for because right now we don’t know. "

Q: Many people are consuming more alcohol in their homes due to the coronavirus pandemic. “Wine with DeWine” has become a trend. How do you know when consumption of alcohol has become an issue and you should seek help?

Dr. BRIAN MERRILL: “It’s impairment. If it is getting in the way of you doing the things that you need to do interpersonally, occupationally, whatever that yardstick is for the things to do with your life, that’s a problem.

The World Health Organization has some some guidelines on moderate alcohol use for people. That’s the sort of thing that a primary care doctor tends to discuss with somebody. Most of the people that I’m working with clinically are coming to us for addiction and so for them, in most of those situations, not drinking at all is generally the guidance.

There were T-shirts with the ‘Wine with DeWine’ thing. I guess it’s funny, but then if you have 10 drinks in the middle of the day while you’re supposed to be taking care of your kids, it’s not that funny all of a sudden.

Q: What gives you hope?

JULIE MANUEL

What gives me hope is the definitely the frontline workers that are out there every day putting their lives on the line ― the firefighters, police officers, health care workers, doctors ,care coordinators, peer support teams, all of these folks that are going out day to day and just risking their lives to make sure that the community has the services that they need.

Our leadership within this community is just really doing a great job of putting putting information out there to help each and every one of us to make sure that we do the best we can to stay safe. And then of course the hope is always just within each other the human spirit just the resiliency.

Each of us and just our community in general. It just always amazes me. Dayton strong for sure.

LISA BALSTER: “What gives me hope is not only the steadfastness of people, but the fact that life is really not all one thing or another.

Even in the midst of this great challenge and suffering, there are really funny things that are happening every day. There are times where we can laugh so hard at things and we can have so much fun. And that’s OK. We should never feel bad or guilty about that if we have a happy moment right now. That’s probably a great thing for us to teach and to be an example to other people. Sometimes in hard times people think we got to walk around and just be sad all the time. That’s not going to help anybody.”

Amelia Robinson

Credit: Lisa Powell

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Credit: Lisa Powell