By Katie Mulkerin
The coronavirus has not only caused physical symptoms among those who’ve contracted the virus, but folks are also struggling with their mental health and anxiety issues.
People who don’t typically see a psychiatrist are seeing them virtually for the first time and doctors have just as much adapting to do as their patients.
Psychiatrists typically read people’s facial expressions and create bonds that will influence the chemistry between doctor and patient.
David Brendel, M.D., is a board-certified adult psychiatrist who treats people with anxiety, depression, bipolar disorder, ADHD, psychosis, substance abuse and other similar conditions. The Harvard Medical School graduate completed his psychiatry residency at Mass General and McLean Hospitals.
“I went into psychiatry because of my strong interests in neuroscience, psychology and philosophy of mind. Practicing psychiatry allows me to help people by integrating treatment with medications and talk therapy,” Brendel said.
Brendel works out of Belmont where he’s been navigating the pandemic and figuring out how to best treat patients during the COVID-19 era. “COVID has caused great stress and worry for so many people, and at the same time it has created opportunities for people to reconnect with their core values,’ Brendel said.
Brendel glances over at the empty red couch in his office in Belmont. He’s had to adapt to long hours of staring at a screen, rather than patients faces. He jumps from virtual meeting to virtual meeting helping each patient.
According to Brendel, many people have experienced a worsening of their psychiatric conditions during the pandemic.
“Anxiety, depression, and all other mental health conditions can be caused or worsened by uncertainty and change. So many people have experienced health concerns [for themselves and their loved ones] as well as financial instability during this time,” he said.
Folks’ routines and daily schedules have completely flip-flopped and social distancing has caused sadness and loneliness. As people face job losses or school closures, dreams and aspirations are truly put on the back burner making folks feel hopeless.
In some cases, Brendel said adjustment to medication regimens and frequency of sessions have helped patients cope. His main goal is to provide patients with the “support and safety to share their deepest and most private feelings about the situation we find ourselves in,” he said.
“By serving as an active listener and trusted advisor, I hope to help my patients find solutions to their most important life challenges,” he said.
Brendel said he misses seeing patients for in-person appointments, but he has been on site at the hospital where he does some consulting work. He said he believes psychiatry can be practiced as safely and effectively via telehealth.
“It can be challenging to sit in front of my computer screen for continuous appointments over many hours, so I try my best to schedule regular breaks between sessions. This helps me to remain focused and present to my patients in our meetings.”
At his practice, Brendel said that online meetings can have advantages and disadvantages. He’s adapted well to remote sessions and is easing the transition for his patients. While some patients find it frustrating to miss the experience of in-person sessions, others find it convenient and timesaving not having to drive to the office for their sessions.
It’s imperative to follow all regulatory changes around COVID-19 and comply with them to practice safely.
“Privacy and confidentiality are essential in medical practice generally and especially in psychiatry, where people share such personal information. I’m using an online video platform which complies with all HIPAA and related standards for safe practice.”
Fortunately, for Brendel, he said he began using an approved electronic prescribing system, which eliminates the need for paper prescriptions in the office.
He will not resume regular in-person sessions until it’s clear that he can practice in accordance with state guidelines around reopening.
Brendel offered a few pieces of specific advice to patients or individuals stressed out about the pandemic. Establishing a regular schedule and routine for self-care such as sleep, exercise, nutrition, and downtime with friends and family.
“Another piece of advice is to stop and think about how to use this time during the pandemic to achieve goals and reconnect with core values such as more time with friends and family, charitable endeavors, development of new skills and hobbies.”
Changing the narrative or rhetoric behind the “stay at home” mantra can influence folks’ productivity. By telling oneself that “you get to stay home and protect the vulnerable population as well as working on yourself” can be a positive mindset.
‘The people who have adapted best during COVID-19 are those who have been flexible and open-minded about creating new and enjoyable patterns of running their lives. Of course, not everyone has that luxury. People who have been sick or lost loved ones to COVID-19 understandably are struggling more profoundly to adapt.”
Brendel specializes in treating adults and for young adults working closely with COVID, their mental state can be particularly vulnerable working on the front lines of the pandemic.
Jenna Olander, a 24-year-old graphic designer for ASICS shoe company, is also a member of the U.S. Air National Guard and was deployed to serve the COVID-19 mission in Bedford at Hanscom Air Force Base.
Olander said she struggled with anxiety starting out the mission and was put in the call center where she would watch the numbers of cases in the nursing homes increase and hear the worried voices of facilities calling her each day. She said she felt like she had to almost desensitize herself to the situation in order to cope at home and remain productive at work.
Her routine resembles Brendel’s recommended coping mechanisms. “I kept myself on a routine, worked out regularly and went for a lot of drives walks in the woods, started painting again,” she said.
Brendel said he understands that there are a lot of similar situations to Olander’s and first time patients are able to talk to a psychiatrist remotely. “People who have experienced job loss and financial problems also are struggling more intensely during this time. They deserve our respect and support. I am doing my best in my professional practice to help many people cope with loss and fear, while also supporting them in looking forward to develop a hopeful plan for the future.”
Andrea Marcotte, a Dunkin Brands marketing coordinator, made some big life changes during the pandemic such as accepting a new job and moving into a new home. She had a relatively positive experience navigating the pandemic. Despite previously struggling with anxiety and felt comfortable coordinating telehealth visits with her psychiatrist.
“At first, I will admit it was scary because everything was shut down but then I realized that I was able to spend way more time with my boyfriend than I ever did before because we had no distractions from work/ life,” Marcotte said.
Three months into the pandemic when social distancing and small gatherings became more encouraged, she had more quality time with friends as well.
“I also realize that instead of going into a crowded bar or restaurant that when I do get to see my friends we actually talk and engage and spend quality time together which I think is something that was rare when the world was “normal.” Going to someone’s house and being able to share a meal together for drinks it’s just different from being out and having a ton of distractions and ppl yelling,” she said. Adding that she feels cleaner and more conscious of what she’s touching and her surroundings.
As Brendel said, this is just one example of someone re-connecting and reflecting on their core values during quarantine.