Dallas is currently in the midst of another triple digit heatwave that, despite the no-doubt immanent arrival of pumpkin-spice season, shows no signs of letting up soon. While there are regular reminders in the news to guard against heat stroke and the physical effects of heat, it is also important to know that extreme heat can negatively impact our mental health as well.
 
A recent meta-analysis published in The Lancet found positive associations between temperature and suicide rates, hospital admissions for mental illness, and community mental health outcomes. Aggression, domestic violence, and substance use can also increase during periods of extreme heat.
 
Certain groups are more vulnerable to the mental health impacts of extreme heat. People with pre-existing mental health conditions, dementia, or those taking certain medications (more on that below) might be at higher risk. Socioeconomic factors, such as poverty and substance use disorders, also substantially contribute to vulnerability.

​Certain classes of medication used to manage physical health conditions can make it harder for your body to handle extreme heat. These include medications to treat heart conditions, blood pressure, diuretics, anticholinergics (such as those prescribed for Parkinson’s and overactive bladder), antihistamines, and decongestants.
 
Similarly, some medications used to manage mental health conditions can impact the body's ability to stay hydrated, regulate temperature, and respond to heat. These include central nervous system stimulants prescribed for ADD/ADHD, medications to treat depression and anxiety (SSRIs, SNRIs, and tricyclic antidepressants), as well as some medications prescribed for schizophrenia and bipolar disorders. These medications can be life-saving and have profound benefits for quality of life, so it is important for healthcare providers and patients to work together to manage medications effectively, especially during heatwaves or other extreme weather events.
 
As we collectively navigate the extreme heat of the next several weeks, you can prioritize your physical and mental health by staying well-hydrated, taking precautions against becoming overheated, and checking on vulnerable family members, friends, and neighbors.
 
If you'd like to learn more about the Lancet study, Dr. Robert Bright, a psychiatrist with the Mayo Clinic, talks more about that research and the effects of heat on mental health here.

Research has shown physical movement to be a powerful tool in alleviating symptoms of depression and anxiety, as well as enhancing our overall sense of well-being. As we enter the sunshine and blue skies of Hot Texan Summer (TM), it is helpful to remember the beneficial effects of movement on our mental health and the importance of incorporating physical activity into our daily lives.

Over the years, a growing body of research has shed light on the positive impact of physical activity on individuals experiencing depression and anxiety. These studies highlight several key findings:
 
Release of Mood-Boosting Chemicals. Engaging in regular physical activity triggers the release of endorphins, neurotransmitters that act as natural painkillers and mood elevators. Endorphins induce feelings of happiness and well-being, counteracting negative emotions. This chemical boost can significantly improve mood and reduce symptoms of anxiety.
 
Neurogenesis and Neuroplasticity. Movement has been shown to promote neurogenesis (the formation of new neurons) and enhance neuroplasticity (the brain's ability to reorganize and adapt). These processes play a vital role in improving cognitive function, memory, and learning abilities. By stimulating the growth and connectivity of brain cells, physical activity helps create a healthier neural network that supports mental well-being. Studies indicate that regular exercise may even significantly reduce the risk of developing dementia.
 
Stress Reduction and Anxiety Management. Movement acts as a natural stress reliever by reducing the levels of stress hormones such as cortisol and promoting relaxation. Regular activity can also help manage anxiety symptoms, which often coexist with depression. Engaging in activities like walking, jogging, yoga, or swimming can provide a much-needed respite from daily stressors, promote a sense of calm and mental clarity, and improve sleep.
 
Social Interaction and Support. Participating in group activities or team sports provides an opportunity for social interaction and support. Engaging in activity with others can foster a sense of belonging and community, creating a supportive environment that combats loneliness and enhances our sense of well-being.
 
Physical activity can be a powerful a complementary tool alongside professional treatment for depression and anxiety. A recent meta-analysis published in JAMA Psychiatry, found that relatively small doses of even moderate physical activity (2 hours per week) were associated with substantially lower risks of depression. (Dr. Roger Seheult examines this and another recent study exploring depressive symptoms and sedentary behavior in adolescence in the video linked below.)

This spring a presidential panel of the American Psychological Association (APA) has produced recommendations for the use of social media by adolescents. The advisory panel was formed to provide recommendations grounded in research to ensure that adolescents develop healthy social media practices. The result is the American Psychological Association Health Advisory on Social Media Use in Adolescence. 

The report notes that while these platforms can promote healthy socialization, their use should be preceded by training in social media literacy to ensure that children and teens have skills that will maximize the chances for balanced, safe and meaningful experiences.

This report notes that social media use is not inherently beneficial or harmful to young people. The effects of social media depend on adolescents' personal and psychological characteristics, social circumstances, and the specific content, features, or functions they encounter on social media platforms. 

The report emphasizes that not all findings apply equally to all children and teens. Scientific findings should be used in conjunction with knowledge of specific kids’ strengths, weaknesses, developmental maturity, and contexts to make decisions tailored to each individual. 

​In addition to the new report, the APA's chief science officer, Dr. Mitch Prinstein, provides Q&A and recommendations for parents on how to help teens develop social media literacy skills. Dr. Prinstein specifically advises parents to:

• Monitor and discuss social media use. Take a multipronged approach to social media management by setting time limits, monitoring your child's online activities, and engaging in ongoing discussions about social media. Limit chat functions and exposure to adult content, and consider allowing social media use only when children are at home.
• Model healthy social media use. Be a positive role model by demonstrating healthy social media behavior. Avoid using social media during family time and set limits on your own social media use. Discuss your own social media use with your children and take social media holidays together as a family.
• Watch for problematic social media use. Be vigilant for signs that your child may be using social media in unhealthy ways. Look for interference with daily routines, excessive use over in-person interactions, lack of sleep or physical activity, inability to stop using social media, and deceptive behavior. If necessary, enforce new limits or seek help from a mental health professional.
• Teach social media literacy. Recognize that social media literacy is essential for adolescents. Work with social media platforms, schools, and your teen to promote social media literacy skills. Discuss topics like recognizing false information, understanding the meaning behind likes, preventing conflicts, promoting positive body image, addressing discrimination, and seeking reliable mental health information.

 
You can read the APA's recommendations in full here, and Dr. Prinstein's Q&A here.

Dr. Dara Greenwood, social psychologist and associate professor of Psychology at Vassar College, provides a thoughtful and engaging article interweaving psychological research with powerful messages from Disney's Encanto that are resonating with children and adults. Greenwood's key take-aways:

Check out the full article here.

Are you looking for some good distractions to help manage your 2020/COVID/quarantine/election/end-of-daylight-savings/holiday stress? These are a few of the things that have helped to keep my mind occupied and my heart hopeful. 

Daniel J. Levitin's Successful Aging: A Neuroscientist Explores the Power and Potential of Our Lives. “Growing old may be the only event in life that is both desired and feared. Daniel Levitin alleviates the fear with sound advice that can tilt the balance so that we have more healthy years and fewer sick ones. The brilliance of this book is that Levitin not only tells us what to do and what not to do—he gracefully and eloquently shares the science behind how we can change our minds and brains, and how even small changes can reap large benefits. Share this book—especially with anyone you hope to grow old with.” -Diane Halpern, past-president of the American Psychological Association

Lori Gottlieb's Maybe You Should Talk to Someone: A Therapist, Her Therapist, and Our Lives Revealed. "[In the end, Gottlieb and her patients] are more aware—of themselves as people, of the choices they’ve made, and of the choices they could go on to make . . . It’s exploration—genuinely wanting to learn answers to the question Why am I like this?, so that maybe, through better understanding of what you’re doing, you figure out how to be who you want to become." -Slate

Mark O'Connell's Notes from the Apocolypse: A Personal Journey to the End of the World and Back. "A fitting travelogue for our stationary moment...O’Connell’s 'future-dread' haltingly yields to faith in humanity’s resilience, resourcefulness, and capacity for cooperation." - New Yorker

Allie Brosch's Solutions and Other Problems. “Gut-busting . . . . Like a millennial James Thurber, Brosh has a knack for seeding a small, choice detail that snowballs into existential chaos . . . [Her] spidery and demented digital portraits, a visual expression of fun-house mirror anxiety, fits her material perfectly. . . This achingly accurate and consistently hilarious comic memoir finds Brosh moving forward and becoming a stronger, braver storyteller page by page.” - Publishers Weekly, Starred Review

Dan Rather's What Unites Us: Reflections on Patriotism. “…a deeply felt reminder of what is the best of America. What Unites Us is at times almost unbearably poignant. Yet Rather’s words provide a sort of salve—and clear thinking about how to recover from these ugly times. What Unites Us is a passionate treatise on preserving the best of America and letting go of that which makes us weaker.” - BookPage

Gail Honeyman's Eleanor Oliphant is Completely Fine. “Eleanor Oliphant is endearing, [a] whip-smart read. . . a fascinating story about loneliness, hope, tragedy and humanity. Honeyman’s delivery is wickedly good, and Eleanor won’t leave you anytime soon." - Associated Press

Rotten Tomatoes guide to 150 Great Feel-Good Movies You can Stream Right Now. (Note that the better reviewed films come latest in the list.)

Empire's list of 30 Feel Good Movies to Distract You from the Horror of 2020.

Some never-fail feel-good films include:
Singin' in the Rain
Spider-Man: Into the Spider-Verse
The Greatest Showman
Paddington (1 and 2, actually)
and The Princess Bride.

The Great British Baking Show (Netflix) may help restore your faith in humanity. With its British charm and contestants who root for one another and take both their wins and losses on the chin, the annual baking competition is feel-good TV at its best.

The Mandalorian (Disney+). Jon Favreau's Disney Original series is an exquisitely shot  gun-slinger Western set in the cinematic universe of Star Wars. Also, Baby Yoda. Need I say more?

Ted Lasso (Apple TV+). Ted Lasso (played by Jason Sudeikis) is an American football coach hired as the unlikely coach for an English premier league football (soccer) club, is definitely less family-friendly, but 100% wholesome with some of the best quote-able quotes to come out of 2020.

A World of Calm (HBO Max). This series of 30-minute documentaries comes from the creators of one of the most popular mediation apps, Calm. One person described an episode to me as "a nature documentary about a sea turtle - except that unlike a nature documentary, the sea turtle in A World of Calm is never in peril!"

Dr. Steven Stosny coined the term "election stress disorder” in 2016, with symptoms such as increased anxiety, insomnia, and difficulty concentrating. Dr. Stosny observed that "the pervasive negativity of political campaigns, amplified by the 24-hour news cycle and social media exposure," creates a significant level of stress, anxiety, or anger in many people.

The American American Psychological Association (APA) Stress in America Survey found that more than two-thirds of U.S. adults (68%) say that the 2020 U.S. presidential election is a significant source of stress in their life. This is a substantial increase from the 2016 presidential election when 52% of US adults reported the same.

“This has been a year unlike any other in living memory,” said Arthur C. Evans Jr., PhD, the APA's chief executive officer. “Not only are we in the midst of a global pandemic that has killed more than 200,000 Americans, but we are also facing increasing division and hostility in the presidential election. Add to that racial turmoil in our cities, the unsteady economy and climate change that has fueled widespread wildfires and other natural disasters. The result is an accumulation of stressors that are taking a physical and emotional toll on Americans.”

The APA offers the following evidence-based advice to help people manage their stress related to the election:

• Uncertainty is frequently stressful, and some people are better at dealing with uncertainty than others. The election, the global pandemic and social unrest are all adding to a sense of uncertainty in our lives. Avoid dwelling on things you can’t control. When uncertainty strikes, many people immediately imagine worst-case scenarios. Break the habit of ruminating on bad outcomes.
• Focus on what you can control. If following the news, watching the debates or scrolling through social media is causing you stress, limit your media consumption. Give yourself permission to take a break from the news.
• Engage in meaningful activities. Rather than fixating on news coverage, find an activity that you really enjoy and spend time doing it. Get involved in issues that are meaningful to you. By making a plan on how you will vote, for example — in person, by mail or as part of early voting — you are more likely to follow through.
• Stay socially connected. Go for a walk or spend time with friends and family. Research shows that people who have at least one or two friends or family members to turn to for emotional support during stressful times tend to cope better than people who don’t have such support.
• Stay active. Moving helps us release the energy we experience when we feel stressed.
• Realize that we might not know who won the election on Election Day. If you think this will raise your anxiety, keep busy with things that you enjoy and stay connected to social support so that you aren’t continually checking for what could be viewed as “bad” news.

This article by Scott Berinato of the HBR explores the different types of grief we are collectively experiencing in the face of this pandemic. 

Finding ways to name what we are feeling, to speak it and ask for help, empowers us to experience and then move through the emotion. As the David Kessler states in the interview, “Emotion needs motion.” Kessler suggests grounding and mindfulness techniques to help calm overwhelming anxiety and re-center ourselves in the present and on the aspects of this situation which we can control.

​As the number of cases of COVID-19 increase, so does our collective anxiety. It can be difficult to know what tomorrow, next week, or next month will bring. This lack of expectations and being unable to plan can heighten anxiety. Routines we may have worked hard to build and which support our work-life balance and mental health are thrown off. And many of us find ourselves isolated from our usual social supports. 

In the video below, clinical psychologist Dr. Alli Mattu addresses important coping skills for working from home, social distancing without feeling isolated, and managing information related to the COVID-19 public health crisis without feeling overwhelmed.

The following additional resources can help individuals and communities navigate this stressful time. Remember, we're all in this together.
​
CDC: COVID-19 Resources
Latest updates, tips and resources by the US Centers for Disease Control.

Living With Mental Illness During COVID-19 Outbreak– Preparing For Your Wellness
This webpage provides information and wellness tips for individuals living with mental health conditions during the COVID-19 outbreak.

Mental health and wellness during a public health crisis
Dr. LaGenia Bailey, a former DBSA board member, discusses tips on how to stay well during this public health crisis. In this podcast, she addresses the benefits of mindfulness practice, lifestyle habits, and ways to stay connected with others to avoid isolation.

COVID-19 Mental Health Support Line: 833-986-1919
Texas Health and Human Services has launched a 24/7 statewide mental health support line to help Texans experiencing anxiety, stress or emotional challenges due to the COVID-19 pandemic. People can call the Statewide COVID-19 Mental Health Support Line 24 hours a day, 7 days a week toll-free at 833-986-1919. Operated by the Harris Center for Mental Health and IDD, the support line offers trauma-informed support and psychological first aid to those experiencing stress and anxiety related to COVID-19.

Seven Crucial Research Findings that can Help People Deal with COVID-19
Psychological research on past crises can help people cope with the daily — sometimes hourly — news flashes about the coronavirus.

How to Transition to Seeing Your Therapist Online
Continue the work of therapy even from a distance. (And yes, Dr. Novinski offers sessions via Telehealth.)

Psychologists’ Advice for Newly Remote Workers
As employers close offices to slow the spread of COVID-19, here’s advice from I/O psychologists on how both managers and employees can work more effectively during this time.

Dial 2-1-1
If you need assistance finding food, paying for housing bills, accessing free childcare, or other essential services, visit 211.org or dial 211 to speak to someone who can help. Run by the United Way.

COVID-19 Ancillary Costs
The HealthWell Foundation announced a COVID-19 Fund that provides up to $250 in assistance with ancillary costs associated with COVID-19. Grants awarded through the fund will provide reimbursement assistance to at risk or quarantined individuals for delivered food, medication, telehealth copays and transportation costs associated with COVID-19.

Care for your Coronavirus Anxiety

Staying Grounded

Meditations and Calming Exercises

National Domestic Violence Hotline
For any victims and survivors who need support, call 1-800-799-7233 or 1-800-799-7233 for TTY, or if you’re unable to speak safely, you can log onto thehotline.org or text LOVEIS to 22522.

Talking to Kids about the Coronavirus

The Parent Guide to Resilience

Yale University's The Science of Well-Being
Yale's most popular class is now free online via Coursera. The course focuses on how to increase happiness and productivity in your everyday life. 

University of Pennsylvania:  Positive Psychology Resilience Skills