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A Therapy for the Times

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Photo by Engin Akyurt on Unsplash

You may not need a peer-reviewed study to tell you how much our mental health has suffered during the pandemic. Just look around at your friends and family, co-workers, even the usually cheerful grocery checker and it’s not hard to detect how many of us have moments of being on edge, overly emotional, depressed, or all of the above as a result of more than 2 years of stress and anxiety.

The ongoing clashes of vax/anti-vax/endlessly nuanced vax-hesitancy et al, have added to the strain of uncertainty, and maybe you have even had a reaction to the jab that you can’t explain that’s got you worried.

Maybe by now you’ve had one of the many covid variants, but that’s no guarantee it’s over in your body or your mind. Maybe you have some signs of long covid, or maybe you keep getting reinfected, as omicron seems to like that particular trick.

It’s all crazy-making.

Depression and Anxiety increased by 25%

In March, the World Health Organization (itself a source of stress throughout the pandemic as its reputation for trustworthiness has varied like the waves on a graph of infections) released a statement broadly encouraging all nations of the world to step up their mental health services and access due to what it states was a 25% increase in depression and anxiety just during the first year of the pandemic.

Now as we are deep into the 3rd year of this world-wide health crisis, mental health services are stretched dangerously thin. One form of treatment, called Cognitive Behavioral Therapy (CBT) may have some advantages over other forms of therapy in addressing issues mushrooming in youth and adults alike.

CBT – what’s that?

CBT is a form of talk therapy that uses modification of thoughts and behaviors to rewire emotional reactivity and its accompanying misperceptions that lead to heightened levels of distress leading to uncontrollable anxiety, depression and so on. The patient’s feelings will be methodically unpacked to show how emotions can side-track perceptions, ultimately facilitating a more rational disengagement from the powerful emotional pull. The intended result is improved resiliency, not just to cope with whatever brought you into therapy, but potentially to be practiced throughout the rest of your life.

Several studies have already shown that CBT has helped to lessen anxiety in covid patients as well as all of us who have been affected by isolation, fear, loss of employment, etc.  It’s suited to the current huge demand for mental health services both via its relatively short-term and goal-oriented format as well as its ability to be administered not just by high-rent leather couch therapists, but also by mid-level providers such as nurse practitioners. The therapy’s forms work very well with remote delivery in a time when telehealth has grown exponentially, and there are even apps that can provide some meaningful encouragement to stick with CBT principles on a daily basis.

Better than talk therapy, but it’s “work”.

“Rather than ploughing into emotion…CBT aims to alter the flawed perceptions…”

If it sounds too good to be true, keep in mind that CBT does require an effortful buy-in from the patient. It takes humility to identify your problem perceptions and behaviors. It takes work to commit to CBT’s proven methods for modifying long-held assumptions and habits. It takes time spent outside the therapist’s office doing homework and other activities to help rewire your routine patterns.

Therapy is usually goal-oriented and within a few sessions it is likely you will have a plan for how to attain the stated goal. Rather than ploughing into emotion for its own often valuable sake, CBT aims to alter the flawed perceptions that precede reactive or difficult emotion.

Based on principles that psychological problems stem from faulty thinking and learned patterns of problematic behaviors, CBT teaches you to recognize the  thinking and modify the behavior. Patients learn problem-solving skills that help them build confidence in a variety of stressful situations as well as increase compassion and understanding toward others who are suffering some of the same manifestations of distress. Body-calming relaxation techniques are also taught.

CBT also applies the principles of neuroplasticity because as you retrain your behavior, the neurons that fire together wire together, and new, more positive habits emerge, replacing former patterns for good. Behavioral impulses in the brain tend to follow the same neuronal routes, regardless of how unhappy they may be making us. When we change the behavior for long enough and with enough resolve, we can truly make profound change right in the grey matter.

Sounds expensive – is it?

CBT is relatively inexpensive, another feature that suits broken and overburdened healthcare systems, and its effectiveness, by some accounts, is much more reliable than some other forms of talk therapy and many forms of medication therapy. The fact that it provides measurable success makes it attractive to potential patients who are reluctant to commit to the expense or uncertainty of open-ended talk therapy. While it is not unheard of for CBT to be supplemented with medication, the fact that it can work without drugs is a big plus to other potential patients who do not want to be pushed in that direction.

Ask your provider for a referral. You may be surprised to find out she has the training to get you started herself. A simple internet search for CBT therapists in your area will turn up a decent roster of possibilities. You can also search for online providers or delve into the literature and self-help apps that use CBT principles if you just want to dip a toe in on your own.

We are all in this together. Through taking better care of our own mental health we can help others find a way to cope better with a pandemic (or war, or climate crisis) that seems like it will be with us for the foreseeable future, or at least until the next one comes along.

Ann Constantino, submitted on behalf of the SoHum Health’s Outreach department.