Laurie Groh, MS, LPC, SAS interviews Garrett Wilk MS, LPC, SAC of Shoreside Therapy about symptoms of anxiety and specifically how social anxiety can be tricky to deal with during social distancing due to the pandemic.
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Garrett Wilk, LPC, SAC
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Laurie: So this is our official second facebook live Q&A. My name's Laurie Groh, co-owner of Shoreside Therapies, and this is Garrett Wilk
Garrett: Hi! I'm Garrrett Wilk, I'm a therapist at Shoreside Therapies.
Laurie: Yeah, so today we wanted to talk a little bit about how COVID has been impacting mental health recently. Obviously we talked a few weeks ago, talked a little bit about some of the things you've been seeing in your practice. But what are some of the things that are coming out in the last month, some issues that you might have been seeing?
Garrett: Yeah, so i've definitely seen, I don't know about you, but I've seen more people with, like depression, just anxiety. I mean, I think the anxiety about COVID has kind of been going on the whole time. But you know, as members go up and down, I think people are more anxious. I've seen people with OCD who may have already had OCD, but it was pretty manageable, that get a lot worse, which we will talk about later. You know people with substance use. That's definitely gotten worse too: a lot of people who were drinking and managing anxiety and other things, and then social anxiety too. I mean people that were already maybe struggling to socialize. You know getting less and less of that socialization, that they really need to get better, I guess.
Laurie: Yeah, I think the social isolation does not help for that, for sure, where it makes every interaction a little bit more difficult and challenging, and then added to this to the social anxiety piece is that, you know we talked about this little bit last time, but people don't really know how to interact and what's going to be okay. What's going to be not okay? You know, do you do the little elbow bump or do we just not even anymore? So, like what might have been uncomfortable for a lot of people? I know a lot of people just are awkward at that first meeting of someone or even if it's a friend you haven't seen in a while. What do you do? Right? So I would imagine at this point people are very uncomfortable and awkward and nervous, even with family.
Garrett: Yeah. It's always changing what people are comfortable with and then, you know, people are getting used to wear masks and like. When do you wear a mask and when do you not? You know, yeah, it is tricky to navigate and it's hard for people who are already struggling in those situations to navigate that. Or if someone already has a lot of anxiety or a lot of fear about COVID or has OCD about contamination, you know those situations just get much much harder where a lot of people, I think, just avoid it, you know.
Laurie: Right, right, so, is there anything before we move on? Is there anything, any suggestion, any tips you might have for somebody that's maybe struggling with that, with the social anxiety piece right now?
Garrett: Yeah, yeah, so I mean I think you know within reason, I think, the for people to use this as an excuse to avoid further. I mean that's oftentimes what people's social anxiety sort of end up doing is avoiding, which makes their social anxiety worse. So being mindful about, like making sure that you know if you're deciding to stay home, is it really because that's the safest thing to do and that's sort of the sort of conscientious, respectful, prudent thing to do? Or is it because I feel anxious about going out and so kind of anxiety related to social anxiety, so sort of gaging what's rational for what you're doing? You know, and also, making sure to avoid things that maybe reason would say is okay, like being outside with a friend, or wearing a mask. Things that if you're socially distanced and taking all the precautions, that you're not avoiding that because you need to be around people to challenge some of those social fears.
Laurie: Right, so it does help to just sort of talk with someone you know and figure out, hey, is this something that I'm doing because I'm trying to be very conscientious of my health and other people's health, or am I maybe using so that I don't have to push myself in that area, which is understandable. It's a hard thing to push, hard thing to push right now, but in general it's a hard thing when you're feeling extremely anxious about something to say, I'm just going to going to go hang out with somebody. I'm going to go ahead and do it. So yeah, kind of figuring that out first helps.
Garrett: Yeah, 100% yeah, I think, and talking to someone usually, I think you're right. That's helpful to like, help you to gauge what's going on for you. You know sometimes it's hard to do that introspective work.
Laurie: I think so too. I think we're really good at using mind tricks, and that can be helpful in times and not helpful in other times, you know.
Garrett: Yeah, definitely.
Laurie: All right, so let's switch gears a little bit now. We're talking about talking to someone right. And when is it time to maybe talk to a therapist? When is it time to go ahead and make that appointment? And maybe you could give us some red flags, some ideas somebody could look for to make the decision. If they're feeling some depression, if they're feeling some anxiety, they're feeling having some symptoms. What are some red flags? How would somebody know? Okay, today is the day. I gotta call and make an appointment.
Garrett: Yeah, yeah, definitely, so you know. I think there's some people who already have existing mental health issues. It's maybe getting worse from this and for some people this is the first time they've ever struggled with their mental health. So you know, I think you're looking for, like big reactions or overreactions in scenarios. Do you look back and say like wow? I can't believe I responded that way or what has happened? Why did I do that? Or if you're more emotionally sensitive to things, if you're really struggling to kind of keep up with the day-to-day you know some people are feeling more fatigue. If you're drinking more or using something else or try to cope, it's not healthy. I think in terms of depression you'd be looking at chronic sadness you're liking into hopelessness, maybe even suicidal thoughts. So if you're having suicidal thoughts you definitely want to be reaching out. You need to be reaching out and talking to someone, letting someone know about that. So with depression it could also be just struggle day today, low-energy, lethargic, that sort of thing.
Laurie: Yes. Low energy right, that energy where... That feeling of taking a shower might feel like a lot. You might be doing it, but that the thought of it is sort of exhausting.
Garrett: Sort of thing, yeah, like barely getting by. Yeah, and I think anxiety is sort of a trickier one, because I think everyone has heightened anxiety with this. But I think you know what you're looking for is, long and sustained. You know you're consistently, significantly anxious, having more heart palpitations. You have excessive worry. It's really difficult to control or stop. Your worry isn't really that rational, like later on, if you look at it, you're like okay, maybe I didn't need to worry that much about that. Or why did I spend the last three days so anxious or worried about that? Or having sleep issues. That's a big one with anxiety too, and then, I think OCD is probably one of the big ones. I see quite a few people with OCD and I feel like people that had lower level OCD, that was maybe really manageable or just barely impact on their lives. I feel like a lot of the folks that I've seen have really seen that get a lot worse, especially if they struggle with contamination. This whole pandemic is playing right into their greatest fears. So it could be like a pattern. So you're having regular and consistent, unwanted or intrusive thoughts, which would be the obsession. And then you have a compulsion which is like a pattern of behaviors that are repetitive, that is designed to try to alleviate the anxiety related to the obsession. Usually people are spending at least an hour a day doing those behaviors. Otherwise you know scrupulosity, which can be religious themes. They could have thoughts about harming other people or fear they might harm other people, straightening andorganization, things like that. I think that's a big one. Right now a lot of people with OCD are struggling, or maybe they had their OCD in a good spot, and now it's just sort of resurged.
Laurie: Right, right, and so that that key right there would be, maybe the amount of time someone spent on it and and maybe how disturbing it could be.
Laurie: Yeah, that can be hard. That can be hard because some things kind of seem like they're manageable with OCD. You can get it into a sort of a manageable space or feels manageable, especially if things aren't being challenged, which again that might be in the spot that we're maybe some of that's not being as challenged as much because there is the social isolation piece.
Garrett: Yeah, yeah definitely, and I think, for people with OCD, they may end up having thoughts like, if they just wash their hands like they may feel like, oh maybe I'll just wash them again to make me feel little more safe or you know maybe I'd better wipe down my kitchen another time or you know so they're going. You know the next step beyond what is reasonable now, like steps to take with COVID, which is of course really hard to gauge. You know certain people find different things reasonable, but you know this is probably really really causing them a lot of anxiety, really occupying their thoughts significantly.
Laurie: Right, right, and so this leads me to my last and final question, because we are, believe it or not, this goes by so quick. We are already at the last question.
Laurie: So my last question is: I'm very excited to hear that you got an anxiety and OCD group that you're doing. So maybe you could talk a little bit about that.
Garrett: Yeah, yeah, so obviously it's probably not a great idea for a group to meet in person right now. So we're going to do it virtually. But it feels like there's a lot of need for people who are struggling with specifically OCD right now that's pretty difficult, but also you know social anxiety or any other anxiety, and so I'm looking, you know, at this group that will help people to understand what's going on for them, learning some scales to be able to handle it or getting support in the group. Learning the best ways to cope with that and to treat it, and I find group is like a really effective way to do that. Oftentimes people feel pretty lonely with mental health, like maybe they're the only one going through what they're going through. So group, I think, will be an amazing way for people to realize other people are going through this too and to get a lot of that support and to get good treatment in a more cost-effective way.
Laurie: That is a great point about the group of like that idea of feeling alone right and that you might be the only one experiencing this and especially if you're not talking to other people about it, which a lot of times I think isn't necessarily what people want to do because they're scared people aren't going to understand it and such a great avenue to be around some people that really know exactly what you're going through. For the most part right, everybody has different experiences, but they can say, oh yeah, yeah, I felt like that once, and I know for a lot of my clients, when when they have that connection with somebody, when they feel like oh, somebody else has experienced this, it just dramatically, you can see in their whole physical being, this sort of feeling of okay, someone gets it, you know, and how powerful that is.
Garrett: Yeah, it's really powerful. Yeah, it's amazing to just feel like okay, this person gets it. I don't have to try to explain this. They're going to understand it, maybe in a way that most people won't.
Laurie: Yes. And there's that other aspect that you mentioned is that other people have other ideas or tips, or this worked really well for me, or even calling you out, saying maybe you're doing this right now, which can be a really really positive thing, especially when you know all of these people. They are there for the same thing, they are there to look out for your best interests and they're trying to help and support, which might not be always true with other people in your circle right.
Garrett: Yeah, 100% yeah, I think I think groups are a great way to do it. I'm really excited to run this group.
Laurie: That's going to be great, all right, so Garrett, we should end. You want to let people know your email and how you can be reached?
Laurie: Awesome, all right. If I was a little bit more tech-savvy, that would be popping up on the screen right now. Maybe next time!
Garrett: Yeah! I'm excited for that! Like infomercials.
Laurie: I know! That would be great, right? All right, well, thanks a lot, Garrett, and we will do another one of these soon!
Garrett: Sounds good thanks.
Laurie: Yeah, take care!
Garrett: You too, bye.