Where are we now and what can we do
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Transcript of Where are we now and what can we do
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Dr Caroline Bell Canterbury District Health Board
Department of Psychological MedicineUniversity of Otago, Christchurch
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Where are we now ?
What is Well being ?
Can we improve it ?
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Insurance, financial, delays ……
Family load disrupted routines, sleep, kids, elderly, friends leaving
Community load changes to city, roads, people left, landscape
Social load no CBD, fewer movies, restaurants, activities
Workplace load
Relocation, shared spaces
Organisational and physical uncertainty, financial
Its not business as usual but demands for business as usual
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CERA All right campaign CDHB
Wide spectrum of response
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Fatigue / exhaustion
Feeling despondent / overwhelmed
Loss of control
Feelings of anger and frustration – lowered tolerance
Poor concentration
Absenteeism / presenteeism
Interpersonal / relationship issues
Substance abuse
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PTSDPerception death - marked hyperarousalRescue workers - PTSD Previous PTSD
Depression
Anxiety disorders
Substance abuse
Relationship problems
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High exposure Life stressors
Financial, homes, businesses, relocation
Limited social supports
Previous mental health difficulties
High risk professions
New group - any of us
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Persistent low mood, loss of hope, suicidal Persistent rumination or memories High levels anxiety/hyperarousal High levels distress Avoidance/withdrawal
Risk taking Aggression/ relationship problems Alcohol or drug abuse
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Not just happiness Life satisfaction and +ve emotions Flourishing
Positive emotions Engagement – flow Relationships Meaning and purpose Accomplishment
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Physical health
Mental health
Relationships
Workplace satisfaction
Community cohesiveness
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Increased activation of the amygdala Focus threat Prepares fight/flight Less interest in non-essential activities
Reduced activation of frontal brain regions
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Amygdala
Regulatory / inhibitory Excitatory
mPFC Overactive amygdala
Impaired vmPFC inhibition onto amygdala networks
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Increased activation of the amygdala Increased vigilance Less interest in non-essential activities
Reduced activation of frontal brain regions Planning, complex thinking
Increased glucocorticoid
Earthquake brain, Bush fire brain, Flood brain
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Head down, blinkered approach
Focus on stress - trying to deal with things can’t control
Reduction innovative strategic thinking
Things add value dropped off
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Reduced wellbeing
Health
Relationships
Social
Career
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Dealing with real practical problems – zoning, insurance, financial
Well being Active not passive process
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Genes
Circumstances
Intentional activity
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Nurture social relationships
Increase flow activities / learning
Look at what is important to you
Optimism, positive emotions
Tolerance and gratitude
Avoid overthinking, flexible approach
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What enhances well being
Exercise Learning Mindfulness Yoga Gratitude
Reduce amygdala activity Increase frontal cortical activity
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Amygdala
Regulatory / inhibitory Excitatory
mPFC Increase vmPFC inhibition onto overactive amygdala networks
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1. TAKE TIME
Fast not necessarily best Often need to build new foundation life
Time Space Energy
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2. ASSESS OUR ENERGY LEVELS
Focus on problems causing the stress Keep on going
Stop listening to our needs (body, relationships, social)
Keep listening needs Recharging – brief and often
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3. FOCUS ON WHAT WE CAN CONTROL
Stress result circumstance and attitude
Circumstances Lots out of our control When stressed focus on most intensive problems
Attitude What can do, have achieved, will do Sleep, relationships, sport, music
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4. WHAT AM I NOT DOING NOW
Stress demands constant focus Drop out things feel not add value to this
But these are exactly things that add value to our lives Time reflect Doing things with friends Doing things give you enjoyment
Can’t wait and put on hold til all over
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5. BUILD BACK ROUTINES
Routines free us up, familiarity, security Give us time
Dropped out of routines or things different
Put new routines back
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Can learn from this what is really important
Should celebrate what we have achieved
We can do something about how we are feeling and our wellbeing
But……….
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This is new and hard
We HAVE TO look after our wellbeing
THIS IS IN OUR CONTROL AND ITS TOO IMPORTANT TO LOSE