Thanksgiving 2020: 5 tips to protect mental health

For most people, Thanksgiving will be very different this year. In this article, we provide 5 basic tips to help bolster our mental health before, during, and after the 2020 holiday season.

Thanksgiving is traditionally a time to share food and frolics with our nearest and dearest. For most of us, this is unlikely to be the case this year. With travel restrictions and quarantines in place, we will need to adjust.

Although the pandemic has affected everyone in different ways, there seems to be little doubt that the average mental health of the population in the United States has declined.

At a time when family and friends are normally the closest, this year, they will be farther away. Looking after our mental health in a proactive way is more important than ever as we enter the holiday season.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

In this Special Feature, we will look at ways to fend off the seemingly inevitable blues of a physically distant Thanksgiving. Even without a pandemic to deal with, the holiday season brings stresses and strains, so with the added pressures this year has presented to us, we need to focus.

Right from the get-go, it is important to make it clear that nothing we provide below can fill the void or heal the anxiety that COVID-19 has produced. Perhaps, though, it might nudge the needle in the right direction. Sometimes, small steps, taken together, can produce significant benefits.

Before we dive in, here is something to bring to the forefront of your mind as often as possible over the coming days and weeks:

Each day, scientists are learning more about how SARS-CoV-2 works. Vaccines are coming. Yes, 2020 has been challenging, but, with medical research in our armory, we will defeat COVID-19.

1. Sleep

No article on maintaining mental health would be complete without mentioning sleep. We do not give it the space that it needs in our modern, neon-lit world. We all need to do better.

Losing sleep interferes with our mood. This is intuitive, but it is also backed by research. For instance, one study concludes, “Sleep loss amplifies the negative emotive effects of disruptive events while reducing the positive effect of goal-enhancing events.”

In other words, if we do not sleep enough, we are more likely to feel negative when things go wrong, and we are less likely to feel good when they go well.

Similarly, another study found that “individuals become more impulsive and experience less positive affect after a period of short sleep.” Once again, reduced sleep duration appears to dampen mood.

At a time when the mood of the nation is at a low ebb, sleeping a little extra might be a relatively simple way to tip the scales in our favor. For advice on getting better sleep, click here.

It is worth noting, though, that the relationship between sleep and mental health is complex and two-way — mental health issues can impact sleep quality, and a lack of sleep can damage mental health.

2. Keep active

As with sleep, any article that aims to boost mental health has to include exercise. As the temperature drops, forcing ourselves outside can become increasingly challenging. Scientists have shown that physical activity can boost mood both in the short and long term.

A review published in 2019, for instance, found a relationship between cardiorespiratory fitness and the risk of common mental health disorders. Similarly, a 2018 meta-analysis concluded that “[a]vailable evidence supports the notion that physical activity can confer protection against the emergence of depression.”

Importantly, we do not need to run a 4-minute mile to gain mental benefits from exercise. A study from 2000 found that short, 10–15-minute walks boosted mood and increased calmness.

So even if it is something simple, such as dancing in your kitchen or walking your dog for a little bit longer, it all counts.

It is true that neither exercise nor sleep can replace a hug from a friend or relative, but if our mood is momentarily boosted or our overall average mood is upped, it might help us manage disappointment better and reframe this difficult year.

3. Addressing loneliness

For many people, loneliness has already been a significant feature of 2020. Reflecting on friends and family during Thanksgiving is likely to intensify those feelings of isolation.

To combat this, make an effort to make contact. Whether it is a simple phone call or a video chat, schedule some conversations in. Remember, you are not the only one feeling lonely. If it is safe and permissible in your area, meet up with a friend somewhere outside and take a walk.

Check in with others — emails, texts, and social media can be useful in times like this. Rather than doomscrolling, send a “How are you?” to someone you miss. They likely miss you, too.

Stay occupied. Empty time can move slowly. Find a new podcast, listen to new or old songs, pick up that guitar, start drawing again, learn a new skill, or anything else. An occupied and engaged mind is less likely to dwell on the loneliness.

A recent study found that people who get involved in an enjoyable task and enter a state of flow fared better during lockdowns and quarantines. The authors write:

“Participants who reported greater flow also reported more positive emotion, less severe depressive symptoms, less loneliness, more healthy behaviors, and fewer unhealthy behaviors.”

4. Eat and drink well

Thanksgiving is associated in no small part with overindulgence. I don’t think it would be fair or reasonable to expect people, in 2020 of all years, to reduce their turkey intake.

With that said, there is growing evidence that what we eat impacts our mood. For instance, a recent review that appears in BMJ concludes:

“Healthy eating patterns, such as the Mediterranean diet, are associated with better mental health than ‘unhealthy’ eating patterns, such as the Western diet.”

With this in mind, ensuring that we eat well in the lead-up to and the days following Thanksgiving could help us keep a steady mind.

While we are discussing consumption, it is worth mentioning alcohol. In the long term, alcohol increases the risk of developing mental health issues, such as depression and anxiety. Although, at the time, alcohol might lift mood and reduce anxiety, it will not help in the long run.

5. Align expectations

Not everyone is on the same page when it comes to the pandemic. Some people might still be shielding, while others might have succumbed to “pandemic fatigue” and be returning to normal prematurely. Others still might use terms such as “scamdemic” and refuse to wear a mask.

Some family members might be pushing for a family meal, like the long distant days of 2019. Others, sensibly, might be visualizing a Zoom-based meal plan.

These differences in position have the potential to cause disappointment and additional stress. It is important to have clear and frank discussions with family members about what they can expect this year.

Remember, with any luck, next Thanksgiving will see a return to some form of normality. Hopefully, we will only have to endure this unusual and uncomfortable Thanksgiving once. If you are not comfortable with someone’s proposed plan, say “no.” And stick to your guns.

With spikes in case numbers across much of the U.S., the most sensible option is to limit human contact as much as possible.

Although laws, rules, and regulations vary between regions, the Centers for Disease Control and Prevention (CDC) have published a document outlining factors people should consider when planning get-togethers and events.

In general, gatherings with more people are risky, as are events in enclosed spaces. People can lower the risk in a number of ways, including:

  • inviting fewer people
  • meeting outdoors
  • wearing masks (unless eating)
  • remaining 6 feet (2 meters) apart
  • washing the hands frequently
  • keeping music low so that people do not need to shout
  • limiting alcohol intake

When it comes down to it, each individual has to make their own decision about how they act within the law. To protect your own mental health, make your own decision and do not allow yourself to be railroaded into doing something that you consider to be too risky.

The safest way to enjoy Thanksgiving this year, unfortunately, is to do it virtually.

The take-home

Individually, the tips outlined above cannot replace the good times we expect from Thanksgiving. However, if we make more of an effort to eat right, sleep right, and move around, the cumulative effect might be enough to enjoy some benefit.

Remember, we are on the home straight. Reach out and talk to friends and family if you are feeling low. The odds are they are feeling low, too. Never be afraid to talk about your emotions. No one is having the holiday season they expected.

As many people struggle during this time, it might be hard to see an end in sight. If you are contemplating self-harm or if you know someone who is, we have a list of excellent resources here. We are in this together, and it will end.

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

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Female hysteria: The history of a controversial 'condition'

For centuries, doctors readily diagnosed women with “hysteria,” an alleged mental health condition that explained away any behaviors or symptoms that made men…uncomfortable.

A fondness of writing, symptoms of post-traumatic stress disorder or depression, and even infertility — for the best part of two centuries, all of these and more could easily fall under the umbrella of “female hysteria.”

Throughout the 18th and 19th centuries, female hysteria was one of the most commonly diagnosed “disorders.” But the mistaken notion that women are somehow predisposed to mental and behavioral conditions is much older than that.

In fact, the term hysteria originated in Ancient Greece. Hippocrates and Plato spoke of the womb, hystera, which they said tended to wander around the female body, causing an array of physical and mental conditions.

But what was female hysteria supposed to be, what were its symptoms, how did doctors “treat” it, and when did they cease to diagnose it as a medical condition?

These are some of the questions that we answer in this Curiosities of Medical History feature.

Female hysteria in the 18th century

While the original notions of female hysteria extend far into the history of medicine and philosophy, this diagnostic became popular in the 18th century.

In 1748, French physician Joseph Raulin described hysteria as a “vaporous ailment” — affection vaporeuse in French — an illness spread through air pollution in large urban areas.

While Raulin noted that both men and women could contract hysteria, women were, according to him, more predisposed to this ailment because of their lazy and irritable nature.

In a treatise published in 1770–1773, another French physician, François Boissier de Sauvages de Lacroix, describes hysteria as something akin to emotional instability, “subject to sudden changes with great sensibility of the soul.”

Some of the hysteria symptoms that he named included: “a swollen abdomen, suffocating angina [chest pain] or dyspnea [shortness of breath], dysphagia [difficulty swallowing], […] cold extremities, tears and laughter, oscitation [yawning], pandiculation [stretching and yawning], delirium, a close and driving pulse, and abundant and clear urine.”

De Sauvages agreed with his predecessors that this condition primarily affected women, and that “men are only rarely hysterical.”

According to him, sexual deprivation was often the cause of female hysteria. To illustrate this, he presented the case study of a nun affected by hysteria, who became cured only when a well-wishing barber took it upon himself to pleasure her.

Another means of “treating” instances of hysteria was through mesmerism, an alleged psychosomatic therapy popularized by Franz Anton Mesmer, a German doctor who was active in 18th-century Europe.

Mesmer believed that living beings were influenced by magnetism, an invisible current that ran through animals and humans, and whose imbalances or fluctuations could lead to health disruptions.

Mesmer alleged that he could act on this magnetic undercurrent and cure humans of various maladies, including hysteria.

Hysteria in the 19th century

Throughout the 19th century and the beginning of the 20th century, there was perhaps even more talk of female hysteria and its potential causes.

Around the 1850s, American physician Silas Weir Mitchell, who had a special interest in hysteria, started promoting the “rest cure” as a “treatment” for this condition.

Rest cure involved lots of bed rest and strict avoidance of all physical and intellectual activity. Mitchell prescribed this treatment preferentially to women who he deemed as having hysteria.

By contrast, he would advise men with hysteria to engage in lots of outdoor exercise.

Mitchell famously prescribed the rest cure to the American writer Charlotte Perkins Gilman, who found the experience so harrowing that she wrote “The Yellow Wallpaper,” a psychological horror story that maps the slow psychological deterioration of a woman who is forced by her doctor, her husband, and her brother to follow this “treatment.”

In France, neuropsychiatrist Pierre Janet, who was most active between the 1880s and the early 1900s, argued that hysteria resulted from a person’s own warped perception of physical illness.

Janet wrote that hysteria was “a nervous disease” where “a dissociation of consciousness” took place, often characterized by symptoms such as somnambulism, the emergence of “double personalities,” and involuntary convulsions.

The founder of psychoanalysis, Sigmund Freud, also took an interest in hysteria, though his views on its causes fluctuate throughout his career.

He argued that hysteria was the conversion of psychological issues into physical symptoms, often with an element of erotic suppression.

At first, he suggested that symptoms of hysteria were caused by traumatic events, though later, he said that previous trauma was not necessary for hysteria to develop.

Vibrators for hysteria?

The 2011 rom-com Hysteria popularized the view that vibrators are tools meant to cure hysteria in female patients.

This story originates from an influential book of medical history: The Technology of Orgasm, by Rachel Maines, which first appeared in 1999.

Maines argued that, in the late 19th century, doctors would often treat female patients’ hysteria symptoms by manually stimulating their genitalia. According to her, the vibrator eventually emerged as a device that would save physicians some effort when treating their patients.

However, more recently, scholars argue that Maines’s perspective was inaccurate and that there was no evidence to support her theory.

The study paper that contradicts Maines’s theory states, “none of her English-language sources even mentions production of ‘paroxysms’ [a euphemism for orgasm] by massage or anything else that could remotely suggest an orgasm.”

Yet such stories and hypotheses emerged precisely because 19th-century medical treatises did emphasize the connection between female sexuality and hysteria.

Some 19th-century doctors infamously argued that problems within the genitalia could cause psychological problems in women — including hysteria.

For instance, Richard Maurice Bucke, a Canadian psychiatrist active in the late 19th century, opted to perform invasive surgery, such as hysterectomies — where doctors remove the uterus — to “cure” female patients of mental illnesses.

Therefore, for a long time, hysteria remained an umbrella term that included numerous and widely different symptoms, reinforcing harmful stereotypes about sex and gender.

While this “condition” is no longer recognized and started to “fall out of fashion” in the 20th century, this was actually a long and unsteady process.

The first Diagnostic and Statistical Manual of Mental Disorders (DSM-I) of the American Psychiatric Association (APA) — published in 1952 — did not list hysteria as a mental health condition.

Yet it reappeared in the DSM-II in 1968, before the APA dropped it again in the DSM-III, in 1980.

Time and again, researchers of medical history point to evidence that hysteria was little more than a way to describe and pathologize “everything that men found mysterious or unmanageable in women.”

And while medical practices have evolved incomparably over the past couple of centuries, investigations still reveal that data about females are often scarce in medical studies.

In turn, this continues to impact whether they receive correct diagnoses and treatments, suggesting that society and medical research have a long way to go to ensure all demographics get the best chance at appropriate healthcare.

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