Dr. Sigal Levy, PH.D.

Good question! It would be important for you to be mindful of your basic needs and meet them. Take care of yourself and give priority to your health.
With that, follow precautions when outside and limit your presence around people while following safety guidelines. Learn mindfulness skills in order to stay calm and learn to let go as long as you take precautionary measures to stay safe. Take steps to improve/maintain good health by eating healthy, exercising to reduce stress and intentionally think positively. It is important to connect with a good support system of family and friends while remaining safe. It is also recommended to limit media exposure so that you become informed of important issues but choose positive media exposure to help you reduce stress and anxiety. It would be very useful to learn meditation. If it is difficult for you to reduce your anxiety, it is advised to seek professional help so that you learn effective skills to reduce your anxiety.

Several things could help reduce anxiety. At times, medication may be indicated and psychiatrists can evaluate and may prescribe appropriate medication depending on the need. I do believe that therapy is highly recommended as it is more effective to be proactive and make therapeutic changes to alleviate symptoms of anxiety. Psychologists and other qualified professionals will help diagnose and provide effective psychotherapeutic treatment such as cognitive-behavioral therapy (BCT) in addition to more holistic approaches such meditation, practice of mindfulness and self-care.

In CBT therapy sessions, the client and clinician are collaboratively working together to find solutions and modify ineffective behaviors with more adaptive ones. When we focus on identifying and replacing specific negative thinking, we are able to change the way we feel and thus be more energized to make effective behavioral changes. As a result, we are able to shift and release hormones such as endorphins to increase pleasure and satisfaction. Also the release of the neurotransmitters dopamine and serotonin are created to promote feelings of happiness and emotional well being.
Cognitive Behavioral Therapy (CBT) can be very helpful to many different mental health issues such as depression, anxiety, bipolar disorder, substance use disorders, eating disorders, etc.

Anxiety, fear and worry are on the rise during COVID-19. First and foremost, I would recommend the following safety guidelines and keeping social distancing. Make a list of things for which you are grateful. I do not recommend excessive listening to the news as it may increase anxiety but rather spending a maximum of 10-15 minutes daily to increase knowledge for your own protection. If you are not working or done with work, focus your time on calming your mind through meditation, book reading, joining online book clubs, exercising, jogging, biking or walking outside if it's allowed. Increase healthy food intake to boost your immune system, speak to family and friends, utilize zoom or other platforms to connect with friends and family especially during holidays, expand or discover your culinary talents, bake something which leaves a pleasant aroma for the day! Did you think of planting a garden if you can or growing herbal plants, flowers in a pot? You can catch up with movies you have wanted to watch but did not have time, dance or learn how to dance using virtual classes offered for free these days. Take a bubble bath, light a candle and listen to relaxing music.
Therapy also helps during such difficult times and is accessible via safe virtual platforms. Cognitive-behavioral therapy is highly effective in lowering anxiety, excessive worry and fear.

A manic phase consists of the following symptoms: racing thoughts, grandiose thinking, abnormal or sense of elation, irritability, decreased need, pressured speech, poor judgement, markedly increased energy and possibly inappropriate social behavior. Symptoms of depression include: sadness, guilt, hopelessness, helplessness, worthlessness, difficulty sleeping or over sleeping, possible suicidal thoughts, loss of interest and pleasure in things which were enjoyable, fatigue/loss of energy, difficulty making decisions or concentrating, change in appetite or weight. A combination of psychotropic medication and psychotherapy has been helpful in treating a bipolar disorder or manic depressive disorder.

Depression may affect 10% of Americans at some point in their lives, and it is treatable. A person that has a relative who suffers from depression has an increased chance of getting depression which argues for a genetic component. With that said, it does not mean that everyone who may have a genetic predisposition may suffer from depression. Some individuals may have innate or learned abilities to overcome life challenges and may not have depression. Environmental factors such as loss, social isolation, breakup of a significant relationship may also elicit depression. When a genetic component for depression is strong, antidepressants may be recommended, especially when symptoms are severe (suicidal thoughts, lack of motivation to follow up with life tasks, and hopelessness). Psychotropic medication may alleviate the severity of symptoms. With or without medication, therapy aimed at increasing healthy coping skills, modifying perceptions in addition to behavioral changes is recommended.

Divorce can create feelings of grief as there is a loss on many levels, loss of a partner, family-in-law, financial, home, spending less time with children due to having two different households etc. Depression may occur following divorce and it is important to connect with social network to overcome negative consequences of a divorce. You can also seek a support group for divorced individuals and/or individual therapy. Just remember that depression does not have to last long and it does get better.

Talk therapy does help as oftentimes we are unable or afraid to really express what is on our minds for various reasons. We may not be aware what causes our anxiety as it may not be available in our conscious mind as we may have suppressed past experiences. Talk therapy helps feel understood, validated and helps us gain knowledge about how to alleviate or reduce anxiety. Just remember that talk therapy is one among other therapeutic methods (i.e., hypnotherapy, deep breathing, mindfulness etc.) which may help reduce anxiety. I hope I clarified your question.

I am sure it is very upsetting to see your grandmother who was always so energetic and vibrant but after the passing of her husband, she may be depressed. Your grandmother would need your support. She may benefit from first talking about all those years and myriads of experiences she had with your grandfather. You can help her by finding a social support group for elderly as she may benefit from a senior citizen center that provides all kinds of activities. There are grief/loss support groups which may help her and also individual therapy. I hope your grandmother regain her energy and continue living life with her loved ones.