anxiety - Musculoskeletal Health Australia (MHA)

04/Jun/2020

As COVID-19 restrictions came into force at the end of March, life as a Musculoskeletal Help Line Nurse began to change. Like many who were lucky enough to be able to work from home, I packed up my office, put it in the boot of my car and set-up my new workspace at home.

Work looked a little different now – face to face meetings became Zoom meetings, COVID-19 health news dominated our searches and we began recording videos to keep consumers updated. But most importantly one constant remained – we were still on the end of the phone or email for when a consumer needed some help or advice.

While the usual enquiries kept coming, there were also stories of personal struggles during the lockdown. People shared their feelings of anxiety surrounding social isolation, their vulnerability and how all too often their exercise routine had diminished, and their pain had increased. We talked over ways to try and overcome this – meditation, mindfulness, online exercise, pain management strategies etc – but sometimes it was just enough to have someone to talk things over with, and to feel like someone was really listening.

While the struggles were evident, it was also lovely to hear reports of some positive experiences that emerged. Social isolation forced many of us to slow down, to reflect on how much we try to squeeze into a day/week, and perhaps allowed us to reflect on the simple things in life that make us happy. For some it was spending more quality time with their immediate family, others enjoyed time to potter in the garden, clear out the cupboards, do some DIY or simply relax with a good book. In a hectic world, pressing the pause button seemed to bring a little light relief in one form or another.

As a nurse I am privileged to be able to share in peoples life experiences, including their ups and downs, and as we all get used to the ‘new normal’ I hope that I can continue to provide a friendly ear to make the COVID-19 journey just that little bit easier.

Clare

And some feedback from one of our recent callers:

“Thank you so much for your caring, helpful time with me, giving me very important vital information that I truly need in this very big, busy, fast city…I have received your email with excellent advice in all possible ways and hope for a better way of going along this painful journey with chronic conditions…in which I may be able to benefit and try…and not to feel so alone. I truly hope that things will change for the better. Thank you again Anne, have a gentle relaxing evening and keep warm. Can’t wait to see and read all the goodies inside the email you sent me. With best wishes and kind regards, VC”

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

Lisa Bywaters

07/May/2020

Hands up if you’re feeling tired at the moment? Or if you’re too weary to raise your hand, just a brief nod will do it. It seems like we’re a nation of tired people at the moment (?).

Why is this? We’re not going out like we used to, to the movies, restaurants, family gatherings, to see friends, sports events, or take the kids to all of their extra-curricular activities. We should be swimming in time and feeling relaxed and rested, right?

Ah, no.

We’re stressed

Stop me if you’ve heard this before but we’re going through unprecedented times. This pandemic is causing massive disruptions to our lives, our families, our work and our routines. This constant uncertainty causes us to feel stressed. All the time.

When we’re stressed our bodies release adrenaline. It’s so we can react to a crisis, the old ’fight or flight’ response. But when the stress is constant, as many of us are feeling at the moment, this has an effect on our health – including making us feel physically and mentally tired.

There are lots of things you can do to manage stress. By understanding what’s causing your stress, you can start to manage it. This may include things like developing a new routine (and sticking to it), exercising, talking with your family about how you’re feeling, finding ways to relax, making sure you’re eating a healthy diet and drinking enough water, getting a good night’s sleep and avoiding excessive use of alcohol and other drugs.

We’re staying indoors more

Because of restrictions we’re staying inside our homes more. So we’re not getting exposed to as much sunlight as we normally would. A lack of sunlight causes the brain to produce more of the hormone melatonin, which makes us sleepy.

To deal with this, schedule time every day to go outside for a walk or stroll in your yard, open your blinds or curtains as soon as you get up and expose yourself to as much sunlight as you can. It’ll help you feel more awake and improve your mood. Just think how much better you feel after being stuck indoors when you get out into the sun. It makes you feel so much more energetic and alive! So this one’s a no brainer. We just have to make time to do it.

We’re sleeping less (or more) than usual

Let’s face it, since this all started our usual everyday routines have been shot to pieces. Work, home life, family, socialising, shopping – it’s all so different at the moment. When you add stress to the mix, our sleep is often affected.

You may find you’re sleeping less than usual because you’re working long hours to catch up on work after spending the day home schooling the kids, or you’re watching more TV and spending more hours online, or stress is causing you to feel more pain and you’re having issues sleeping through the night.

Or you may be sleeping more – trying to rid yourself of this constant feeling of tiredness, or because you’re bored, or because it’s cold outside and you’re feeling cosy and warm indoors, or because you’re feeling sad. Not enough sleep, too much sleep and poor quality sleep will all increase how tired you feel.

That’s why it’s important that you stick to a sleep schedule – even on the weekends. Get out of bed in the morning and go to bed at night, at the same time every day. Your body needs this regularity for your internal clock to function properly, and to help you fall asleep and wake up more easily and feeling more refreshed.

And if you’re regularly finding it difficult to sleep or get out of bed because you’re feeling really sad or down, it’s a really good idea to talk with someone about this, whether it’s family, a close friend or your doctor. Please don’t ignore this.

We’re exercising less

Many of us are finding we’re exercising less because we don’t have access to our warm water exercise classes, tai chi, gyms and exercise groups. Not getting enough exercise can make you feel sluggish and tired. If this continues for some time, we start to get out of shape and feel less inclined to exercise. So it’s really important to make exercise – whether it’s online videos and apps, walking, dusting off your old exercise DVDs, or dancing around the living room – an essential part of your everyday routine. And get the family involved. Everyone needs to be exercising and staying active for our physical and mental wellbeing. If you’re home alone, use a video app to call a friend and exercise together. You’ll find you’ll feel more energised and happier when you’re exercising regularly.

We live with chronic conditions

Apart from all of above affecting how tired we’re feeling, we live with chronic musculoskeletal conditions and other health issues. These often cause us to feel fatigued. Many of our medications and living with chronic pain can also make us feel excessively tired. When you add a pandemic on top of that, the unique issues you’re facing – how the virus may affect you, worry about being more at risk, how to safely access your healthcare team, navigating telehealth – it can heighten you’re feelings of fatigue.

Many of the things we’ve looked at – such as establishing a routine, getting adequate sleep, eating well, exercising and staying connected with your family, friends and work colleagues will help you with some of these issues.

You can also get help from your GP and from the nurses on our Help Line. Contact a peer support group or go online and connect with others dealing with similar things. Even just talking with others who know exactly how you’re feeling can help you feel less isolated.

We may need to talk with our doctor

Finally if you’re concerned that your tiredness is due to more than just the reasons listed above, it might be worth talking with your doctor about it. Your tiredness may be caused by other things like vitamin deficiency (for example iron and vitamin D), side effects of your medications, feeling sad, anxious or depressed or it may indicate another health issue. So make an appointment to discuss it with your doctor – either in person or via a telehealth consultation.

Contact our free national Help Line

More to explore

Managing fatigue
Versus Arthritis(UK)
No wonder isolation’s so tiring. All those extra, tiny decisions are taxing our brains
The Conversation, 1 May 2020
Why am I so exhausted? How to combat the unexpected side effects of coronavirus isolation
7News, 9 April 2020
Here is why you might be feeling tired while on lockdown
The Conversation, 7 April 2020
5 ways to wipe out winter tiredness
NHS (UK)
Does your self-care plan need some TLC?
Musculoskeletal Australia
Getting a good night’s sleep
Musculoskeletal Australia

Photo by Tracey Hocking on Unsplash

Lisa Bywaters

30/Apr/2020

Have you noticed how many more people seem to be out and about – in the shops, on the road, walking in the park? And even though restrictions haven’t changed yet, many seem to have become a bit more relaxed when it comes to their activities and physical distancing?

While many of you have self-isolated in the past because of your musculoskeletal condition or other health reasons, what we’re all experiencing now is unprecedented. And for it to go on this long, with only a glimmer of light at the end of the tunnel, it’s no wonder we’re all going a little stir crazy.

There may be many reasons for this:

In Australia we’ve done exceptionally well at flattening the curve. But that means most of us don’t know anyone affected by COVID-19. So the virus doesn’t seem quite real to a lot of us.
We started iso thinking it was a chance to do the odds jobs, hobbies, reading, Marie Kondo-ing your space etc. And we’ve either done all of those things, or we’ve realised there was a reason we didn’t do them in the first place – we don’t want to! So now we’re getting a bit bored.
Decisions are being made that affect our lives, our families, our work and finances. And most of the time we have no say in these decisions. So we feel out of control.
The reality of home schooling, the chaos of everyone working from home, the isolation of being cooped up in your house alone, the constant internet and tech issues, fighting for space, the endless baking of banana bread…we’re over it.
We’re social beings, but we’re having to make do with virtual almost everything. But phone and video calls can’t compete with or replace the face-to-face connections with our family and loved ones. We want and miss our physical interactions.
All of the restrictions are a bit confusing – especially since every state/territory has their own specific set. So we’re confused, and a little jealous of the areas that are slowly easing restrictions.
We just want things to return to normal.

But we really need to adhere to the restrictions in our state/territory.

It’s hard. But we’re up for the challenge. So when you start getting a bit itchy or grumpy or frustrated, here are some things you can do:

Remember why we’re doing this. Think of the health system and the frontline workers and essential services. Think of the vulnerable in our society (which may indeed be you or someone you care about).
Remember there are outliers. People have become very seriously ill or have died from this virus for reasons we don’t understand. There are still so many unknowns when it comes to COVID-19 – so not following the advice from our health officials will put you and others at risk.
Check the restrictions relevant to you. Visit the website of your state/territory health department so you know what you need to be doing.
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Stick to your routine. Get up at the same time each day. Exercise regularly. Eat healthy meals. Plan time for fun and creative things you can do in and around your home.
Connect with others. Yes, we’re getting sick of our phones and computers (who thought they’d ever say that ??) but they’re the safest way for us to connect with the people important to us. So do it. Pick up the phone or get on your computer and make a call. Talk about anything other than the virus. Reminisce about fun times, silly things you’ve done together, jokes you’ve heard. It’s a great way to give yourself a lift when you’re feeling down. Contact the people you know are on their own and may be struggling. See how they’re doing and if you can help in any way. I know I keep saying it, but we really are in this together.
Set yourself a challenge or goal. It may involve looking after your health – e.g. exercising 30 minutes a day 5 days a week – or getting your finances in order, or starting an evening book club with the kids, or scheduling time each day to meditate/read/listen to music/relax, or plant a vegie garden, or doing that 3,000 piece jigsaw…Think of something you really want to do. Not the things you thought of at the start of iso, but something that seems more relevant to you 2 months into isolation – and set yourself the challenge to do that. If you encounter obstacles, that’s fine. Look for ways to manage them and move on.
Ignore the social media posts from the people who seem to be achieving amazing things during iso. You know the ones…they’ve learned a language, repainted their house, started a successful online business and written a book – all while working full time and home schooling 5 children under the age of 5. What a load of rubbish. Remember we generally use social media to present ourselves in the best light – it’s not always an accurate representation of what’s really happening. So take these posts with a grain of salt, or stop following them all together. It’s pointless comparing your situation with someone else’s. And it can make you feel stressed or inadequate, so try not to do it. You’re doing the best you can – so be kind to yourself.
Remember this will end.

Contact our free national Help Line

Lisa Bywaters

22/Apr/2020

Updated July 2022

Feeling overwhelmed, exhausted, stressed and frustrated by 2022? You’re not alone! It’s been a bumpy ride. Filled with uncertainty, new pressures, lots of unknowns and a lack of control, many of us are feeling anxious, upset and vulnerable. When you have a musculoskeletal condition and live with regular pain and fatigue, the urge to retreat to your warm, cosy bed and pull the covers over your head can be very tempting.

But you’re strong. You can take control of the situation and do something proactive by examining your self-care plan. Ask yourself – “is my plan realistic now? Or does it need updating in light of the changes to my world?”

What is self-care?

Self-care is a popular term these days, with lots of different definitions and uses.

The World Health Organisation defines self-care as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker” (1).

That’s a rather dry definition, so for the everyday person with a musculoskeletal condition, we describe self-care as the things you consciously and deliberately do to take care of your physical, mental and emotional health and wellbeing.

It includes everything from exercising regularly and staying active, eating a healthy diet, getting a good night’s sleep, caring for your mental health, managing pain and fatigue, seeing your healthcare team regularly, learning about your musculoskeletal condition, and staying connected with family and friends. It also involves things like good hygiene, avoiding risky behaviours and actions, and using medicines and treatments appropriately.

So to create a self-care plan for yourself that’s realistic and achievable, let’s get real, start small and appreciate the things you can do right now.

Get some sleep

Easier said than done I hear you say! But getting good quality sleep is crucial for our everyday functioning. If it’s an issue for you, especially at the moment, part of your 2022 self-care plan may be to look at ways you can improve your sleep quality and quantity. We have resources to help you – including nurses you can speak to on our Help Line (see details at bottom) and info on our website. Or if it’s a problem you feel you need extra help with, talk with your doctor (in person or via a telehealth consultation) to get professional help.

Eat a healthy, nutritious diet

While it’s tempting when you’re feeling crappy to eat foods you think of as comforting (e.g. chocolate, cheese, ice cream, biscuits, alcohol) you need to enjoy them in moderation. While they may make you happy for a while, it’s only temporary. Too much of a good thing can lead to weight gain and other health issues. Eating a variety of healthy foods, in a range of colours will make you feel better overall and will give you more energy. And on the days you’re feeling great, prepare some healthy meals you can pop in the freezer for the days you’re feeling lousy.

Stay active

Regular exercise has many health benefits for people with musculoskeletal conditions. It helps improve your symptoms, including pain, stiffness and fatigue.

When you exercise, your body releases chemicals such as endorphins, serotonin and dopamine into your bloodstream. They’re sometimes called ‘feel-good’ chemicals because they boost your mood and make you feel good. These chemicals also interact with receptors in your brain and ‘turn down the volume’ on your pain system.

Being active is also essential for your overall good health and wellbeing. It helps keep your muscles, bones and joints strong so that you can keep moving. It reduces your risk of developing other conditions such as heart disease, osteoporosis and diabetes. It boosts your mood, benefits your mental health, helps with weight control and improves sleep. If you’re not sure where to begin when it comes to starting an exercise program, talk with your doctor, physiotherapist or exercise physiologist for some advice.

Take care of your mental health

It’s really easy when you’re constantly surrounded by virus talk and the doom and gloom of the 24 hour news cycle to become overwhelmed. Especially if you’re also worried about your health, family, work and finances. And when you’re stressed and not looking after yourself properly, it can affect all aspects of your life including your family life, your ability to focus on work properly, sleep well, eat well…and so it becomes a vicious cycle.

The good news is there are lots of things you can do to look after your mental health during this time (read our blog for tips and strategies) including getting professional help if you need it. Again you can access the help you need in person or via a telehealth consultation. Talk with your doctor if you want more information about getting professional help.

But a really simple thing you can do immediately is to limit your exposure to the news – pick a time when you’ll catch up on what’s happening – for example the evening news or morning bulletin – and then turn it off and tune it out.

Cleaning – plan, prioritise and pace

Cleaning – yourself, your kids, your home can be an enormous challenge. Hands up if there are days you feel like you need a nap after having a shower in the morning? It happens to most of us living with chronic pain at one time or another. But the best thing you can do is to plan, prioritise and pace yourself.

Even before you get out of bed, while you’re lying in your warm, little cocoon, plan what you’d like to do during the day. Maybe have a notepad and pen beside your bed, or use a note app on your phone and write it all down. You can even do your planning the night before.

OK, seeing it in one place, you can see that it’s a lot 😕.

So now to the second P – prioritise. What are the things you really need to do? Do you really need to wash your hair today, or can you use the dry shampoo? Do you really need to vacuum the entire house, or just the living area? You know how you’re feeling on any given day – so plan, then prioritise.

Which then brings us to the 3rd P – pacing. Whatever you’re doing – cleaning, exercising, cooking, working, gardening, playing with the kids – pace yourself. It’s not a race – so be generous with your time and build in space for rest breaks.

And finally, when it comes to cleaning, don’t forget hand washing. We still need to do it regularly and thoroughly. We also need to be careful how we cough, sneeze and blow our noses. Check out our hygiene 101 blog for more info.

Make time for the things you enjoy

When you’ve given the basics of your self-care plan some TLC and revised it for the current world, now take some time to consider other aspects of your self-care. You may not have the time, energy or inclination to do these sorts of things most days, but schedule time to do the things that make you happy, relaxed, or pampered at least once a week – like a bubble bath, taking an hour to curl up with a good book, having a moment of peace and quiet in your garden to relax, doing a jigsaw puzzle, a video chat with your bestie. We all need these moments to help us recharge, especially when life is so crazy and unsettled.

Contact our free national Help Line

Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.