National Safety Month

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June is National Safety Month! National Safety Month is a reminder to be more aware and help prevent deaths at work and unnecessary injuries in our homes, communities, and on the roads. The CDC encourages a 4-week plan that could be implemented the entire year.

Emergency Preparedness incorporates health and occupational safety into any emergency response plan. Identifying preparedness activities and strategic planning protocols are created to protect recovery and response workers. The best way to prepare for emergency situations is to actively participate in safety drills both at home and at work. If there is ever an emergency, being trained in First Aid CPR is a useful skill.

Wellness in a holistic approach for workers well-being, safety, and health has been explored as an opportunity to advance while protecting workers from hazards. Prolonged periods of high stress levels can lead to a number of physical ailments which can possibly lead to the risk of depression. Sleep is also important for your complete health. Lack of sleep in some jobs can have an adverse effect on the person and the people around them. Pilots, trucking, healthcare, and emergency responses are all occupations where fatigue is a serious problem.

Falls are a problem that’s preventable in the workplace but also remain persistent. Retail and wholesale industries and health services continue to have the highest number of nonfatal fall injuries. The number one cause of construction-worker fatalities are falls. Falls from heights often cause more serious injuries, deaths and are a safety risk for all age groups.

Motor vehicle accidents are a common danger. Ninety-four percent of motor vehicles accidents involve human error. Buckling up every time you are in a motor vehicles is a simple step that can take to help prevent injuries and death. An impaired driver plays a role in many crashes and driver impairments range from distracted driving to drugs, alcohol, and fatigue.

Clean Air Month

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Take a deep breath and smell the trees and spring air. May is Clean Air Month. Clean air has a natural balance of gases such as carbon dioxide, oxygen, and nitrogen. The Clean Air Act started in 1970 and has been successfully reducing air quality related to premature death and health conditions.

The four key climate change that impacts the influence social determinants of health includes: rising sea levels and flooding, extreme temperatures, extreme natural disasters and weather along with air quality and pollution. Social determinants of mental and physical well-being can make a big difference depending on the quality of life and health. Some examples of this could be access to nature or neighborhood safety, or availability to local healthy foods. Almost 4 out of 10 people live in a place that pollution levels are too dangerous to breathe safely.

The University of Washington found that higher levels of air pollution have a greater impact on mental health. Air pollution is associated with behavior changes because people spend less time outside which creates a more sedentary lifestyle. This lifestyle can be related to social isolation or distress.In 2016, there was an environmental research review that concluded even though more research is needed exposure to air pollution has an increased risk of autism.

Rush University Medical Center researchers studied the cognitive (the brain processes such as remembering, reasoning, and thinking) effects of air pollution. The most dangerous kind of air pollution is fine particulate matter because it is smaller, found in motor vehicle exhaust, along with the public transportation exhaust such as buses and trains. Smaller particles infiltrate the body which gets into the lungs then into the blood system. When this matter is inhaled, attaches to the nerve endings in the nasal cavities, then it travels to the brain.

These are things we can do to help control or prevent air pollution: reduce car usage; keep your vehicles well-maintained which reduces harmful exhaust emissions; avoid burning candles, at home; say no to plastic or reduce, recycle, reuse; plant more trees and grass to limit bare soil areas which reduces dust in the air; and quit smoking.

Alcohol Awareness Month

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April is Alcohol Awareness Month. This is a disease that is not pinpointed by factors like sex, race, genetics, or socioeconomics as a single case but behavioral, psychological and genetic factors can contribute to having this disease. Alcoholism changes the neurochemistry and brain, which is why a person with this addiction may not be able in control of their actions. The severity of alcohol addiction varies from person to person. There are some people that drink heavily all day and there are others that will stay sober for a while the binge drink.

There are many different factors that can increase the risk of a person turning to alcohol and eventually developing a dependency on alcohol. They can range from:

Relieving Stress: As a sedative and depressant, alcohol produces feelings of pleasure but this can also build a tolerance requiring the need to consume more alcohol for the same amount of pleasure.

Trauma: Some people treat unresolved trauma through excessive drinking.

Lack of Connection: Some people feel alcohol will make it easier to forge new bonds or feel the void of feeling inadequately connected to others.

Coping with Loss: Depending on alcohol some people feel that it can help ease their grief in difficult times but even if it’s temporary it can spiral into a drinking problem.

Some of the more common warning signs of alcoholism include: not being able to control their alcohol consumption; spending a lot of money on alcohol; craving to drink alcohol even when the person is not drinking; having the need to keep drinking more; personal responsibilities being ignored to drink alcohol more; and acting differently after drinking.One of the biggest decisions someone with an alcohol addiction will face is deciding to seek help. The 3 phrases Alcohol treatment is broken into detoxification (this should be completed by professionals), rehabilitation (this can be either inpatient rehab or outpatient rehab), and maintenance (this could include counseling, support groups, or recovery resources).

Brain Injury Awareness Month

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March is Brain Injury Awareness Month and the campaign theme is #Change Your Mind. The campaign is helping to raise awareness and de-stigmatizing brain injury through outreach within the brain community, promoting the different types of available support for people living with a brain injury, and empowering the survivors of brain injury and their caregivers.

Every 9 seconds someone sustains a brain injury in the United States, which makes up more than 3.5 million children and adults. An acquired brain injury (ABI) is not induced by birth trauma, congenital, hereditary, or is not degenerative and is most often associated with pressure on the brain. A traumatic brain injury (TBI) is caused by an external force which damages the skull or causes the brain to move inside the skull.

The typical causes of acquired brain injury are: poisoning or exposure to toxic substances, infection, strangulation, choking, drowning, tumors, heart attacks, strokes, abuse of illegal drugs, neurological illnesses, and aneurysms.

The typical causes of traumatic brain injury are: car accidents, blows to the head, sports injuries, accidents or falls, and physical violence.

Some physical symptoms of brain damage could include persistent headaches, tremors, extreme mental and physical fatigue, sensitivity to light, paralysis, slurred speech, sleep disorders, and loss of consciousness.

Some emotional and behavioral symptoms could include reduced tolerance for stress, sluggishness, denial of disability, increased aggressiveness, flattened or heightened emotions or reactions, and irritability and impatience.

Some ways to possibly reduce the risk of brain damage is: never shake a child, install window guards to keep young children from falling out of open windows, wear helmets while cycling or during sports, install shock-absorbing material on playgrounds, if you have a gun keep it unloaded and locked away, wear seatbelts in cars, drive safely, install and use handrails on stairways, don’t use illegal drugs, drink alcohol in moderation but never drink alone and avoid falls by using a stepstool when reaching for high items.

International Boost Self-Esteem Month

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February 2019 – Help Avoid Clinical Depression. Our self-esteem is something that is always changing throughout our lives. A healthy self-esteem can improve your mental health. If someone is suffering from existing severe mental health struggles like anxiety and depression, a boost in their self-esteem can possibly increase their feelings of worth and help manage feelings of emptiness and sadness.

It is good to pay attention to your “self-talk.” Sometimes we are very critical of ourselves and others. Once you are aware of negative self-talk, you can you can challenge those thoughts when they arise.

One thing to help boost your self-esteem is to accept your flaws. We have to remember to separate the flaws that are unchangeable from ones we can work on. Accepting a flaw doesn’t mean that you like your flaw, it just means you have chosen to not let something you cannot change control you.

Another way to boost your self-esteem is to celebrate your personal strengths and practice gratitude. You could incorporate 5 minutes into your daily life to reflect on your personal strengths. These strengths could range from not only who you are physically but also your relationships, your personality, and your abilities. This can be how you are a caretaker of people and/or animals, how people come to you because you will make them laugh, or how you show people in your life that you love them.

Practicing self-care is another excellent way to boost your self-esteem. Self-care is a difficult practice and we find reasons why we don’t do it or as often as we should. Self-care requires you to focus on yourself and your needs which includes having sufficient sleep, proper mind and body nourishment, and doing what provides you with a sense of peace and well-being.

Human Trafficking Prevention Month

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January is Human Trafficking Prevention Month. As of June 30, 2018, North Carolina reported 14,117 calls and 5,147 human trafficking case. Attorney General Josh Stein noted that North Carolina had 258 reported cases of human trafficking in 2017. In 2016, The National Human Trafficking Hotline reported 182 cases in 2016 and North Carolina was ranked 10th in reported human trafficking cases.

California, Texas, and New York are the three states with the highest human trafficking activity. California cities Los Angeles, San Diego, and San Francisco are 3 of the 10 worst child sex trafficking areas.

On January 17, 2018 the Fayetteville Observer reported that “more than half of all human trafficking cases filed in state court during the last fiscal year occurred in Cumberland County”. The article explores how the proximity to Interstate 95 and Fort Liberty, in addition to the opioid crisis, makes Cumberland County more vulnerable to this type of crime. The reported numbers involving victims also reflects the diligent police work that is happening in Cumberland County, according to the article. Pitt, Forsyth, Wake, Johnston, Nash, Wilson, Brunswick, New Hanover, Pender, Onslow and Craven are the other counties listed for having human trafficking cases within the recorded year.

The NC Human Trafficking Task Force Manual

Mental Health Education Blogs

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Resilience

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By MICHAEL SHAPIRO, PhD

October 2020

So here we are, almost a year into a debacle that began as an “outbreak,” grew into an epidemic, and was ultimately declared a pandemic back in March…which now feels like an eternity ago. People have been sickened, lives have been lost, economies have tanked, lines have been drawn in the sand, and every facet of life as we know it has been completely disrupted. No one has been spared. Everyone has been impacted, emotionally if not physically.

Unless you’re super-human (or inhuman), there have been moments in which you’ve wondered whether or not the world will ever recover. When will we again get to stand in line impatiently at McDonald’s, push and shove our way through a crowded bar, or glower disdainfully at that guy in the next row at the movie theater who’s making all that noise with his candy? When will we be able to cough or sneeze in a public place without being eyed suspiciously or asked to go home for fourteen days? Will we ever regain the willpower or emotional energy to return to “life-as-it-was”…that is, if “life-as-it-was” ever wants to return to us? I believe that we will. Why? Because of an invariable and inescapably human commodity known as resilience.

Webster (who, as far as I know, is long deceased and did not have the pandemic in mind when he coined this definition) describes resilience as “…the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress.”  I believe he was referring to clay, metal, marshmallows, and stuff like that; but I think you get the picture and understand how it can be applied to ourselves and our current situation. The Oxford dictionary defines it as “…the capacity to recover quickly from difficulties; toughness.” The American Psychological Association (my people) describe resilience as “…the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of stress.” Now we’re getting somewhere!

The point is this: resilience is a thing, and we all have it. For all its seemingly innumerable faults, humankind is—and always has been—resilient. Humanity has endured huge collective struggles, including other pandemics and natural disasters, and has lived to pick up the pieces and go home. World wars have threatened to annihilate both the species and the planet…yet here we are. This is not to minimize the loss and misery these incidents have caused; but it serves as a testimony to our collective resilience that humanity has endured, grown a little wiser (hopefully), and is still here for me to make fun of.

As your psychologist, I wish that I could offer you a pamphlet with quick and easy system for becoming more resilient during this time, maybe of a “10 Steps to Resilience” kind of thing. In the world of psychology, it is known that there are some inborn qualities that contribute to resiliency: a positive outlook, an optimistic personality, and a willingness to use tragedies as opportunities for growth. However, regardless of how much of each of these attributes you might already possess, I can tell you this: you’re already resilient, and you know it!

If you weren’t already resilient, you would have quit school immediately (if they had allowed you to) after getting sent to the principal that time in the second grade (yeah, remember that?). You would have never dated again after that pretty girl or boy rejected you in the seventh grade. You would have never sought employment again after getting fired from your first job after getting caught smoking in the parking lot during your shift (wait…you mean that didn’t happen to everyone?). You’ve been sick, and even if you haven’t recovered completely, you’ve learned to adapt. You learned a “new normal” every time you had another child, moved to a different place, had a financial setback, lost a friendship,  or endured the death of someone close to you. Although you may minimize these successes or taken them for granted, you shouldn’t: the fact that you’re still here, reading this blog, means that you’re resilient.

If you’re still not convinced of your own resilience, then take heart in this: resilience can be learned. One of my personal heroes is Dr. Viktor Frankl, who was a psychiatrist and neurologist who survived internment in various Nazi concentration camps for three years, beginning in 1942. Over that three years his father and brother died, and his mother and wife were killed. Frankl himself suffered abuse and starvation. Even so, he survived by finding meaning in what was happening to him. He tried to help despondent prisoners, and in doing so discovered that suffering can be endured if one finds in it a purpose. This culminated in his famous quote about survival (“Those who have a ‘why’ to live can bear with any ‘how’”) and, ultimately, his amazing book, Man’s Search for Meaning (recommended reading for…well, pretty much every person on the planet). His conclusions about finding meaning in suffering have since been borne out in scientific research: according to a study in Health Psychology, people who believed that stress would kill them were 43% more likely to die than those who saw the benefits of stress, or at least believed that they could grow as a result of it!  So, to endure stress and be resilient, we need to learn how to re-frame it as beneficial rather than destructive.

Being resilient doesn’t mean being free of struggles…it means that you have the ability to struggle well. If you’re a member of the human race, you’ve certainly learned something about resilience over the past year, and you most certainly deserve a pat on the back for enduring the dumpster fire that is commonly known as “2020”. As we continue to navigate through whatever is to come, I hope that you will learn to find meaning in your trials…and hope fervently for fewer learning opportunities in 2021!

The Masks We Wear (or Don’t)

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By MICHAEL SHAPIRO, PhD

July 2020

Masks. Of all the things that we have on our menu of things to get upset about during the pandemic area, we choose masks.

Both the World Health Organization and the Centers of Disease Control and Prevention now strongly recommend wearing face coverings in public, in an effort to “flatten the curve” of the pandemic. Early in the pandemic, this was not so. In fact, both organizations initially suggested just the opposite, mainly because of the relatively low prevalence of the disease at the time, and partly because scientists did not yet understand the degree to which the coronavirus could be spread by asymptomatic carriers. Since then, epidemiological data (showing how death rates have been lower in locations that have mandates in place), case reports, and at least one very interesting high-speed video experiment (showing how respiratory droplets are spread when coughing, sneezing, and talking) have all supported the usefulness and wisdom of simply wearing something over your face. In fact, a recent forecast from the Institute of Health Metrics and Evaluation suggests that if 95% of the population would wear a mask in public, there would be as many as 33,000 fewer deaths in the United States by October 1.

Okay. I get it. It’s not a cure or an ultimate solution, but it’s an incredibly important step in risk reduction. It should be easy. Spiderman does it all the time and has never, as far as we know, transmitted a virus. However, I’d like to take this opportunity to publicly confess that I haven’t been a big fan (of masks, that is. Not Spiderman). Yes, I’m a healthcare provider who is trained in applied science. Yes, I work in a Family Medicine clinic that (wisely) requires all providers and patients to wear masks in the building. Yes, I have a loving wife who carries enough masks in the glove compartment of her car to stage a Wild West-style bank robbery. In the face (no pun intended) of all the supportive scientific evidence, I’m perplexed at my own resistance to this idea, and I’ve had to look deep inside myself to figure out why I feel this way.

Most people have reasonably good reasons to be mask-aversive. They say masks are uncomfortable, especially in the heat of the summer. They say that masks interfere with breathing, or that being “forced” to wear a mask infringes on their rights (specifically, their constitutional right to infect others. It must be in one of those amendments somewhere). I have to admit that my reasons are less rational, and not as well thought-out:

Whenever I think about wearing a mask in public, a small, repressed, macho “tough guy” who resides deep within my psyche makes an appearance and tells me that to do so would be a sign of “weakness”. This little entity in my head (don’t we all have them?) is surprisingly loud, looks a bit like John Wayne, and insists that to wear a mask is just an admission that I’m cowardly, old, and physically frail (whether or not that’s actually true is irrelevant to this discussion). I also assume that people will think I’m somehow antisocial or want nothing to do with them. In other words, I worry about what people will think of me, when in truth, people probably spend a LOT less time thinking about me than I think they do!

Also, as a psychologist, I have to say that I frankly dislike the fact that masks obscure half of my ability to read peoples’ expressions. I can no longer discern what they’re thinking or feeling…at least from the nose down. Conversely, I dislike being unable to use half of my face to express my emotions to others! I’ve always prided myself on my habit of giving a big smile to everyone I see. Anthropologists have shown that monkeys do the same thing in the wild to express their peaceful intentions and not get beat up when entering a potentially hostile jungle situation (I think you can see the analogy). Hence, with a mask, I feel that I’m being deprived of one of the most simple self-defense tools that nature grants freely to less complex mammals who are much farther down the food chain than I am!

As irrational and convoluted as these thoughts may be, they plagued me until the governor of our great state—in a complete inversion of the aforementioned Wild West culture—made it illegal NOT to wear a mask, as of 5:00 p.m. on June 26th of this year. This changed everything! At last, the playing field is completely level. No longer does anyone need to question or consider the motives of anyone else: now we’re all just trying to obey the law and not get fined! This has enabled me to make a complete transition; from being completely insecure about wearing a mask, to now being completely smug and condescending towards people who are not wearing a mask! This, my friends, is true freedom…the freedom to feel superior to lawbreakers!

I can now look with great respect upon my fellow North Carolinians, all of whom are taking this one simple step (sometimes unwillingly…but who cares?) that will do so much to insure the health of others and bring this pandemic to a more abrupt end.  Seeing everyone wear a mask in public gives me a warm feeling of camaraderie, as if we are, truly, “all in this together.” It’s supported by science, it’s socially unifying, and it’s good for everyone’s health! So please, in the name of humanity, bear with some discomfort and wear a mask whenever you go outside. With any luck, the type of mask you wear will become a fashion statement…and then you’ll have something else to be insecure about!

Illness Anxiety in the Pandemic Era

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By MICHAEL SHAPIRO, PhD

May 2020

I’ve never been a Harry Potter fan. In fact, I’m not even exactly sure what the Harry Potter series is about. My understanding is that it revolves around a bunch of kids who ride broomsticks and play some kind of anti-gravity version of basketball at a private school in some place that looks kind of like the Rocky Mountains, but with fewer Starbucks. Oh, and one of the kids has a scar on his head.

I also know that an important component of the storyline involves a “Book of Spells” or some such thing. Evidently, this book has all the rules or spells (or whatever) that adolescent magicians need to do their job or learn their craft (or whatever).

So, here in the equally magical world of Behavioral Health, we have also have mysterious book known as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (known to you Muggles as “the DSM 5”). This single volume contains a detailed description of every mental disorder anyone has ever had, or could possibly have. These disorders span from the easily recognizable (like depression) to the obscure (like trichotillomania, or compulsive hair-pulling). I’ve often told people that if you look through the DSM 5 long enough, you’ll find some disorder that fits you, no matter how mentally healthy you may feel at the moment.

Anyway, in the DSM 5, there’s a diagnosis called Illness Anxiety Disorder. To qualify for that diagnosis, you have to be obsessively worried about the possibility of acquiring a serious illness. You have to be constantly anxious about your own health, and in an attempt to relieve that anxiety, you have to either engage in excessive health-related behaviors (for example, repeatedly checking your body for signs of illness) or totally avoid healthcare (e.g., staying away from hospitals and doctors’ offices).  Interestingly, another requirement is that this preoccupation with your own health has to be “excessive or disproportionate.”

Ah! Therein lies the big philosophical question: in the days of the COVID-19 pandemic, aren’t we all obsessively and disproportionately preoccupied with acquiring a serious illness? Aren’t we all engaging in health-related behaviors and avoiding hospitals and doctors’ offices?  In fact, haven’t we been ordered to do these things by our local governments? If so, does this mean that we are all suffering from Illness Anxiety Disorder?  More importantly, if we’re all doing these things, then is it really a disorder at all, or are we exhibiting completely normal behavior, just like everyone else?

I’m not exactly sure, but I think my head just imploded while trying to sort this all out. Personally, my hope is that our obsessive preoccupation with the coronavirus can still be considered a “disorder” because that’s good for my business. In fact, I’d like to take this opportunity to thank social media for contributing to my business by fanning the flames of anxiety with an inescapable, constant barrage of false, inflammatory, and often contradictory information. Thanks, Facebook!

But seriously, I have seen many patients over the last two months who are understandably worried and have expressed their anxiety through unanswerable questions and despairing comments like, “Am I going to catch this?”, “Will this ever end?”, “I’m afraid they’re going to lift restrictions too soon!”, and “I feel trapped!” This anxiety has been brought about by a stressful event, sort of like what happens in Posttraumatic Stress Disorder. However, with PTSD, the threat has already passed, and it was probably something very visible (like a tornado or other natural disaster). With the coronavirus, we have an invisible threat, we don’t know when it will end, and we don’t even know if it has touched our lives yet or not. In this respect, a global pandemic is unique amongst stressful events!

So, how can you calm yourself in the midst of so much uncertainty? Before answering that, let me first mention that we here at SR-AHEC are applied scientists–rigorously trained health care providers–who, I’m proud to say, do nothing that isn’t based on solid, verifiable science! We try to rely solely on treatments that have been tested and validated under the cold, dispassionate light of the scientific method! That’s why we don’t bleed patients with leeches anymore (well, except maybe that one time last year. But come on! I couldn’t think of anything else to do, and I made sure that it was covered by insurance first).

The practice of employing only scientifically proven medical techniques is known as “Evidence-Based Medicine” (EBM). What does EBM have to say about dealing with our anxieties in this time? Well, it just so happens that the Centre for Evidence-Based Medicine (no, I didn’t misspell a word. This place is located in the UK, where they spell some things rather oddly) has analyzed many scientific articles on the topic and has come up with the following evidence-based suggestions:

  • Minimize your exposure to the news and other media (I recommend no more than an hour per day to get caught up on the day’s events).
  • Use trusted sources to access information about the pandemic (as I said in my last blog, you can pretty much trust anything that has been bears the CDC seal of approval).
  • Stay connected with family and friends, online or via telephone (just don’t lose your temper when you can’t figure out how to turn on the audio).
  • Provide help and support to other people in the community (like your elderly next-door neighbor, who could use a little help with the groceries).
  • Practice meditation and mindfulness (this can be as simple as stopping whatever you’re doing, taking a deep breath, observing your own body for signs of tension, and asking yourself what you need to do next).
  • Look after your body by maintaining a healthy diet and exercising regularly (see our earlier “Guidance to Good Health” blog about exercises you can do at home. Oh, and keep your hand out of the Cheetos).
  • Avoid unhealthy coping strategies, like drugs and alcohol (interestingly, online sales of alcohol have gone up by 243% during this pandemic! Even sales of Corona beer have, ironically, increased by 50%! How weird is that?).
  • Keep doing activities you enjoy (preferably not playing video games or watching movies that involve death, destruction, or mayhem. Sesame Street is probably OK…just stay six feet away from Cookie Monster. I question his personal hygiene).

I would add to these a brief three-step cognitive behavior therapy exercise that I do with my patients:

Step 1: Ask yourself, “What is the worst possible thing that could happen to me?” Your answer may be something like, “I’m going to catch this and die.”

Step 2: Force yourself to consider the best possible scenario: for example, “I’m going to be completely OK. The statistics are on my side.”

Step 3: Consider the most likely scenario, and develop a plan for that: for instance, “I may get infected, but for most adults, the symptoms are mild. If I get sick, I’ve figured out exactly where to go for emergency care, and I might actually get caught up on all my Downton Abbey episodes while I’m recovering.”

These steps may all seem fairly self-evident, but once again, they are based in fact and have been verified by research, so I trust them. So, Illness Anxiety Disorder or just a “normal” reaction to a really abnormal situation?  Who cares? It’s what all the cool kids are doing. Just do what the science says. Oh, and for social distancing, just use Harry Potter’s “cloak of invisibility.” I think he has one of those.

Lemmings, Toilets, and Reptile Brains: How Should We Respond to COVID-19 Hysteria?

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By MICHAEL SHAPIRO, PhD

March 2020

There is a myth with which we’re all familiar. It has to do with lemmings. As you might know, lemmings are adorable little rodents that are typically found in or near the Arctic tundra. They are usually around 6 inches in length, with a cute stubby tail, soft fur, and the appealing little face that is characteristic of some of our most cherished herbivores (like the Easter bunny). They migrate in large herds, and during their migratory season they appear suddenly, en masse, seemingly out of nowhere.

However, the most persistent myth about lemmings is that when their population becomes unsustainably great, they commit mass suicide by following each other off of tall seaside cliffs. This myth is partly based on the fact that every three or four years, a slice of lemmings (no…really! That’s what a group of lemmings is called!) will get so big that they’ll head out and try to migrate elsewhere, where there’s more room, and they assume that their property taxes will be lower. In doing so, they often cross a body of moving water (like a river), and several of them – (the ones who were too arrogant to wear life vests) will drown.

The myth that this was actually a form of suicide took hold in 1958, when Disney filmmakers aired a documentary that showed a bunch of lemmings jumping to their death. However, contrary to our abiding faith in all Disney productions, this was completely staged! Yes, Disney actually pushed the poor creatures off a cliff while the cameras were rolling, in order to perpetuate the myth that lemmings follow each other blindly unto death! Although completely fraudulent, it’s a good thing they did this with lemmings and not mice, or there would be no Mickey to induce vacationers into Disney theme parks, where people blindly follow each other en masse over a financial cliff.

I said all that to say this: the lemming has become a metaphor for someone who blindly follows the crowd, even into the face of a catastrophe. As I’ve listened to the news and have strived (futilely) to find even a single sheet of toilet paper within a 20-mile radius of my home, the lemming metaphor has popped into my mind more than once. We have been inundated with news about the emerging coronavirus pandemic, and very little of that news has been good. Consequently, we watch each other anxiously, waiting to act on any new piece of information with a hair trigger. For example, I’m reasonably certain that the recent run on toilet paper (which future historians will undoubtedly refer to as “The Great Fecal Hygiene Crisis of 2020” or something like that) was started by one guy in one WalMart in one small town who looked at a shelf of TP and said, overly loudly (as people are apt to do in WalMart) something like, “Gosh, I wonder if I should buy some extra?” Cue the lemmings.

At this point, you might want to invoke the misunderstood and sometimes misused term, “mass hysteria.” This term (also known as “mass psychogenic illness” or “mass sociogenic illness”) refers to the rapid spread of symptoms through a population where there is no viral or bacterial agent to account for those symptoms. So, let’s get this straight from the get-go: to attribute the symptoms of covid-19 (the illness caused by the coronavirus) to “mass hysteria” is a misnomer, because it suggests that the symptoms are not real. Nothing could be further from the truth, and we need to take seriously this threat to global health. Instead, it’s our reaction to that threat that bears some scrutiny.

With this in mind, the term “moral panic” is a more accurate description for the phenomenon that has left you without any toilet paper. This term, as it is currently used, links the collective anxiety of a group (in response to some perceived danger or threat) to social media influences. According to sociologist Stanley Cohen, this happens in stages: first, something (or someone) is identified as a threat to community interests. Next, the threat is depicted in symbolic or overly simplified form by the media. This raises public concern, which in turn provokes a response from authorities or policy makers. Then, the ensuing panic over the issue results in some kind of change within the community…and the next thing you know, there you are, left on the potty, searching desperately for any reasonably soft piece of paper (or other material) within easy reach.

In this way, moral panic is a self-perpetuating problem. Panic is contagious. It spreads like proverbial wildfire, as it has following many media revelations that have called to question our way of life. For example, look what happened to Halloween after the New York Times published a 1970 article about people tampering with unwrapped treats (which had actually happened only once, in a small town in upstate New York). As a result of that single article and subsequent panic, we now have Trunk or Treat…and individually wrapped candies that are infuriatingly difficult to open.

So, how do we avoid contributing to moral panic? How do we keep from making matters worse by panicking over every new piece of information? Well, let’s start with this: don’t panic over every new piece of information. With few exceptions, panic is an irrational response to some stimulus, or a disproportional response to a perceived threat. Jumping to irrational conclusions (often based on erroneous information) propels panic; not the other way around. The panic response is governed by the instinctive, primitive part of your brain, which is often referred to by neuroscientists as the mesencephalon or “reptilian brain.” To avoid panic, one must tame the reptile by engaging the telencephalon, or “thinking” part of the brain. How do we do that?

First, choose not to accept your first instinctive reaction to something fearful. Suppress the primitive part of your brain. After all, it’s that part of your brain that tries to get you to eat with your hands when you’re at a fancy restaurant or pee off your porch when you feel the call of nature (um…okay, maybe that’s just me). Instead, gather more information before deciding how to react. To do that—and this is vitally important—seek out sources of information that the “thinking” part of your brain tells you are trustworthy! For example, when it comes to new information about covid-19, I think we can have total confidence in the CDC. It is an established public health institute that’s been around since 1946 and is crammed full of really, really, really smart people who have built entire careers out of studying the propagation of infectious diseases. Unlike us, they spend every day knee-deep in pathogens, applying their big brains to solving problems just like this one. Yeah, I think we can be absolutely OK with doing whatever they tell us to do. They’re not lemmings, they’re scientists.

In contrast, look with a very skeptical eye on any post or sound bite that is launched by a partisan political group, a corporation that stands to capitalize on the crisis (including popular media), or the guy in your neighborhood that bought all that Purell to re-sell at $75.00 a bottle. They’re not scientists, they’re the Disney filmmakers who are pushing the lemmings over the edge.

Even less trustworthy is your cousin, uncle, brother-in-law, or cousin’s uncle’s brother-in-law who posts on Facebook and considers the shortage of toilet paper to be the prelude to the collapse of civilization which, as he’ll remind you, he has been predicting since the beginning of civilization. As far as modern science can determine, having no TP has a mortality rate of zero. It may be a temporary inconvenience, but it is not the end of the world (in fact, if you own the Charmin company, things are looking pretty good from your perspective, aren’t they?). Let’s keep things in perspective.

Once you’ve decided not to listen to biased, partisan, or un-scientific sources, now do this: don’t listen to anything. Take a break. No, I’m not urging you to ignore reality, repress your feelings, wear rose-colored glasses, or minimize this threat to our collective health. I’m not going to try to pacify you with a cliché (“Don’t worry. We’ve been through all this before. Look at the bubonic plague of the 14th century! We’re still here, aren’t we?”); I’m urging you to momentarily stop the barrage of inflammatory, often conflicting information. Stuck at home? Don’t watch the news, watch SpongeBob. Listen to music (just not the soundtrack to Outbreak). Read a fiction or fantasy novel, for cryin’ out loud…it’s one of those leafy paper things over there on your shelf. Once again, I’m not advocating burying your head in the sand (after all, there are germs there, too!). I’m just urging you to give it a rest and put it in neutral for a little while. Afterwards, you’ll feel energized, refreshed, and ready to think rationally.

Lastly, don’t contribute to the panic by becoming a virus yourself. How do you think they came up with the term “going viral”? Like a virus, information (everything from cute puppy videos to hate speech) gets disseminated when one “host” (electronics consumer) shares with several others who, in turn, share with others…thereby spreading the information (or dis-information) exponentially. This kind of indiscriminate sharing has an almost magical ability to magnify disproportionally the importance of whatever it is you’re sharing. I mean, come on; was “Gangnam Style” really that fascinating? Would it ever have lived for more than a few seconds outside of the petri dish of social media? Yeah, I don’t think so either.

So, when your aforementioned cousin’s uncle’s brother-in-law posts his perception of the impending world cataclysm, please don’t respond, and please don’t “share” with others. Let’s practice some electronic “social distancing.” Don’t contribute to moral panic, and don’t be a lemming or a reptile or a host to an electronic virus. The very fact that you’re reading this blog is proof that you are an intelligent, rational, thinking human being with excellent taste and a critical eye. Time to start acting like one. Meanwhile, I’ll continue to stand here in the grocery store, staring at this shelf of duct tape and brown lunch bags, wondering if they would make an acceptable proxy for toilet tissue.