Important Conversations: Anxiety Management and Wellness


As coronavirus moves its way across the country, Dr. Kim Gorgens, a psychologist with more than 20 years of experience, recommends that rheumatologists proactively reach out to their patients to address concerns that may lead to stress and ill-advised changes in treatment regimens, such as stopping treatments without consulting a physician.

As COVID-19 continues to disrupt the routines of your practice and the lives of your patients, it's important to recognize how easily every normal or adaptive emotional response (e.g., fear, anger, sadness) can evolve into rumination, despair, panic, and even hopelessness.As a psychologist with more than 20 years of experience in treating clients, training clinicians, and researching the effects of stress, I am sharing tools that I use in my practice, recommend other practices adopt and have even adopted for my own mental health. Now, more than ever, we are called upon to heal ourselves.First, reach out to your patients―NOW. You may be seeing more of your sicker patients now, but those you haven’t heard from may have some high-stakes questions. Rheumatology patients may be wondering whether to stop or reduce their immunosuppressant medications and risk a flare-up if doing so would outweigh the risks of COVID-19.Rheumatology patients may also have questions about alarming news headlines that suggest anti-inflammatory drugs may aggravate or worsen COVID-19. Consider reaching out proactively to your patients with reassurance and direction. Importantly, recommend preventative measures, such as handwashing and quarantine, plus highlight COVID-19 symptoms rheumatology patients should have on their radar, such as fever, cough and shortness of breath.Because COVID-19 spreads quickly and easily, self-imposed social isolation may be more of a necessity for immunocompromised rheumatology patients. But, isolation, as you know, can have a negative impact on mental health. It can heighten anxiety as a result of inactivity, information overload, and unpredictability. (Contributing Author:  Margaret Port, M.A., project director, Columbia University Department of Psychiatry and New York State Psychiatric Institute.)In the following slideshow, we list some mental health resources and highlight coping strategies I've utilized in my practice.

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