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COVID 19 - A Walk In The Park

Posted By: James Morrissey

COVID 19 - A Walk In The Park - 05/05/20 05:28 PM

James Morrissey shares photos from his retreats in Inwood Hill Park, in New York City, and shares ideas on ways to find resiliency during this global health epidemic.

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Posted By: James Morrissey

Re: COVID 19 - A Walk In The Park - 05/05/20 05:30 PM

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The Novel Corona Virus, aka Covid 19, has hardly been a "Walk in the Park." It has been dehabilitating to our country - both economically and socially. With today's 24 Hour news cycle, it is easy to get sucked down into the rabbit hole of death and economic depression. Even as we begin to see some signs of stabilization here in the New York City region, and we are beginning to imagine what life will look like when things begin to open for business again, we are learning that it could be quite some time until we really see normalcy again. With the future tantalizingly in front of us - the cold realities that social distancing is not over, and that we will not be able to really enjoy basic freedoms in the way that we have in the past is even more overwhelming. Basic things, like companionship with relatives and friends, or enjoying cultural events like the theater or a show or a sports event or - dare I say it - GOING TO WORK and spending time with comrades are now questionable for possibly months more. If you are in part of the country where your life has not had to change very much - know that you are envied - and that I wish on no one what has happened here.

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There is an old phrase, "May you live in interesting times." For most people though, this has been anything but interesting - it has been an ordeal. All I read on the Social Media is how bored people are, or how frustrated people are with home schooling their children, or how much weight people are putting on because they are at home with nothing to do but eat...and don't get me started on the tirade of angry political posts. Let's be clear about something - for the most part, these people are the lucky ones. Others have had to deal with even more difficult issues, such as having lost a job - or have had to deal with sickness and/or death as a result of the virus. It has been devastating - but we can get through this.

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During this period, I have found myself falling back on things that I love in order to be able to keep myself motivated - including hiking and photography. As travel is not really allowed (and last month, one of our neighboring states was sending troopers door to door to find out if people had recently been in New York), I have been doing my best to shoot in my back yard - which happens to be Inwood Hill and Isham Parks, here in the Inwood section of Manhattan. For those of you not familiar with Inwood Hill Park, it is an amazing piece of "Old New York' that does not exist anywhere else. If you live in the City and have never been to Inwood Hill Park, you are missing something. Over the years, I have seen a variety of wildlife that include: Hawks, Eagles, Deer, Coyote, Red Fox and an assortment of song birds. As these photos are more intimate, given the park confines, there will be no sweeping vistas. I really needed to work hard to 'reduce' my images into something that was visually appealing. During this exercise, it occurred to me that it might be nice to share some photos and also talk about ways that people can find resiliency during this unprecedented time.

You might ask, who is this jerk on the internet giving me mental health tips? Well, that is a fair question. I am pretty much just a jerk on the internet - but I am a jerk on the internet with nearly 25 years of experience working in the world of mental health. I am also an evidence and data junkie. Obviously, there is no one size fits all for anyone, so your mileage may vary, but all of the things I am doing are evidenced based and are shown to work in specific circumstances. I am including a list of articles and abstracts from peer reviewed journals at the bottom of this article if you are interested in delving further. I hope that some of these ideas can be helpful in regards to finding a balance that leads to a happy home-life during a time when so many people are spending time...well, at home. So let's get to the skinny - things that I have been attempting to implement include: (1) keeping a regular routine, (2) regular exercise, (3) staying connected with loved ones while social distancing, (4) taking more time to be out in nature (5) finding ways to feel like I have control, and (6) finding things to be grateful for. Also, if you have something that works, send me a note!

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Routines....routines....routines. I don't know about you, but Covid-19 has really showed me that I like routines. My quarantining co-workers, have told me that their jobs have frequently gone from 8 hour days into much longer ones as they intersperse work and home life. Staying productive and sharp becomes challenging, particularly as they struggle with competing tasks in their home - like raising children who are supposed to be at school, or fighting temptations of the Internet and Television. I have been hearing people complain about poor sleep, and then having real difficulty focusing throughout the day. In short - all of this self-quarantining shelter in place is having an impact on even really well adjusted people. Let me suggest that keeping to the basics is everything...and for me that means starting with a consistent routine. I try to go to sleep at the same time every evening and wake up in the morning. As someone who has historically struggled going to sleep at night, I have been using a technique called the 4-7-8 Breathing Technique. It has really worked for me. If that doesn't work, I also suggest other things - like having a bedtime routine, sleeping in a dark, cool and noise free environment, and shutting off the screens a minimum of 30 minutes before bed. Also, divorce yourself of your cellphone in the bedroom. Keep it far away, and make sure that the light it emits is not distracting. Along these lines, I also suggest trying to keep your eating times consistent. If you ate lunch at 12 PM at work - do so as you work from home. Keep your day structured just as you would have if you were going back and forth to the office. There have been multiple studies that show that keeping to a structure can help keep us happier and more productive.

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Let's talk about fitness! As many of you know, I am an avid exerciser. Last year, my wife and I performed our first triathalon and we had three scheduled for this year. Because of Covid, that's all been canceled. However, I am still keeping fit to the best of my ability. I believe strongly that the separation between that which is considered physical health and that which is mental health is pretty arbitrary and that the two items are not independent. That does not mean that you will not find happy pepole who are not physically healthy, or depressed people that are physically fit. Like all things, there is a continuum to life and not everyone fits in a neat parcel. However, there are lots of studies that correlate improved happiness with regular physical activity. With that in mind, consult your primary doctor and get out there and start doing some exercise! You don't need to do a lot at first - just get out there and build a routine that works for you. When it comes to exercise, while I prefer to row and bike and hike, my feeling is that the best exercise routine for you is the one that you will regularly do. You are going to hear a theme through this article - set small goals for yourself and try to stick to them.

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Staying Connected (while social distancing) - this has probably been one of the hardest things for people. It stinks being stuck at home - and not everyone has a 'quaran-team.' It stinks not seeing our friends and family. For many, particularly those who have lost their jobs, I imagine that the days are all blurring together - and I can only imagine that it is very easy to become overwhelmed by it all. We are also seeing signs that society is starting to crack a bit, with the "liberate" movement that seems designed to get us to stop social distancing. To be clear, I do not look down on these people - I feel like we need more evidence before we do things that could be very harmful to the general public's health and I am looking to models like Sweden's* where there potentially could be a middle path between all and nothing (noting that our countries are very different in composition in regards to health care, the general health of its people, etc). One thing that we have done at home is starting a weekly Zoom meeting with our family. I now see my brothers, sister and parents more than I ever did - right from the comfort of our homes. We have also added extended family members, like my aunts and uncle. It is nice because we are getting the opportunity to see some people in a way that we never did. While I will admit that it is still a bit contrived, it is far better than nothing. I also try to call people on the phone as well.

* Editor's Note * I am adding this on July 27th. I am disappointed to say that it the Swedish model doesn't look so great at the moment. The government and prominent scientists seem to be in disagreement about how successful Sweden has been on curbing Covid. I am not qualified to judge - but I am putting two opposing articles below. We need more data.

Sweden split on coronavirus immunity
Doctors and scientists say government’s figures are based on a "completely unproven assumption."
https://www.politico.com/news/2020/07/24/sweden-catches-first-glimpse-of-herd-immunity-381117

Sweden hoped herd immunity would curb COVID-19. Don't do what we did. It's not working. (Note, this is an Opinion piece, an Open Letter from 25 concerned doctors and scientists about Covid. Their names and credentials are listed at the bottom of the piece).
https://www.usatoday.com/story/opin...y-drove-up-death-toll-column/5472100002/

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Taking Time To Be In Nature - You might think that I would have started here with my article given that it was my time in Inwood Hill Park that inspired me to write this. For people who live outside of New York City, they might not think of the various opportunities that New Yorkers have to be out in open and woodsy places. New York City has a lot of small oases in each borough. For example, here in Manhattan, we have Inwood Hill Park and Central Park. The Bronx has VanCortland and the Bronx Park, with its lovely views of the Bronx River. Brooklyn has its Central Park rival, Prospect Park. Staten Island has Clove Lakes Parks. Queens has Kissena Park, and the amazing Jamaica Bay Wildlife Refuge (I know, its not a City park - but it is in Queens and it is awesome). In short, nature is conveniently located, even here in New York City. There have now been multiple studies that show that people who spend time in nature are less likely to feel depressed. They even have quantified it with a magic number - it's 90 minutes. We have been taking serious advantage of our local parks. Every night, Chanthee and I hike through Inwood Hill Park, at the tip of Manhattan. It is an amazing experience - and you can forget for a moment or three that you are in New York City, particularly now as the forest is starting to fill itself out.

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Control Issues - we all have them...and most of us feel better when we are calling the shots. Seriously. I can not underscore the importance of feeling like you have some control in your life. At the same time, something like Covid - or any illness can make you feel like you have been robbed of that commodity. This is where embracing evidence and science becomes so important. While I cannot guarantee that I won't get sick from Covid, I can do things that I know make me less at risk - like washing my hands regularly, social distancing and wearing a mask. One can think of our social distancing efforts as being like the story of Sisyphus - finding salvation through accepting our fate and not giving up.


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Expressing Gratitiude - Before I get the collective eye-roll, I am serious. This is not something that has to be metaphysical or spiritual - and it is something that we can all do - even those of us in the Freethought Community. If anything, I think this is one of those areas where we non-believers can really take a page from our religious brothers and sisters in adopting a valuable coping strategy that has an evidence base that we can incorporate. For example, there is evidence that just the act of writing things down that you are happy about can make you a happier and healthier person, even when life is tough. Being thankful can be about big things - but I usually like to think about the small things. Just like goals in life - it is best to start with small measurable ones than by creating things that you cannot actually do. Take a moment and think - what can you be thankful for? Some things I have to be thankful for - the company of Chanthee and my pets (my Quaran-Team), my job and co-workers, my friends and the youth I mentor. I am glad that I still have a job, and that I live in a really nice place with great neighbors. When I read this what I just wrote, I feel like a four year old saying his night prayers! I will bet that no matter how hard things are at the moment that most people can find something in their lives to be thankful for. Let's start there. Big things are made of little things. You also might find that you have more than a few things to be thankful for - even during this crisis.

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Mindfulness - This is a method that was recommended to me by my Uncle Peter Schwimer, who is also a LCSW with a long resume working in the field of mental health. The concept of mindfulness simply involves focusing on your present situation and state of mind. Developing mindfulness is done through a combination of breathing, concentration/focus and body awareness (including the release of tension). While the data is still being developed, there is a lot of excitement that the process of being mindful may help with a variety of different ailments. For example, studies have shown benefits of mindfulness against an array of conditions both physical and mental, including anxiety, depression, and post-traumatic stress disorder.

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I want to take a moment and talk about the larger experience of what we are going through as a society in regards to social distancing. I think it is fair to say that we are going through a period where there is great restlessness and social upheaval. There is a lot of anxiety about the economy and the impact of a long shut down - and everyone has been impacted. I also think it is also fair to say that the fortunate ones who have not experienced serious sickness or death are feeling stir crazy. No one feels good about it. Personally, I have not visited my parents since Christmas. I have not seen my sister or my aunt and many of my friends. This closure has had financial repercussions as well. This all stinks - and the truth be told, I have been damned fortunate. I am alive. I have a job. My people are safe. The Stoics teach us that we should not complain about life. The door of the prison is open. Pardon the Borges reference. It is on the money though. If we are patient, we will get through this. The key to opening our prison is in front of us. The paradox is that we need to make sure that we don't go through it until we have an idea that it is safe. We don't want to be like an elephant tethered - but we also need to be reasonably assured that we won't accidentally hurt someone else regardless of how we may individually feel. I hope that as we begin the process of moving towards normalcy and opening the country that we will all try to be respectful of our neighbors and notwithstanding how we feel about our own health and safety, that we don't take actions to impede upon the life and liberty of other people who are concerned about their health and safety.

Last, if all of these things are not working, if you are still feelling like you are having a hard time coping, consider reaching out to a professional therapist and or psychiatrist. There is nothing shameful in feeling sad or depressed, and there are people who have devoted their lives in order to figure out how to help people feel less depressed and to live with less anxiety. Well - that's all I got. If you have something that you feel works, send it a long. I know that I have said it before - but I am a big fan of repetition. I KNOW there is at least one paragraph on routines and structure in here somewhere. smile If there is an evidence based intervention, I will gladly add it along.

Posted By: James Morrissey

Re: COVID 19 - A Walk In The Park - 05/05/20 05:31 PM

This is the evidence for the assertions that I have shared above. For the most part, these are scholarly articles published in peer reviewed journals. The trick with what we use as 'evidence' is that when one performs a study one is usually looking at a very specific question, so there may need to be be a little extrapolation. I have also included more generalized journals and blogs that have more accessible commentary.


(1) Routine:
11 Tips for a Morning Routine That Supports Mental Health
https://www.goodtherapy.org/blog/11-tips-for-a-morning-routine-that-supports-mental-health-1022197

The Power of a Morning Routine
https://www.nami.org/blogs/nami-blog/august-2017/the-power-of-a-morning-routine

Why routines are good for your health
https://www.piedmont.org/living-better/why-routines-are-good-for-your-health

The Mental Health Benefits Of Having A Daily Routine
https://www.blurtitout.org/2018/11/08/mental-health-benefits-routine/

(2) Exercise:
The Mental Health Benefits of Exercise
https://www.helpguide.org/articles/healthy-living/the-mental-health-benefits-of-exercise.htm

How Your Mental Health Reaps the Benefits of Exercise
New research shows why physical exercise is essential to mental health.
https://www.psychologytoday.com/us/...ental-health-reaps-the-benefits-exercise

EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH).
Eur Psychiatry. 2018 Oct;54:124-144. doi: 10.1016/j.eurpsy.2018.07.004
https://www.ncbi.nlm.nih.gov/pubmed/30257806

Physical activity and mental health in children and adolescents: a review of reviews.
Br J Sports Med. 2011 Sep;45(11):886-95. doi: 10.1136/bjsports-2011-090185. Epub 2011 Aug 1.
https://www.ncbi.nlm.nih.gov/pubmed/21807669

Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis.
Sports Med. 2017 Feb;47(2):343-352. doi: 10.1007/s40279-016-0574-1
https://www.ncbi.nlm.nih.gov/pubmed/27299747


(3) Importance of Social Relationships/Staying Connected:

Good Social Relationships Are The Most Consistent Predictor of a Happy Life
https://medium.com/kaizen-habits/go...t-predictor-of-a-happy-life-742d234cc5d2

Change of depressive symptoms in a French nine-year longitudinal study of aging: Gender differences and relationships between social support, health status and depressive symptoms.
Arch Gerontol Geriatr. 2020 Apr 22;89:104059. doi: 10.1016/j.archger.2020.104059
https://www.ncbi.nlm.nih.gov/pubmed/32334334

Social relationships and risk of dementia: A systematic review and meta-analysis of longitudinal cohort studies.
Ageing Res Rev. 2015 Jul;22:39-57. doi: 10.1016/j.arr.2015.04.006. Epub 2015 May 5
https://www.ncbi.nlm.nih.gov/pubmed/25956016

Preventing social isolation in older people.
Maturitas. 2018 Jul;113:80-84. doi: 10.1016/j.maturitas.2018.04.014. Epub 2018 Apr 30
https://www.ncbi.nlm.nih.gov/pubmed/29903652


(4) Being Out in Nature:
We Are Wired To Be Outside (Note annoying insistence on logging in)
Science is demonstrating what we intuitively know: Nature makes us happy.
https://www.nationalgeographic.com/news/2017/02/nature-fix-brain-happy-florence-williams/

How Walking in Nature Changes the Brain
https://well.blogs.nytimes.com/2015/07/22/how-nature-changes-the-brain/

Sour mood getting you down? Get back to nature
https://www.health.harvard.edu/mind-and-mood/sour-mood-getting-you-down-get-back-to-nature

The relationship between nature connectedness and happiness: a meta-analysis.
Front Psychol. 2014 Sep 8;5:976. doi: 10.3389/fpsyg.2014.00976. eCollection 2014
https://www.ncbi.nlm.nih.gov/pubmed/25249992

Connectedness to Nature: Its Impact on Sustainable Behaviors and Happiness in Children
Front Psychol. 2020 Feb 26;11:276. doi: 10.3389/fpsyg.2020.00276. eCollection 2020.
https://www.ncbi.nlm.nih.gov/pubmed/32174866

30 Days Wild and the Relationships Between Engagement With Nature's Beauty, Nature Connectedness and Well-Being.
Front Psychol. 2018 Sep 3;9:1500. doi: 10.3389/fpsyg.2018.01500. eCollection 2018
https://www.ncbi.nlm.nih.gov/pubmed/30233443

(5) Control Issues:
Too much of a good thing? Exploring the inverted-U relationship between self-control and happiness.
J Pers. 2018 Jun;86(3):380-396. doi: 10.1111/jopy.12322. Epub 2017 Jun 21.
https://www.ncbi.nlm.nih.gov/pubmed/28480971

J Am Geriatr Soc. 2015 Jan;63(1):24-38. doi: 10.1111/jgs.13178.
Factors that affect quality of life from the perspective of people with dementia: a metasynthesis.
https://www.ncbi.nlm.nih.gov/pubmed/25597556

Is feeling "in control" related to happiness in daily life?
Larson R.
Psychol Rep. 1989 Jun;64(3 Pt 1):775-84.PMID:
2748778
https://www.ncbi.nlm.nih.gov/pubmed/2748778

(6) Gratitude:
How Gratitude Changes You and Your Brain
New research is starting to explore how gratitude works to improve our mental health.
https://greatergood.berkeley.edu/article/item/how_gratitude_changes_you_and_your_brain

Thankful for the little things: A meta-analysis of gratitude interventions.
J Couns Psychol. 2016 Jan;63(1):20-31. doi: 10.1037/cou0000107. Epub 2015 Nov 16.
https://www.ncbi.nlm.nih.gov/pubmed/26575348

The effects of two novel gratitude and mindfulness interventions on well-being.
J Altern Complement Med. 2015 Apr;21(4):243-5. doi: 10.1089/acm.2014.0119. Epub 2015 Mar 31.
https://www.ncbi.nlm.nih.gov/pubmed/25826108

Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review.
Am J Health Promot. 2020 Apr 27:890117120920451. doi: 10.1177/0890117120920451
https://www.ncbi.nlm.nih.gov/pubmed/32338522

The Relationship Between Gratitude and Loneliness: The Potential Benefits of Gratitude for Promoting Social Bonds.
Eur J Psychol. 2015 May 29;11(2):323-34. doi: 10.5964/ejop.v11i2.826. eCollection 2015 May.
https://www.ncbi.nlm.nih.gov/pubmed/27247660

Forgiveness, Gratitude, Happiness, and Prosocial Bystander Behavior in Bullying.
Front Psychol. 2020 Jan 8;10:2827. doi: 10.3389/fpsyg.2019.02827. eCollection 2019
https://www.ncbi.nlm.nih.gov/pubmed/31969844

(7) Mindfulness:
Researchers study how it seems to change the brain in depressed patients
https://news.harvard.edu/gazette/st...-change-the-brain-in-depressed-patients/

Evidence-based Mindfulness: What Science Tells Us About Mindfulness Meditation and Its Benefits
https://consultqd.clevelandclinic.o...mindfulness-meditation-and-its-benefits/

What are the benefits of mindfulness
https://www.apa.org/monitor/2012/07-08/ce-corner

Where's the Proof That Mindfulness Meditation Works?
https://www.scientificamerican.com/article/wheres-the-proof-that-mindfulness-meditation-works1/

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