Using the 'MASK' strategy to help patients cope with pandemic-related anxiety with Dr. Eliza W. Menninger

Eliza W. Menninger, MD, spoke with Psychcast host Lorenzo Norris, MD, about how to help patients deal with anxiety related to the COVID-19 pandemic.

Dr. Menninger is medical director of the behavioral health partial hospital program at McLean Hospital in Belmont, Mass. She treats patients with major depression, bipolar disorder, schizophrenia, and schizoaffective disorder. Dr. Menninger also treats patients in McLean's Schizophrenia and Bipolar Disorder Outpatient Clinic. She has no disclosures.

Dr. Norris has no disclosures.

Take-home points

• Anxiety related to stress, fear, worry, and grief has spiked in all phases of the pandemic. Initially, we faced uncertainty not knowing how to adapt to restrictions, and we assumed that the adaptations would be short term. Six months into the pandemic, we've moved into questions about maintaining these adaptive processes over the long term.
• As the medical director of a partial hospitalization program, Dr. Menninger created an acronym, "MASK," to help people cope with the stress of the pandemic.
• MASK stands for Make boundaries, Avoid the virus, Stay connected, Keep the faith.

Summary

• Making boundaries refers to encouraging people to use similar behaviors from their past routines to maintain normalcy. For example, for people who work from home, Dr. Menninger suggests getting dressed and ready for work as though you're actually going, and taking breaks from screens to reduce virtual platform fatigue. People are feeling socially and physically restricted by the pandemic, and she emphasizes going outside regularly. Boundaries that help delineate physical spaces and emotional responsibilities can alleviate the physical and mental clutter that compounds stress.
• Avoiding the virus is a constant chore, so Dr. Menninger came up with a humorous song aimed at helping her patients remember their role in avoiding exposure to the coronavirus.
• Staying connected means focusing on the social connection and feeling the presence of the other person instead of just sensing the temporary connection provided through the virtual platform. Dr. Menninger suggests imagining that the person with whom you're connecting is in the room with you. Self-care through maintaining routines; exercising; maintaining healthy nutrition; seeking out humor; and enjoying art, music, and other stimuli helps people connect with themselves and others.
• Keeping the faith means remembering that the pandemic will end, and we have the tools to build resilience in ourselves and patients. Dr. Menninger finds hope in the way her clinical staff has been creative to make a difference in the patients' life amid the constant changes. She and Dr. Norris cite examples of patients using creativity to overcome overwhelming life circumstances, build on their strengths, and reframe the pandemic to find the silver lining.

Reference

Marcus PH et al. Current Psychiatry. 2020 Dec;19(12):28-33.

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Show notes by Jacqueline Posada, MD, associate producer of the Psychcast; assistant clinical professor in the department of psychiatry and behavioral sciences at George Washington University in Washington; and staff physician at George Washington Medical Faculty Associates, also in Washington. Dr. Posada has no conflicts of interest.

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