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Ep. 117 - LiveWell Talk On...COVID-19 and PTSD (Kayla Orr, MSW, LISW)

episode 117

Ep. 117 - LiveWell Talk On...COVID-19 and PTSD

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Host: 
Dr. Dustin Arnold, chief medical officer, UnityPoint Health - St. Luke's Hospital

Guest: Kayla Orr, MSW, LISW, therapist, St. Luke's Counseling Center

Dr. Arnold:
This is LiveWell Talk on COVID-19 and post-traumatic stress disorder, PTSD. I'm Dr. Arnold, chief medical officer at UnityPoint Health - St. Luke's Hospital. COVID-19 and the pandemic in general has effected people's mental health over the last year. And it has been a traumatic event for some people, lockdowns, restrictions, etc., whether or not to get a vaccine. Patients may be dealing with post-traumatic stress. Joining me today is Kayla Orr, therapist at St. Luke's Counseling Center. Kayla specializes in trauma counseling, as well as eye movement desensitization reprocessing. I didn't know what that is, so I'm looking forward to asking you about that Kayla. You know, when people think about post-traumatic stress, they think about, you know, Vietnam, combat, some sort of felony crime that was committed. But that's not always true, correct?

Kayla Orr:
Correct.

Dr. Arnold:
You can have post-traumatic stress from things that—to each his own post-traumatic stress, I guess that's what I'm trying to say.

Kayla Orr:
Yeah.

Dr. Arnold:
You know, just because one person found this a stressful situation, someone else might not. So could you tell us about that and how you approach this post-traumatic stress disorder?

Kayla Orr:
Sure. Like you said, I mean, any traumatic event that someone experiences it's their perception of what happened in the event and how their body's responding to it. And so really, you know, we could be in the same situation, we could both be in a car accident together and you could respond completely differently, be able to cope with it. You have good support systems, that sort of thing to back you up. But you know, me, maybe I don't have those supports and I maybe I'm prone to more anxiety, depression type things. I already have these going on in my life, and so I respond differently. I maybe don't have the right sort of coping strategies or just not the right support systems in my life where I'm able to kind of get through the situation that happened and be able to move forward. And so needing a little bit more assistance would be what I would suggest, that someone's seeking out some help to talk with somebody to kind of process through that trauma.

Dr. Arnold:
Have you seen people with post-traumatic stress from COVID?

Kayla Orr:
Yes. I've seen some that have gotten it from COVID, more of like the acute stress disorder, which is kind of the precursor to a PTSD diagnosis. It's a little—it doesn't last as long in their life, as long as they're maintaining those coping strategies. But yes, I have seen some PTSD directly from COVID-19. People have experienced deaths of loved ones, or just, I mean, the lockdowns in general can be traumatic for people. And so various reasons I've seen PTSD through COVID-19. Yeah.

Dr. Arnold:
Yeah. I think for some of the staff, staff always grieve when they lose a patient.

Kayla Orr:
Of course.

Dr. Arnold:
You know, and that's—do you have to compartmentalize it so you can go see the next patient? Absolutely. And that's one of the noble things about medicine, but also one of its tragedies, the compartmentalization.

Kayla Orr:
Right.

Dr. Arnold:
But, it's extra hard when it's someone that was young that died. We've had some 49 year olds, some you know, 47 year old people that are younger than me, die with young kids and a young wife, etc. And so I know the staff has—that's been tough on them, really tough. I mean, it's tough on when they lose a patient in general.

Kayla Orr:
Absolutely.

Dr. Arnold:
Well, I want to get to what is EMDR, eye movement desensitization reprocessing. Never heard of this, tell me what it is.

Kayla Orr:
Okay. So it's an eight phase treatment. Dr. Francine Shapiro developed this using the idea of REM sleep, so the rapid eye movement that we do when we're sleeping, connecting that right brain in that left brain. And so we're using bilateral stimulation. There's lots of ways to do that. The eye movements, kind of following our fingers, this type of thing is how you're trained, but they have lots of equipment you can buy. There's a light bar that you can use to follow, different things like that. And so we use that to process through the traumatic events that have occurred. So we, you know, recall that memory. We think of those negative thoughts that come along with that, because typically there's a lot of, it's my fault, a lot of negative self-talk that we're processing through when we have traumatic incidents happen. And so we're working through those to reprocess basically how we think about those situations. It's also a very body-based therapy where we focus on: where are you feeling that tension in your body? Are you feeling that in your stomach? Your throat, are you feeling kind of like that pit there? And we really focus on those to bring some of that tension down through that bilateral stimulation. It really allows that the internal associations that the person is doing to be changed in their memory and then their feelings and their thoughts about the situation. Obviously we can't take the situation away that happened, but they're able to think differently about the trauma that happened to them, and change those thoughts to be something more positive. Like, I know it's not my fault. I have power in this situation. I can get through this, that sort of thing. Yeah.

Dr. Arnold:
So is this something like, if I had a traumatic event, I go have this done? You know, one session or one series of treatments then I'm cured, or is this an ongoing sort of thing?

Kayla Orr:
It's an ongoing sort of therapy. We typically do once a week, 45 minutes to 60 minutes. And then it really depends on the trauma. So we can get—if you have one specific instance that happened to you, you know, that traumatic incident, we can probably process through that pretty quick. You know, four to five, six, sometimes seven sessions. If you're talking more of a complex trauma, this kind of builds on other traumas you've had in your life. You know, I've done sessions, you know, six months, seven months with people just because there's just so much that they've associated with this trauma on top of it. So it really varies depending on the patient, everybody's different. And so I can't give like a specific timeline for how long people will be in this therapy. Yeah.

Dr. Arnold:
Well that makes sense. Better than throwing a medication at it, you know, really.

Kayla Orr:
Absolutely.

Dr. Arnold:
How does—this is kind of off the question, but same realm here. How do service dogs help people with PTSD? Is it just a distraction for them? I mean, you see some of the soldiers particularly, have a service dog for PTSD. I know my dogs put me in a good mood. I love my dogs. I love my dogs more than I love my family for the most part. You know, Tanya and I used to joke when the kids were little. We'd say, well, if we divorced it's the kids every other weekend, but we're going to fight like hell to get sole custody of the dogs. You know what I mean?

Kayla Orr:
Of course, yeah.

Dr. Arnold:
So how does that work? I mean, how does that work, the PTSD and the dogs?

Kayla Orr:
So if we're talking an actual service dog, the kind that have had the training, which is most likely what you're talking about, they have special training to notice when this person's, you know, body is changing. If they're starting to feel more anxious or if they're, you know, they're trained kind of what this person's triggers are, that sort of thing. So they're specifically designed for this person. Kind of like a medication would be to target something specific. This dog is trained to notice, you know, this is an area that, you know, maybe triggers this person or I'm noticing whatever it is in their body that is telling me that they're starting to get more anxious or they're getting more fearful. And so they're able to, you know, get that person out of that situation if they can. Or just be there for that person through that situation if they need to be there with them.

Dr. Arnold:
That is fascinating.

Kayla Orr:
Yeah.

Dr. Arnold:
I always say: humans, we don't deserve dogs.

Kayla Orr:
It's true, yeah.

Dr. Arnold:
So just in general, because not everyone that's going to listen to this podcast either has PTSD or knows someone who has PTSD. What is your general advice for people struggling with mental illness during COVID-19?

Kayla Orr:
Sure. I say, you know, make sure you're taking care of yourself. We're all—you know, especially through COVID-19, we're very focused on other people and taking care of other people and making sure other people are safe. And so being very focused on yourself, giving yourself that time that you need, you know, to calm down. Whether that be some form of exercise, you know, good nutrition, spending time with family when you can and when you're comfortable doing so, and just making sure you're listening to your body and your own needs. And obviously if you are struggling, to seek out some professional help is definitely kind of what I recommend to people.

Dr. Arnold:
Well, I mean, I'm a huge mental health advocate. You know, you would have your diabetes treated by a professional, you should also have your disorders of your brain treated by a professional. So if a listener wanted to get an appointment or talk to someone about mental health, how would they do that?

Kayla Orr:
So UnityPoint employees have the EAP services. And so they would just call the EAP number at St. Luke's or whether you're any other UnityPoint, wherever you're at, calling that EAP number.

Dr. Arnold:
EAP is the Employee Assistance Program.

Kayla Orr:
Employee Assistance Program, yes. Sorry. And then, you know, if you're here in Cedar Rapids, we have the St. Luke's counseling center. So you can call that number. Or Abbe Health as well is also part of UnityPoint now too. But then, I mean, obviously UnityPoint is all over press at the state of Iowa, and so giving direct numbers would be difficult for me to do for everyone. But yeah, that's kind of what—you know, reaching out to any counseling centers you have in the area, or really checking into the employee assistance program. And for listeners that aren't part of UnityPoint, you know, a lot of organizations do have their own employee assistance programs. You just needed to reach out to your HR department, and they'll be able to tell you if they offer that.

Dr. Arnold:
Yeah. I think that the take home point there is, you're not in this alone.

Kayla Orr:
Right.

Dr. Arnold:
There is, you know, there's nothing new under the sun, as the Bible says and there's people here to help if you need it. Well this is absolutely great information. I'm glad I now know what EMDR therapy is, and I'm far from an expert, but at least I learned something. This has been great information. Once again this is Kayla Orr, therapist at St. Luke's Counseling Center. For more information, visit UnityPoint.org. Thank you for listening to LiveWell Talk On. If you enjoyed this episode, don't forget to subscribe. And if you want to spread the word, please give us a five-star review and tell your family, friends, neighbors, strangers about our podcasts. We're available on Apple Podcast, Spotify, Pandora, or wherever you get your podcasts. Until next time, be well.