October 10 was World Mental Health Day, a campaign by the World Health Organization each year to raise awareness of mental health issues and mobilize efforts in support of mental health. This year, the day falls during a time where the COVID pandemic has created economic, social, and health implications that are unprecedented. Combine that with the stress of a tumultuous political climate and multiple natural disasters across the country and it’s no wonder that many people are feeling anxious and/or depressed.

One of the manifestations of poor mental health that we see in our clinic is our patients’ experience of pain and/or dizziness. We know that stress can trigger migraines, so many of our patients with migraines have been experiencing more frequent episodes of dizziness, imbalance, and/or headache. Dizziness is sometimes a manifestation of anxiety, and anxiety can also increase the sensitivity of the nervous system to dizziness. This complex relationship results in a greater perceived intensity of dizziness from a less intense trigger.

In addition, because mental health and pain are both controlled by an interaction between the brain and the nervous system, anxiety and depression can influence a person’s pain experience. Pain can feel more or less intense depending upon mood. Have you ever noticed that when you are having a bad day, your back pain flares up? This is especially true for chronic pain, which is controlled by the brain’s perception of a problem after the initial injury has healed.

So how do we promote good mental health? One of the most natural ways to reduce anxiety and depression is to exercise. In particular, aerobic exercise, such as walking, swimming, biking, or rowing, helps to boost mood. To get the recommended “moderate-intensity” of aerobic exercise recommended by the American Heart Association, it is best to exercise at a 3-5/10 on a 0 to 10 scale, where 0 is completely resting and 10 is maximum exertion.

Social interaction is also a mood booster, but difficulties with safe social interaction during the pandemic have left many people feeling isolated. Still, with a little creativity, you can find ways to socialize while still maintaining social distancing. Pick up the phone and call a friend, host a video call for a group of friends, or cook and eat a meal over video chat. There are also groups meeting virtually to make jewelry, do jigsaw puzzles, and play board games. Low-risk outdoor activities include going for a walk with a friend, sitting on your driveway and talking with neighbors, or having a picnic. Whenever possible, wear your mask and maintain 6 feet of distance.

Practicing mindfulness and using meditation techniques can also be useful for managing stress and anxiety. A simple breathing exercise includes deepening the breath by inhaling for a slow count of 4, holding for a slow count of 7, and exhaling for a slow count of 8. You can also practice diaphragmatic breathing, during which you place a hand on your belly and breathe into your hand, causing your hand to rise.

There are also many apps available that have free trials or free basic content designed to help you perform guided meditation. A few of these include Headspace, Calm, Insight Timer, and Smiling Mind. Even a few minutes per day of practice has been shown to have long term positive impacts on mental health.

There are also many resources available to help those who may be struggling with their mental health. Some publicly available include  CDC Mental Health Tools and Resources, CDC Coping with Stress, National Alliance on Mental Illness, National Institute of Mental Health, and Substance Abuse and Mental Health Services Administration.

As the weather gets cooler and the days get darker, it is likely that we will continue to see an increased reliance on mental health providers and services throughout the country. Remember to be kind to each other.