Mentally Preparing for the Presidential Outcome

Already stress and anxiety are building as America awaits the outcome of today’s Presidential Election.

Some might wonder why I am discussing a political situation when this is a website devoted to ICD medical coding. Well, it’s for two main reasons.

One is that the incidence of many full-blown psychiatric diagnoses have been increasing for years, and even more rapidly this year, at least those influenced by undue societal stress and trauma – that is, anxiety disorders, PTSD, and depressive disorders.

Secondly, ICD-10 has actually been a strong supporter of the social determinants of health (SDoH), and surely, the governments of the United States constitute one of those. As such, we have Z60: “Problems related to social environment.” There are other Z codes that are also relevant to this time of the COVID-19 pandemic.

And as Dr. Erica Remer told us not long ago, these Z codes are underused, but they are there for good reasons.

Even if this premise is correct, then how to prepare to be as mentally healthy as possible in the aftermath of the election, no matter who wins? A divisive aftermath could last a long time. Of course, there is lots of advice already floating around, like the usual “diet, exercise, and control what you can,” but there is one other piece of advice I ran into serendipitously.

On Sept. 29, I appeared on Talk Ten Tuesdays to talk about the emotional state of our country. Right after the program, I walked past a TV, and whoever was on the local TV show (which I never ever watch because I think it is too sappy, called Morning Blend, I think.) Whoever it was mentioned “emotional agility.” “That’s it,” I thought!

My recommendation back at the end of the September show was to try to find the sweet spot for your intensity of anxiety and depression: not too much and not too little, just the right amount to fit the circumstances. But there are other emotions of importance, too: anger, irritability, and even joy, among them. Plus, our emotional reactions may be like a roller-coaster ride as the election plays out. What we need for all of that is emotional agility. So, what is that?

After encountering the snippet on TV, I tried to find the relevant literature. What I found was a book by Susan David called, wouldn’t you know it, Emotional Agility: Get Unstuck, Embrace Change, and Thrive in Work and Life. Not only that, but it was released on Sept. 6, 2016, right before the prior election. Did she somehow know that we were going to need that emotional agility then, and I think even more, now?

A teaser for the book is to recognize your emotions and think about how to use them for any given stressor. That ability to pause and dampen our reactivity to stress is a key step to that agility. And breaking up the built-in chronic stress reaction in these stressful times is absolutely critical, because if we do not, the body keeps releasing stress hormones, which lead to increased inflammation throughout the body and brain, including a poorly functioning immune system.

What helps that transition the most continuously? As another new book, Growing Young, tells us, being or having been in a satisfying long-term romantic relationship, good friends, and being kind and volunteering.

Programming Note: Listen to Dr. Moffic today on Talk Ten Tuesdays, 10 a.m. EST, as he answers questions from listeners seeking advice about coping with the outcome of today’s Presidential Election. Register to listen.

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H. Steven Moffic, MD

H. Steven Moffic, MD, is an award-winning author whose fifth book, “The Ethical Way: Challenges & Solutions for Managed Behavioral Health,” is considered a seminal study on healthcare ethics. Always in demand as a writer, Dr. Moffic has attracted a national audience with his three blogs— Psychiatry Times, Behavior Healthcare, and Over 65.H. Dr. Moffic, who is also a popular guest on Talk Ten Tuesdays, recently received the Administrative Psychiatry Award from the American Psychiatric Association (APA) and the American Association of Psychiatrist Administrators (AAPA).

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