What an unpredictable world we live in!

Six months ago we were all going along our merry ways, enjoying our lives. Masks were for Purim, Social Media was bigger than Social Distancing, and Corona was still an imported beer enjoyed with a lime. Then before you could spell quarantine, everything was flipped upside down by the Coronavirus Pandemic.

With around a million deaths worldwide, most of us have a friend or a loved one who has tragically passed away. Quarantined in our homes at various times and at our wits end, it became very difficult to maintain our collective sanity. As a psychiatrist, I was heartbroken to watch as the stress of the pandemic drove many my patients into clinical depression, relapse on drugs and alcohol, domestic violence, and other mental health emergencies.

And then there’s the economic disaster that accompanied the pandemic. So many businesses closed, so many people without jobs, and lines at the food banks piling up.

Most of the time when there is a crisis, I encourage my patients to be empowered, to take responsibility for creating their own change. Out of work? Rewrite your resume and send it out to ten new people each day! Diagnosed with high blood pressure? Hit the gym every morning and cut the nachos from your diet!

In general, stress doesn’t get much done in the practical realm. Sure, you’ve got to get your taxes done if you still haven’t filed them, but once you’ve submitted everything and put the letter in the mailbox, worrying won’t get you anywhere! Already had your interview for a new position? Anxiety about whether the promotion will come won’t make you any more likely to wind up a junior vice-president and will only cost you sleep. Being nervous about the results of a COVID-19 test won’t make it any more likely to come back negative. That and the stress might just kill you!

Most things break into two categories: things that are in our control (basically our own emotions) and things that aren’t (basically everything else).

For those of us who are suffering massively as a result of the pandemic, it’s important to remember that in general, most things break into two categories: things that are in our control (basically our own emotions) and things that aren’t (basically everything else). When faced with the former, it’s time to lace up our boots and get marching with a positive attitude in order to prevail. When dealing with the latter, it’s critical not to panic, worry oneself into a heart attack, or torture our loved ones with our own projected anger and fear.

So what is the psychiatrist recommending then? As I wrote in a previous article, it is possible to build resilience – the emotional/psychological/physical/spiritual ability to weather the storm – through daily activities like mindfulness and cardiovascular exercise. And most certainly, individuals who are in need of professional help should seek help.

But for others who are down in the dumps and feeling overwhelmed by the current circumstances without clinical psychiatric challenges, it’s time to accept that there isn’t much that we can do right now to fight the waves. Rather it’s time to accept the situation for what it is and to tread water until the current situation passes. Professional help is certainly available and mental health clinicians like myself may try to help you change your perspective.

Yes, it feels like we are carrying a massive weight! It’s there and we can’t shake it. But holding this proverbial sack of bricks in our arms will tire us out immediately. We need to take these cinderblocks of stress and shove them into our backpacks which will make it easier to shoulder the load. Yes, the worry will still be there, but it’s more manageable when we compartmentalize it a bit and focus on what we are able to control as opposed to being consumed by what we can’t.

Again, to be clear, I’m not recommending for folks to ignore their stress. Rather to think about whether we will let it crush us or whether we will work on acknowledging it’s there and that there isn’t too much we can do about it beyond focusing on the good in our lives.

Over a decade ago, my sagacious Psychopharmacology Professor was nearing his fiftieth year of teaching psychiatry residents at Harvard Medical School. One particular afternoon, Dr. S. was discussing new findings regarding Botox injections as a treatment for depression. Apparently, the origins of this treatment were quite serendipitous when a husband and wife happened upon a fascinating discovery.

The husband, a high-end private dermatologist, had noticed that the Botox injections he was administering to his patients – as a treatment of facial wrinkles – were associated with better moods and happiness beyond what one would expect after such a simple cosmetic procedure. He went and told his wife – a clinical psychiatrist – who happened to try the same treatment on some of her patients experiencing depression. Lo and behold...an improvement in mood was seen by many!

Dr. S. was appropriately cautious to endorse Botox injections as a first-line treatment of depression, but he had an interesting theory as to why it might work. Just like there are nerves in our limbs and torso – called proprioceptors – telling us where the body is positioned and how it is moving in relation to the rest of its parts, these nerves also exist within our face. Except that instead of telling us that our arms are up and our legs are down, facial proprioceptors tell us that we are sad when we frown, surprised when we raise our eyebrows, and happy when we smile. Dr. S. suggested that by relieving facial muscle tension – in wrinkly folk – and creating a more pleasant facial expression, Botox injections facilitated the facial nerves to tell the brain that all is fine and dandy.

As always, my beloved mentor ended each lecture with a blunt summary and this week was no different. Simple, short, and sweet, Dr. S. told us, “Just get out there and smile. It works for patients, it works for me, and it’ll work for you.”

If Dr. S. and his half-a-century of clinical wisdom was endorsing smiling as a means for generating positivity, it was certainly enough to get me going. That and my kindergarten teacher’s maxim of “turning that frown upside down.” Or perhaps a quote from The Grateful Dead: “Nothing left to do but Smile, Smile, Smile.”

We all carry burdens and they’ve most certainly gotten more intense in the current pandemic. That being said, smiling is contagious and can brighten not only your own day, but the day of your family, friends, and fellow human beings.

The great sage, Shammai, famously taught, “Greet every person with a pleasant smile,” (Ethics of Our Fathers 1:15). This isn’t just advice, it’s basic Jewish Law!

So rearrange the load to ensure it doesn’t consume you, strap on a smile for the road ahead, and stop for a brief moment to smell the expresso beans. Rosh Hashanah is coming and it’s time to start the New Year with a positive attitude!