After a year of toxic stress ignited by so much fear and uncertainty, now is a good time to reset, pay attention to your mental health and develop some healthy ways to manage the pressures going forward.

Brain science has led to some drug-free techniques that you can put to use right now.

I am health psychologist who developed a method that harnesses our rip-roaring emotions to rapidly switch off stress and activate positive emotions instead. This technique from emotional brain training is not perfect for everyone, but it can help many people break free of stress when they get stuck on negative thoughts.

Why the stress response is so hard to turn off

Three key things make it hard to turn off stress-activated negative emotions:

• First, our genes make us worrywarts. Our hunter-gatherer ancestors survived by assuming every rustle in the grasses was a lurking hungry lion, not harmless birds hunting for seeds. We’re essentially programmed to be hyperaware of threats, and our brains rapidly launch stress chemicals and negative emotions in response.

• Second, the chemical cascade of stress hormones in the brain associated with negative emotions impairs cognitive flexibility, goal-directed behavior and self-control.

• Third, our tendency to avoid dealing with negative emotions puts people in a perpetual cycle of ignoring unpleasant feelings, which amplifies stress and the risk of emotional health problems.

Traditional approaches for coping with stress were based on cognitive-behavioral therapy, which focuses on modifying patterns of thinking and behavior. It was developed before our modern understanding of stress overload.

Researchers at New York University discovered a paradox: Although cognitive methods were effective in low-stress situations, they were less effective when dealing with the high stress of modern life.

Emotional brain training works with these high-stress emotions in an effort to tame them, releasing negative emotions as the first of two steps in preventing stress overload.

Step 1: Release negative emotions

The only negative emotion in the brain that supports taking action rather than avoidance and passivity is anger.

Studies have shown that the suppression of anger is associated with depression and that suppressing anger doesn’t reduce the emotion. Healthy release of anger instead has been found to reduce other stress-related health risks.

Our technique is to switch off stress overload by using a controlled burst of anger to help the brain exert better emotional control and allow emotions to flow rather than become chronic and toxic. After that first short burst, other feelings can flow, starting with sadness to grieve the loss of safety, then fear and regret, or what we would do differently next time.

You can talk yourself through the stages. To experiment with the process, use these simple phrases to express the negative feelings and release your stress: “I feel angry that …”; “I feel sad that …”; “I feel afraid that …”; and “I feel guilty that …”

Step 2. Express positive emotions

After releasing negative emotions, positive emotions can naturally arise. Express these feelings using the same approach: “I feel grateful that …”; “I feel happy that …”; “I feel secure that …”; and “I feel proud that …”

Your mindset can quickly change, a phenomenon that has many potential explanations. One explanation is that in positive states, your brain’s neural circuits that store memories from when you were in the same positive state in the past can be spontaneously activated. Another is that the switch from negative to positive emotions quiets your sympathetic nervous system – which triggers the fight-or-flight response – and activates the parasympathetic system, which acts more like a brake on strong emotions.

Here’s what the whole stress relief process might look like like for me right now:

• I feel angry that we’re all isolated and I can’t see my new grandson Henry.

• I hate it that everything is so messed up! I HATE THAT!!!

• I feel sad that I am alone right now.

• I feel afraid that this will never end.

• I feel guilty that I am complaining! I am lucky to be alive and have shelter and love in my life.

Then the positive:

• I feel grateful that my daughter-in-law sends me photos of Henry.

• I feel happy that my husband and I laughed together this morning.

• I feel secure that this will eventually pass.

• I feel proud that I am doing the best I can to cope.

After a daunting year, and with more challenges ahead in 2021, upgrading your approach to emotions can be a drug-free mood booster. Our COVID-19 fears need not consume us. We can outsmart the brain’s fear response and find moments that sparkle with promise.

[Get our best science, health and technology stories. Sign up for The Conversation’s science newsletter.]

Laurel Mellin, Associate Professor Emeritus of Family & Community Medicine and Pediatrics, University of California, San Francisco

This article is republished from The Conversation under a Creative Commons license. Read the original article.

When one of my co-workers found out about a tiny, orphaned kitten that needed a home a few months ago, he didn’t hesitate to adopt it. He says his new companion helped make the months of COVID-19 isolation at home much less stressful.

He is not alone. Animal shelters and breeders across the country have reported record numbers of dog and cat adoptions in recent months.

But after my co-worker returned to work, he says his adorable kitten started urinating on the kitchen counter while he was away.

Another friend is worried about how her dog will react when she returns to the office. Her big, goofy Labrador retriever follows her everywhere, even to the bathroom. When she leaves to run a quick errand, the dog sits by the back door and whines, awaiting her return.

What should these pet owners do?

The problem with sudden changes in routine

A change in routine, such as suddenly being alone for many hours every day, is a major cause of separation anxiety for both dogs and cats.

Separation anxiety is more than a little whimpering when you head out the door. It’s major, unwanted behavior that happens every time you leave or are away.

For dogs and cats, this can mean excessive pacing, barking or howling, whimpering or self-grooming as you get ready to leave. In some cases it can mean urinating or defecating around the house, often in places where scents linger, such as on bedding or rugs, or destroying household items in your absence. Extreme clinginess or neediness is another symptom.

Separation anxiety won’t go away on its own, and it can be difficult to get rid of entirely. But there are ways to manage it. As a clinical veterinarian and professor, I am often asked to help people find ways to ease their pets’ anxiety.

What not to do

First, it’s important to understand that it’s not about you – it’s about your pet. Your dog or cat is not trying to teach you a lesson or get revenge. Animals don’t act out of spite.

Instead, it’s a signal of extreme distress and frustration that should be approached like any other medical ailment. Your pet doesn’t want to experience separation anxiety any more than you want to experience its consequences.

For this reason, punishment is never the answer. For one thing, your pet won’t connect the punishment with something that happened hours – or even a few minutes – earlier. And punishment may only exacerbate your pet’s anxiety and stress.

Similarly, going to the opposite extreme by praising or giving affection when your pet is suffering anxiety also will make the problem worse.

The goal is to create a balanced relationship so your pet tolerates being alone. First, get your pet checked out by a veterinarian to rule out physical conditions, such as a urinary tract infection if your pet urinates in inappropriate places.

Next, make sure your pet gets plenty of exercise and mental stimulation. For dogs, this may mean a long run or brisk walk every day. Getting exercise shortly before you leave the house may put your dog in a more relaxed state while you’re gone. It’s harder to feel stressed when the endorphin levels are elevated. For cats, this could mean a change of environment by being outdoors in a safe, enclosed area such as a “catio.”

Treating separation anxiety with behavior change

Here, we’re talking about your behavior. The goal is to make your absence seem like no big deal. Making a fuss over your pet when you leave or arrive home only makes matters worse. If you treat it like it’s routine, your pet will learn to do the same.

Try to figure out when your pet starts to show signs of anxiety and turn that into a low-key activity. If it’s when you pick up your handbag, for example, practice picking it up and putting it back down several times over a few hours. Similarly, get dressed or put on your shoes earlier than usual but stay home instead of leaving right away. Try starting your car’s engine and then turning it off and walking back inside.

Next, practice short absences. When you’re at home, make it a point to spend some time in another room. In addition, leave the house long enough to run an errand or two, then gradually increase the time that you’re away so that being gone for a full day becomes part of the family routine.

Changing the environment

Boredom makes separation anxiety worse. Providing an activity for your pet while you’re gone, such as a puzzle toy stuffed with treats, or simply hiding treats around the house will make your absence less stressful. Other options for dogs and cats include collars and plug-in devices that release calming pheromones.

To maintain your bond while you’re gone, place a piece of clothing that you have worn recently in a prominent place, such as on your bed or couch, to comfort your pet. Similarly, you can leave the TV or radio on – there are even special programs just for pets – or set up a camera so you can observe and interact with your pet remotely. Some of these come equipped with a laser pointer or treats you can dispense.

Using supplements or medication

In some severe cases, when the animal harms itself or causes property damage, medication or supplements might be necessary. These alter the brain’s neurotransmitters to create a sense of calm.

[Deep knowledge, daily. Sign up for The Conversation’s newsletter.]

While some are readily available without a prescription, it’s a good idea to get advice from your veterinarian to determine which are safest and most effective for your pet’s situation. Medication can help reduce the anxiety, making it easier for the pet to learn new coping skills. A behavior modification plan accompanying the use of medication can help manage this problem.

Separation anxiety is difficult for both you and your pet. But a few simple changes can make a huge difference as life returns to some semblance of normal.

Lori M Teller, Clinical Associate Professor, Veterinary Telehealth, Texas A&M University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The enormous job of vaccinating the nation is underway, but for rural Americans, getting a COVID-19 vaccine becomes harder the farther they are from urban centers.

The current vaccines’ cold storage requirements and shipping rules mean many rural hospitals can’t serve as vaccination distribution hubs. That can leave rural residents – about 20% of the U.S. population in all – traveling long distances, if they’re able to travel at all.

Getting the word to rural residents about when they can be vaccinated isn’t easy either, and the extraordinary amount of misinformation downplaying the risk of the coronavirus this past year has had an impact on rural residents’ willingness to get the vaccine.

We work in rural health care settings and have been examining the barriers to health care for these patients to find ways to ensure health and safety.

The problem with big batches and cold storage

The first two authorized vaccines – one made by Pfizer and BioNTech and the other by Moderna – are mRNA vaccines. It’s a new type of vaccine that uses the molecular instructions for building virus proteins rather than injecting parts of the weakened virus itself. Both must be kept in very cold temperatures.

To ensure stability, the vaccine doses are shipped in special containers with dry ice, and for now, vaccines are being delivered only in large batches. The Pfizer vaccine is shipped in increments of 975 doses at a time, which creates a challenge for small hospitals.

Urban areas will be able to quickly distribute those doses, but finding enough patients to vaccinate quickly in rural areas may prove more difficult.

Moderna’s vaccine is somewhat more manageable, with a minimum order of 100 doses.

Both vaccines also require two doses per person, with the second dose of Pfizer’s vaccine given 21 days later and Moderna’s 28 days.

As a result, the vaccine distribution efforts will favor hubs that cater to more populated areas to avoid wasting any vaccine or leaving patients unable to get their second dose.

Cold storage is another challenge, since small hospitals are less likely to have expensive freezers. The Pfizer vaccine must be stored at minus 94 degrees Fahrenheit (minus 70 Celsius) and Moderna’s at minus 4 Fahrenheit. There are limits on how many times the vaccine shipping containers can be opened and how quickly the vaccines must be distributed. Once thawed and prepared, the Pfizer vaccine must be used within five days and Moderna’s within 30 days.

Each patient must receive both doses of the vaccine from the same manufacturer to ensure safety and effectiveness, adding to the challenge. Manufacturers have included personal dosing cards for patients to carry with them to help address this challenge.

Rural America’s take on COVID-19 and vaccines

Rural America already has difficult barriers to health care access.

It has fewer health care providers serving a more geographically diverse population than in metropolitan communities. And in many of these areas, rural hospitals have been closing at an alarming rate, leaving people to travel farther for care. The population is also older. Public transportation that could help poor or elderly residents reach hospitals is rare, and distance and geography, such as mountain roads, can mean driving to those sites takes time.

Getting accurate information about the vaccine and how to receive it into rural areas has also proved difficult. Many rural counties still have limited access to broadband internet connections, smartphone service and other technologies. That often means residents rely on television, newspapers and radio for news, which can limit the depth and scope of information.

While some rural counties have started getting the word out, many don’t not seem to have specific plans on how to inform their residents about how and when each person can get the vaccine, let alone specific plans for actually giving it. They often rely just on local press releases that many residents never see.

Rural nonprofit health care organizations have tried to bridge that gap and improve rural communications about vaccines and the pandemic. Care Compass Network, which coordinates organizations across southern New York, has offered educational webinars with the latest information about the virus and the vaccines, for example. But there is still much work to do.

[Get facts about coronavirus and the latest research. Sign up for The Conversation’s newsletter.]

Rural Americans’ views on vaccines are influenced by media and word of mouth, politics and religion, as well as previous experience with vaccinations and, perhaps most importantly, the difficulty of accessing health care.

In a survey conducted by the Kaiser Family Foundation in December, about 35% of rural Americans said they probably or definitely would not get the vaccine, higher than the 27% nationwide.

Small batches, new vaccines and pharmacies

Getting enough of the U.S. vaccinated to eventually end the pandemic will require more work in all of these areas. That includes improving shipping and storage processes so orders can be broken up and distributed to smaller hospitals, distributing more vaccine doses, and improving communication.

With Moderna’s vaccine arriving in smaller batches and not requiring such low temperatures for stability, it may prove to be more accessible for rural areas in the near future. Utah has already taken advantage of those characteristics to get initial doses to smaller hospitals outside its urban areas and has started vaccinating health care providers. Pfizer has said it may be able to offer smaller batches by April.

Other vaccines on the horizon are also expected to have less stringent storage requirements and may potentially be delivered in a one-shot method rather than a two-dose series. The falling number of rural hospitals still remains a challenge for getting vaccines to patients, though. Allowing community pharmacies to offer the vaccine – particularly if independent pharmacies are included – could eventually help expand the distribution network in rural areas.

Bennett Doughty, Clinical Assistant Professor, Pharmacy Practice, Binghamton University, State University of New York and Pamela Stewart Fahs, Professor of Rural Nursing, Binghamton University, State University of New York

This article is republished from The Conversation under a Creative Commons license. Read the original article.