Tag: coronavirus

The Rise of Telehealth

Telehealth wasn’t new to COVID-19. The concept has been around for decades and applies differently to different areas of medicine. That being said, one of its most positive potential uses has been in the area of mental health, and in that regard, COVID-19 may have pushed us towards telehealth in a big way.

First, check out this USA Today article on the subject. This line stuck with me:

Prior to the pandemic, Blue Cross Blue Shield of Massachusetts received about 200 telehealth claims per day. That number reached up to 40,0000 claims per day from April to May 2020, and the insurer is still receiving about 30,000 claims per day almost a year later, according to spokesperson Amy McHugh.

The article also noted that ” mental health appointments made up about 53% of the 7.5 million telehealth claims processed by Blue Cross Blue Shield of Massachusetts since March 2020.”

This isn’t a surprise, and many of us have had experiences with it. I know I had numerous virtual appointments via telehealth over this pandemic, and I found it every bit as effective as an in-person visit. Maybe even more so – the flexibility that came with it was highly beneficial. I remember having a therapy appointment from my office in Harrisburg!

Of course, it’s not for everyone, but there is unquestionably good news in the area of telehealth. According to a 2020 article from the American Psychological Association, telehealth seems to be working so far. There are even some questions as to whether or not telehealth may be more effective for some groups that are typically less willing to visit a psychiatrists office – like men – as it allows them to get therapy without having to leave their house, thus reducing potential barriers and making it easier for them to overcome self-imposed stigma.

The USA Today article also noted that telehealth can make a therapist more efficient. Said one therapist, “I probably spend somewhere between 2 to 5 minutes per patient moving from one room to another or pausing to document or checking something on their file or handing something off. There are built-in inefficiencies that isn’t time spending with the person… but some of those inefficiencies are taken care of by the fact that everything is electronic.”

Obviously, COVID pushed us more this way as part of all of our efforts to socially distance. However, major challenges remain in terms of full utilization and effectiveness of telehealth services. First, telehealth is predicated on the idea that someone has the broadband infrastructure and necessary equipment. As this pandemic has shown, that is NOT the case for everyone, particularly among rural Americans or the urban poor. Lacking such equipment means that someone will not be able to get the help they need.

Furthermore, there are insurance barriers. Not all insurance companies cover telehealth, and while states of emergency have knocked down many of these barriers, they haven’t destroyed all. As such, insurance regulations need to be updated in many states. However, this presents a problem in and of itself. For example, in Pennsylvania, the issue has been tripped up due to attempts to limit telehealth services and prevent abortion services from being prescribed or conducted via telehealth. Don’t ask.

The point is this: Telehealth is great, but we’ve got a long way to go.

Let me conclude with this: Did you have a telehealth experience with COVID-19? What was it like? Did you find it to be as effective as an in-person visit? We’d love to hear from you – give us your comments below!

The debate about in-person vs. virtual school misses the point

As a parent – and as a policy-maker – it seems as if everything we do these days is related to COVID. How will we recover? How can we ensure that everyone is getting the vaccine who deserves it? How can we deal with the devastating economic and unemployment effects? How soon can we (safely) get kids back into school?

Of course, the mental health impacts of COVID are damning as well, and much of that blame – at least for our kids – has been thrown at the feet of virtual learning. There is a lot of truth in that, of course. Evidence is clear that the mental health of our kids are, on the whole, suffering, with a rise noted in self-reported rates of depression and visits to the emergency room. Some are quick to cite the idea that this is a direct result of the fact that millions of kids are in some sort of virtual learning environment now, either full-time or on a hybrid schedule.

That being said, I really, truly believe that much of this debate misses the point. Why? Because – even for kids who are in school – they’re not getting their usual experience.

If you are in the real world in any capacity, you know it: Everything is different. Wear your mask. Wash your hands. STAY MORE THAN SIX FEET AWAY FROM ME. And if you are someone who was prone to anxiety, you are nervous every time you go out, because you can, quite literally, contract a deadly disease at any moment.

Okay, fine. Now, take all those fears and all those changes, and apply them to school. What do you get? A recipe for disaster. Take this article from Wisconsin Public Radio that details the struggles of kids in the pandemic. It notes, correctly, that zoom school makes it harder for kids to get the help they need and limits social interactions and the desperately needed personal connections. But, it also notes that in-person school is not a panacea:

With the broad disruption wrought by COVID-19, though, simply bringing students back into classrooms doesn’t resolve their mental health concerns.

In the Lake Mills district, where Kisten [a school psychologist] works, students have been mostly attending school in person since the start of the year.

“There’s a lot of grief right now, but the students don’t really have the right words to express that, or they don’t even know what it is that they’re feeling,” she said.

Other evidence has buttressed this point: Kids’ mental health is suffering regardless of where they are in school.

I don’t want to miss the point: Zoom and electronic learning is a cause for mental illness. There’s no question about it. However, even among those who are in school, things aren’t normal. And this is hurting the mental health of our kids.

The debate about whether or not kids should be in school or virtual misses the point entirely. We should be concentrating on SAFELY getting all of our kids back into school, then providing them with the mental health supports that they need in order to thrive. Even kids who are in school are reporting difficulties right now. Real-life or virtual, they’re in pain.

Four tips on how to cope with Zoomsgiving

Ahh, Thanksgiving, time to…yeah, this sucks. No two ways about it.

Experts have all but begged us to skip traditional Thanksgiving with our families this year, noting that the prospect of massive gathers from people that come from numerous communities is a perfect caldron to allow for (even more) explosive growth of COVID-19. There’s no question that Thanksgiving has the potential to be deadly for hundreds of thousands of Americans, as we’ve seen with every holiday since COVID-19 began.

Need further proof of the danger that Thanksgiving presents to all of us? Just look at what happened in Canada. Canadian Thanksgiving is October 11. Experts there begged Canadians to skip their usual holiday. Many listened. Many did not. The result: Massive spikes.

Okay, fine, you get it. We have to skip our usual Thanksgiving this year and turn another life event digital. God, this sucks. I mean, let’s all be clear about it. This sucks. So, how do you cope? Some thoughts.

First, yeah, we’re all tired of Zoom…but it’s better than nothing. To their infinite credit, Zoom is waving their forty minute limit on free calls in an effort to get people to stay home. Yes, of course this is marketing, but let’s give credit where credit is due, it’s a good move. I’d even go one step further if you are truly worried about Thanksgiving: Get your damn laptop and put the person who is missing in the seat where they would normally be. Want to really sell the illusion to yourself or your kids? Set a place setting. Does it sound silly? Sure. Who gives a damn. We’re eight months into a flipping pandemic. Go to town. Do you. All that matters on this one is that you and your family feel good.

Second, if you’re going to sell the illusion of togetherness, do it. Arrange the Zoom call and make sure your family is eating at the same time. If they are close by, do what my wife is doing: Make a “care package” meal for the family, and have them pick it up (outside, while wearing a mask). Eat at the same time. It’s not the same. Of course, it’s not the same. But again – we’re so blessed when you get right down to it. We have the ability to be together, even if we cannot actually be together. Can you imagine if this happened in 2000? Even 2010?

Third, start a new tradition. What works for you? How can you celebrate without truly being with all of your family? What event can you do together that will make the day more special, even if you aren’t in the same room? I’d add one twist to this: Whatever your new tradition is, be it a game, movie, special walk – make it something expandable. Remember, God willing, this will have passed by next year. What can you do that you can incorporate your family into when we’re all together again next year?

Fourth, practice some self-care – and maybe “us” care. This sucks. Don’t pretend it doesn’t. If you have kids who desperately want to hug Grandma and Grandpa (sigh), let them feel their pain. Don’t tell them nothing is wrong – allow them to express their feelings and their pain. From there, take care of them. Help them work through their pain, and then do something nice together. My wife has introduced our kids to “spa baths” where they get a bath, but with bubbles, candles, and spa music – and then I have to put a damn towel in the drier so they have warm towels…anyway, it’s a nice touch. But do something nice for yourself and your loved ones.

I get it…I really do. We’re all so, so tired. But, again, we’re blessed…there’s light at the end of the tunnel. We have to get through this tough winter, and a better day is likely ahead.

New Study Reveals The Mental Health Impacts Of COVID

Hello, everyone!

First, I apologize. Candidates for political office who try to manage too many aspects of their life wind up losing track of something, and in this case, the blog bit the dust for a bit. That’s my bad. Thankfully, I won reelection by a pretty good margin. I was planning on getting back to this last weekend, and then things went to heck again as I entered another election – this one also with good results!

Anyway, I’m back and hoping to get back to my one blog entry a week schedule.

Wish I had happier things to write about, though.

So, here’s the latest of the COVID-19 chronicles. A new study has revealed some devastating mental health information about the disease: 1 in 5 people who recover from COVID-19 develop a mental illness. This comes from a study that was published in The Lancet, one of the most prestigious medical journals in the world. According to the interpretation of the study:

Survivors of COVID-19 appear to be at increased risk of psychiatric sequelae, and a psychiatric diagnosis might be an independent risk factor for COVID-19. Although preliminary, our findings have implications for clinical services, and prospective cohort studies are warranted.

The study further warns that this does happen even to patients who had no previous diagnosis, with anxiety issues among the most commonly diagnosed issues that came in the aftermath of COVID.

There are a lot of implications from this study. The first may be the most frightening: Does COVID-19 cause long-term mental illness in some biological way? There is preliminary evidence to suggest that there may be long-term health concerns, although more evidence is unquestionably needed before definitive conclusions can be drawn.

Another possibility is something that we’ve spoken about regularly on this blog: The interaction between real life and mental health. Getting COVID-19 must be a terrifying experience. I’ve been lucky enough to avoid it so far, as has everyone in my life who I love, but let’s face it, we’ve all spent months absolutely terrified of the concept. We all hear the horror stories, see the businesses closing, the people retreating into isolation after a potential exposure. To get the disease – particularly if you have a difficult time coping with it or recovering – must be an exceptionally frightening experience.

Then add the socio-economic factors: The isolation from your family and friends. The inability to work and make money – particularly if you are economically insecure – and all the anxiety in the world makes sense.

Oh, and have we mentioned how the mental health system is going to be even more overwhelmed than it already is?

Is the news all bleak? No, of course not. We know it’s coming. We know that we need to spend more time and money on our mental health system. We have the chance to react. And hopefully, our federal and state governments will.

As always, I’d love to hear your thoughts. Any mental health experiences with COVID that you want to share? Let us know in the comments below!

Are suicides increasing during COVID-19?

It was a frequently used argument during the pandemic, one often used against lockdowns: Suicide rates would increase as a result of social isolation, financial hardships, and more limited access to proper medical care. This fear was repeated by medical professionals and medical health care experts. Even Donald Trump repeated the line at one point, arguing that extensive lockdowns would lead to “thousands” of suicides. So great that he and so many others suddenly care about mental health when they spent years defunding services that would prevent suicide and trying to rip health care away from millions, but that’s a completely different story, so let’s move on, let’s move on.

We’re about four months into some of the various lock-downs and quarantines. The question is obvious: What does the data say? Are suicide rates on the rise?

It seems like its too early to tell. We will only be able to more definitively tell the numbers when the annual suicide numbers come out at the beginning of the year, and even then, it will be extremely difficult to determine the cause of the suicide. However, there is some evidence to indicate that things are not as bad as many of us feared they would be – though that could very, very easily change.

First, let’s look at what data is available and what data has been misleading. At the beginning of the pandemic, a doctor said that his California hospital had seen “a year’s worth of suicide attempts” during a four-week period. That report was utterly debunked: Numbers had barely increased at the hospital in question, and locals reported that they believed the local rate had remained stable in the area.

Apparently, calls to some suicide hotlines have increased. Outreach to suicide prevention text lines has increased as well. However, this may not be a bad thing, as it may be a reflection of people turning to the closest support line to get help. Indeed, if these hotlines are working, the increase in calls may be a good thing. Again, unfortunately, there’s no evidence to say one way or the other.

I couldn’t find any hard data discussing whether or not there was any evidence of suicide rate increases in the United States – if someone has that, please correct me. However, I did find evidence that suicide rates have actually dropped 20% in Germany. This is a preliminary finding, so it is likely too early to draw hard conclusions from it.

There is no question that COVID-19 will cause a massive spike in a wide array of social problems, and suicide would certainly seem to be one of these problems. However, as noted by many articles on the subject, it’s more nuanced than simply saying that “The lockdowns led to more deaths.” The pandemic also ripped apart the economy, threw us into a recession, and maybe a depression. There is clear evidence that down economies lead to higher rates of mental illness and suicide. As such, it is difficult to say that lockdowns lead to suicides. It is much more complex than that.

So, what’s the conclusion? There’s no conclusion. Not yet. Time will tell. But, more importantly, policymakers and the community at large must continue to work to mitigate the economic and social impacts of COVID – particularly on the mentally ill. I’m hoping to be able to work on that one over the summer.

COVID-19, Mental Health and Black Lives Matter

Hey, everyone!

First, I apologize. My blog entries have obviously been spotty for the past few months. There is a reason for that: The real world. Simply put, my job as State Representative became too overwhelming. This, along with other responsibilities, made it really difficult for me to blog. I am sorry and I will try to get back into my twice a week habit now.

So, let’s get right to it. Every one of us has been following the murder of George Floyd and the subsequent explosion of the Black Lives Matters movement. If you read my blog, I’m guessing you are at least somewhat progressively orientated. That probably means you are shocked and horrified at the current state of the world, and want to do something to make it better.

As a white man, I can’t sit here and yammer on about what the Black Lives Matter movement means. I represent a district that is about 1/2 minorities and work with dozens of other elected officials who are people of color, and I’ve tried to learn from their experiences to figure out not only how to do my job better, but how to be a better person.

From my perspective, acknowledging those limitations, I’ve come to the conclusion that we scream Black Lives Matter because society has decided for centuries that they don’t. That we scream Black Lives Matter at the top of our lungs because the communities of color have been devastated, destroyed, and degraded for centuries in a way that white people cannot begin to fathom.

To the casual observer, I think it gets too easy to assume that the entire Black Lives Matter movement only revolves around police reform and criminal justice. As best I can tell, that isn’t only the case. Black Lives Matter, at least to me, means that we address all of the systemic inequities in our society. That means addressing countless areas of our public policy, including education, urban planning, economic development, health care access and more.

It also, unquestionably, means mental health. I’ve written on this topic before, but even the briefest of looks at Google shows the enormous disparity facing the minority communities when it comes to mental health. Furthermore, new studies show that that levels of anxiety and depression spiked among the African American population after the murder of George Floyd. As if their burden wasn’t already enough to shoulder.

All this brings me back to COVID. I wrote a line in Redemption that I barely even thought about until a reviewer flagged it: “When civilization collapses, it doesn’t collapse evenly.” COVID has taught us that, hasn’t it? Obviously, civilization isn’t collapsing, but boy has it taken some hits.

And those hits have not been evenly distributed.

Just take a look at how COVID has hit minority communities. The evidence is painfully clear: According to the CDC, minority communities in general – and the African American community specifically – are more likely to contract COVID, be hospitalized as a result of COVID, and die from COVID. This isn’t a result of any genetic challenges. Instead, its a result of systematic discrimination that has resulted in years of poor health care access in general, substandard living conditions and worse health.

When civilization collapses, it won’t collapse evenly.

What’s my point? Pretty obvious. I think most of us agree with the statement that Black Lvies Matter. That means we have to act like it. It means our policy has to reflect those values, and that must be carried out in the way that we discuss all aspects of public policy. Mental health must be part of that equation.

The Long View

Morning, everybody!

As I type this, it is about two months from March 12, or as my wife and I have come to call it, the “before times.” I refer specifically to March 12, because in my mind, that’s the day Corona snapped away from an abstract problem to “Oh, hell, this is bad.” March 12 is the day that my local school district canceled classes after a potential COVID exposure with a teacher. It’s the day my region saw it’s first positive case. It’s the day local private schools began to close. It’s the day I closed my legislative offices. It’s also around the day that Tom Hanks announced he was positive and sports games started getting canceled. That, in my mind, is when everything started to change and become much more real.

So, what’s happened during those two months? Uhh…you know what, never mind. Let’s just not do that. You’ve lived it with me. You know how bad this is.

I’m writing this entry today with a simple goal: To urge you to change your perspective and to take the long view.

In those two months, tens of millions became unemployed. Businesses have collapsed. Large sectors of the economy have been decimated. Millions have been infected. Most of us know someone who was. Many of us lost family members or friends. This has been a nightmare and one that will change the world.

It will pass. All pandemics pass. Everything returns. Not to “normal,” but yes, everything returns.

So, here’s my plea in today’s entry: As best as you can, take the long view.

Whatever you have done in your life, however you have lived, you have unquestionably struggled. You have endured pain you thought would break you, lost people you thought you could never live without. You have undergone trauma, experienced things that were meant to bury you. However much pain you are in, however terrible things seem and whatever darkness you are currently surrounded by, please remember this:

You. Have. Survived.

In moments like this, it can be easy to lose perspective. It can be easy to forget that you have endured periods of your life that were so filled with darkness you never thought you’d recover. Please remember those moments at times like this. Please remember that you have gotten through and that you will again and again.

It’s been going on so long it can be easy to remember, but please: This pandemic will end. All pandemics do. This moment will pass. You will hug your family members again. You will go back to work. This moment will fade into your personal history. It will not be forever.

As best as you are capable during a pandemic, take the long view. Remember that time will ease this.

 

The Importance of Routine – Especially Now

My buddies in Harrisburg constantly make fun of me.

There are many reasons for this: My obvious good looks, my undeniable charm and my searing insight into local politics…okay none of those are true, but this is a tough time, let me pretend, okay?

No, there’s actually one reason in particular that they make fun of me that I wanted to talk about today, and I wanted to touch on it to discuss why it’s even more important, particularly now. My friends in Harrisburg make fun of me because I am an old man. I go to bed early. I HATE being out late. If we’re at a dinner or something, and it goes later than 8pm, I’m cranky.

Why? I have a routine. I like to be back in my hotel room by 8pm or so. I spend the time getting myself set up for the next day. I iron my shirt, load my gym bag. Then I spend an hour or so putzing around on the computer or reading, finishing up Emails. Around 10pm, I take a shower. By 1030, if not earlier, I like to be in bed.

My alarm is set for like 530am the next morning. I wake up, stumble around my hotel, climb into my car and head to the gym in the Capitol building. I work out, starting around 615 or so. Done by 715, shower and dressed by 745, grab breakfast and start my day.

Okay. Why the hell do you care about my evening and morning routine?

I mention it to make a point. I hate being away from my home and my family. Absolutely, positively hate it. That being said, when it comes to Harrisburg, more often than not, I’m in a hotel room at the end of the day. I’m about 90 minutes from home, so if we have a late-night or early morning, its just not worth getting in my car and going home.

So, for a guy with anxiety and depression issues, spending a lot of time away from home and the family that I love can be a challenge, and yes, it can be anxiety-producing. I’m probably in a hotel 50-70 nights a year (well, that will change this year for sure, but that’s another story).

One of the ways I have found to cope with it? I have a routine. And I mean a SET ROUTINE that I absolutely despise breaking and do not do so under virtually any circumstances. This routine absolutely, positively helps keep me grounded and focused. It is unquestionably a way to fight off my anxiety. It also has an added benefit: It keeps me prepared and set for the day in Harrisburg – days which are, incidentally, insanely busy. I frequently liken session days to bouncing around like a pinball.

Anyway, this entry is Corona related. How and why? Well, we’ve been indoors for a month now, and for many of us, we probably still have some time to go. If you are one of the lucky ones who is healthy and well, and able to stay in your home, your normal routine has probably been shot to hell. You’re now working from home, doing things you never thought possible from the comfort of your living room, trying to manage your kids’ education, worry about family and friends, etc.

There is a reason we all have routines. They are comforting and save your body invaluable decision-making energy. I get it – quarantine means we can back off of the things that keep us tied to the normal world, right? Sure, if that’s what you want. But understand that there is going to be quite a bit of anxiety associated with that.

The best thing I can advise? Find a routine, and stick to it. Develop the discipline to find things that keep you healthy and well. Set an alarm and get up at the same time. Dedicate X hours a day to doing Y. Go to bed at the same time. If you are working from home, develop a habit that signifies you’re done with work (change out of jeans and into sweatpants, go for a walk, whatever).

Routines help. And they help even more now at moments where we are cut off from so much that we know and love. Find a routine for yourself, and stick with it. Even now. Especially now.

What Do You Look Forward To?

Like everyone, the Schlossberg family has just had a grand ole time with adjusting to quarantine life. I’ve been legislating from my office, voting on bills from my bedroom, and trying to help desperate individuals try to access government benefits like unemployment. Brenna is trying to adjust to online teaching and constantly worries about her students or whether or not they are safe, eating well and being cared for. The kids are doing better than us, mostly, but Lord knows they miss their friends and their school lives. I’m just grateful they aren’t older and haven’t quite lost the idea that this is just an adventure with the family.

Life is hard. It’s hard for all of us, and you don’t need me to tell you that. And let me acknowledge again, I have it a hell of a lot better than many. Brenna, the kids and I are safe and healthy. We have food. We have shelter and we face no immediate economic thread as a result of this. There are so many people in worse shape than us. I don’t say that to devalue our pain or that of others, but to acknowledge that we have good fortune that others don’t.

But, I want to take a second to share a piece of advice that I have found incredibly useful as the days drag on, and this goes for everyone, no matter what your circumstances or levels of comfort are.

Every day, when the kids go to bed, I have a huge piece of cheesecake. I mean, we’re talking a piece of cheesecake the size of my head. It’s cherry cheesecake and from the Amish Bakery at the Allentown Farmer’s Market. Yes, I’d like several pieces, right now. Cheesecake and a big glass of milk.

Why am I writing about this on a blog about mental health?

I didn’t mean to do it, but at some point, I realized that the cheesecake became something I’d look forward to towards the end of the day. A goal. A point of relaxation. Like many of you, the lines between my work and professional life have always been relatively blurred, but even more so now that my home is also my office. The cheesecake was the ultimate sign of relaxation for me. It became something I’d look forward to. A nightly ritual I could enjoy that marked the end of the day.

At moments I was stressed, anxious or tired, I’d say to myself, “Just keep going. There’s cheesecake at the end of the day.”

This is probably useful for more than just a pandemic, but I have absolutely found that setting a ritual, adhering to that ritual, and enjoying that ritual can be very useful during the more stressful moments of a day. It gives me something to strive to – a little treat. It doesn’t have to be much. It doesn’t have to be cheesecake. But I have absolutely found that giving myself a pleasant reward at the end of a stressful day can make a world of difference.

So, that’s my advice to you. Set a goal. Stick to it. And find what works for you.

Have a wonderful day, everyone. Take care of yourselves and each other!

Remember this is a special moment – and go easy on yourself

Of all the things I’ve said since this stupid thing began – and I’ve said a lot – this is the one that stays with me. It’s something I said to my kids and then got quoted by a reporter. It occurred in the one time I’ve been to Harrisburg since the pandemic began, and that was for changing the House rules to allow for remote voting.

In the article, I was voting from my office and being interviewed by a reporter. I was just musing over the incredible strangeness of the entire situation, and I said:

This is so bizzare. I went for a walk with my kids the other day and I said, ‘I want you kids to remember this because I know it’s strange and scary. But one, we’re going to get through it, and two, your kids and grandkids will ask you what was it like to live through the coronavirus pandemic.’

I had said it to my kids the day before and I meant every word. I was trying to make sure my kids – 8 and 7 – understood the incredible uniqueness of the situation. None of us have ever lived through anything like this before. When we saw a deadly plague in some fiction book, it was quick and brutal. Not…locked in your house.

But, as has been noted by many people smarter than me, this time period is incredibly frightening. Even for those of us who are lucky enough to still be employed, it is stressful and anxiety-inducing. And it’s causing incredible stress and feelings of inadequacy. For example. Common thoughts and fears:

  • I’m stuck in my house – why am feeling so much pressure?
  • How am I going to educate my kids and do my job?
  • What happens if I get sick?
  • I can’t adjust to working this way!

An example? My poor wife (I am sharing this with her permission). She has been very (and understandably) stressed about teaching. She teaches in my local school district and switching the way you teach – in a time-pressure way, when you haven’t been trained until a few weeks ago – is awful. She is nervous about doing a good job and reaching her students appropriately.

I have said to her the same thing I’ll now say to all of you: You do the best you can. I have lost tons of sleep worrying about family, friends, and constituents. We all have. I think the best thing we can do is acknowledge that this is a special moment. Are our kids going to be okay? Yeah, most likely, they will. Will they be behind in school? I mean, compared to where they would have been in a world where some guy didn’t interact with a bat or something, yes. But compared to other kids? Probably not! And even if they are: That’s okay!

People. This is a literal plague. It is a life-taking, economy-wrecking, socially-life-destroying plague. You don’t have to write the next great American novel. You don’t have to start a new instrument, clean your house from top to bottom or personally reshingle your roof. You can just get through it, and that’s more than enough.

Acknowledge that this is a specially painful moment. And don’t judge yourself too harshly.