How Nurse Practitioners Can Combat the Sunday Scaries
A nurse practitioner expert speaks about normalizing anxiety and how to help patients make healthier choices for a better Monday.
In his letter of introduction to the 2024 AANP Practice Report, the American Association of Nurse Practitioners® (AANP) CEO Jon Fanning, MS, CAE, CNED, highlighted a few of the major findings by AANP’s researchers, including: “The three most commonly treated conditions by NPs are anxiety (64.5%), hypertension (64.0%) and pain (63.6%).” According to the World Health Organization, Hypertension is “a major cause of premature death worldwide”, so it may come as a surprise to learn that more patients come to their nurse practitioner (NP) to speak about anxiety than high blood pressure. Unlike hypertension, anxiety is a mental disorder that can feel awful but is treatable and not physically dangerous. As succinctly put in an article on the Anxiety & Depression Society of America’s website: “Anxiety Won’t Kill You.” Yet, for the 19.1% of Americans who report having an anxiety disorder, symptoms can range from the simply frustrating to deeply debilitating.
While not an expression of the most troubling kind of anxiety, what is referred to as the “Sunday Scaries” exhibits the framework that structures the classic form of this illness. On a recent episode of NP Pulse: The Voice of the Nurse Practitioner®, guest Shonda Phelon, DNP, FNP-BC, GNP-BC, APMHNP-BC, remembers that she first heard of the term “Sunday Scaries” used by her daughter to describe anxiety about the coming workweek. “If we have activities on Sunday afternoon, it prolongs the weekend. The Sunday Scaries don't set in,” the daughter explained to her mother as to why the family was opting into a later church time than the typical a.m. service. That got Phelon thinking more about this expression of anxiety and how to counter it as an NP. Read on to learn takeaways from her presentation on Sunday Scaries at the 2024 AANP National Conference and how she approaches anxiety when she treats her patients.
Guided Steps to Relax and Focus
One of Phelon’s recommendations for helping her patients deal with anxiety is to begin by destigmatizing the disorder. “The first thing I like to do is normalize anxiety,” she says. By doing so, her patients “feel like, okay — this is what happens to me, and I can manage it.” Other management strategies include intentionally making an effort to relax by listening to calming music and taking deep breaths, and active measures like exercise. Phelon’s approach to exercise begins by meeting the patient where they are. “I really try to focus on, ‘What do you like to do?’ So, if they say, ‘I like to shoot basketball,’ well, get out and dribble the basketball and shoot it. Or, you know, ‘I like to ride my bike.’ Well, bike ride this many times a week.”
Phelon notes how important it is to encourage positive behaviors in patients. “I've actually written prescriptions for going to the gym three times a week...with any positive behavior, I think all the studies have shown that the more we — as the health care provider they choose — are recommending it, the more likely it is to happen. It may not happen on that first visit, but if we keep hammering away, eventually it will come through.”
When reflecting on her own daughter’s experience with the “Sunday Scaries,” Phelon notes that “Anxiety is the most common mental health disorder, and it's really rampant in the younger population — adolescents, young adults, the twenty-somethings. If you think about it, they've grown up in a really bad way.” In addition to the trauma of living through the pandemic and an unstable global era, younger people see the world in a vastly different way, thanks to social media and technology, than previous generations.
Of course, just criticizing social media and the availability of cell phones does not solve any problems. Instead, Phelon urges NPs to put into practice what they preach regarding staying focused and away from spending an unnecessary amount of time on phones. “I think we have to model that behavior to our kids and young adults. Even as a college instructor, we find ourselves carrying that phone with us, and then we wonder why they [the students] have it on their desk and they're picking it up while we're lecturing [...] we've got to model better behavior, I think.”
More Mental Health Resources
AANP has more information on psychology for NPs at all practice levels, from NPs considering specializing in mental health to NPs already working in this specialty who may benefit from clinical resources including practice briefs, handouts and more. Finally, the AANP Psych and Mental Health Community is open to all AANP members either practicing or just interested in the specialty. Annual dues are only $20 annually, and offers members access to a cutting-edge, online forum where NPs exchange knowledge and engage in discussions.