By Jan Cheek, MSW, LCSW
One of the only things that has been certain during this time of uncertainty as we face the Coronavirus pandemic is that all people experience anxiety to some degree. Not all anxiety is bad and some anxiety is normal in times of uncertainty. The good thing about normal anxiety is that it creates and promotes adaptive, preventive, and cautionary behaviors which in turn often reduces excessive stress and anxiety which can sometimes become destructive and debilitating.
Anxiety is our body’s natural response to stress. Symptoms of anxiety include feeling nervous and restless, worrying, body tension, a sense of impending danger, dread, and doom, increased heart rate, hyperventilation, excessive sweating, trembling and tremors, weakness, fatigue, poor concentration, obsessing on worries, irritability, and agitation. Some anxiety helps us cope, but excessive anxiety creates panic states and suffering, obsession; we make mistakes, make poor decisions, “stress out” ourselves and those around us.
Normal anxiety is a reaction to events and situations in our lives that require us to be alerted that we may need to be prepared to take action; the well known “fight, flight, or freeze” responses. Most normal anxiety allows us to adapt effectively to an impending situation appropriately, managing the associated stress and required concerns, and anxiety symptoms do not become intrusive or create impairment.
People with Anxiety Disorders often catastrophize and become overwhelmed with spiraling worry of dread and worst-case scenarios. The Disorders of Anxiety primarily recognized according to the DSM-5 are Generalized Anxiety Disorder, Panic Disorder, Social Phobia – Social Anxiety Disorder, Separation Anxiety Disorder; and other closely related Disorders of Anxiety in the DSM-5 include Obsessive Compulsive Disorder, Acute Stress Disorder, and Post Traumatic Stress Disorder. Anxiety becomes a “Disorder” when it creates impairment and intrusion to daily functioning, and rather than becoming a natural adaptive response to stress, anxiety becomes an intolerance of uncertainty in times of uncertainty — and even in the absence of uncertainty.
People who suffer from chronic and acute anxiety and intense worry truly suffer and worry even when they know their intense worry is increasing their own suffering. They perceive that it is a vicious cycle that is challenging to break without intervention. During this time that we are all experiencing the uncertainty of the COVID-19 pandemic, I have heard some anxiety sufferers exclaim that now some people worrying about the unknowns of the virus are starting to understand just how true anxiety sufferers feel on a regular basis and it has become validating to them. The difference is that people with the predisposition for an anxiety disorder may develop very impairing symptoms, while others may experience uncomfortable, but adaptive symptoms and it may never escalate to the level of a pervasive disorder.
Typical worry thoughts during this time might be: What if I cannot pay my bills? What if I get sick? What if someone I love gets sick? What if I cannot manage my kids all day? What if I cannot manage at home schooling and working from home? What if I end up in the hospital like those people on television? What if I never see my friends again? Who will take care of my kids if I die? What will I do If I cannot get food?
Worry thoughts are normal, but they are not helpful to dwell on. It may be helpful to simply write them down to release them from the looping in your brain. Write down a possible solution. It does not have to be a perfect solution, simply a possibility to answer the question. To reduce anxiety and worry, it is best during this time to stay informed by reliable and trustworthy sources, but to limit how often you check for coronavirus updates. Focus on the things you can control instead of things you cannot control. It is NOT in your control how long the pandemic will last and how other people are behaving. You can control, however, whether you wash your hands frequently and effectively and manage your own risks, and whether you touch your own face, whether you follow the guidelines of social distancing, and get enough rest, and avoid crowds.
Even with social distancing, anxiety can be reduced, by staying socially connected. Stay in touch with people through regular phone calls, texting and messaging, and video chatting. These methods can ease anxiety and reduce moodiness and depression during these times of potential loneliness, allowing us to still feel connected to our families and friends. Do not allow the coronavirus be the focus of all conversations. Be kind to yourself and to others as ways to manage stress and anxiety. Maintain a routine for yourself and your family. Take time for enjoyable activities such as reading, crafts, movies at home, exercise, cooking, gardening, and spending time with pets, our furry family members.
Getting fresh air and being active outdoors relieves anxiety and improves mood. Avoid self-medicating during times of uncertainty with alcohol and other substances. Alcohol use and use of other drugs and vices typically create other negative outcomes rather than the desired problem solving. Use coping strategies that you have already learned that have been helpful in other challenging times during this time we are facing trials with the coronavirus. If you are a parent, talk with your kids, answering their questions in an age appropriate way, reassuring their safety. Let kids know that it is okay to be confused and upset about the changes; but as the parent, demonstrate solid ways to cope, limit exposure to the news, and establish regular routines that create predictability and security for your family.
If you or anyone you know is concerned that you may be experiencing anxiety that is not adaptive or any other mental health or substance use concern, Behavioral Healthcare Associates, LLC has several experienced independently licensed therapists and a double boarded (child-adolescent and general) psychiatrist available to evaluate and treat mental health and substance use issues. During this time of COVID-19, we are providing telehealth services. Please call our office for more information or to set up an appointment 919-292-1464 or check out our website to gather additional info