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COVID-19 Anxiety

At the beginning of the COVID-19 pandemic, I experienced something totally new and not at all pleasant: what turned out to be panic attacks. The kind that made me feel like I was going to pass out. Several times a day — plus sometimes in the middle of the night — my heart and mind raced. I felt breathless, shaky, and confused. A couple times it felt like I could die (I couldn’t).

I know I wasn’t alone. Several studies (like this one) show that anxiety levels are through the roof, impacting many people who have never experienced issues like this in the past and exacerbating symptoms for those who already have mental health disorders. In a report called “COVID-19 and the Public Mental Health System” by the New York State Office of Mental Health, more than 6,000 people who participate in or receive mental health services and/or their family members were surveyed earlier this year. About 70 percent reported some increase in anxiety, stress, or symptoms.

People with chronic illnesses may be especially prone to anxiety. Research shows that anxiety and depression are common in conditions like arthritis — I have rheumatoid arthritis — to begin with. And this year, those of us with underlying health issues have had a lot to worry about. Many of us have been isolating more strictly than others. We’ve had concerns about how our medications and health conditions affect our risk for COVID-19.

I could keep going, but the truth is I honestly don’t know anyone who hasn’t expressed any feelings of uneasiness these days. (Maybe a couple mask-less jerks?) Anxiety comes in all shapes, sizes, and severities but it definitely seems ubiquitous during the coronavirus crisis.

“People are understandably anxious. People are dying and having economic woes,” says Katie Willard Virant, LCSW, a psychotherapist in St. Louis and author of the Psychology Today blog Chronically Me: The Emotional Landscape of Chronic Illness. “The uncertainty of the pandemic itself and the boredom are preying on all of us.”

There is some good news to report about the anxiety we’re collectively feeling. First of all, Willard Virant reports, “it’s not unhealthy to have a bit of anxiety. Anxiety is a protective measure by our body to say, ‘Hey, we’re in danger.’”

It alerts to feeling that something isn’t quite right, which can actually help us pinpoint what’s worrying us and try to address it.

Second of all, experts are certain that most of us will get through it. “Humans are quite resilient,” Roxane Cohen Silver, PhD, a Professor of Psychological Science, Medicine, and Public Health at the University of California, Irvine, remarked during a panel discussion about mental health and COVID-19 earlier this year.

Third of all, I believe her. Nine months after I first started experiencing my panic attacks, I haven’t keeled over yet. I still have crippling anxiety sometimes but over time I have learned how to manage it better. Here are the tweaks I’ve made in my life to help alleviate my anxiety:

1. I stopped putting myself in anxiety-producing situations

This will obviously be different for everyone but for me, for example, I noticed that my body started vibrating with fear the minute I got in the car to go to the grocery store. Personally, I just don’t feel safe there, especially after reading in my local paper that in my  county in California, grocery stores are one of the biggest hotspots for contracting COVID.

Makes sense to me. There are people everywhere roaming around, touching everything, plus, I’ve had one too many screaming matches with maskless marauders. So, instead of having a breakdown every time I needed milk, I simply stopped going inside grocery stores. Now I do contactless pickup in the parking lot through the store’s app. Sure, sometimes they accidentally give me a small jar of mayonnaise instead of the industrial vat I requested, but I’ll live. Literally.

Walking my dogs was another activity that was giving me major agita, which sucked because leaving my house and walking around outside has become one of the only enjoyable parts of my day. But maskless dummies kept coming up to pet my dogs. I get it, they’re adorable, but get the *$!# away from me!

When I dared to put my hand up to stop one lady, she got mad. Now whenever she sees me, she gives me royal stink eye. To make sure I’m the most hated person in my neighborhood, I currently make myself totally unapproachable in dark sunglasses and a black mask, even after the sun goes down. Nobody comes up to me anymore, probably because they think I have COVID or I’m Jeffrey Dahmer. And that’s fine with me. I don’t dread walking my dogs anymore, other than running into a wily coyote here and there.

Willard Virant agrees with my approach (though maybe not the part where I dress up like the Unabomber or one of Michael Jackson’s children). “It’s a good strategy to think ahead. What are going to be the things will trip off my anxiety alarm and how do I avoid certain things that feel too risky to me?”

2. I reason with myself

We’ve all done that thing when we get a slight sniffle, ache, or pain, and we think we have COVID and totally freak out. “We have a hyper awareness of our bodies right now,” Willard Virant confirms.

After nine months of this, I’m finally figuring out truths about my body I never knew before and because of that knowledge, I’ve stopped overreacting. Like when I get a sore throat, I say to myself, hey, guess what, who knew, turns out you have a lot of post-nasal drip, and that’s why your throat tickles a little. Or since I discovered that my panic attacks don’t last forever (only about 20 minutes) I remind myself to be patient because it is a fact that it will end. That gives me comfort.

Through practice, I also obtained the ability to calmly think through and analyze what was happening in my body, instead of knee-jerk going to the worst diagnosis possible. So, now, let’s say I have that tickle in my throat. I Wonder Twin Powers Activate myself into a lawyer, then lay out my case and present evidence to myself.

“When was the last time you went anywhere without a mask on?”

I haven’t.

“Who do you think could have given this to you?”

Nobody.

“In what situation have you been exposed to anyone or anything with COVID?”

None.

“YOU CAN’T HANDLE THE TRUTH!”

I don’t say that actually. I’ve just always wanted to. Anyway, through my cross examination of myself, it’s clear that the possibility of me having COVID is slim to nil. Again, that allays my fears.

“Anxiety is a signal emotion,” Willard Virant explains. “When you do what you described, laying out the evidence, you’re saying, ‘Hi, signal. I heard you. And here’s the evidence and it’s going to be okay.’ You stop flashing the light.”

Anxiety comes from our limbic/emotional brain, Willard Virant adds. Your neocortex, your higher brain, talks back and says, ‘Okay, thanks for the warning, but it’s okay. We are safe.’ That’s a great skill to keep practicing. The more you do that, the quicker and more effective your brain gets at doing that.”

3. I do breathing exercises

I have relied so much on the Calm and Breathing apps since the pandemic began. They’ve been absolute lifesavers. Don’t discount them as kooky hippie “ohm-ing” devices. Their meditations and proper inhaling and exhaling techniques are proven to tamp down anxiety, slow the heart rate, and positively stimulate the nervous system. According research in Harvard Business Review, simply “breathing in for a count of four and out for a count of eight for just a few minutes can start to calm your nervous system.”

Both Yale and University of Arizona have done recent studies that show that breathing can have an immediate positive impact on stress, mood, and conscientiousness. “When we are in a highly stressed state, our prefrontal cortex — the part of our brain responsible for rational thinking — is impaired, so logic seldom helps to regain control,” an article about the research in Harvard Business Review concludes. “This can make it hard to think straight or be emotionally intelligent … but with breathing techniques, it is possible to gain some mastery over your mind.”

4. I stay present as much as possible

When you’re in the middle of an anxiety attack you are the opposite of present. “You’re not in the moment because you’re doing ‘what-ifs’ and freaking out about the future,” says Willard Virant.

There are two things that help me when this happens.

During the day, I go outside on my patio for some fresh air to stimulate three of my senses again — sight, smell, and sound — and that brings me immediately into the present. Not to mention the obvious, it’s good for you to be in nature. A recent study in the journal Ecological Applications concluded that “a regular dose of nature can contribute to the improvement of a wide range of mental health outcomes” during the pandemic.

At night, if my mind wanders frantically in bed, I play a brain-teasing game like backgammon or chess on my phone. I find it helps me concentrate/focus and not spin out in a million directions, even though I’m so bad at chess and refuse to take lessons and lose a lot. Some people like video games, but they numb me out into a zombie. But to each their own.

5. I perform acts of kindness

Anxiety naturally makes you obsess about yourself. So, if I do a nice deed for someone else, it puts the internal dialogue loop about my own issues on hold. I recently cleaned out all of my cupboards and donated everything I could to a local food bank. On Thanksgiving, even though my mom (who I live with) and I were alone for the first time ever for the holiday, I knew that some of her widow friends were also lonely and isolated because of quarantine and wouldn’t make a big turkey-and-stuffing dinner just for themselves. So we bought a huge turkey and delivered plates of food to them.

“Getting out of your own head can help manage anxiety,” Willard Virant confirms. “Everybody is suffering, not just you. To do an act of kindness, to reach out to someone else, is to embrace that common humanity and maybe take away some of the loneliness and anxiety. Realizing we’re all human together helps.”

6. I listen to religious music

I’m not religious. At all. I’ve rarely been to a church or synagogue, other than for weddings and bar/bat mitzvahs, and I know nada zip zilch about the Bible or Torah. And yet, during the pandemic, I stumbled on an incredible, uplifting Dolly Parton duet called “There Was Jesus.” I was so blown away by it, it inspired me to download even more spiritual music. Now, when I’m feeling anxious, I jump in the car, roll down the windows, and belt out tunes about Him or Buddha or Burning Bushes at the top of my lungs.

I think I’m gravitating toward these religious songs because they’re hopeful. Also, there are so many beautiful powerful voices in gospel music, during a time when we all feel alone, weakened, and isolated.

Willard Virant believes my religious awakening may have a higher purpose. Surrounded by death and sadness 24/7, she thinks maybe I’m searching for the meaning of life. “I think it’s certainly caused all of us to think about that.”

I’m not sure — it’s an excellent point — but I do know that it has helped me find peace during the roughest times we’ve had in 2020.

7. I limit news, phone time, and Zoom

This seems like a no-brainer but it’s worth reminding ourselves that research shows how damaging doom-scrolling is for our mental health. People who spent more time checking the news at the peak of the pandemic in Singapore had a higher risk of feeling depressed, anxious, and stressed, a study showed.

“Media consumption is almost like food consumption,” Willard Virant explains. “We’re careful about what we put into our bodies because we know it affects us, and we should be as careful about what we put into our minds. It certainly can affect us as much as food affects our bodies.”

To keep the anxiety at bay, I refused to Zoom anymore, unless it’s for work. I cleansed my Facebook contacts. I hid anyone who was stressing me out for any reason, whether it was politics or posting pics of group gatherings. My TV watching habits have become as sunny as a California day in June. I watch Friends and Parks and Rec reruns and family-friendly specials like The Rockettes Christmas Spectacular instead of the carnival barkers on cable news.

I avoid shows that contain death and murder, especially against women (The Undoing was the final straw, plus I’m okay not watching Big Sky cuz I really don’t find women being abducted and trapped in a barn for sex slavery entertainment anyway.) Give me a good old Beat Bobby Flay marathon on the Food Network and I’m content and calm.

These are the ways I’ve found can help alleviate anxiety for me. If things like this don’t work for you, or your anxiety is truly interfering with your life and you can’t sleep or function day to day, seek help from a professional — and don’t wait. Willard Virant suggests checking out Psychology Today’s Find a Therapist database. Plug in your zip code and you’ll get a list of mental health professionals in your area, including a bio.

“When anxiety takes over and is all consuming, we run into trouble,” Willard Virant says. “The good news is that anxiety is really treatable. There’s no need to suffer.”

Get Mental Health Support

We understand how difficult it can be to cope during these uncertain times, especially when you are living with chronic illness. It is important to talk to someone who can help. You should contact your primary care physician or your insurance provider to learn about the supportive resources that are available to you. Here are other mental health resources for your reference:

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COVID-19 and the Public Mental Health System. New York State Office of Mental Health. December 8, 2020. https://omh.ny.gov/omhweb/planning/507/omh-statewide-town-hall-2020.pdf.

Interview with Katie Willard Virant, LCSW, a psychotherapist in St. Louis and author of the Psychology Todayblog Chronically Me: The Emotional Landscape of Chronic Illness

Pan KY, et al. The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-control cohorts. The Lancet Psychiatry. December 8, 2020. doi: https://doi.org/10.1016/S2215-0366(20)30491-0.

Seppälä E, et al. Research: Why Breathing Is So Effective at Reducing Stress. Harvard Business Review. September 29, 2020. https://hbr.org/2020/09/research-why-breathing-is-so-effective-at-reducing-stress.

Social Isolation, Mental Health, and COVID-19. SciLine. March 30, 2020. https://www.sciline.org/media-briefings-blog/social-mental-covid.

Soga M, et al. The room with a green view: the importance of nearby nature for mental health during the COVID-19 pandemic. Ecological Applications. November 17, 2020. doi: https://doi.org/10.1002/eap.2248.

Teng A. Obsession with Covid-19 news linked to higher risk of anxiety: Study. December 17, 2020. https://www.straitstimes.com/singapore/parenting-education/obsession-with-covid-19-news-linked-to-higher-risk-of-anxiety-study.

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