February 25, 2020

How to Deal with Anxiety in the Wake of the Coronavirus

A few months ago, the term Coronavirus might have been a pithy description for the hangover resulting from over-consumption of a certain Mexican beer. Now it is an illness of mounting virulence, turning markets upside down at each report of new cases and sparking fears of quarantine, contagion, and mass infection. No surprise, then, that anxiety, too—so often comorbid with global crises of any sort—is also on the rise.

graphic for how to deal with anxiety in the wake of the coronavirus

To a certain extent, anxiety is justified. We don’t know (at the time of this writing) the exact parameters of this disease, and the fact that it has just jumped species is certainly a reasonable basis for concern. With this in mind, what can you do to protect yourself? Wash your hands. Stay home when you are sick. Disinfect household surfaces. Maybe even wear one of those funny-looking surgical face-masks.

But beyond reasonable self-care measures, there is very little that most of us (non-epidemiologists) can actually do. So when our worrying escalates to the point that we are now consumed with thoughts and fears about Coronavirus, we need to take action before we are debilitated not by the disease we fear but, paradoxically, by fear itself. For this, we turn to the evidence-based method known as Cognitive Behavioral Therapy (CBT), through which we examine (1) fearful beliefs underlying the anxiety, (2) avoidance behaviors through which we attempt to escape our anxiety, and (3) the physical aspects of anxiety.

Fearful Beliefs

When we feel anxious, we can tend to catastrophize, imagining that everything in the world is going wrong and that there is no hope in an unpredictable, dangerous, menacing future. With practice, these chaotic beliefs can be recognized for what they are: not critical truths but, rather, heightened emotions masquerading as thoughts. Once these beliefs are identified, change is possible.

Avoidance Behaviors

When our anxiety takes us to unmanageable peaks, many of us choose to simply jump off the cliff—into the apparent safety of avoidance. But as appealing as it may be to start binge-drinking in earnest or to develop an online gambling habit, you will not have solved the world Coronavirus crisis. Instead, you will have added a drinking or gambling problem to your list of (very real) concerns. For this reason, avoidance should be replaced with behaviors that improve our ability to respond to—not escape from—challenging situations.

Physical Symptoms

The body in a state of anxiety is a very uncomfortable place to be. Muscles tense, heart rates spike, and breathing thins. These evolutionary responses emulate our response to physical threats, like being chased by a bear or falling out of a tree. Unfortunately, nothing about this state of arousal is useful in responding to psychological threats. It follows that we must train ourselves to relax our bodies as an important component of managing our anxiety.

Here are some practical tips for addressing the cognitive, avoidant, and physical components of and responses to anxiety.

  • Get all your fears out on paper, without censoring or editing anything. Don’t worry about how ridiculous or overblown they may seem. Then make an appointment to go over them later in lieu of revising them over and over in your mind. That is to say, you are stopping the runaway train of perseveration and telling yourself that you will absolutely make time for all these worries—later. They just can’t occupy your mind all day.
  • Question yourself. Instead of trying to tell yourself that your worries are unfounded or ridiculous, try asking yourself specific questions about the likelihood of your predictions. For example, if you fear that the Coronavirus will spread to your hometown and that you will contract the Coronavirus, take the time to evaluate that possibility. Keep in mind the global population (7.7 billion) and the current reach of the virus (a dozen countries, 80,000 confirmed cases at the time of this writing), and you can calculate. Next, ask yourself what the worst possible outcome is, and what you can do to prevent this from happening. Strange as it is to say, it can be freeing to write the answer to that first question—which is, of course, infection and, perhaps, death. OK, so we’ve faced the monster in the closet. Which brings us to our next tool—
  • In some ways this resembles redirection, a tool we use with children. But when managing the fearful child inside of us, this tool is no less powerful. Turn on Monty Python and the Holy Grail and chuckle at the humorous depiction of an undeniably virulent historical pandemic: the Black Plague. Search for SNL sketches about previous health scares, like Anthrax, H1N1, and even AIDS. The human capacity to laugh at horrible things is one of our more interesting protective mechanisms. It speaks to our resilience and shows us that nothing is so serious that it cannot be a source of comedy.
  • Diaphragmatic breathing—otherwise known as Ujjayi or “ocean breath”—is a powerful tool to calm us in stressful circumstances. Breathe into your belly while keeping your shoulders relaxed, and let your abdomen expand as you inhale. Your limbic system will almost immediately respond by filling your body with calm. Even a few minutes of this respiratory reset button can do wonders.
  • Get out and move your body. Research has shown that just 20 minutes of enjoyable physical activity can produce the endorphins and other feel-good chemicals to dramatically improve even the lowest of moods.
  • Get help. If none of these techniques affords you adequate relief and you feel yourself spiraling deeper into anxiety, don’t be afraid to reach out for help. Talk to a friend, family member, spiritual advisor, or mental-health practitioner to make sure you get the support you need.

Remember: it isn’t our external circumstance that determines how OK we are. We always get to be the final arbiters of our own outcomes. With a few tweaks to our thoughts and responses in the face of anxiety, we can endeavor to enjoy the lives we have been blessed with—Coronavirus or not.

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