anxiety

 

The uncertainty and general threat surrounding coronavirus are causing anxiety and fear. I’d like to share with you some information about and strategies for dealing with these primal emotions.

First, it will be helpful if we define and differentiate between anxiety and fear. Anxiety is future-oriented thinking based on imagined worst-case scenarios (“What if” thinking, also known as catastrophic thinking or “future-tripping”). Fear is worry about a situation that is happening in the here and now and for which there is evidence.

The human brain is an amazing organ that has helped us survive and evolve for millions of years. Our brains have an amazing ability to anticipate and avoid or reduce the impact of future dangers based on past and current circumstances. When the anticipatory processes of the brain match the severity of threat and danger, this is a helpful, adaptive feature. However, when there is a lot of uncertainty about a novel situation, and a lack of data to assess the actual danger level (as is the situation we are all in with the coronavirus) the brain will still try to evaluate the potential threat in an attempt to avoid a negative outcome.

Without enough information to go on, the brain fills in the blanks, which can create on one extreme unhelpful and irrational anxiety, hysteria, and panic. On the other extreme, we can ignore facts and real threats that are supported by evidence, leading to potentially risky and harmful choices that could put oneself or others at risk. Ideally, we want to be somewhere in the middle, thinking that is based on evidence, data and reality while doing what we can to keep ourselves and others safe.

Here is an example of the difference:

Anxiety: “What if we don’t go back to work and I end up homeless and living on the streets”

Fear: “This is scary to not know when we will be able to go back to work.”

Living in a state of anxiety releases stress hormones like cortisol and adrenaline, and when these are flowing our immune system’s effectiveness is reduced. When our body senses a threat it de-prioritizes fighting off infections. So remaining anxious increases your risk of getting sick and staying sick for longer. Once we have stress hormones flowing in our body, with increased heart rate and anxious chest breathing, this gives our brain feedback that there is an actual threat so our mind will start to race and look for more threats. If there are no immediate threats, our brain will then look for future threats and more “what if” thinking will happen, which will release more stress hormones. This creates an anxiety feedback loop. When in this state, the part of our brain that makes rational decisions and problem solves is no longer working, so we are more likely to make decisions that are rash, defensive, attacking, and unhelpful. If you are able to think fear thoughts (realistic and rational thoughts based on evidence) rather than anxious thoughts, then it is easier to do the next step of acceptance, letting go, and refocusing on what is in your control.

Let’s explore more of what CAN be done:

1. Practice compassion and validation for yourself and others: validate yourself and others that this really is a scary time of uncertainty. There are a lot of unknowns and that can be scary. Validation can help reduce anxiety in yourself and others as long as it stays with validating emotions, events, situations that there is evidence for, and not made up scenarios.

2. Radical Acceptance: this is the concept of radically accepting things as they are rather than wishing they were different. Much of human suffering comes from wishing things are different than they are. We can generate internal peace by accepting things that are out of our control, and refocusing on what is IN our control. Try writing on the left side of a piece of paper “IN my control” and on the right side “OUT of my control” and create a list related to your current worries. Your behaviors, reactions, and thoughts are in your control, and other peoples’ behaviors, thoughts, emotions, reactions, the news, and all events outside of you are out of your control. For all the things that are out of our control, we want to practice radical acceptance. When anxious ask yourself, is this in my control or out of my control? Re-focus your mental and physical energy to the things you can control. For those things that are out of our control, radical acceptance looks like acknowledging the situation without judging the situation or criticizing yourself or others. Radical acceptance might sound like “It’s no use fighting the past,” “The future is out of my control and worrying about it won’t change the outcome and is a waste of time and energy,” or “It’s frustrating that I have to work from home, but I accept that is how it has to be right now to keep myself and others safe.”

3. Practice relaxation and mindfulness strategies: future tripping leads to anxiety.
Instead focus on the here and now. One way to get in touch with and pay attention to the present is to connect with your 5 senses. You can also practice calm belly breathing techniques and guided relaxations or meditations. I suggest using youtube and typing in “guided calm breathing” and “guided relaxation.” Use this time to improve your relaxation and mindfulness skills.

4. Exercise. You might not be able to do your usual activities like going to classes, the gym, or the ski hill, but you can go for walks or do at home exercises. An example of at home exercise is Fiton which is a free exercise app you can do from home with no equipment and you can connect with your friends to share your workouts.

5. Challenge irrational, unhelpful “what if” thinking (called catastrophic thinking or future tripping) to come up with more helpful, rational thinking. Ask yourself, What is the evidence for this?, What is the actual chance of this happening?, What might be the best case scenario?, Will any amount of worry change the outcome?, and What would I tell a friend to make them feel better if they said this to me?

6. Acknowledge and label anxiety as it comes up as a fear of uncertainty, not reality. You can even thank your brain for doing its job of trying to protect you, and let it know you got this and it’s going to be ok. Even if you don’t know that, remember that thinking calming thoughts increases your immune system functioning and your decision making skills, so it’s worth practicing.

7. Practice gratitude. Neurons that fire together wire together, so our habitual thinking
creates pathways that our brain will unconsciously repeat. If we focus on appreciating
what we have in the here and now, we can start to create positive thinking pathways that lead to less stress and more physical and emotional health and happiness. You can start a gratitude journal where each evening you write down 3 things that happened that you are grateful for and WHY you are grateful for them (this last part is essential to get the full neurochemical benefits of a gratitude journal).

8. Avoid/limit the news. If we watch and focus on negative things, we will wire our brain towards negativity. Most news is exaggerated and full of invalid information with the goal of getting viewers hooked. You can have a supportive friend tell you if something major happens instead, or give yourself 5-10 minutes a day to check in on the status of things.

9. Take advantage of the gift of time. (If you’re lucky enough to have it.) We often complain about not having enough time to work on self care, self reflection, reading, continuing education. Use this gift of time to take an online course, read that book you’ve been meaning to read, or start planning a vacation.

10. Stay connected with friends and family. Use technology to stay connected during this time, and maybe teach someone who needs these tools how to use them!

11. Engage in counseling. If you feel you need support from a licensed professional therapist with anxiety, depression, stress, or relationship problems that are arising or exacerbated during this difficult time, we offer tele-therapy and online counseling services, using highly effective evidence-based practices such as CBT, DBT, Solution-Focused Therapy and The Gottman Method Couples Therapy.