In the past few weeks, government agencies and news outlets have discussed the emergence of the COVID 19 Coronavirus. Currently, San Francisco is placed under a “shelter in place” order. Understandably, this pandemic is a source of anxiety, perhaps fear.
The cancellation of major events, closed borders, and stories from hospitals in affected countries only serve to heighten this anxiety. At Good Therapy SF, many of our clients are working from home to promote social distancing and reduce the risk of contamination.
The gravity of COVID 19 forces us to reassess what we thought was possible, and work to accept a new reality. Anxiety is a natural part of this acceptance process. However, it does not have to be unmanageable. There are various effective methods for managing anxiety during this time..
Understanding the three parts of anxiety, focusing on what you can control, and deconstructing anxiety thoughts all help in making anxiety more manageable.
Behaviors, Thoughts, and Physical Symptoms make up the three parts of anxiety. Any one of these three parts can be triggered, and this will begin the anxiety process.
Each part of anxiety has its own pattern. When we are anxious, our behaviors will focus on avoidance. When we have anxiety thoughts, they will focus on the worst case scenario. When we feel physical symptoms, they will be interpreted as overly dangerous.
For example, think of someone that is panicking over the recent news of COVID 19. They are likely afraid to leave their home (avoidance), thinking that the world is going to end (worst case scenario), and are overly worried that their increase in heart rate is going to cause a heart attack (physical symptom interpreted as dangerous).
Interestingly, just knowing the patterns of the three parts of anxiety in and of itself helps to reduce symptoms. This is because the brain is malleable, and having this information helps to “rewire” our brains. A study on Stanford and Yale law students, as well as a meta-analysis with surgical patients helps to illustrate this effect.
Further, knowing the three parts of anxiety helps provide a useful road map to reduce these symptoms. This road map is what Cognitive Behavioral Therapists will follow when treating someone with anxiety.
Anxiety creates a sense of being out of control. Many individuals in the Bay Area are successful because they have found methods to create a sense of control. In many ways, control is a coping skill. There are routines, both mental and physical, that people follow to provide peace of mind. When these routines are interrupted, stress and anxiety are an expected outcome.
Reminding yourself of what is routined, or still stable in your life can help reignite this coping mechanism. Some examples could include:
Maintaining a regular sleep schedule – sleep is foundational for anxiety management. Even if you work from home, go to bed and wake up at the same times every day.
Eating nutritious foods.
Limiting caffeine intake.
Engage in some type of movement or exercise at the same time every day.
Only checking news updates once or twice a day – never at night.
Staying in contact with friends and family – discuss topics other than Coronavirus and limit conversation with people that are triggering.
Meditation or journaling.
Allow yourself to be distracted with something fun, such as a podcast or game.
Do something helpful for someone else.
During panic moments, remind yourself you only need to focus on your part of the world. Many people become anxious worrying about what is happening in a country where they have no control over the outcomes.
Remember that some anxiety is expected and normal for the situation – labeling emotions helps to “tame” them.
All anxious thoughts follow the same two part pattern:
We assume the worst case scenario is going to happen. Typically we are not aware of what we are really afraid of, so it takes a moment of reflection to find this answer.
We lack the confidence in believing we can cope with this worse case scenario. There is a hyper-focus on the worst case scenario happening, and an absence of problem solving this worst case situation, or even thinking what will happen after the worst case scenario.
Anxious thoughts become less intense when you are able to identify these two parts, and respond back to them with a more reasonable perspective. Think of it as being willing to negotiate with yourself. For example:
Anxiety Thought: I’m so worried about those people in Milan.
Worst Case: The same thing is going to happen to me and I can’t handle it.
More Reasonable Perspective: I’ve handled difficult situations before. I won’t like it, but I’ll be okay.
Anxiety Thought: I’m just so stressed listening to the news.
Worst Case: Everything I’m hearing is definitely going to happen. It’s the end of the world.
More Reasonable Perspective: The world is facing a serious virus, but it’s not the end.
Anxiety Thought: I can’t believe all of this is happening
Worst Case: I really don’t understand the world. Everything I knew to be true is wrong.
More Reasonable Perspective: Of course my worldview would change with this type of news, but this doesn’t mean everything I knew was wrong.
If you find the more reasonable perspective is not helping, then you have not correctly identified the worst case scenario. Often, the more irrational it sounds, the more likely it is the worst case thinking.In this situation it is important to recognize the issue so you are properly managing anxiety.
The impact of the COVID 19 Coronavirus is devastating, and anxiety is a natural response. Maintaining normal levels of anxiety is equally as important as keeping yourself and others safe. Too much panic causes thinking errors and impulsive decision making.
Understanding the three parts of anxiety, focusing on actions you can control, and deconstructing anxiety thoughts are helpful ways for managing anxiety.
