By: Anthony L. Rostain, MD, MA, Chief and Chair, Department of Psychiatry and Behavioral Health, Cooper University Health Care; and Kelly Gilrain, PhD, Director of Behavioral Medicine, Licensed Clinical Psychologist, Cooper University Health Care, and Assistant Professor of Medicine, Cooper Medical School of Rowan University
As the COVID-19 pandemic spreads, fears are growing among our families and ourselves, particularly because we are health care workers. It’s important to remember that anxiety is a normal human emotion. It arises when we anticipate a dangerous situation and these sensations (physical and mental) are designed to keep us safe from harm. However, when worry and fear become excessive and persistent, life feels hard to manage. Humans fear what we do not know or understand.
With COVID-19, we are facing a different type of threat. It’s less visible and hard to grasp. Getting anxious about the virus can be helpful, if it helps us to prepare for action. However, if anxiety turns to extreme worry or panic, it can overwhelm us.
Some individuals are more susceptible to anxiety at this time, including those who already have elevated health anxiety or generalized anxiety disorder. People who struggle with these issues may feel there is more of a threat with COVID-19, particularly because they may seek out more and more information in an effort to reduce anxiety. This, however, can increase negative thoughts and beliefs. Those who have experienced a past traumatic experience related to health issues may note a heightened sense of vulnerability, as well. If you have a loved one who is sick, the high level of exposure to news and media outlets may trigger even more anxiety.
The best way to manage anxiety related to COVID-19 or other illness-related health issues is to limit media exposure. Turn to one or two trusted news sources such as the Centers for Disease Control and Prevention or the World Health Organization. These organizations communicate accurate information, which will protect you from consuming material that may be overly provocative. Make sure you keep a broader perspective on the issue and avoid “catastrophic thinking” or “tunnel vision.”
Another important step is to take protective “self-care” measures:
- Handwashing > 20 seconds
- Trying not to touch your face
- Limit touching elevator buttons, door handles, stair rails, etc.
- Clean your work station, phone, computer/keyboard with Clorox wipes
- Limit immediate exposure to those who might be ill with flu-like symptoms
- Do not shake hands or hug as a greeting (for now)
When helping individuals who have anxiety, thought challenging is an easy way to manage distressing thoughts that are especially negativistic and unhelpful. Some easy questions to ask yourself regarding a negative thought include the following:
Is the thought really true?
- Am I 100% sure that ___________will happen?
- How many times has __________happened before?
- Have I confused a thought with a fact?
- What would I tell a friend if he/she had the same thought?
- If it did happen, what could I do to cope with or handle it?
- Is my judgment based on the way I feel instead of facts?
You can also draw a table with two columns – write your health worries in the first column, and then write more balanced thoughts in the second column. For example, in the first column you may write, “I am worried that I will acquire COVID-19,” and in the second column, “I am taking precautionary measures to ensure my health and safety.”
By asking yourself the question, “How is this interfering with the things I enjoy?” you may find a response to be, “COVID-19 has me staying in my house more often and not enjoying activities that I value.” If this is the case, what can you do during the coming weeks?
First, explore your values, discover what is truly important to you, and build upon those areas to ensure that you remain consistent with the ideas and activities you find beneficial (click here). If you value physical activity but have concerns about the cleanliness at your gym, identify alternate ways to be physically active (i.e. run or walk outside). If you enjoy eating out, perhaps invest time in learning how to prepare new foods at home.
The important idea is to keep your time filled with valuable activities and maintain a relatively normal schedule so your mind is not filled with excessive worry. Finding ways to be present and in the moment is also another very effective tool to combat anxiety. The term “mindfulness” was coined over 40 years ago by Jon Kabat-Zinn and is an essential practice that allows individuals to focus on their present environment, rather than on the past or the future, which can instigate distressful thoughts or emotions.
Engaging in mindfulness means focusing your attention on your thoughts, feelings, and bodily sensations for a certain period of time without passing judgment and simply accepting the current moment. This allows us to be more focused on our thoughts and how they may be driving up our anxiety. (Apps to use for mindfulness: Calm, Simple Habit, HeadSpace, Breathe, Mindfulness Coach).
Finally, health care workers may feel a heightened sense of anxiety about coming into contact with those who are ill. This can be balanced by medical knowledge about typical virus transmission and by taking the safety precautions we always take when working with patients with infections.
Remember to limit your media exposure and keep working to achieve work-life integration. Focusing on the here-and-now of life, and on the little tasks that need to be done, can be very effective in reducing anxiety-producing thoughts.