There is no doubt that the uncertainty during epidemics and pandemics can generate feelings of anxiety and worry. Not knowing how exactly you will be impacted or how bad things may get can affect your body and mind. It is important to not only be mindful of your physical health during such challenging times but also to pay attention to your mental wellness.
What is Anxiety?
Having anxiety and worry during a pandemic or epidemic is a natural response to the situation. This is a sign that your health matters to you and that your health is something to care about.
Anxiety is an evolutionary response designed to keep you safe. This response is an alarm system that is activated whenever you believe you are faced with danger or threat. When the alarm system automatically turns on, it causes physiological changes in your body to prepare you to fight or run away. These changes include rapid heartbeat and breathing, increased blood pressure, tense muscles or shakiness, sense of choking, headaches, nausea, and perspiration.
You may also have difficulty concentrating, difficulty making decisions, hypervigilance of the threat, restlessness, irritability or edginess, helplessness, sleep disturbances, increased depression, and a sense of dread or doom.
In addition to physiological changes, you may also experience worrying thoughts that typically involve a fear that something bad will happen in the future to you or your loved ones. You may also act in unhelpful ways that contribute to your anxiety, such as excessively researching diseases and their symptoms on the internet, frequently visiting doctors, and excessively checking and inspecting bodily symptoms.
Physical Health Consequences to Anxiety
If you experience prolonged anxiety, you may be at greater risk for developing chronic medical conditions (ex: heart disease and gastrointestinal disorders). High levels of anxiety and stress can also impact your physical health by lowering your immune functioning (thus increasing your susceptibility and vulnerability of contracting illness) as well as affecting your sleep hygiene, appetite, concentration, tiredness, and energy levels. It is therefore important to seek out support and learn strategies for managing your anxiety.
Adaptive Anxiety vs. Maladaptive Anxiety
Anxiety, like all emotional states, can be experienced in varying degrees of intensity. At the low end of the intensity range, anxiety is normal and adaptive. At the high end of the intensity range, anxiety can become pathological and maladaptive. It is important to reflect on whether the intensity of anxiety is manageable. See whether you feel that you are still able to follow your daily routine or whether you are feeling very overwhelmed that you cannot be efficient in your life. Remember that often, the epidemic of anxiety can increase more rapidly than the epidemic of the illness itself.
When anxiety is excessive, you may react impulsively and unsafely without thinking clearly and critically. This places yourself and others in unnecessary harm. For example, panic buying at grocery stores where many people congregate together in long line-ups, thus increasing the likelihood of exposure; stockpiling items and creating a shortage could affect the vulnerable population who truly need them. You may also misinterpret bodily sensations as signs of potential infection and go to the ER risking exposure to the virus.
Recognizing Maladaptive Anxiety:
In order to recognize whether you are exhibiting maladaptive anxiety, check-in with yourself. Signs include:
- Noticing your mind being preoccupied by stressful events only related to the epidemic or pandemic
- Becoming more sensitive towards news or information regarding the situation
- Constantly checking social media or any news sources for information
- Having difficulty staying focused and/or concentrating on anything else other than the epidemic or pandemic
- Having trouble falling asleep
- Experiencing strong physiological symptoms such as shallow and rapid breathing, rapid heartbeat, perspiration, tense muscles, dizziness, increased blood pressure, dry mouth, trembling
Strategies for Managing Your Anxiety
Note that you are not helpless in light of an epidemic or pandemic. You can always choose your response to the situation. Be your own advocate and speak up for your needs. Do what helps YOU feel a sense of safety. Strategies for coping will be different for everyone; do not compare yourself to others.
Here are some things you can do to care for your mental wellness:
Managing Unpleasant Emotions and Physiological Sensations
Acknowledge your experience and allow yourself to exhibit unpleasant or uncomfortable physiological sensations and emotions. Unpleasant emotions are a NATURAL part of the human experience.
- The uncertainty and novelty of an epidemic or pandemic can increase the levels of anxiety that you exhibit. You may feel helpless about what will happen or what you can do to prevent further stress.
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- Ask yourself whether worrying is helpful or useful in this moment. Unless you are taking steps to actively do something about an issue that you are worried about, worrying is not really helpful. It can instead rob you of the present as well as impact your energy, time, and focus.
- Try to be okay with a certain level of intolerance by separating what is within your control and what is out of your control. Attend to and act on the things that you do have control over. Try to let go of those “what-if” worries, as they may not be helpful or accurate.
- Determine what are the costs of worrying for you and how it is affecting your productivity, relationships, and overall well-being.
- Learn to accept distress when the situation is not solvable. Sometimes you cannot control events happening in your life and must embrace uncertainty. Give yourself a pre-set time, roughly ten minutes a day, to worry and then practice distress tolerance (Use the acronyms IMPROVE or ACCEPTS to help shift your focus from upsetting thoughts and emotions to more adaptive ones.
- Practice grounding skills (ex: mindfulness, visualization, meditation, yoga, tai chi) and relaxation strategies (ex: deep breathing or progressive muscle relaxation). This will help you calm your unpleasant physiological symptoms. This helps to allow yourself to think critically and clearly. Practicing mindfulness techniques will also allow you to stay present, instead of worrying about future uncertainty.
Managing Unhelpful or Irrational Thoughts
- Educate yourself about the epidemic or pandemic. Health care providers and health authorities should provide information on the disease, its diagnosis and symptomology, and treatment. Do not be afraid to ask questions. Ask your supports to obtain information in the event that you are unable to secure this information on your own.
- There is extensive news coverage about the outbreak. Ensure the source of information you are reading or listening to is credible (WHO, CDC). Try to trust these reliable sources that are guiding us and looking after our best interests. The unpredictable future of an epidemic or pandemic can be exacerbated by myths and misinformation.
- Allow yourself to check one credible source once a day if you wish to current. Take a break and switch off from the news occasionally. Avoid excessively checking social media and news apps. Turn off notifications from these apps.
Use Optimism to Cope with Anxiety
Rather than imagining the worst-case scenario and worrying about it, ask yourself the following to see if you are:
- Getting ahead of yourself, assuming something bad will happen when you don’t really know the outcome
- Overestimating how bad the consequences will be
- Underestimating my ability to cope if the worst-case scenario happens
- Rely on past evidence of human nature being resilient and able to survive difficult situations.
- Remind yourself that the epidemic or pandemic will NOT last forever.
Managing Your Maladaptive Behaviors
- Create a daily routine that prioritizes looking after yourself under safe conditions. Get enough sleep, eat regular nutritious meals, and try to do some physical activity.
- Try to follow your ordinary routine as much as possible. Get up at the same time, as usual, follow your usual morning routines, and go to bed at your usual time. You can set your alarm to remind you of your schedule. Build-in time for lunch breaks, cups of tea or coffee, and engaging in self-care activities.
- Follow health and safety recommendations for preventative measures, which may include:
- Washing your hands for twenty seconds
- Sanitizing high-touch places in your home or place of work
- Avoiding touching your face
- Engaging in social distancing and avoiding crowds
- Stopping non-essential shopping and travel
- Working from home if permitted
- Washing your fruits and vegetables properly
- Using protective equipment and gear at work, if necessary
- Seeking testing and medical care if you are ill
- Staying at home if you are feeling unwell
- As handshakes can spread germs, alternative gestures where you can still be cordial include:
- Placing your right hand on your heart
- Nodding politely
- Bowing
- Namaste
- Showing the peace sign
- Clasping your own hands together
Proactive Measures You Can Take:
While the elbow bump or foot tap might be favorable for some, the gestures still involve some level of contact, especially if we are recommended to sneeze or cough in our elbows. If you do shake hands, be prepared by always carrying a travel size hand sanitizer to clean your hands if you cannot wash them with soap
Adapting to Changes in Your Life:
- Talk to your employer about any policies they have for working from home if this is possible for your job. Plan ahead for working from home if you can. Your employer may be able to help you set things up in advance, like any technology you might need (ex: webcam, headphone with microphone, apps, or other software and devices).
- Social distancing is not only a way to protect yourself, but also a way to protect loved ones and vulnerable populations. Enhance your social support systems and get creative with social distancing by utilizing other modes of communication services. Voice calling, texting, video calling or emailing your supports can help you feel more grounded and remind you that there are people in your life with whom you can connect. If you are unfamiliar with how to use a computer or other devices, you can learn how to improve skills (ex: https://www.learnmyway.com/). Ask your supports to help you get started.
- When you connect with your supports, try to talk about something else than the epidemic or pandemic. Feel free to avoid or excuse yourself from conversations that are more amplified or catastrophic in nature (ex: what might happen, what you cannot predict).
- Reframe the situation of social distancing from “I am stuck inside” to “I now have the opportunity to attend to my home, my supports, my community, and myself.” Approaching this situation with a mindset of feeling trapped or stuck may only increase your anxiety.
Practicing Social Distancing:
Social distancing may feel daunting, but it may also be a perfect opportunity to take time for yourself.
- Engage in pleasurable and relaxing activities (ex: going for a walk, cleaning your home, dancing to music, listening to natural sounds on YouTube, listening to a podcast, watching documentaries, playing sudoku, and practicing yoga).
- Learn new skills or hobbies that you always wanted to try (ex: playing instruments, drawing or learning origami, knitting, gardening, cooking, writing, learning a language, computer programming).
- Exercise at home to expel excess energy (ex: watch an exercise video on YouTube or go for a walk or jog outside)
- If you decided what makes you feel safe is to limit attendance of large social events, ensure that your separation from others is based on potential for sickness versus isolating because it is a component of depression.
- As you engage in social isolation, if you start to feel claustrophobic or trapped, you can change your immediate environment by opening the windows to let in the fresh air. If you try looking at the sky out of the window, you can increase your concept of space. You can also spend time sitting on your doorstep or in the garden if it is not communal.
Practicing Compassion and Gratitude:
- Helping others can give you a sense of purpose and control. Act compassionately and support those vulnerable populations, such as purchasing their groceries or pharmaceutical needs or sharing overstocked food or pharmaceutical supplies with neighbors, family members, and peers.
- Remember our common humanity. When we are fearful, our first instinct may be to cast blame on others or to indulge in prejudice toward groups we see as responsible. Eliminate stigma associated with an epidemic or pandemic. The risk of infection is not dependent on race, ethnicity, or culture. We should proceed with knowledge, understanding, compassion, and collaboration while protecting ourselves and each other.
- Show gratitude and say “thank you” to those who are doing what they can to fight an epidemic or pandemic.
