How to Manage Coronavirus-induced Anxiety

While people with an underlying anxiety disorder may be experiencing a heightened sense of panic or dread during this pandemic, pretty much everyone is grappling with some amount of unease as life as we know it is unhinged or even uprooted. Many people are staying home, which can disrupt our markers of daily life and leave us feeling disoriented and discombobulated. And as of right now, there is no end in sight, adding to our sense of powerlessness and confusion. Here are some simple things one can do to help manage this anxiety.

One course of action to combat anxiety is to slow down one’s heartrate using various relaxation techniques. There are a variety of useful tools such as guided visualization and progressive muscle relaxation. However, the simplest anxiety management technique I teach my patients is deep breathing. Many people have picked up faulty habits and have adopted shallow breathing patterns. Such breathing can actually exacerbate anxiety and panic. I work with patients to retrain their natural breath so that they develop diaphragmatic breathing. This allows the individual to take in vastly more air and slows down the whole process from inhalation to exhalation.

Think of our chest and stomach cavity as a cylinder. Put one hand on your rib cage and the other on your stomach. On a count of three breathe in, first fill your belly, and then, when that is full, expand your chest. You can fill the entire cavity, all the way around the back. Do this in reverse for the exhale. On a count of three, first exhale the air from your chest, followed by your stomach. When you feel that you’ve exhaled all the air in your chest and stomach cavity, pull up from your groin to get the last of the air out. Repeat this cycle three to five times. Try this a few times during the day. This is easy to do because you can do it anywhere and it takes very little time. With practice, this can eventually retrain the way you breathe so that it will be there automatically when you are most anxious. Remember, this is like opening a parachute: you wouldn’t wait until you are in midair to learn how to open it. You need to practice it over and over so that it will be there when you need it. After enough practice, try increasing to a count of four or five for each inhale and exhale.

Slowing down one’s breathing may prove a useful way to manage anxiety, but some people prefer to accelerate their heartrate as another anxiety management skill. The thinking is that changing one’s heartrate is the key, whether that means slowing it down or speeding it up. Any type of cardio activity can work: running, jogging, biking, jumping rope, dancing, swimming, and other athletic activities.

Another activity I personally find helpful with managing anxiety is to engage in some repetitive motion. Cleaning is an excellent example of this. Try scouring a pan or cleaning a floor. Something about the physical movement and repetition lends itself to getting the anxiety out of the body. Besides, you can benefit from having a clean surrounding!

This is not one size fits all. Experiment with some of the suggestions here and see which work best for you. You might come up with ideas not mentioned. What’s most important is that you find things that help lessen your anxiety and that you are actually likely to do. And remember, we are all going through this together. You are not alone.

Life in the Age of COVID-19

Everything feels rather upside down as we try to adapt to this new normal of life with the coronavirus pandemic. Most people seem to be at least a little bit unsettled by this outbreak. It’s not at all surprising for us to feel unease when there are so many unknowns and things are so up in the air. Many therapists are grappling with these feelings ourselves as we work to help our patients best manage their anxiety, restlessness, isolation, and relationship difficulties. The following are some initial thoughts I have on these subjects.

Most people are likely to feel some amount of anxiety but people who already struggle with underlying anxiety disorders or depression are particularly vulnerable to having difficulty coping. I recommend trying doable actions such as taking walks, running, meditation, deep breathing, guided visualizations and talking to friends and family for support. I strongly encourage people to limit the amount of time they spend listening to the news, as this can spike anxiety exponentially. In some ways, this crisis is similar to what it was like after 9/11 in terms of our collective anxiety. At that time, as now, limiting one’s exposure to tv was essential to maintaining health and wellness.

Many people are living alone and therefore quite isolated. Reaching out to people is crucial. Perhaps you have one or two close friends who are in a similar situation. Try making an agreement to connect with each other daily. Meeting via an online video platform such as Skype or Zoom is a great idea. I’ve been doing this for all my therapy sessions. While meeting in person is preferred, this is the next best option. Seeing a person face to face goes a long way. Having a pet is another great way to combat loneliness. Reportedly, there has been a rise of the number of people buying pets for this very reason. Now is also a good time to call your therapist if you have one. People need not wait for their appointment to reach out for help.

While some people are having a hard time with so much solitude, others are struggling with having their nerves frayed by spending so much time at home with their partners. Many of these couples were experiencing difficulties before, but even in the healthiest relationships “sheltering in place” can be a true test. If possible, I think it’s vital for individuals to find time alone by getting outside or going into a separate room. I’ve encouraged couples I work with to come up with a code word to signal to a partner they need a time out if things get too heated. Is it possible to call a “truce” to not bring up loaded discussions or arguments while we are bunkered down? Now is the time for us to be extraordinarily gentle with ourselves and others.

It may be hard to structure one’s time when trapped at home. I think it is important to treat one’s life much as you would if you were going to your job. Try getting dressed much as you might if you were going into the office. If working from home, try setting clear time boundaries. Make sure you have start and end times, schedule breaks, and aim to only address personal matters outside of these time boundaries. I suggest scheduling your personal time as well. You can break these down into chores, family time, and personal time. Children obviously require a lot of structured play and learning, but we also may benefit from scheduling our days so that we don’t find ourselves ruminating, festering with anxiety, and struggling to get anything done.

Thankfully, Blue Cross Blue Shield is allowing us to practice online psychotherapy during this pandemic. I foresee more people needing our services due to this crisis. My hope is that people won’t hesitate to reach out in such a trying time. While it certainly doesn’t take the place of seeing patients in the office, I am pleasantly surprised to see how effective remote psychotherapy can be. How very fortunate we are to be living in a time where such a thing is possible! Best wishes for health and calm as we navigate this unknown territory together.