Anxiety during the Pandemic: When to Seek Help?

Is it possible to not be anxious when the coronavirus pandemic threatens our lives, health, and economic wellbeing while disrupting routines and relationships in ways most people until now associated with science fiction movies? Experiencing restlessness, unease, and worry about what is to come is understandable in the light of the sudden loss of control, predictability, and safety we have been faced with.

Being anxious is part of being human. Although no one has ever said, “I love feeling anxious!” some anxiety is adaptive and helpful. Anxiety can make you more awake and motivated to act. It alerts you to issues that matter to you. In the ideal world, you would get to quickly resolve anxiety-provoking concerns and move on, feeling once again at peace and in control. But what if it is not clear what action you can take, or, even worse, no action can be taken to eliminate the anxiety trigger? Under such circumstances anxiety can rapidly worsen, especially if your coping mechanisms tend towards avoidance and/or suppression of feelings, if you have a history of anxiety, or a biological predisposition to anxiety. How can you know if the anxiety you are experiencing calls for assistance from a mental health professional?

In order to distinguish whether anxiety is just a mild, though unwelcome, companion during times of uncertainty and stress such as the pandemic, or a clinical symptom that needs further evaluation by a mental health professional, consider four key dimensions of your experience: distress, intensity, frequency, and degree to which anxiety is interfering with your life.

Anxiety likely falls within normal range of experience if:

  • you can still enjoy your life and be present to what matters to you even when anxiety is present (distress dimension),
  • you are able to control how you feel with some ease; anxiety is fleeting and diminishes considerably thanks to your coping efforts; it shows up in response to a particular stressor and feels proportionate to it (intensity dimension),
  • you are able to experience a variety of other emotions and anxiety does not dominate your daily life; you are able to return to a state of relative calm which is much more frequent than the state of anxiety (frequency dimension),
  • you are able to engage in and enjoy important aspects of your life such as relationships, work, hobbies, or other activities (interference dimension)

If you are concerned about any one of these four dimensions, it is a good idea to consider seeing a mental health professional to determine the best course of action. An additional factor to take into account is how long you have been feeling anxious. Experiencing unrelenting anxiety for a day is likely bearable; being gripped by it for two or more weeks is overwhelming. Common symptoms that suggest that further evaluation is needed include panic and anxiety attacks, recurrent muscle tension or heart palpitations, constant worry, fear, restlessness, obsessive thoughts, and not enjoying things that used to make you happy.

Remember that when it comes to how you feel, it is critical to be honest with yourself and not default to black and white notions about how you “should” feel and cope. Every person’s experience of anxiety is different: What may be tolerable to you, may not be to someone else, and vice versa. I find that when it comes to anxiety, people often suffer in silence for years, believing either that they should be able to “get a grip” or that things are not so bad even though their ability to live life on their terms is severely impaired by their anxiety symptoms. Although I strive to avoid “should” statements due to how judgmental they can be, here is one I feel compelled to make: No one should have to power through all-consuming, painful anxiety symptoms without support. The good news is that anxiety is treatable.

Beyond seeing a mental health professional, here are some of the self-help strategies that have been shown to reduce anxiety if practiced regularly.

Breathe, meditate, and do yoga. Anxiety is all about the future (What if I lose my job? What if my loved one gets sick?) and it causes a buildup of tension and other uncomfortable physical symptoms. Breathwork, meditation, and yoga lessen anxiety because they teach us that the only moment that exists is the here and now and that this moment is worthy of our attention and can be inhabited fully. These practices also soothe the body, allay some of the physical aspects of anxiety, and calm the mind.

Examine your thoughts. When you are anxious, your thought process becomes riddled with so-called “thinking errors.” These are irrational thought patterns that, unchecked, will make you feel more anxious and down. For example, catastrophizing is a common thinking error. As you read the news about the economic effects of the pandemic, you might think: “I will never stop feeling stress about finances!” and this can lead to rumination and distress about what is to come. Look up other common thinking errors (there are many!) and make an effort to arrive at more balanced ways of viewing your situation. If you would prefer not to try to change your thought patterns, you can learn to observe your thoughts nonjudgmentally, without reacting to them. This is at the heart of mindfulness practice.

Find your tribe. The more isolated, misunderstood or unsupported you feel, the greater the likelihood of feeling worried and apprehensive. Connect with others who are willing to be real and vulnerable with you.

Welcome humor. Easier said than done when you are feeling anxious, but making efforts to embrace humor and look on the bright side has tremendous benefits. When we laugh, our muscles relax, stress hormones drop, and our outlook changes. Rather than viewing the world as a scary place, we notice that it can be safe and fun. We become more positive and upbeat. Smile more, read cartoons, watch comedies, play games – basically, do more of what usually makes you laugh. And most importantly, set the intent to laugh more, including at yourself.

Improve your self-care plan and follow-through. Do you eat balanced meals? Do you spend some time outside in the sun every day? Do you drink enough water? Do you get adequate sleep? Do you put your phone or tablet aside at some point in the evening? Do you have a good sleep routine? Likely you have answered “no” to at least one or more of these questions. Commit to improving at least one self-care area at a time and follow through.

During the global crisis created by the coronavirus pandemic, we are vulnerable to the many negative ramifications of prolonged distress. If you feel gripped by unrelenting anxiety, do not wait to reach out for professional support. Knowing when to reach for help is a key component of resilience.