Anxiety Management Techniques

Anxiety Management Techniques

The Institute for Disaster Mental Health developed tips for community members. Please feel free to share and distribute widely.

COVID-19: Managing Stress in this Anxious Time

Let’s start with the assumption that everyone capable of understanding current events is living in a state somewhere between “kind of stressed” and “extremely anxious.” That’s natural. Infectious disease outbreaks are one of the most distressing forms of disaster to deal with psychologically because of the uncertainty they cause. With more typical disasters we know for sure whether we’ve been personally impacted, and while the physical and emotional recovery processes can be lengthy and difficult, at least we can be confident that the worst is over once the event ends.

Disease outbreaks don’t have that kind of clear time boundary. This leaves us in an ongoing state of feeling at risk, which is not the kind of acute stressor our “fight or flight” system evolved to deal with effectively. Staying braced for a threat over an extended period of time takes a real toll on our bodies and minds, so it’s essential to recognize and address our stress to prevent it from becoming overwhelming.

It’s also, for lack of a better term, just plain creepy to think that we may have been exposed to something that will make us sick in the future. And, in the case of the COVID-19 outbreak where many infected people have minimal symptoms but may still be capable of passing the disease on to others, it’s also disturbing to think that our own actions may be putting other people at risk if we go to work, move around the community, check on elderly relatives, and so on. It’s another type of outbreak-related uncertainty: We may not feel sick or have any reason to believe we’re a threat to others, but we still question our own potential role in spreading the disease, adding a layer of guilt to simple actions like going to the grocery store.

So what can we do to manage these multiple sources of uncertainty and stress? Plenty, starting with recognizing that it makes sense to feel anxious in these circumstances. There’s nothing weak or irrational about these feelings, and accepting that fact is the first step towards handling them.

Name It and Tame It

It may be helpful to pause for a moment and reflect on what you’re actually concerned about: Are you worried that you’ll get sick yourself, or that a family member will? Or that you’ll be unable to keep working and earning money? Or that there will never again be an adequate supply of toilet paper in your local market? It’s likely that you’re worried about a combination of potential issues of varying levels of seriousness, and it’s easy for those concerns to get mashed up together into a single swirling cloud of anxiety and dread that feels impossible to handle.

In fact, there’s a lot you can do to take control of your stress. Start by breaking that cloud down into manageable parts by consciously thinking through these questions:

  • Exactly what is worrying you right now? Write down a list to get your thoughts out of your head and to give them some structure.
  • How likely it is that each of those threats really will impact you? You may realize that some worries are actually so unlikely that you can cross them off your list entirely, freeing up brain space to address the concerns you do need to take seriously.

Then break that list down further into categories of what you can control (at least partially) and what you can’t, and make plans for how you’ll deal with both types of concerns.

Change What You Can

Once you’ve identified your primary sources of stress, tackle the things you actually can alter. You may realize that you can reduce the impact of concerns in this category by implementing problem-focused coping strategies. That may involve a kind of second-level approach: You can’t control whether your kids are sent home from school for an extended period, for example, but you can control whether you have a plan to deal with childcare if that occurs.

So make that plan, and then make a backup plan for your original plan – and let it be okay if those plans are not perfect, because they won’t be. But in times of stress or rapid change it’s a lot easier to activate a pre-existing strategy than to develop one on the fly, so it’s worth some mental preparation to really think through potential demands in advance so you’re not caught unprepared when they suddenly arise. You’ll probably find that simply having those plans in place gives you sense of control that reduces some anxiety about these particular concerns.

Accept What You Can’t Change

It’s equally important to recognize that some things are simply out of our control during this time, whether we like it or not. For issues you can’t really control or change, think about using emotion-focused coping strategies that help you manage your feelings. For example, you may not be able to talk yourself out of worrying about the health of your elderly parents, but you can consider strategies for how you’ll handle these unavoidable emotions and prevent them from overwhelming you.

We all know the lists of healthy coping methods like mindfulness, exercise, journaling, and so on. These are great ways of maintaining calm if they work for you, but being reminded to follow these practices just adds more stress for some people. Maybe you prefer to manage your emotions by taking a brief break from your worries in the form of a book, game, or TV show, or you like to stress bake, or scream into a pillow. It really doesn’t matter what you do so long as you actively do something that helps you both feel and function better.

Choose Your News Carefully

It’s important to stay informed about what’s going on, but that should not be your main focus in life throughout the outbreak. There is a lot of misinformation and conflicting news circulating, which just compounds confusion and stress for many people. Part of that is due to the rapidly evolving situation which legitimate news outlets are struggling to keep up with, but part results from people spreading rumors, or using misinformation to try to sell products or advance political agendas.

For accurate scientific guidance, you can’t do better than the Centers for Disease Control website. That’s the most reliable source for current information about the disease itself as well as resources for dealing with its effects.

To keep up with local impacts, choose a single news source you’ve found to be reputable in the past, and set yourself a schedule for when you’ll check for updates. Unless you’re actually in charge of the response, you probably don’t need to be monitoring the news 24/7, and you may find it reduces your stress considerably to limit your exposure to a few intentional news checks a day, rather than keeping the outbreak top of mind by constantly monitoring the latest information.

The same goes for social media: It can be a great way to stay connected with positive sources of social support, but Facebook and the like are not good places to get reputable information. These sites may expose you to a lot of dubious theories and rumors, sowing confusion and stress, so consider limiting your social media use and being selective in what you expose yourself to in all media.

Don’t Judge Yourself, or Others

This may sound obvious but it’s worth remembering: People will react to this outbreak with different degrees of concern based on factors like their individual situation (for example, do they have kids or other dependents to worry about; does their work expose them to potentially sick people; were they already dealing with financial stress) and their personal characteristics (for example, do they experience anxiety or depression even under more typical life conditions).

It’s easy to slip into criticizing others across both ends of the reactivity spectrum (i.e., “why are you freaking out?” vs. “why aren’t you freaking out?”). That’s especially problematic if family members, especially partners, have different reaction styles and coping methods, causing friction and limiting their ability to support each other during these trying times. Keep in mind that personal coping styles vary and you can’t change other people, but you can make an effort to tolerate different reactions.

Stay Connected!

One of the things we know from research is that social support is very important to resilience and recovery during times of stress. The more isolated and alone we feel, the more likely it is that our mental health will be negatively affected. This is likely to be particularly true during this time of self-quarantining, isolation, and social distancing.

So, do what you can do to stay connected to your social support network of family, friends, and colleagues. Even staying in regular contact with a single person can be beneficial. Obviously we may need to connect in different ways than we’re used to doing, but it’s important to stay connected nevertheless. You don’t have to spend time talking about the stress of the current situation (although that can be helpful for people who feel the need to talk about it), but just be intentional about reaching out and making time to be together, in person or virtually.

To Summarize:

1) Do what you can to take charge of your anxiety by breaking your concerns down into manageable chunks.
2) Change what you can, and work on strategies for accepting and coping with what you can’t.
3) Limit your media exposure so you’re not dwelling on the situation.
4) Stay connected, through whatever means are available, to the people that are important to you.
5) Above all, remember what stress management strategies work for you, and actually use them regularly to get through this challenging outbreak.

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