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How to manage anxiety during a pandemic

We’re living in a stressful time. It’s important to take care of our mental health.

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Anxiety is so idiosyncratic that it’s difficult to pinpoint a “type” that’s most common. For some, it might feel like vines of dread roping themselves around you the night before a big work deadline, or maybe like a creeping cloud of unease that settles in during your morning commute. Maybe you cope by taking prescribed medication or going for a run; maybe you’ve gotten suspiciously into baking bread.

No matter what your specific brand of anxiety looks like, it’s probably safe to say that the novel coronavirus pandemic isn’t helping it. At the urging of public health officials, large public gatherings have been canceled, obsessive hand-washing is all but mandatory, and much of the world is in an uneasy state of lockdown. There is a lot of uncertainty and a lot of physical isolation, and being alone with your thoughts may be more distressing than ever.

And while there’s no cure for the heightened anxiety that’s all but inevitable in these stressful, unprecedented times, there are ways to smarten your approach to dealing with it that can meaningfully reduce your overall sense of helplessness. Because if we have to sit at home feeling waves of anxiety, we at least can learn how to be experts at managing them.

Know that it’s okay to have anxiety. You’re not alone.

In the ancient Chinese military treatise The Art of War, Sun Tzu wrote, “If you know the enemy and know yourself, you need not fear the result of a hundred battles.”

The first step to mastering your anxiety is to recognize what it is when it happens. Instead of ignoring it and letting it build up and take over, simply note the anxiety as soon as you feel the buzzing in your heart, the spinning in your brain: This is anxiety.

When we do this, we take the emotion, or the anxiety even, out of anxiety. Recognizing the feeling of anxiety puts you back in control; instead of facing an amorphous threat that can feel overwhelming and scary, you’re now dealing with a known entity.

Once we recognize it, we can explore its source. Anxiety is an emotional response to an anticipated future threat. And while there’s a lot of panic around the general idea of the coronavirus itself, we can usually get more specific about what we’re truly concerned with, says Joel Minden, a psychologist and author of the new book Show Your Anxiety Who’s Boss.

Some people might be responding to practical concerns like the threat of job loss, the lack of social contact, or the availability of supplies, Minden says. Others might be overwhelmed by future-oriented concerns about the anxiety itself (“I’m emotionally distressed and can’t function”) or uncertainty (“I don’t know what will happen, but I can’t stop thinking about how awful things will be”).

“When we get some perspective on what anxiety is, it’s easier to explore new, more productive ways to relate to it,” Minden says. “And when we normalize anxiety, there’s some comfort that comes with knowing that others feel that way, too, and it’s okay to have those authentic but difficult feelings.”

As an actionable step, try writing down your worries, getting as granular and close to the root cause as possible. As you write, what may have seemed like an overwhelming, murky constellation of problems will suddenly come into focus and be narrowed down to a set of realistic concerns. This will make it easier to problem-solve, eliminate obstacles, and be more accepting of the things you can’t predict or change.

The better we can get at pinpointing the root causes of our anxiety, the more manageable the anxiety becomes.

As scary as it may seem, facing your fears will provide a sense of relief

Once you’ve identified the contours of your anxiety, it’s time to create a plan of attack. We tend not to run toward the things we fear, but Minden says there are long-term benefits to taking concrete steps to improve your situation, even when it feels more important to put them off until you’re in a better emotional position to cope.

“When we respond to avoidance urges by taking action, we prioritize personal control and fulfillment over anxiety management,” he says.

It’s important to sit with your emotions, and to allow any feelings to exist alongside whatever actionable steps you’re taking. The simple acts of picking up groceries or medical supplies, FaceTiming with a friend, or reading up on well-sourced news — despite its ability to provoke anxiety initially — can prove to be worthy challenges that will lead to a greater sense of personal control in the long term.

This is especially true if you fall into one of the populations deemed most vulnerable to the virus, like older adults and those with underlying health conditions. Taking steps to mitigate risk — avoiding large crowds or being extra-vigilant about hand-washing and sanitizing shared living spaces — is necessary; it can also create a sense of purpose in a time that can feel aimless and overwhelming.

“Action binds anxiety; that’s a research finding,” Hanson says. “If you take appropriate action and you know what you’re doing, it’ll calm you down.”

On the other hand, be honest with yourself about things that are actually harming your mental health. It’s also okay to deliberately avoid certain situations that can worsen your circumstances or mind space, according to Rick Hanson, a psychologist and author of the forthcoming book Neurodharma: New Science, Ancient Wisdom, and Seven Practices of the Highest Happiness. This could mean avoiding the onslaught of opinions on Twitter, the rising death tolls in news stories, or the texts from friends and family members that trigger anxious thoughts.

For some, the reality of “sheltering in place” is inherently stressful. Whether it’s the idea of crowding into close quarters with roommates or being unable to relieve stress through normal social interaction that’s contributing to your anxiety, Hanson says it’s key to establish solid boundaries for yourself and tune in to what your mind is telling you.

If you’re holed up with someone who differs from you in their evaluation of the severity of the situation or their level of preparedness, for example, it’s possible to approach the situation with empathy while also standing firm on your own needs. Hanson says it’s helpful to think of yourself as a sturdy tree weathering a storm: The thoughts and feelings of others blow by while you stand open to them but unbowed.

“Concretely, this could mean disengaging from someone’s riff or rant and not getting into a discussion or argument about it,” he says. “Maybe saying something like, ‘I respect your right to take the steps you believe are good and necessary for you. I also have the right to take the steps that I believe are good and necessary for me.’ Maybe agree to disagree.”

Be easy on yourself. Some days will be worse than others.

Ultimately, anxiety is an inevitable part of life. No matter how hard you try to “hack” anxiety, it is still likely to seep in around the edges. Anxiety isn’t something to be conquered but something to acknowledge and manage.

This is why it’s important to be realistic about its role in your life, and cut yourself some slack on the days you’re feeling bad — days, even, when things do seem unmanageable. We’re living through a global health crisis, after all; times are tough, they’re stressful, and struggling with dark thoughts or overwhelming feelings is to be expected.

“If you’re warm and supportive when other people get overwhelmed, see if you can treat yourself the same way,” Minden says. “A good response to destructive ideas like ‘What’s wrong with me? Why am I getting so anxious?’ is something like ‘It’s okay to have difficult feelings. I know where they come from. I want to be patient and kind with myself because I’m going through a hard time. And that’s okay.’”

Hanson points out that it’s also important to recognize that we might be ultra-sensitive to others’ anxiety right now. Our social brains are hardwired through evolution to pick up on other people’s fear and absorb it as our own.

“We look to [other people] on social media, walking down the street, standing there with a mask on, it makes us anxious, broadly,” Hanson says. “And that’s a perfectly ordinary kind of thing. What we should do from a practical standpoint is to take on reasonable input from others, but meanwhile not let the fear itself be contagious.”

Learn and practice ways to calm and center yourself

On top of naming the exact causes of your anxiety and creating actionable steps toward management and self-compassion, Hanson recommends a couple of “quick and dirty” natural methods for physically soothing the overworked mind.

First, focus on bringing awareness into your own body, especially through internal sensations like your chest rising and falling with your breath. According to Hanson, being mindful about your breathing helps switch off the neural circuitry that anxiety ramps up, leading to an overall feeling of calm. Whether in a quiet room or in the middle of what feels like a burst of panic, try counting your breaths — one slow inhale through the nose, one long exhale through the mouth, then repeat — relaxing into the process and being mindful of each one, and gradually feeling your heart rate slow.

Second, try to keep yourself grounded in the present. Anxiety is, after all, based in an uncertainty around and fear of the future — what might happen next. To help practice physical mindfulness, run your finger from your forehead straight back to the top of your head. According to Hanson, focusing this attention to the midline of the cortex naturally quiets stress about the future and the past, and tends to bring you into circuits on the other side of the brain that support present-moment mindfulness and a sense of well-being.

There’s research that supports the idea that “crossing the midline” has calming benefits — it’s why activities that require careful, precise hand movements, like knitting and crocheting, are often recommended as possible anxiety relief methods.

Third, he recommends turning to physical remembrances of strength — flashing back to your own moxie and grit. Think back to when you held your first crow pose in yoga, or when you carried that window AC unit up four flights of stairs, or even when you patiently held a friend close who was going through a hard time. By bringing up the somatic memory — the body sense — of being strong and determined, you will remind yourself that if you could get through that, you can get through this, too.

If you’re having trouble quieting your mind on your own, there are a ton of great ADAA-reviewed mental health resources that can help. Apps like Calm, Headspace, and offer relief in the form of guided meditations, algorithmically generated playlists, and mindfulness exercises, all free (although most offer subscription options after the first couple of “sessions”).

It also should be noted that not all anxiety can be self-managed — that’s why mental health professionals exist. If the worrying and sleeplessness feel out of control, or you’re suffering from constant panic attacks — or if you are using alcohol or drugs to cope, or have other mental health concerns — call your primary care doctor to put you in touch with a mental health care professional.

If you are concerned about costs and going to the doctor during a time of social distancing, Rebecca Heilweil noted at Recode that Medicare recently announced it would temporarily expand coverage for providers using telehealth-based services, including mental health counseling, and the government is also making it easier for patients to use apps like FaceTime and Skype to meet with doctors and mental health professionals. Meanwhile, the Drug Enforcement Administration is also making it easier to “e-prescribe” certain controlled substances, including those that treat mental health conditions.

And if you or anyone you know is experiencing suicidal thoughts or considering self-harm, you can text CRISIS to 741741 for free to the Crisis Text Line for confidential crisis counseling, or call the National Suicide Prevention Lifeline, 1-800-273-8255; if it’s an emergency, call 911.

“We’re all being tested at this time, and we will get to the other side of it, and we’ll look back and ask ourselves how we conducted ourselves during this time, including how we treated other people,” Hanson says. “All we can do each day is the best we can do, but we can do the best we can each day.”