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Battling anxiety in times of COVID-19: Experts suggest strategies to cope with feelings of fear, worry

UPDATED: Fri., May 15, 2020

Nurse Jeanette Averett comforts a 56-year-old woman suffering from COVID-19 who was struggling with anxiety because of her non-invasive ventilator at Roseland Community Hospital in Chicago on April 28. (Ashlee Rezin Garcia / AP)
Nurse Jeanette Averett comforts a 56-year-old woman suffering from COVID-19 who was struggling with anxiety because of her non-invasive ventilator at Roseland Community Hospital in Chicago on April 28. (Ashlee Rezin Garcia / AP)

Fear and anxiety in COVID-19 times can spiral – even trigger a panic attack – but experts say strategies can help you reframe and battle back.

Some panic attacks also can mimic COVID-19 symptoms – shortness of breath, body tightness, chest pain and feeling chills or overheated. Check for fever, length of symptoms and if aches are from tension, said Dr. Jennifer Erickson, a Seattle psychiatrist.

Erickson, a certified doctor in osteopathic medicine, is seeing patients via telehealth for the University of Washington Medical Center’s Montlake and neighborhood clinics. She said there’s an uptick in appointments because of anxiety and stress amid the COVID-19 pandemic.

“We’re seeing a lot of anxiety symptoms,” Erickson said. “They’re worried because of COVID, or they’re worried about COVID economically because they’ve lost their job or fear they’ll lose the job.

“There is worry because they’re at home with kids now doing home schooling, or they’re worried about the food supply and noticing they can’t buy some of what they could before.”

People can’t use typical coping mechanisms such as time with friends and hobbies. “They’re also missing life events like graduation,” she said.

Certified life coach Anita Kanti said she’s helping more clients reporting stress and anxiety because of COVID-19. Based in Orange County, California, she’s the author of “Behaving Bravely: How to Mindshift Life’s Challenges.”

“I definitely think we’re in an age where fear and anxiety have spiked during self-isolation and people are worried,” Kanti said.

“The best way to respond is to think about what drives the stress and anxiety? Let’s figure out what those triggers are and determine what can change. Don’t worry through it – wander through it. It’s a better journey.”

Anxiety overdrive

Erickson said a first panic attack might include sensations such as a racing heart rate, shortness of breath, body tension, feeling flushed, perhaps sweating and nausea.

“Anxiety attacks typically come out of the blue,” she said. “Given the amount of stress and anxiety and new ways of functioning in the world right now, people are potentially set up to have their first panic attack.”

To avoid added stress thinking it’s COVID-19 symptoms, she added: “Think about if you have fever, true body aches or coughing. It’s also the timing. Were you feeling shortness of breath earlier, having a cough or were feverish earlier? Did you have body aches in the morning, or did all of this come on at once?”

You can try distraction techniques to see if tension eases, she said.

“Find an object in your house, ideally with lots of colors and angles,” Erickson said. “Look at it and mentally go through them, count how many angles, note differences in shapes, how many colors do you see?

“If you notice you’re calming down, your breathing slows, and you start to feel more calm, it’s probably anxiety-related.”

Try progressive muscle relaxation to ease tension. Start at the toes and relax each part of your body slowly. Another strategy is square breathing: Breathe in for 4 seconds, then hold your breath 4 seconds, breathe out for 4 seconds, then hold again for 4 seconds. Repeat the pattern.

‘Lion-like courage’

Think about anchors to tether you during uncertain times, Kanti said.

“Practice lion-like courage,” she said. “What that means is accepting and knowing that there is stress and your emotions. Take a pause for a moment, and make a choice to select a new belief.”

For example, a thought can go from “this situation is a no-way-out” to “this is uncertainty; I have been through the unknown before, and it is temporary.”

A change in thinking can make a difference in fight and flight situations and help us make decisions, Kanti said. It’s positive affirmations to shift thoughts.

Another step is to reframe what self-isolation means as social distancing or physical separation for health reasons. It’s much different than loneliness, which can feel like you’re trapped, she said.

“The self-isolation is the No.1 thing spiking anxiety and fear, so it’s learning how to reframe self-isolation. We can focus on a new mantra that combats the negative connotation.”

Think of social bridging instead. “That reminds us still to be responsible and free to stay connected, whether it be through digital technology to individuals in our network or bridging to new environments.”

You can bridge to learn a skill or intentionally reach out to family, co-workers and friends. “Staying connected has never changed and should never stop.”

Worry sessions

It’s human nature to worry, Erickson said. She encourages writing such emotions in a journal or setting 10-minute worry sessions.

“It’s worth scheduling and allowing yourself to worry,” she said. “It would be wonderful if we could turn off parts of the brain, but we’re designed to have emotions, and worry is one of them.”

If you do a worry session, let your mind wander down any panic rabbit holes, but do so for 10 minutes or a reasonable short session, Erickson said. When the timer goes off, take a deep breath.

“You give yourself permission to not ignore that worry. It consolidates the time. It allows it to be in a space as opposed to worrying about it throughout the day or trying to ignore your worry.”

Try to keep a clear mind for the rest of the day. A journal can work the same way, to write about anxious feelings with a similar 10-minute mark when you close the journal.

“It almost allows you to get it out of your head to acknowledge worry, but you’re also putting it some place. It doesn’t have to be in your mind. But the key is you don’t write in it throughout the day.”

Stay in your lane

Kanti describes staying in your lane as managing what you do know rather than the unknown. Limit the outside noise that can increase the tendency to stay in distress.

“Instead, stay engaged at work, chase the facts, and focus on your day-to-day progress,” Kanti said. “It’s important to make simple game plans, to revise your plans whether in health areas, finances, work environment or reviewing your information for mortgage or rent.”

Sometimes, it means unplugging and tuning inward.

“Maybe you need to back off, tune into your inner self, and that could be meditation or turning to faith-based techniques, identifying what can change and focus on healthier lifestyles.

“Understand what works for you, and learn along the way. Take some opportunities because it is temporary. The key here is how to implement some changes that will benefit you going forward.”

Go easy on yourself

Give yourself credit in light of changes we’re all trying to process, Erickson said.

“We’re doing good enough in a time when everything is not great,” she said. Go easy on yourself also if you have a panic attack.

“Often people feel embarrassed. When you have your first panic attack, you feel like you’re not in control. You have to do your best to banish those thoughts. We’re hardwired to experience anxiety, and this is a very anxiety-provoking time.”

In seeking help or support, realize it is progress in this unusual time.

“If you have ongoing questions or concerns or a fever and chills, reach out to your primary care doctor, or you can reach out to your local mental health providers.”

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