By Lindsay Simon, Special to Moonshine

The amount of uncertainty surrounding the novel coronavirus is causing anxiety and fear, some of it valid and helpful, some of it unhelpful. Let’s see if we can sort through this situation to help get to a healthier place mentally and emotionally in these uncertain times.

The human brain is an amazing organ that has helped us survive and evolve as a species for millions of years. Our brains have an amazing ability to anticipate and avoid or reduce the impact of future dangers based on the past and current circumstances. When the anticipatory processes of the brain match the severity of threat and danger, this is a helpful and adaptive feature. However, when there is a lot of uncertainty about a situation, due to it being novel, and a lack of data to the actual danger level — as is the situation with the coronavirus — the brain will try to anticipate the level of potential threat without accurate data and information.

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Without enough information to go on, the brain fills in the blanks. On one extreme, this can create unhelpful and irrational anxiety, hysteria, and panic; on the other extreme, potentially risky and harmful decisions and behaviors that could put oneself or others at risk. Ideally, we want somewhere in the middle, more helpful thinking that is based on evidence, data, and reality.

Let’s begin by defining and differentiating between anxiety and fear. Anxiety is irrational future-oriented thinking based on imagined worst case scenarios (“what-if” thinking, also known as catastrophic thinking or future-tripping). Fear is worry about a situation that is happening in the here and now based on actual events and evidence.

Anxiety: “What if this is the apocalypse and everyone starts killing each other and there’s not enough toilet paper?”

Fear: “It seems like there are a lot of people panicking and now I might not be able to buy toilet paper for a week or two until the stores are able to re-stock.” (There is not a shortage of toilet paper, it is still coming from the factories, just everyone buying it at once makes the current store stocks go quickly, but people will not be using more toilet paper. The same amount will be used regardless of the virus, unlike the need for test kits, of which there is an actual shortage.)

Anxiety: “What if the virus comes and we all die?”

Fear: “So far, the statistics show that 80% of the people who get infected have mild symptoms, most people who get it will recover, and if we use social distancing and listen to the CDC and WHO guidelines about quarantining, we can slow the curve of this pandemic and there will be enough hospital beds for the people that will need them. I can do my part to help with this by working from home and washing my hands in accordance to the CDC guidelines.” 

It’s important to recognize that living in a state of anxiety releases stress hormones such as cortisol and adrenaline, and when these are flowing, our immune system shuts down. This is because when our body senses a threat, it deprioritizes fighting off infections. So remaining anxious actually increases your risk of not being able to fight off the virus, so figuring out how to not be anxious is very important. Also, once we have stress hormones flowing in our body, with increased heart rate and anxious chest breathing, our brain receives feedback that there is an actual threat, so it will start to race and look for more threats.

If there are no immediate threats right in front of us, our brain will then look for potential future threats and more “what-if” thinking will occur, which will result in the release of more stress hormones. This creates an anxiety feedback loop. In addition, when in an anxious state, the part of our brain that makes rational decisions and solves problems no longer works, so we are more likely to make decisions that are rash, defensive, attacking, and unhelpful. Additionally, anxiety can affect your sleep, and poor sleep is also linked to lower immune functioning.  

So what can you do? Here are some tips to help reduce anxiety and manage the fear in this current situation.

  1. Practice compassion and validation for yourself and others: Allow yourself and others to feel validated that this really is a scary time of uncertainty. There are a lot of unknowns and that can be scary. Validation can help reduce anxiety in yourself and others as long as it is with respect to emotions, events, situations for which there is no evidence, and not made up scenarios in your mind or the minds of others.
  2. Radical Acceptance: This is the concept of radically accepting things as they are rather than wishing they were different. Much of human suffering comes from wishing things are different than they actually are. We can create a lot of internal peace by accepting things that are out of our control and refocusing on what is in our control. Get yourself a blank sheet of paper and draw a line down the middle to divide it in half. At the top of the left side, write “IN my control” and on the right side, write “OUT of my control.” Create a list related to this current situation. You will find that your behaviors, reactions, and thoughts are in your control, and other people’s behaviors, thoughts, emotions, and reactions, as well as the news and events outside of you, are out of your control. For all the things in the right column, we want to practice radical acceptance. Refocus your mental and physical energy to the things on the left column. When anxious, ask yourself, “Is this in my control or out of my control?” If you answer, “out of my control,” then work on radically accepting and identifying what is in your control.
  3. Practice relaxation and mindfulness strategies. Future-tripping thinking leads to anxiety. Instead, focus on the here and now. One way to do that is to get in touch with, and pay attention to, your five senses. You can also practice calm belly-breathing techniques and guided relaxations or meditations. I suggest going on YouTube and typing in “guided calm breathing” and “guided relaxation.” Use this time as a gift to improve your relaxation and mindfulness skills. 
  4. Exercise. You might not be able to do your usual activities like going to classes, the gym, or the ski hill, but you can go for walks or do at-home exercises. An example of at-home exercise is Fiton, a free exercise app you can do from home with no equipment. You can even connect with friends to share workouts.
  5. Challenge irrational, unhelpful “what-if” thinking to come up with more helpful, rational thinking. Ask yourself questions like: “What is the evidence for this? What is the chance of this actually happening? What might be the best-case scenario? Will any amount of worry change the outcome? What would I tell a friend to make them feel better if they said this to me?”
  6. Acknowledge and label anxiety as it comes up as a fear of uncertainty, not reality. You can even thank your brain for doing its job of trying to protect you, and let it know you got this and it’s going to be ok. Even if you don’t know that, remember, thinking calming thoughts increases immune system functioning and decision-making skills, which will improve the outcome. So you do have some control there. 
  7. Practice gratitude. Neurons that fire together, wire together, so our habitual thinking creates pathways that our brain will unconsciously repeat. If we actively focus on appreciating what we have in the here and now, we can start to create positive thinking pathways that lead to less stress and more physical and emotional health and happiness. You can start a gratitude journal. Each evening write down three things for which you are grateful, as well as why you are grateful for them. (This last part is essential to get the neurochemical benefits of a gratitude journal.) 
  8. Take advantage of the gift of time. We often complain about not having enough time to work on self-care, self-reflection, reading, continuing education. Take this gift of time to take an online course, read that book you’ve been putting off, or plan that future vacation for which you haven’t had time.
  9. Stay connected with friends and family. Use technology to stay connected during this time, and maybe share some of these tools you learned!
  10. Engage in counseling. If you feel you need the help from a licensed professional therapist to help with anxiety, depression, stress, or relationship problems that are arising or exacerbated during this difficult time, use digital tools to connect with a therapist or tele-therapy.*

~ Lindsay Simon, LMFT, is clinical director and owner of A Balanced Life: Individual, Child and Family Therapy Inc. in South Lake Tahoe. Connect with Lindsay at abalancedlifetahoe.com. *A Balanced Life offers tele-therapy and online counseling services using evidence-based practices such as CBT, DBT, Solution-Focused Therapy, and The Gottman Method Couples Therapy.

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