03/14/2020
I've been seeing some (understandably) heightened anxiety due to COVID-19, so I wanted to share some strategies for managing anxiety, with particular attention paid to a few strategies I think are less likely to be familiar to most people. This is a long post, so feel free to skim or ignore.
First, some strategies I think of as pretty widely known are: distracting yourself (especially with pleasurable activities), reducing exposure to anxiety-provoking media, physical exercise, adequate sleep, relaxed breathing, reducing caffeine consumption, meditation (guided or not), and modifying behavior when it is prudent to do so (e.g. "I'm worried about crowds right now, so I'm not going to go to the concert" or "I'm going to wash my hands now"). Of course there are other ways people cope, but these ones seem to me to be good to highlight as general info. (Though even for these, consult with your doctor and/or therapist to make sure that they are good ideas for you if they would constitute a significant change for you.)
These next few I don't think are as familiar, so I'm going to provide some explanation (with the same caveat about checking with your own providers):
1. Cognitive distancing/defusion. Put simply, this strategy involves working to notice that your thoughts aren't necessarily true, that your thinking is a process that you can observe and step back from. One tactic that highlights this awareness is to state ideas in terms of being a thought rather than just stating the idea directly. For example, consider a worrying thought such as, "We're going to run out of money." This might seem fully realistic or true, but we've all had thoughts like that seem realistic during a fearful moment only to later realize we were overreacting. By saying, "I'm having the thought that we're going to run out of money," you are taking a step back and inviting an awareness that the thought that seems real is nevertheless not a direct experience of reality. There's a lot more to distancing and defusion, but maybe this example can at least illustrate the concept.
2. Progressive muscle relaxation (PMR). If you experience anxiety with any regularity, you've probably noticed that anxiety is accompanied by muscle tension -- often most apparent in your neck, your shoulders, or your jaw. This muscle tension is often brought on by anxiety, but the tense muscles then contribute to sustaining the anxiety -- the mind and body are reminding and encouraging each other to be prepared for a potential threat. Accordingly, intentionally engaging in a systematic process of relaxing those tense muscles engages what's been called the 'relaxation response' -- the body signaling to the brain that there's no need to be on high alert. Here's a video put out by one of the groups at Emory University that does a good job introducing the concept and then providing guidance for how to do PMR. https://www.youtube.com/watch?v=oV_ebOzX8OA
3. Mindful acceptance of the physical sensations of anxiety. Negatively judging the experience of anxiety is common -- after all, it can feel uncomfortable. But unfortunately, the more strongly a person dislikes feeling anxious, the more likely they are to fall into a feedback loop that just makes it worse. What happens is that the discomfort or dislike of anxiety is so strong that it becomes a trigger for even more anxiety ("I hate this feeling" or "I'll never sleep if I feel this way" or "I'm going crazy"). This kind of negative judgement of the feeling as something that needs to be avoided or stopped ends up backfiring and resulting in significantly increased anxiety instead. As an alternative, it can help to shift toward a nonjudgmental and present-focused awareness of the sensations, noticing the sensations involved with the emotion in objective terms (e.g. "I feel tightness in my chest, my heart is going quickly") instead of judgmental terms (e.g. "I'm freaking out, I hate this..." etc.). For some people, this idea works intuitively after just a little experimentation with it, but most people have to do at least some work to learn to think this way and then find that it fully clicks only after significant practice.
FINAL THOUGHTS: If you're finding yourself really struggling with anxiety, you should consider seeking professional help with it. I'm sharing these ideas because I've been seeing some friends expressing normal levels of anxiety as we all weather this pandemic. But, if you are someone having what might be considered an excessively anxious response or if your anxiety is impairing your ability to function, then I'd encourage you to consider getting help other than just self-help. Many therapists are offering options for online counseling, and I've seen that some of them are doing so at a discounted rate right now because of the current situation.
