Dealing with anxiety during the Covid-19 pandemic

With the Covid-19 pandemic completely upturning many aspects of “normal” life, an increased level of anxiety is to be expected, but excessive amounts of it can be debilitating. How do we walk the line between being cautious and being unduly worried or obsessing over worst-case scenarios all the time?

It is worth remembering at this stage that most of us are not at the mercy of anxiety. Unless we have a diagnosed condition related to anxiety, such as panic disorder or obsessive-compulsive disorder which need professional help, we can make a few tweaks to the way we approach the situation at hand that might help us deal with it better.

The first thing to keep in mind when it comes to anxiety is that it is not a bad word. While the mere mention of the word anxiety can make us uncomfortable and get our hearts racing, it is in reality an adaptive emotion. It signals danger and is the body’s normal response to difficult or threatening situations. As with any emotion, however, excessive anxiety can be pathological.

Adaptive versus maladaptive anxiety

At some intuitive level, we all know the difference between “good” or adaptive anxiety, and the not-so-good kind. Pre-exam jitters, for instance, fall under the former category. In the Harry Potter series, Hermione Granger says, “I never feel you perform as well in exams if you’re not a bit nervous”. Anxiety in this instance provides us with the motivation to study.

On a more basic level, anxiety is simply a survival mechanism – it leads to a fearful response, which in turn causes us to take protective action. Our ancestors needed to feel afraid when they saw a predator, so that they would know to protect themselves. Thus, the right amount of anxiety, at the right time, is essential for survival. Excessive anxiety, however, is maladaptive for one of two reasons – either because it is too intense, or because it is triggered by stimuli that are not harmful.

With respect to crises such as the Covid-19 pandemic, some amount of anxiety serves a purpose. Without it, we would not undertake precautionary measures such as masking, social distancing or hand washing. At the same time, it is critical to do so in a measured manner based on rational, scientific advice. In fact, the scourge of WhatsApp forwards suggesting everything from “steam therapies” to other non evidence-based cures feed on our anxiety as a society. Not only is excessive anxiety bad for our mental health, it has also been found to negatively affect our immune systems.

Perceived threat is not the same as real threat

An important thing to remember while talking about fear and anxiety is that our brains are easily fooled. Just because we are showing signs of anxiety, it does not automatically mean that we are in some kind of danger, immediate or otherwise. Neural studies indicate that the unconscious evaluation of a stimulus (say, a fear-inducing one) begins before the stimulus is consciously processed. This is why, for example, our heart starts pounding faster when we hear a knock on the window in the middle of the night, and only later, once we have realised that the cause of the knocking was the branch of a tree, does the fear subside.

Nestled deep within the human brain is a tiny almond-shaped structure called the amygdala which plays an important role in coordinating the fear response. The amygdala seems to be the part of the brain that intervenes between the regions concerned with the bodily expression of emotion and the areas of the brain that are concerned with conscious feeling. What happens in the brain when people are terrorised is that the conscious processing of fears is short-circuited in favor of the more autonomic fear response.

Simply asking ourselves logical questions, such as the likelihood of the event we fear occurring, can force more conscious regions of the brain (parts of the cerebral cortex) to come into play.

With respect to the Covid-19 pandemic, this article says it best – “...the majority of people who practice social distancing will not get COVID-19; among those who do get infected, the majority will not need hospital-level care; and the majority of those who are hospitalized will survive.” So while news headlines everyday might be alarming, those of us who have no comorbidities or are not in a vulnerable age group have no reason to worry excessively or obsess over our health so long as we are practicing caution.

It is also important, of course, to keep assessing the situation and modifying our behavior based on the data. We do have limited reserves of energy, after all. Restricting ourselves too much can have a paradoxical effect – like how when media outlets in the US and society in general “scolded” masked people for going to the beach (now considered a much safer activity than gathering indoors) in summer. This excessive, unnecessary restriction, provoked people to break the norms and gather in groups indoors anyway during the bleak winter. It helps, in other words, to conserve our self-protective streak for situations that really need it.

Ways to deal with anxiety

In addition to arming ourselves with more knowledge about the things we fear, what are some other ways in which we can cope? (Again, I'm assuming here that the person reading this does not have disorders related to anxiety, which require professional help).

First, try to establish a routine in your day-to-day life. The brain is more anxious and stressed during uncertain conditions, so it helps to have at least a few aspects of our lives under our control, or at least for us to have a perception of control. Like I’d mentioned previously, our brains are easily fooled. At the same time, however, we must try and resist the temptation to indulge in behaviors that merely make us feel better about the situation, without really understanding if they help at all, or are in fact harmful in any way.

Avoiding buying newspapers or rubbing groceries with bleach were possibly excusable behaviors when not much was known about the virus, but with evidence accumulating that surface transmission risk is low, these actions become problematic.

Hygiene theatre is a good example of this, where people and establishments claim to be “safe” just because they scrub and disinfect surfaces thoroughly. Given that surface transmission risk of coronavirus is low, all this scrubbing (of surfaces in restaurants, and grocery packages at home), which has minimal benefits, might lead to a false sense of security and a tendency to ignore more sensible safety measures such as masking, hand-washing and social distancing.

Social distancing itself can be anxiety inducing, until we realise that it does not mean social isolation. During these times of enhanced virtual connectivity, video calls and virtual game nights with family and friends can be remarkably effective at maintaining human connection, which is vital at a time like this.

Studies have shown that a person’s mindset can affect the way they deal with stress. Simply tweaking our thinking from “stress is debilitating” to “stress can be enhancing” can change our response to be more positive. I have to mention another caveat at this point – simply smiling through stress or convincing ourselves to cheer up and that “things will be fine” (termed FONO or the fear of a negative outlook) is not the most adaptive of reactions. Suppressing negative emotions can just cause them to resurface in unwelcome ways. Such “toxic positivity” has a simple antidote – rather than push uncomfortable emotions away, simply notice them and let them be, and they will pass.

Sleep is essential to maintain emotional equilibrium. Studies have found that the amygdala is more prone to have heightened responses to negative stimuli when an individual is sleep deprived. Sleep deprivation is also associated with reduced connectivity between the amygdala and higher-order brain structures such as the prefrontal cortex which are responsible for the top-down modulation of emotion. Trying to get good-quality sleep for at least eight hours a night is an endeavor worth pursuing.

Similarly, exercise can have a positive effect on our emotions. Not only does getting our bodies moving improve our moods and reduce anxiety and stress, it can also have other welcome side-effects like enhancing thinking and memory skills.

All in all, we need to make our anxiety about the situation work in a positive manner for us, without allowing ourselves to crumble under the pressure. While this might seem like a tall ask on some days, allowing ourselves the space to overcome anxiety might just help us come out of this situation stronger.

(Aditi Subramaniam is a neuroscientist turned writer who is fascinated by the workings of the brain and how we can ‘rewire’ it to our advantage. She enjoys writing about the neuroscience of everyday life, and its practical implications for parenting)

Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.