THE threat that the novel coronavirus (COVID-19) poses to physical health is serious and ongoing, and as the outbreak continues, the relentless fear, stress, and uncertainty are taking their toll on mental health as well.
"The coronavirus is causing widespread panic not only to [people] who suffer from anxiety already, but also to the community at large," said Carrie C. Mead, MS, LCPC, a psychotherapist in Maryland.
The reasoning behind the anxiety is simple, even if the road to managing it is not. Fear is a natural and adaptive response to situations like these, one of the basic survival mechanisms programmed to keep us alive, explained neuroscientist Jud Brewer, MD, PhD, head of the Mindfulness Center at Brown University and founder of MindSciences. "Yet when you couple fear with uncertainty, then that leads to anxiety."
Add to that the nonstop flow of information, some of it more accurate than others, fed to us by social media and the news. The barrage of anxiety-inducing headlines makes it incredibly easy to spiral into panic, feeding into a phenomenon called social contagion.
"I think of social contagion as basically passing emotion from one person to another," Dr. Brewer said. Essentially, panic and other strong emotions can spread like viruses in their own right, especially through social media, ramping up any preexisting anxiety and leaving you feeling helpless, scared, and likely to pass the stress on to others.
Anxiety around the coronavirus outbreak is natural, but managing it can be difficult, especially if you're cut off from your usual routine and network of support, as many of us now are.
In this unprecedented situation, we asked 13 mental health professionals how to understand coronavirus anxiety and the best ways to cope and stay calm while navigating this uniquely challenging time.
1. Accept and explore your anxiety
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"It's important to acknowledge that the anxiety is present," said clinical psychologist Carla Manly, PhD. Pretending your fear isn't there is counterproductive; you'll only make yourself more anxious. Instead, "treat it with compassion," said psychotherapist Emily Souder, MA, LCSW.
"Know that it is not in control of you, and that your anxious thoughts are not representative of truth. See them as separate from you, if possible."
Dr. Manly suggests rating your anxiety on a scale from zero to 10. "This step slows down emotional reactivity and adds a level of objectivity and self-awareness," she explained.
Your mind has to refocus in order to assess your level of anxiety, and giving a rating helps to make the anxiety seem more manageable.
"If the anxiety rises, the person is able to track how much it is rising and what might have triggered the increase," Dr. Manly added. This helps you feel in control of your anxiety, rather than the other way around.
It's also helpful to ask yourself what, specifically, you're anxious about right now. Contracting the virus? Passing it to loved ones? Losing your job? Ask yourself what you can do to manage the issue, Dr. Manly said, whether that's following the approved treatment and prevention strategies for COVID-19, discussing your job security with a manager, or reducing your time on news sites to ease worry.
Then, either practice acceptance of the issue or take steps to address it, such as working remotely or taking care of your health.
2 Center yourself when anxiety hits
If you feel your anxiety levels rising, the first thing to do is take a couple of deep breaths, Dr. Brewer told POPSUGAR.
This is a simple technique to calm yourself and engage the parts of your brain that deal with focus, memory, and problem-solving (your prefrontal cortex).
From there, Dr. Brewer recommended bringing your awareness to your feet or "feeling your feet," a mindfulness exercise that will "literally ground you."
You can also try the five-four-three-two-one grounding technique, said Jennifer Wolkin, PhD, an NYC-based licensed clinical psychologist. "The idea behind the method is to get the person out of their own head," she explained. Here's how to do it:
* Notice five things that you can see. "You can start with the more blatant, but then see if you can go deeper and see the subtle things in the space around you."
* Notice four things you can hear. Again, start with more obvious sounds, then hone in on less-noticeable ones.
* Pay attention to three things you can feel in your body. Can you feel your heart beating? Are you hungry or full? Any areas of pain or soreness? "Note them silently to yourself. What do you feel going on inside your body?"
*Smell two things. Sniff the snack you're eating or smell the lotion you used on your hands this morning. "What else can you smell, as subtle as it might be? Note it to yourself, without judging it."
*Find one thing you can taste. This could be the aftertaste of your last meal, toothpaste, mouthwash, or just your breath. "If you can't connect with a taste right in this moment, conjure the last taste you remember, and just notice it, without judging it."
*Repeat as necessary. "Each time, see if you can challenge yourself to find new things to sense."
3 Limit social media and the news
Use social media first and foremost as a way to connect with family and friends during a time when you might be feeling isolated. If you log on to Twitter, Facebook, Instagram, or Reddit for news as well, be smart about it.
"While it's important to stay abreast of the developments, it's most unhelpful to consume every bit of news provided," Mead told POPSUGAR.
Follow a few verified news outlets that you trust, as well as the Center For Disease Control and the World Health Organization, for news that's accurate and up to date. It's fine to unfollow or block sources that are only causing you anxiety.
Many of the mental health professionals we talked to recommended setting certain times of the day to check your news feeds and social media, limiting yourself to one to three scrolls per day.
"Each person's tolerance will be different, but the key is to notice how you feel before and after watching the news and adjust accordingly," Mead said.
4 Create a routine
"Establishing a daily routine gives you a sense of personal structure that is vital for managing emotional stress during a changing time," said Maggie Craddock, LCSW.
Decide what your priorities are right now and set boundaries between different activities, especially if you're transitioning to a work-from-home setup.
"Remembering to take time to exercise, eat well, connect with people you care about and do simple things that bring you joy is also foundational to maintaining your emotional resilience under pressure," Craddock added.
5 Set aside quiet time
"I recommend a daily practice of mindfulness, meditation, or prayer," Mead said. "These grounding practices are highly effective in calming the autonomic nervous system and the fight-or-flight center of the brain."
She advised starting with seven to 10 minutes of quiet every day, then increasing to twice a day. "Small steps will make a huge impact."
During your quiet time, try guided breathing, meditation, or visualization, using meditation apps if you need help starting, said Alexandra Finkel, LCSW, co-owner and therapist at Kind Minds Therapy.
Focusing on your breath can interrupt spiraling thoughts and can help to lower your heart rate and blood pressure when you're under stress, she explained.
"Journaling can help you get your worried thoughts and feelings out of your head and body," said psychotherapist Deb Courtney, MA, PhD, LCSW. Start by freewriting for a few minutes to let your emotions flow out.
"You can then follow that up with journaling a gratitude list of 10 things you are grateful for," Dr. Courtney said. Here are more tips on starting a journaling habit for mental health.
Keeping to a fitness routine right now is crucial for both mental and physical health, even if it doesn't look like your usual workout routine.
"Releasing endorphins is an effective way to fight stress and anxiety and to give your mind a break from everything," said Finkel. Go for a walk or a run to get out of the house. (Check the local guidelines in your area to make sure this is safe.)
If you're staying inside, stream a workout online. Many online fitness platforms are offering free workouts right now; here's a comprehensive list to choose from.
If streaming or getting outside aren't options, do a few bodyweight exercises just to get your body moving, then finish off your routine with stretching or meditation, Finkel said.
8 Go outside, if possible
Check local guidelines for your community to make sure it's safe to go outside. If so, just stepping out of your home for some fresh air can help to clear your mind and cleanse any anxious thoughts.
"Go for a walk, or sit and read a book outside," said Meira Ellias, LCSW, owner and director of DC Therapeutic Services.
Walk, jog, or simply "move your body in a way that feels good to you," Dr. Courtney recommended. "Feel your feet grounded on the earth with each step. Breathe in the fresh air. Give gratitude to your body. Notice all of the beauty you pass on the way."
9 Find silver lining in social distancing
Social distancing and self-quarantine have many of us spending more time indoors than usual, which can make you feel restless, anxious, and stir-crazy.
Do your best to keep busy during your time at home by doing things you enjoy and working towards achievable goals. "Plan something fun!" Ellias suggested. "Is there a book you have been meaning to read? Maybe a show you have been wanting to watch?"
"Break out your bucket list," added Tony Ortega, licensed clinical psychologist in New York City. Take any steps you can towards the goals you haven't had time for: writing a book, planning a business, applying to school, learning to cook — whatever it may be.
Big or small, "these are all things that will add positively to your life in the midst of this chaos."
(PS: It's also fine to relax and not do anything special at all. Do what feels best for you.)
10 Talk to friends and family
"Something really important to consider while we're practicing social distancing is the impact that isolation can have on our mental health," said therapist Kellie "Casey" Cook, MS, LPC.
Be proactive about this by making a point to stay in touch with people. "That might mean having a FaceTime date with a friend or calling a family member. Start a group text with some friends while you're watching a show together. If you've been working from home, reach out to your coworkers to ask how they're doing."
Try to shift your perspective about isolation as well. "Instead of feeling like you are going through this alone, you can shift your perspective and think of it as something that the entire country is experiencing together," said psychotherapist Mia Rosenberg, LCSW, owner of Upsider Therapy in New York City.
"Shifting perspective and focusing on how to reframe thoughts in a more solutions-focused and positive way can help people remain optimistic and hopeful during this challenging time."
11 Focus on what you can control
Focus on the facts and what you can control. Avoid catastrophizing.
When it comes to the coronavirus outbreak, "try not to catastrophize," said counselor Stephanie Wijkstrom, MS, LPC, NCC, founder of Counseling and Wellness Center of Pittsburgh.
"Keep in mind that not every sneeze is coronavirus, and recovery for our bodies and civilization is much more than likely, so do your best to remind yourself and others of this reality."
It's easy to get stressed and anxious about the scale of the outbreak, and to feel powerless when you're scrolling through scary headlines.
Accept those feelings — they're normal! Then, said Jaime Zuckerman, PhD, a licensed clinical psychologist in Philadelphia, "focus on what you can control: washing your hands, practicing social distancing, and following other CDC guidelines.
12 Remember that this will pass
It may be difficult right now to look beyond your immediate fears and anxiety, but it's important to remind yourself that "it will not always be this way," Finkel said.
"We are in very scary times right now, with limited information to predict what things will look like in even a few days from now.
Taking time to recognize that this is not the permanent future is necessary to fight feelings of, 'This will never end.' Many, many crises have occurred before and have been resolved over time."