CORONAVIRUS ANXIETY and COPING
The arrival of the Coronavirus has sparked alarm and dismay throughout the country and across the world. It is clear now that it poses a very real threat to our health and well-being. Television and radio channels, social media platforms and print media are all front-loading their broadcasts with Coronavirus stories and statistics. It is appropriate to feel anxious at this time: anxious for ourselves and anxious for others we may care about.
In this blog I’m going to talk about dealing with that anxiety in a way that builds resilience in coping and allows us to express appropriately what is a reasonable reaction to the circumstances we find ourselves in now.
It’s important first to distinguish here between good and bad anxiety. Good anxiety is the excitement we may feel because school is closed or we’re now working from home. Bad anxiety is the dread we may feel reading about the exponential rise in the cases of Coronavirus around the world.
It’s also important to realise that each of us has developed a set of coping mechanisms to face whatever life throws at us whether it’s a fight with a sibling, homework, the Leaving Cert, job interviews, a broken heart, illness or bereavement. As evolutionary beings we have evolved to cope with the stresses we encounter throughout life.
In facing Coronavirus, all of us will struggle to deal with an environmental factor beyond our control. In today’s society, this is further complicated by the always-on, always-available media platforms. Terrorism, Brexit and climate change have contributed to recent higher levels of ambient anxiety. By ambient, I mean a pervasive anxiety without a clear threat - a masked or mad gunman; an incomprehensible message on the side of a red bus; a vague message about killing all the fish. This distracting uncertainty has been utterly replaced by the Coronavirus.
Coronavirus anxiety is real. Coronavirus is not a political or potential phenomenon; it is a real and present danger. To dismiss it would deny the hard-wired Fight/Flight/Freeze responses on which our survival as a species depended. To cope with it, we have evolved sophisticated coping mechanisms beyond the Fight/Flight/Freeze responses, some of which I outline below under the headings, Relationship, Self-care and Sleep.
The first way we learn to cope is through relationship. Our carers introduce us to coping and help us to cope. Family, friends, peers, they listen to our worries and share their ways of coping to make us more resilient.
Over time, we develop attachment to various groups. At a time like this, the most significant would be the one comprised of those whose expertise and authority we respect - experts, reporters, colleagues. This circle is an important resource for coping calmly in crisis. Their validation is an objective one based on the knowledge and expertise that they are willing to share. Significantly, this circle should not include online groups whose identity or expertise is not confirmed in real life.
So, talk to these intimate groups and privilege advice from them.
Our bodies are the first coping mechanism we discover, and in tolerating and regulating its needs we learn how to regulate and tolerate anxiety. As infants our first experience of anxiety is as hunger and thirst. At times of stress, we frequently regress to an infantile state; we complain and appeal for help to others to assist us. All too often, this means that we do not attend to our own needs for food and drink, instead hoping for some magic ‘parent’ to take over regulating that anxiety trigger.
Not eating or drinking correctly places additional stress on the body and compromises our cognitive function. Neither of these consequences increase our ability to cope adequately. Instead, try to be a good parent to yourself. Cut back on the sweets and sugars that your infantile self might crave ; make sure you drink enough, and in order to become hydrated not drunk.
So, stock up on soft toilet roll - and vegetables!
Regular exercise stresses and relaxes the body in familiar repetitive patterns, increasing the body’s capacity to cope and allowing the brain to relax, also. A simple exercise such as a walk in the park can change one’s perspective on a problem entirely. Swimming laps is an almost meditative practice; focussing on the movement and breathing is an excellent treatment for racing thoughts and excessive rumination. Martial arts, dance classes and yoga offer disciplined mind-body co-ordination, building muscle-memory and a powerful sense of confidence in one’s body’s responses - and therefore, one’s ability to cope.
Breathing exercises such as this one https://www.youtube.com/watch?v=YRPh_GaiL8s are the kind of easy exercise that you can practice several times on an anxious day.
So, find an exercise that suits your lifestyle and that you enjoy; do it regularly; do it with friends; do it now.
Getting enough sleep is critical at times of stress. Sleep, as Shakespeare said, ‘knits up the ravelled sleeve of care’. When we sleep, we rehabilitate the body and the mind. Bones and muscles get repaired; memories get indexed appropriately, and we dream. Dreaming is a fundamentally important coping mechanism. Even nightmares help us to cope, as Freud discovered with his post-traumatic WWII soldiers.
Sleeping properly requires what’s called ‘sleep hygiene’ to establish a healthy sleep pattern. Develop a before-bed routine and keep to it. If you cannot sleep, get up after 30 minutes, go back downstairs, repeat the before-bed routine and return to bed. If your sleep is disturbed, it is important that going to bed should mean going to sleep. Do not watch TV or any screened device in bed and do not stay in bed, failing to sleep, beyond 30 minutes.
So, go to bed regularly; keep your bedroom clear of technology; make yourself warm and cosy and SLEEP.
PART II: Anxiety and Panic disorders
The coping suggestions above are for everyone to practice. Some people, however, may have seriously compromised ability to cope, due to pre-existing mental health problems or environmental circumstances. For those with anxiety or panic disorder, I suggest below some ways in which to cope with this added burden that the Coronavirus brings.
I believe the best coping mechanism of all is Self-Care. To that end, I urge all my clients to consider preparing a MENTAL HEALTH EMERGENCY KIT. I suggest below some of the items you might include in such a kit. Whether you prepare such a kit, where you keep it, whether it is real or virtual, is up to you. But simply knowing how you naturally cope and being able to expand those mechanisms to cope with developing situations is an essential mental health skill. To organise these suggestions and to help you remember them, I have arranged them under the heading of our five senses: sight, smell, sound, touch and taste.
There’s a very good reason why, if you’re feeling anxious or under attack, you instinctually close your eyes. It brings your focussed attention to your body, to reflection. Closing your eyes is your first line of defence against being overwhelmed, whether by social media or the TV 24/7 news feed. Close your eyes deliberately and VISUALISE instead. Visualise your breath as you ground yourself in your breathing. Visualise a safe space that you’ve practiced with your therapist.
When you are more grounded, go to your Mental Health Emergency Kit and take out the image you’ve put there. It could be a photo of your pet, of someone you care about, of someone cares about you. It could be a photograph of somewhere special, a cartoon, an inspirational poem or prayer, or a link to a clip from your favourite comedy programme. Look at it and relax into the image, into your associations to it.
If you are actively panicking, unable to breathe properly, losing peripheral vision, feeling de-personalised, the fastest route to the brain is through the nose. So, grab some essential oil - peppermint oil is very good for this - and sniff! This should ground you in your body immediately. Choose the oil for your emergency Kit for its pungency, to be most immediately effective, something like patchouli or even Olbas Oil! Your favourite perfume will probably be not pungent enough if you’re having a panic attack, but you could put some, or some rose-scented hand cream in the Kit to keep you grounded.
It’s not possible, unfortunately, to close your ears but you can replace what you’re hearing with something else. First, turn off whatever you’re listening to now. Move away from it - the person, TV, radio or whatever is flooding you with panic. Second, choose to listen to something that is less provocative and more conducive to calm reflection.
If you’re actively panicking, talk to yourself. Your own voice is, after all, the most familiar one to you. Make a series of fact statements, preferably ones you have practiced with your therapist. Simple statements work best. Try grounding yourself in time and space by saying something such as: ‘I am at home. It’s Sunday morning. I am in my kitchen.’ Speaking slowly, breathing deeply, check your senses and repeat the results to yourself: ‘I am safe. I can hear my dog snoring. I can smell toast. I am going to make myself a nice cup of tea. I am going to get through this.’
Call someone. Hearing another person’s voice is extremely grounding if your anxiety manifests as feeling de-realised. If you’re feeling panicked in this way, call Samaritans (116 123). Put the number in your phone and call it. If you have your breathing under control and you feel less emotionally overwhelmed, call a family member, a friend, your therapist or a helpline. Make a playlist of your favourite songs or of ambient music or an ASMR playlist. Call Alexa or Siri to play a pre-set relaxation track for you. If you like poetry, consider making a playlist of your own from the wonderful treasure that is the UCD special collection of Irish poets reading their poems at https://www.youtube.com/user/ucdlibspecialcoll.
If you’re having a panic attack, applying a cold wet cloth or ice cubes to the back of your neck can shock your body into grounded-ness. Similarly, running cold water over your hands and wrists will halt the physical escalation of your panic reaction. If you’re not actually panicking yet, how better to ground yourself than to actually feel the ground? Take off your shoes and stretch your toes out to feel the ground beneath your feet. Stand against a wall or door and appreciate its support. As you belly-breathe, feel the vertebrae in your spine being backed up by this solid support-structure. Sitting at your desk with your eyes closed, spread your flattened hands in front of you and imagine your breath anchoring you to your seat.
Check your body - are your shoulders hunched, is your jaw clenched? Stretch and relax into a more comfortable position. Ask yourself, are you cold - or too warm? Respond to your body’s needs and validate that self-care.
The fact statements above, when the sound of your own voice is grounding you, can also include statements such as, ‘I’m touching the floor, the counter, the wall…’
In your emergency Kit, consider having a favourite item of clothing that soothes you. It might be a scarf or a cardigan or something more personal. Whatever it is, pack it if you need it. Remember, even a galactic hitch-hiker needs his towel ;).
Fidget toys, stress balls, prayer/worry beads, plasticine/clay - these are all items that soothe and relax those with more kinetic coping mechanisms. Choose what suits you and stock the Kit appropriately.
If you’re actually having a panic attack, you may not be able to eat or drink anything until your breathing is regulated. If you can, though, accepting a glass of water can be the simplest of grounding exercises.
Many people have a green tea or chamomile tea teabag in their Kit. Others keep an emergency tub of ice cream in the freezer, or a tin of hard sweets to suck. And, while hot chocolate may take a little longer to make, it might be exactly the restorative you need.
Close your eyes, focus on the taste and allow yourself to associate to whatever encouraged you to choose it. Maybe it’s a sweet you loved as a child; or a tea you discovered as an adult. Choose carefully so that stocking any of these items in your Kit becomes a clear expression of self-care.
I hope some of these suggestions have resonated with you. At least, I hope you are now better aware of how you can cope, and perhaps you can see how you have been coping already. Preparing the Emergency Kit may be its own coping mechanism; simply knowing that you’ve invested that time and thought in self-care is a significant reassurance and self-affirmation.
These are suggestions. My intention is to suggest something so you can make it your own. Take these ideas and add, amend, adapt them to your own lifestyle and your own character. Make of them your own and use them well.
All that remains for me to say now is, as with all good things, share and repeat as often as required ;).