By Jon Hershfield, MFT

Director, OCD and Anxiety Center, Sheppard Pratt

COVID-19 is a hurricane of uncertainties. How it appeared, how it behaves, how we stay safe from it, and how long it’s going to be a burden on the world are all mired in mystery. While fear is how our bodies respond to danger we can clearly identify, anxiety is how our bodies respond to the more confusing, abstract potential threats we imagine in the future.

Both experiences are the body’s normal biological strategy to help keep us safe. Our heart rate goes up for energy in case we need to run or fight. Our muscles get tense so we have the ability to freeze or quickly spring into action. Our breathing becomes short and rapid, an attempt to increase the oxygen in the brain so we can remain sharp and alert. Even the mind becomes modified to offer both a laser-like focus on the perceived threat and, simultaneously, a racing, hyper-analytic thought-cruncher to help us come up with strategies for escaping it. While these qualities can be helpful, both to defend us from obvious dangers and to prepare us for potential ones, they become problematic and overwhelming when we see unbearable uncertainty all around us.

Obsessive compulsive disorder, generalized anxiety disorder, and related disorders are characterized by an intolerance of uncertainty around unwanted thoughts and ineffective strategies for navigating the distress that comes with it. But whether you suffer from a diagnosed condition or not, COVID-19 has been a mental health challenge for us all. There’s simply more uncertainty about the things we care about than most of us are used to contending with. So increased anxiety is the new normal, for now. While anxiety itself is a natural process that we should not automatically avoid, significant and prolonged anxiety certainly comes with a price. Anxiety can interfere in concentration and sleep, cause digestive problems, mood swings, and worst of all, lead to avoidance of the things we really value.

Managing anxiety comes in two forms: reducing it when it is unbearably high and expanding our willingness to accept it as a temporary and natural bodily state. For immediate anxiety reduction, strategies that involve readjusting the pace at which oxygen flows to the brain and reducing tension in the muscles can be effective. Taking slow, paced breaths of a few seconds in, and a few more seconds out, can calm the anxious brain in just a few minutes. In a similar amount of time, progressive muscle relaxation can help send the signal to the brain that it’s ok to turn down the internal alarm. This exercise can be done by gently tensing and releasing your muscles, starting at the top of your head and gradually working your way down to your toes. You can also do this exercise without tensing your muscles, but simply imagining them release as you scan your body.

While anxiety reduction strategies are important skills, we can’t practice them all day every day. For the bigger picture skill of managing more pervasive anxiety like the kind that COVID-19 has brought to many of us, your focus needs to be on enhancing your tolerance and acceptance skills. Here are some core concepts to work with:

  • Remind yourself that anxiety is a normal part of the body’s functioning and focus on what the experience actually is instead of what it could mean. In other words, if your heart rate has gone up, tell yourself that you can notice how your heart feels instead of telling yourself that it signifies something bad is about to happen.
  • Normalize the unknown. Practice labeling the scary stories in your head about the future as simply uncertainty and, without reassuring yourself about the specifics of the future (this never really works because your brain knows you can’t predict the future!), remind yourself that you are capable of living with uncertainty. You’ve been doing it your whole life, and now you’re simply being asked to do it on a grander scale.
  • Pay attention to what’s happening in the here-and-now besides your anxious thoughts and feelings. Look to each of your senses in the present moment and pay particular attention to what’s good now. COVID-19 and the anxiety it has brought us do not have the power to make your favorite song any less a work of art. The softness of your pet’s fur, the taste of your favorite spice, or an actor’s amazing performance in your favorite movie remain unphased by all of this uncertainty. Practice catching yourself lost in thought about the unknown future and invite yourself back to what’s good in this moment. Developing a meditation practice is an excellent way to enhance this skill.

We know we will get through this piece of history because nothing in life is permanent. All thoughts, feeling, and experiences pass in time. It’s the when and the how that eludes us. It’s okay to feel anxious about this when and how problem. That just means your body and brain are invested in keeping you and your loved ones safe. But if we let anxiety go unchecked, it zaps the joy out of life and cuts us off from the things we care about even more than quarantine does.

For managing intense anxiety in the short-term, look to paced breathing and progressive muscle relaxation for some relief. For improving your overall relationship to anxiety, ask yourself to lean in to the experience as a normal bodily event, welcome uncertainty as a part of life you can accept, and practice bringing your attention back to the present moment where you can key in to what you value and what remains untouched by this pandemic.

Jon Hershfield, MFT is the director of the OCD and Anxiety Center at Sheppard Pratt.

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