Anxiety, Self-Care and COVID-19

There is no doubt that the presence of the Coronavirus / COVID-19 is causing emotional distress in the community and amongst individuals.  In this article I outline why this happens, how you can manage your anxiety, and why it is important that you prioritise your self-care now.  

Some initial research into the first month of COVID-19 found mental health difficulties were at least twice as prevalent as in non-pandemic circumstances. For some people the restrictions around COVID-19 are a blip in their lives, for others the impact is significant and ongoing. And, as to be expected, the people most impacted are the most vulnerable in society.  

The need for practical, positive, flexible self-care to manage this ongoing anxiety and stress is clear.  
 
WHY DOES THE PRESENCE OF COVID-19 TRIGGER FEAR?
In many people the presence of COVID-19 and being in the midst of a panademic triggers fear (as well as anger and sadness).  At its most basic a pandemic represents a threat to life.  You are given daily updated global totals of how many people have died.  Additionally, the presence of COVID-19 threatens your health, your liberty, your place in society, and exposes the divide between the haves and the have nots, both locally and globally.  
 
WHAT HAPPENS IN THE FLIGHT, FIGHT AND FREEZE RESPONSE?
When fear is triggered your body responds on instinct.  It sends you into an acute stress response.  Without you thinking about it, physiological changes in the body happen that are designed to keep you safe.  These instinctive and primitive reactions cannot tell the difference between threats – that happens next.  So your body responds as if the threat is right there – like having a ferocious tiger appear in front of you.

Once your brain identifies something as a threat to your safety, it sends a message to your adrenal glands requesting energy to take action.
 
When your body responds a cocktail of biochemical survival hormones are released such as adrenaline, noradrenaline, cortisol, norepinpephrine and ephinephrine.  These hormones influence everything you do, from eating and running to feeling, thinking and behaving.  Your heart will start beating quicker as it pumps blood to the areas that your brain believes are needed right now, like your muscles.  A rush of adrenaline causes your lungs to take in more oxygen which the heart pushes to the rest of the body.  Your breathing becomes more rapid and shallow  as the airway between the nose and the lungs constricts.
 
Examples of how the fight, flight and freeze responses are appearing in the community follow:

Fight Response
Includes arguing with the government and authorities, defiance (eg breaking the law and community standards – think house parties, extended family gatherings, toilet paper hoarding, refusing to be tested), blame, deflect, disbelief (eg conspiracy theories) increase of domestic violence, ostracization, and abuse.  
 
Flight Response
Includes people fleeing to their holiday homes.  Other people may avoid all societal contact, not even going out for daily walks.
 
Freeze Response
Think stuck brain.  Inability to change routines or do anything proactive.  For example – binge watching Netflix, losing track of the day, not being able to adjust to current reality.  
 
THEN WHAT HAPPENS AFTER THE FEAR RESPONSE?
Usually when the situation that triggers the fear response disappears, your body starts to return to normal.  The fear response is an emergency response and is designed for short term work.  However, when a threatening situation is ongoing, like the threat of COVID-19, you can start to experience chronic stress.  
 
Without engaging in intervention, like good self-care, your feelings can start to overwhelm you.
 
WHAT HAPPENS WHEN I EXPERIENCE CHRONIC STRESS?
Some of the common effects of chronic stress can include: 

• Tight muscles – resulting in headaches, neck and shoulder pain, muscle trembling.
• Increase in likelihood of you getting sick, and aggravating pre-existing illnesses.
• High blood pressure, abnormal heartbeat.  Also linked to heart disease, heart attack and heart failure
• Stomach upsets 
• Skin complaints such as acne and psoriasis.
• Exhaustion
• Interference with clear and logical thinking
• Depression

WHAT OTHER FACTORS ARE CONTRIBUTING TO INCREASED ANXIETY?
The nature of Covid-19 is accompanied by factors other than physical threat that are contributing to, not just increased anxiety and depression in the community, but also reported increases in death by suicide.
 
These factors include loss or lack of control, the unknown, uncertainty, economic pressure and isolation; and the presence of other emotions such as sadness and anger.  
 
Loss or lack of control
Having the government restrict movement is not something our society is used to, or likes.  It raises questions such as of how far is this going?  Is it needed?  When your daily routine is changed by someone else this is very disruptive.  Additionally, government control highlights societal vulnerability.
 
Societal vulnerability and level of resources
There are numerous examples of how your circumstances impact on your ability to manage  Covid-19 and contribute to anxiety.  I have outlined a few below 

• If you have the financial resources you can stockpile – hoards of toilet paper, whilst those with only enough to buy what they need miss out.
• If you don’t have wifi or can’t afford data – you lose a major source of connection with the world.
• If you are in a nursing home or government facility – your loss of connection and restriction is greater.
• If you’re living by yourself and have no one to talk to regularly
• If you are living in an unsafe house, you are at high risk.

 
The unknown and living with uncertainty
With Covid-19 you don’t know what is going to happen next.  You wait each day to see what the numbers are doing.  There are have many cases of unknown origin. You don’t know where the next cases are going to be found, you don’t even know when the next press conference is going to be held.  You don’t know when you’ll be put into lockdown, or how long is it going to last?
 
Facts are being debated in social media. Is it a government conspiracy?  Is it a Chinese world takeover by manufactured virus?  How exactly is it spread?  Will there ever be a vaccine?
 
Your brain craves routine. We really are creatures of habits, and when the way you live is changed without your control it contributes to anxiety.  Your thinking brain is designed to problem solve, and when it can’t do that effectively due to lack of information, or changing parameters, this creates anxiety.  
 
Not knowing when it will end and what the long term repercussions will be.  Will I get my job back?  When will Jobkeeper finish?  When can I open my business?  Am I going to lose everything?  These are chronic sources of stress, leading to ongoing anxiety.

 Isolation
Prior to Covid-19 the world was experiencing unprecedented loneliness and isolation.  Although as part of Covid-19 the emphasis is on connecting people virtually, there are many, particularly vulnerable people for whom physical isolation is a significant contribution to increased loneliness.  ​

WHAT CAN I DO TO HELP REDUCE MY ANXIETY?  
Some of these factors above you can do nothing directly to change.  When a threat is ongoing, without intervention your Fear Switch will keep firing and that’s unsustainable.  You will end up exhausted and your mind and body energy will run out.
 
I can’t get rid of the ongoing threat of COVID-19 or tell you when it will end, however, there are many things you can do help reduce your anxiety and general stress levels.  I am going to share with you some practical strategies that you can do right now. This is where self-care is so important.  Taking responsibility for your physical and mental health changes the focus away from what you can’t control to what you can control.  
 
Of course, if your level of stress and anxiety is significant please seek professional assistance.  I am available for online consultations; there are a number of organisations providing free support, in particular Beyond Blue: otherwise check in with your GP as your first point of call.

START HERE

1. Reduce exposure to the fear trigger.

• This includes TV, radio, newspapers, podcasts, social media.  There are no shortages of places to tune into information!  But each time you do you are exposing yourself anew to the Fear trigger.
• Tune into trusted sources once or twice a day.
• Do not make this your sole topic of conversation with others

 

I can’t get rid of the ongoing threat of COVID-19, or tell you when it will end, however, there are many things you can do help reduce your anxiety and general stress levels. ​

NOW DO THIS
Following are some are positive, practical strategies that anyone can do, anywhere.  They are found within my Five Foundations of Self-Care model that I use in my wellbeing and self-care programs for women who do too much and mental health professionals.  

The different foundations tap into different areas that are scientifically proven to be associated with positive mental health.  I have included a few examples from the model that may appeal to you.  Have a go at the one that stands out the most.
 
Emotional Regulation:  Cultivate happiness.  What makes you laugh?  Watch TV, YouTube, DVD that are funny.  Play a game you know people love.  Share a joke.  Follow positive news stories.  Humour is individual, tap into yours. 
 
Cognition:  Look at what you can control.  Your mind is a thinking machine and left to its own devices will go over and over again all the what ifs.  Journalling is a great way to express your feelings and thoughts and help with clarity.  Here is a journal prompt to help you get into a more positive and constructive mindset.  Grab a piece of paper and pen and start to write - “I can control……”, or “I have control over….”.  Aim to fill the whole page and start each new sentence with one of the prompts.  
 
Physical:  To calm your body a daily walk is thoroughly recommended.  I know for me Covid-19 restrictions have meant less incidental exercise., this is the exercise you do without planning for it and having to organise things.  For me I have always walked when I take my children to their sport training, or watch them at activities.  But their activities aren’t on at the moment.  Maybe you used to walk your children to school and can’t do that anymore, or walked part of the way to work, and now you are working from home.  
 
But I want to add in dancing, because maybe you can’t walk outside for some reason, or you just want to try something different..  This you can do in short bursts at home.  Make a playlist, or just play your favourite CD, album or dance without music.  Let yourself really go and move to your emotions.  
 
Meaning:  What is important to you?  How can still access that in your current circumstances?  This can require some creative thinking.  What can you can do to continue your pursuit of meaning?  My value of supporting people is now being expressed entirely online through telehealth, vlogs, writing, zoom meetings etc, rather than face to face.
 
Connection:  Connect with yourself.  When you acknowledge how you are really feeling, this is a way of releasing some of your feelings power over you.  It may sound weird, but I encourage you to give it a go.  You can simply say it aloud.  “I am feeling worried”, “I am feeling stressed” etc.  The emphasis is on saying the word feeling, rather than saying, “I’m so worried”, “I’m stressed”.  Try it both ways and see how it feels.
 
You might be scared of acknowledging how you are really feeling, OR you might be totally stuck in the feeling.   Either way this strategy can help. You cannot block out just one emotion successfully.  If you do, you are effectively stopping your emotional message system.  You become numb and unable to experience joy and other positive emotions as well.  You tend to stop caring about yourself and your needs.
 
This is not what we want to be the legacy of COVID-19.  Looking after yourself, practicing positive, practical self-care is the best way to avoid long-term mental health difficulties.
 
REMEMBER

1. Trigger (threat)
2. Fear
3. Instinctive, acute stress response
4. Fight, flight or freeze
5. Feelings are moderated by individual factors such as past experiences, strengths, resources, thinking, existing feelings, self-talk, awareness, knowledge, physical and mental health.
6. Feelings are influenced by societal factors such as class, income, minority status, 
7. You can interrupt the stress response, you can manage your feelings through awareness and positive strategies.
8. Interrupting the stress response allows you to think clearer, make better decisions, prevent chronic stress conditions, reduce anxiety and depression symptoms; and, to keep living your best life in accordance with your present circumstances.

 
Thank you for reading, and I hope you have found the information useful.  I am a psychologist of over 12 years, a mother of three and a solo practitioner.  You can find more about me here.  If you would like help with managing your anxiety and finding your calm, I would love to help you.  Click here to become part of my self-care community.  And if you would like specific information on anything discussed or want to book a self-care session, you are warmly welcome to contact me.

Until next time, take care of yourself.


Kim Dunn
Psychologist, Mentor, Connections and Self-Care Leader.
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