Anxiety and COVID-19

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Anxiety is a natural reaction for many people during the current COVID-19 pandemic. People may experience worries about health (for ourselves and others), the future, financial situations, academic and work responsibilities, discrimination, and relationships with others. It is natural for these worries to arise in response to uncertainty. People may also experience racing thoughts, restlessness, fatigue, insomnia, irritability, increased heart rate, breathing problems, and/or nausea as part of feeling anxious that can be overwhelming and interfere with our daily life. Below are some strategies and a "CAPS Care Plan" for managing anxiety related to the current COVID-19 pandemic. Remember that everyone responds differently to situations depending on your background, culture, and community you may live in. Be kind to yourself and practice coping strategies that best fit your needs and work for you.

  • 1. Managing racing/anxious thoughts:
    • “What-if” thoughts are typical when experiencing anxiety. These thoughts may focus on things we don't have much control over. It is beneficial to be more intentional about being aware of these thoughts and focusing on what is in your control. One thing to practice when you start to worry is writing out what you have control over and what you don't have control over. An example may look like this:
      • What's in my control? 
         

        - My actions
        - My Health
        - Establishing a routine
        What's not in my control? 
        - Other people's action
        - Other people's health
        - School opening or closing

    • People with anxiety often have irrational and unrealistic thoughts. There are numerous ways to help manage these unhelpful thoughts.
      • Thought challenging helps to broaden our perspective and focus on the bigger picture. One technique that can help challenge your thoughts is to use the THINK acronym:
         

        T - is the thought 100% True?
        H - is the thought Helpful to me? Or is it harmful to me?
        I - is the thought Inspirational to me? Or is it insulting?
        N - is the thought Necessary? Is this thought significant enough to put all my energy and focus?
        K - is the thought Kind?

        Another technique may simply be writing out your unhelpful thoughts in one column, using THINK to assess each thoughts, and in the next column rephrasing these thoughts in a more realistic, compassionate way.

    • Mindfulness/grounding techniques help us connect with the present moment rather than thinking about the past or the future. You can practice being mindful by bringing your awareness to the present moment using your 5 senses.
      • Try noticing:
         

        - 5 things you can SEE
        - 4 things you can FEEL
        - 3 things you can HEAR
        - 2 things you can SMELL
        - 1 thing you can TASTE

        (Click Here for more information on mindfulness)

    • Self-compassion has many benefits in reducing psychological distress, particularly anxiety. As many of us have not experienced a pandemic like COVID-19, it's understandable that we have a number of feelings. However, sometimes rather than validating our feelings, we engage in self-criticism and self-judgement. Self-compassion means treating yourself with kindness, empathy, and care, and practicing self-compassion can help you manage anxious thoughts and feelings. Try this self-compassion exercise:
      •  

        - Think about a time a friend came to you feeling anxious (e.g. "What if I don't do well in school because of the pandemic?)
        - Reflect on how you would respond to that friend
        - Now, think about how you respond to yourself in this situation
        - Did you notice a difference between your response to your friend and to yourself? (You may likely notice that the response to your friend is more compassionate as compared to the response to yourself that may be more self-critical.)
        - Then, see if you can practice giving yourself a compassionate response

    • Journaling your thoughts and feelings can be a good emotional outlet and a way to track your mood. Just a reminder: there are no rules or right way to journal. You can jot down your thoughts and feelings with a couple of words or paragraphs, write out specifics from your day, and/or get creative (e.g., poetry, spoken word, creative writing). Journaling is a strategy/self care tool that provides time to reflect and engage in self-awareness.
    • Practicing gratitude can help manage anxiety. In fact, research suggests that practicing gratitude has numerous benefits, including reducing anxiety, enhancing mood, improving sleep, and building up the immune system. Below are tips for practicing gratitude:
      •  

        - Send a “grati-text” to friend and/or family member letting them know that you are grateful for them
        - Start a gratitude journal where you set aside weekly time (e.g. 2x/week, 5 min) and write down at least one thing you are grateful for

  • 2. Taking care of your body with relaxation techniques:
    • When we are experiencing anxiety, we not only experience mental distress, but it is common for our bodies to be affected (e.g., increased heart rate, muscle tension, etc.). Practicing deep breathing can help us feel calm and relax our bodies.
      • Try this brief deep breathing technique:
        Put your hand on your stomach. Inhale for 4 seconds, hold for 4 seconds, and exhale for 4 seconds. As you inhale, you should feel your stomach expand like a balloon. As you exhale, your stomach should fall. Continue to do this at least 3-5 times (or 5-10min) and notice how your body feels after deep breathing.
      • Click Here for CAPS relaxation videos
      • Below are some apps that may help in practicing deep breathing exercises:

        - CAPS Stressbusters App (specific to UM)
        - Headspace
        - Calm
        - Stop, Breathe & Think

  • 3. Coping with feelings of loneliness and isolation while practicing social distancing:
    • Due to the pandemic, our typical, daily in-person interactions with others have been limited, which may result in feeling lonely, isolated, and worried. Maintaining relationships, even during this time, can help reduce anxiety. Below are ways to maintain connections:
      • - Schedule phone or video chats with family and friends, especially those you haven’t spoken to in a while
        - Use video chat apps and/or websites to play games like Houseparty, GamePigeon, or Playingcards.io 
        - Have a virtual happy hour, party, and/or meal times over phone/video chat
        - Use the Netflix Party extension to watch Netflix with your friends online
        - Send handwritten letters, emails, or a virtual card service like Postable to family and friends
        - Play games via apps on your mobile phone, tablet, or computer, inviting others to play with you
        - Use social media to stay in touch with others
    • Engaging with the people you live with: you may be quarantined/self-isolating with roommates or family. Getting creative with activities with roommates or family members could distract from anxiety. Here are some examples of fun/soothing things that you can do together.
      • - Play board games, doing puzzles, or playing charades
        - Start a new TV series together
        - Play video games together
        - Have “themed” or dress up dinners
        - Try a new recipe
  • 4. Limiting exposure to media:
    • Anxiety can be fueled by too much media intake. Constantly hearing about the pandemic can be overwhelming. To reduce anxiety, it may be helpful to take breaks from watching, reading, or listening to news stories, including social media. We recognize that given a person’s context (i.e., background, culture, environment, community), it may be difficult to step away from the media, and encourage you to do what feels best for you. Some tips to disconnect/unplug include:
      • - Put your phone on do not disturb
        - Set time limits for watching, reading, and listening to media
        - Turn off news alert notifications
        - Find additional tips HERE
  • 5. Creating structure with a daily routine:
    • COVID-19 and social distancing may have thrown you off your regular routine, resulting in increased anxiety. Anxiety often causes avoidance and may start interfering with completing tasks/projects/”things to do” lists in your life. Establishing a daily routine can reduce overwhelmed feelings, create a sense of control, and predictability. Below are some ideas to help:
      • - Create a flexible schedule of what you would like your days to look like (have a daily planner, calendar, list)
        - Have a set wake time and a bed-time
        - If possible, eat meals around the same time daily
        - Drink enough water throughout the day
        - Make a list of weekly goals you would like to accomplish. Break these goals into smaller parts and cross them off as you go
        - Identify 1-3 important tasks to help you prioritize
        - Try out productivity techniques (e.g., Pomodoro Technique)
        - Schedule regular breaks (e.g., 10-15 min breaks)
        - Set aside time to organize and clean your space
        - Create weekly rituals (e.g. call/video chat friends on Saturdays)
  • 6. Taking care of your body with physical activity:
    • Physical activity can reduce anxiety, increase energy, and enhance brain function. Research shows that you only need about 20 min, 3x/week to experience the benefits of movement. Here are some tips to get your body moving:
      • - Stream online workout videos (YouTube) 
        - Browse Pinterest for Indoor/outdoor workouts
        - Take a walk, jog/run, bike ride, or rollerblade/skate
        - Dance while watching instructional videos or just have an unscripted dance party
        - Yoga
        - Stretch
  • 7. Engaging in pleasurable/self-care activities:
    • Engaging in self-care, pleasurable, rejuvenating activities can improve your anxiety. You can even make them be your long-lasting care routine. We encourage using rituals and strategies based on your cultural values, background, and multiple social identities. Please be kind to yourself as self-care is not “one size fits all.”
      • Examples of pleasurable activities 
        - Engage in gardening
        - Bake
        - Try new recipes
        - Make your favorite meal
        - Drink tea
        - Do some arts and crafts (i.e., drawing, painting, knitting)
        - Do coloring
        - Take a relaxing bath or try a new soothing scent in your home
        - Meditate
        - Make a list of your personal strengths
        - Play "brain games" like Sudoku, crosswords, or word-searches
        - Do a jig-saw puzzle
        - Watch a movie or tv show
        - Listen to a new podcast
        - Read a new book (hard copy or audio-book)
        - Enhance or reconnect with your spirituality
        - Listen to your favorite music
        - Play/learn to play an instrument
        - Spend time with your pet(s)
        - Take a nap
        - Practice new hair or make-up styles
  • 8. Create your own care plan to manage anxiety:

References

- Coronavirus Anxiety Workbook https://thewellnesssociety.org/free-coronavirus-anxiety-workbook/
- Coronavirus Disease 2019. Stress and Coping. Center for Disease Control and Prevention 
- Yale Medicine. Feeling Anxious about COVID-19 https://www.yalemedicine.org/stories/covid-19-anxiety/
- Arizona Coalition to End Sexual and Domestic Violence. Self-Care during COVID-10 https://drive.google.com/file/d/1Je-9JTlpBSWx9jcObU3jjsd7773XSNSv/view 

Resources for other psychological conditions that may be associated with anxiety and COVID-19