Tuesday, October 27

Understanding and Managing Your Anxiety During COVID and Beyond

1

By Steve Joordens

How are you? Don’t tell me, I know. Given all that is going on related to COVID-19 — the health worries, the money worries, the “what the heck comes next?” worries — you’re feeling anxious. We all are.

This article provides some highlights of my free online course called Mind Control: Managing Your Anxiety During COVID19, that is focused on helping people manage their anxiety during this crisis.

Following the structure of the course, I first describe the biological machinery underlying the anxiety response and what it has evolved to do well — keep us alive in the face of acute threats. This system was not designed to be chronically active, and when it is for too long it can compromise our immune system, thus it is important to learn to manage one’s anxiety response.

Fortunately, there are some clear ways of doing this. In this article and the course, I focus on two methods. The first is formally learning the skill of how to command your body into a relaxed state via the use of guided relaxation. The second is managing anxiety via a thoughtful approach to the stimuli and activities you engage in, some of which feed anxiety and some of which actively counter it. I end by briefly discussing the challenges of isolation, and how one can use the two approaches just described to tolerate isolation and emerge from it psychologically stronger.

Highlights of this article:

  • Given the danger and uncertainty associated with COVID19, most of us feel a level of chronic anxiety greater than any we have experienced in the past.
  • If we don’t learn to manage this anxiety response, we could end up with compromised immune systems, or the anxiety could evolve into depression.
  • Luckily, the system underlying our anxiety response is relatively simple, and with knowledge and practice one can exert some level of control over it.
  • One way to control anxiety is to formally learn how to put your body into a relaxed state — a body cannot be both anxious and relaxed at the same time.
  • Another approach is to consider the effect various stimuli and activities have on our level of anxiety, and to then configure our day in ways that ensure we can escape anxiety for parts of each day, or even directly fight the anxiety response via certain activities like laughing or singing.
  • Living in isolation also causes some unique anxiety which is different depending on one’s specific situation. With the knowledge and strategies described above — and more thoroughly in the course — one can configure a “way of being” during isolation that will allow one to manage their anxiety until such time as we can again co-mingle.

With the anxiety brought on by a crisis like the current COVID-19 pandemic, our negative thoughts race, our hearts beat faster, and we feel like our body has energy — but we don’t know what to do with it. It’s uncomfortable, and sometimes downright scary, and we all feel it for at least some of the day. 

The good news is that with a little knowledge and practice you can manage your anxiety response.  You’ll never be fully free of it for long, but you can control it, and you can customize your days in a way that gives you frequent breaks from anxiety.  Right now, it’s not just a good idea to learn these skills, it may be critical. As we know from the pioneering work of Hans Selye, if anxiety is left unchecked for too long it weakens our immune system, obviously not a good thing with a virus making the rounds.  In addition, anxiety can become depression, and depression is a worse place to be. So, for both of these reasons it is time for you to learn some Jedi mind-tricks that you can use to control your own mind and, through it, your body.

With support from the University of Toronto and my friends at Coursera, I recently created a free online course called Mind Control: Managing Your Anxiety During COVID19.  In this article I will describe some of the highlights of the course as another way of sharing these tips. Specifically, I will first explain what the anxiety response is, what it’s meant to do, why it feels like it does, and how — via practice with guided relaxation — we can learn to directly counter it. 

Next, I will highlight how certain stimuli or activities affect our anxiety levels — some increasing anxiety, some allowing an escape from anxiety, and some with special mojo in the sense that they actually support mental wellness. I’ll then touch on isolation and how one can use the information I presented to configure a way of living that will include managing your mind.

Understanding the Anxiety Response

Of course, most of our deep cognitive processing is performed by our brain, and some by the tissue in our spines. Together these are referred to as our Central Nervous System. For now, let’s collectively refer to it as our “mind,” as this is where our thinking is occurring. The mind interfaces with the body (e.g., muscles, sensory cells in our bodies, our internal organs, etc) via the Peripheral Nervous System. Critically, this peripheral nervous system has two modes of operating: the parasympathetic mode and the sympathetic mode.

The parasympathetic mode is associated with being in a relaxed state. When you are relaxed your mind releases hormones that promote digestion of food, delivery of nutrients to the body, and the elimination of waste. During this time your heart rate tends to be low, your breathing slow and shallow, and your mouth moist with saliva, which promotes digestion. In a sense, your mind is focusing on the long-term maintenance of your body. Most of the time this is the typical mode of operation we are in.

However, there is a small part of your brain we call your amygdala, and its entire purpose is to analyze all the incoming sensory information for any sign of threat. If it detects threat, it flips you into sympathetic mode. Almost immediately all of the processes of digestion stop, your eyes dilate (to get more information from the outside world), your heart rate quickens, your breathing picks up, and hormones are released to make you feel less pain. Your body is readying for action, readying to either fight the threat or to flee from it. Thus, your muscles receive oxygen to make you stronger and faster, and your reduced sensitivity to pain allow you to push physical boundaries. This is about short-term survival. Either you take down the threat, or you get the heck away from it. This reaction is at the heart of the anxiety you are currently feeling.

It’s important to highlight that this response evolved when threats tended to be acute.  That is, some predator might show up, you enter fight or flee mode, you do your thing, and if you survive the experience it tends to be over and done with in a relatively short period of time.  In our modern world though, “threats” can be more abstract, and they also can be much more chronic, staying present for longer periods of time. This is what we often label chronic stress.

As mentioned previously, experiencing chronic stress for too long can lead to a compromised immune system, and thus, it becomes critical to learn how to control it.  This is a direct skill we can all learn, a true Jedi mind-control trick! 

A Jedi Mind Control Trick to Combat Anxiety

Here’s the key to the trick: your body cannot be simultaneously anxious and relaxed.  You can be in one mode or the other, but not both. So, the mind trick involves learning how to banish anxiety by imposing a relaxed state on your body with your mind. This isn’t something we just know how to do. It is a skill that must be learned, and like all skills, it is only learned through practice.

To understand the need for practice I like this analogy: When you command this skill it’s like transporting your body to a new place — but your ability to do that depends critically on how familiar you are with that place and how to get there. 

You learn those things, what the place called relaxation feels like and how to get there, initially via the regular use of something called guided relaxation. I provide an audio tape of me walking you through a guided relaxation as part of my course, but there are also countless versions available online. Feel free to find one you like, but make sure it’s not just nice music, it should be a much more formal relaxation induction.

To demystify this, the guided relaxation I use asks you to lie down in a comfortable position, and to listen to and then do what I ask you to do.  I’ll then say something like, “Let’s begin with your feet, I want you to flex your foot muscles as though you were making a fist with your feet … hold that as long as you can and as tight as you can … it should start to hurt … good… tolerate as much pain as you can …hold it… hold it… then let go and as you do focus on the feeling of the tension leaving your feet …feel it go, like its slipping down the drain …that is what releasing tension feels like …and feel how your foot feels now that you have released. That is what real relaxation feels like. Now, let’s move to your calf muscles. Tense your calf muscles …”.

You get the idea. We work our way through the whole body up to and including your face muscles, doing the same thing, continually feeling what it feels like to release tension, and to embrace relaxation.

If you go through this process regularly, maybe even a couple or three times per day (it takes about 10 minutes each time) you will at some point no longer need the guide.  You will be able to walk yourself through, and as you do you’ll be able to achieve that relaxed state more quickly and easily. Practice enough and it will become something you can do in an instant.  You experience something, you feel your anxiety rising, and you mentally take control, impose relaxation, and in so doing you banish the anxiety. Let’s see Luke Skywalker do that! 

Thoughtful Interactions with Your Environment

Anxiety doesn’t just exist on its own; it must be fed or, more accurately, it must be triggered.  Recall that anxiety is triggered and fed when the amygdala senses threat in the information it is processing — information that comes from our senses (i.e., the external world), and information that comes from our consciousness (i.e., the internal world).  If your internal thoughts are full of anxiety, one can use their senses to replace — or what clinicians might call substitute — the anxious thoughts with more healthy thoughts. Consider this with respect to the following three classes of activities you might engage in.

Feeding Anxiety

Given all the ambiguity concerning COVID-19, information is precious to us.  Moreover, new information arrives in a pseudo-random manner, and this can addict us to the source of information as we keep thinking something new could be revealed at any moment.  The result is that we continually monitor the news. The problem is that each minute we watch or read the news, our brain is seeing and hearing about the threat. Your amygdala is triggered, and your anxiety response is being fed.

Of course, some exposure to news is necessary for vital information, but my advice to you is to take control of your exposure to news.  Budget your exposure and turn off any news-related notifications on your smartphone. You decide when you will expose yourself to the news, rather than having it “jump out” at you.  Tell yourself you’ll just watch for a bit (and stick to it), and then when that time is up, consider engaging in one of the next classes of activity.

Replacing Anxious Thoughts

Do you get lost in books?  Watching movies?  For me it’s GarageBand. If I start trying to create a song in GarageBand, hours can pass with me thinking of almost nothing but the song.  Find those activities that take you away, or more accurately, that take your mind somewhere and keep it there. These activities can fill your mind and, in the process, crowd out the anxious thoughts.  They provide an escape, a way to use your sensory processing to essentially “change the channel” on your thoughts. For example, after getting your news hit, change the channel, but using one of these activities as a sort of cognitive palette cleaner.

Escapes with Mojo

Escaping anxious thoughts is useful, but some escapes have a special mojo.  They not only provide an escape but they provide an escape that counters the negative effects of anxiety with positive effects.  I cannot describe each in detail here, but the list includes laughter, singing, dancing, aerobic activities, and activities that leave you feeling you have accomplished something.  My favorite recommendation is Karaoke!  When done as a family it typically combines singing, dancing and laughing! Very cool.

These activities feed your positive mental health, they make you feel good, and that counters the fear and uncertainty that anxious thoughts promote.  Find the ones that work for you, and make sure you budget them into your day as well.

The Rest of the Story

The two sections above relate to Weeks 1 and 2 of my online course, respectively.  In the third week I focus on living in isolation. I discuss the psychological challenges of isolation, and then draw on the advice highlighted above to ultimately recommend a way of adapting to isolation that will allow you to manage your anxiety, both via your new ability to command relaxation, and via a thoughtful approach to scheduling events within your day.

Overall then, my message is the following; Your anxieties are perfectly normal and reflect the workings of a very primitive part of our survival machinery.  In many situations, this machinery works well and allows us to meet acute threats we encounter in life. But COVID-19 is engaging this machinery in a way it was not designed for, and if left unchecked problems will arise. 

The good news is, while we often allow this machinery to do its thing on its own, with some knowledge and a thoughtful approach to our world we can take control of the machinery. We will never banish anxiety totally, but we can manage it and, in the process, gain a level of control that is critical to our mental health at this time.


About the author

Professor Steve Joordens in the Director of the Advanced Learning Technologies Lab at the University of Toronto Scarborough.   He teaches a very large Introduction to Psychology class at his institution, and also on Coursera.org.  His research focuses primarily on the creation and assessment of educational technologies, especially those focused on formal approaches to skill development.  His teaching and research have won him a number of institutional, provincial and national awards recognize a sustained and significant impact on higher education in Canada.

1 Comment