How to cope with health anxiety related to the coronavirus pandemic

The global coronavirus situation is evolving rapidly, and it can feel very overwhelming to keep up with the many headlines and ever-changing governmental rules and expert recommendations. Many of us, understandably, are experiencing new or increased feelings of anxiety related to the coronavirus pandemic — which is affecting our daily lives in a multitude of significant ways.

It's completely normal to experience health anxiety right now, in the midst of a global pandemic, says Dr. Martin Antony, a professor of psychology at Ryerson University and co-author of The Anti-Anxiety Workbook. But not all of the Cognitive Behavioral Therapy techniques that you might use to manage everyday anxiety will be applicable in this acute situation. "Many of the strategies that we would normally use for anxiety, when people have anxiety about something when there is no real threat, are not necessarily relevant, or not relevant in the same way, in a situation where there is a potential threat," says Dr. Antony.

It's also important to note that it's a crucial time from a public health perspective for all of us to be careful about following public health guidelines. "The threat is not, right now anyway, as much an individual threat, as it is a public health threat," says Dr. Antony. "All of these things that we're being asked to do — social distancing, handwashing and avoiding large groups, for example — are essential to prevent this situation from turning into something where there's a much higher individual risk."

Realistic versus unrealistic anxieties

When it comes to using Cognitive Behavioral Therapy techniques to help manage anxiety, the important question to ask is whether you're dealing with anxieties that are founded in reality. In other words, the first step is really to figure out which of your thoughts are realistic and which are exaggerated or unrealistic. "The challenge with this situation is it's changing from day to day; it's changing so quickly that it can be hard to evaluate what thoughts are realistic and unrealistic," says Dr. Antony.

"With unrealistic anxiety, where there is no actual threat, we typically recommend that people do the things that make them anxious, and that they challenge those thoughts," says Dr. Antony. Looking for evidence for, and against, those thoughts can help you try to shift them.

"With realistic anxiety, where there is some threat, we don't encourage people to do the thing that scares them," says Dr. Antony. Instead, using problem-solving skills to deal with the threat and taking actions that help manage risk can help you manage anxiety in this case. Relaxation-based strategies, breathing exercises, and mindfulness exercises can also be helpful for taking the edge off when people are stressed, suggests Dr. Antony. 

Cognitive Behavioral Therapy techniques that might help right now

"There are cognitive techniques which involve challenging unrealistic or exaggerated thinking that is contributing to anxiety," says Dr. Antony. Worksheets or apps, for example, use a 'thought record' strategy to help you identify your negative thought, the evidence in favour and the evidence that contradicts that thought, and help you look at things from different perspectives. The goal here is to arrive at a more balanced, flexible way of looking at the situation, notes Dr. Antony.

And with the current pandemic, certain behavioural strategies from Cognitive Behavioral Therapy can be particularly helpful. "In the case of a situation where there is a realistic stressor — there's a disease we're trying to flatten the curve with, or there's economic stress — strategies more focused on things like problem-solving can help people deal with the situation," says Dr. Antony. 

Trying to think about problems in a different way can help you manage your health anxiety. Some people with a positive problem orientation assume that most problems can be solved and see them as challenges to be overcome, whereas other people might see problems in a much more negative light, as things to be avoided at all cost. "We want people to really try to think about problems as challenges to be solved, not unsolvable events over which they have no control," says Dr. Antony.

Once you shift the way you look at problems, there are five main steps for actually trying to solve them. Step one is identifying the problem; step two is brainstorming possible solutions; step three is evaluating the solutions by looking at the potential costs and benefits; step four is choosing and implementing the best solution; and step five is evaluating how it went. "These are things that many of us just do naturally all the time," says Dr. Antony. "But for some people, when they get overwhelmed with a particular problem, it may not be as obvious to them exactly what steps they need to take to solve it. This is one strategy that we teach people for dealing with realistic stresses that are causing anxiety for them."

Other behavioural techniques, including mindfulness meditation and relaxation-based strategies like slowing down your breathing, can also help you feel less anxious, says Dr. Antony. Social support and exercise can be very useful for managing stress as well; even though we're being encouraged to practice social distancing, it can be helpful to connect with the people you care about using technology such as FaceTime or Skype.  

Find an information balance

"Under different circumstances, I would say to someone with excessive health anxiety to absolutely stay away from the news," says Dr. Antony, pointing out that "cyberchondria" can be an issue for people who have health anxiety. But in this case, you do need to keep up with new recommendations from trusted sources like Health Canada and the Centers for Disease Control and Prevention (CDC), so it's about taking a balanced approach.  

"It might be going to certain reputable sites, such as government websites, once a day to see whether the recommendations have changed, but not spending your whole day online looking at every possible site," says Dr. Antony. "But if [your anxiety] is really getting the best of you, then one strategy might be to reduce that [exposure to information] while still finding ways to keep informed of the things that you need to know about." 

Know that this situation is temporary

In this context, during a global pandemic, it's not as concerning for Dr. Antony that people are more anxious about their health. "It just means they're going to follow [public health] guidelines more, and it's going to help flatten the curve," says Dr. Antony. "It's temporary, and it's less of a problem in the next little while. It would be more concerning to me if this was going to be a long-standing issue for somebody, or it's going to really interfere with their lives over the long term." Dr. Antony notes that the COVID-19 pandemic might have other negative impacts on people's well-being that can be concerning; for example, if they're prone to depression and are now more socially isolated, or if they're already struggling with anxiety and are experiencing financial setbacks.

"The situation is uncertain, and that's contributing to your anxiety," says Dr. Antony. "What I would encourage people to do is to accept some level of anxiety right now, [knowing] that it's temporary." He also points out that it's sometimes much easier to deal with anxiety that's shared — we're all going through this situation together, and we should make use of available social support.  

Truc Nguyen is a Toronto-based writer, editor and stylist. Follow her at @trucnguyen.