How to Handle Excessive Worry Related to COVID-19

The world faces a significant threat right now, and it would be absurd to deny it. This threat is invisible, and we don’t know how to respond precisely. For some of us, we might be underreacting and not protecting ourselves or loved ones. For others, there might be so much anxiety that it leads to paralysis from the fear.

This article discusses ways that people can get stuck in their worries and how to break this negative cycle.

The Purpose of Anxiety

In working with people with anxiety, patients often ask for help in making their anxiety disappear. However, anxiety is an important signal that we need so we can take corrective action. If we encounter a bear in the woods, our fear leads to action. Without fear, we would not survive long. For patients with too much anxiety, they need to find the spot where their emotion is informative, but the volume is not cranked up so high that they can’t hear the signal.

In this current situation, we don’t know how much of a threat COVID-19 is or how much we should worry. The trajectory of the coronavirus is uncertain and unpredictable, which are features that fuel anxiety and threat-processing in the brain (Marker & Alyward, 2011). It can lead to uncontrollable worry for some. There are some common mechanisms in people with excessive worry that might be helpful to deconstruct to help people respond efficiently to COVID-19.

Intolerance of Uncertainty

In 1929, the ticker tape system that showed the results of trading on the NY Stock Exchange could only print 268 characters per minute. Thus, when trading sped up, the tape would run minutes behind. On October 24, 1929, the ticker tape was running a few minutes late as stock prices began to fall. Without information, the traders started assuming the worst and started selling stocks. The tape kept falling further behind as anxious speculation fell over the market without any understanding of what was currently happening.

In our current situation with COVID-19, we also are behind on information. Public health officials and epidemiologists are creating predictive models that rely on many unknowns. Models cannot tell us everything we need to know as we don’t have all the data yet. In 1929, as in 2020, we do not know how bad things are.

One key component of excessive worry is the intolerance of uncertainty (Lee, Orsillo, Roemer, & Allen, 2009). For people with excessive anxiety, uncertainty is a trigger for worry. With the COVID-19 pandemic, there is a great deal of uncontrollability and unpredictability. When we don’t know what will happen, we wonder whether we will be able to cope with these threats. Sometimes our mind goes to the worst possible outcome.

It is essential to be able to live with uncertainty, which is much easier said than done. If we can be comfortable not knowing, it will make our lives easier. For people with a high intolerance of uncertainty, a spiral occurs. They will seek out as much information as possible to reduce uncertainty. When we cannot find answers, our anxiety does not subside, and it increases more.

This downward cycle is what leads people to have problems with excessive anxiety. This spiral can be a slippery slope if we focus too much on reading news about the pandemic. For patients, we try to break the cycle by having them sit with uncertainty and try not to find an answer. We can emulate this by reducing our need to find out everything about COVID-19 and its effects.

Key point: It is OK to learn about COVID-19 and the process, but don’t obsessively read articles in an attempt to get rid of uncertainty. We don’t have all the answers, and the more we obsess over getting rid of our uncertainty, the more anxious we will become. Find one or two reputable sources of information.

Anxiety Essential Reads

Facing Fears of the Future

Why Today's Kids Are Facing a Meaning Crisis

Emotional Reasoning and Overestimation of Threat

Another process that can raise anxiety is when people use their emotions to determine the severity of the threat. A typical way this process might occur is on an airplane when there is turbulence. We might look at a flight attendant to see if he/she looks worried. We use the emotions of the flight attendant to see whether we should be worried. The problem with using this information is we don’t know if our or others’ feelings are correctly tuned. If we rely on others to gauge our anxiety response, we might be making our anxiety worse. Social media and news sources can sometimes increase our emotions. If you feel your emotions (or others) are driving your anxiety, take a step back, and notice how your emotions are misleading you.

Our goal is to find a balance between using our anxiety to create enough action to be safe, but not too much where it spills over into excessive worry. We can look at the worst possible outcomes, but we must also look at other possible outcomes. We can question the probability of each outcome with logic (don’t let emotional reasoning take over). We can think like a scientist, weighing the evidence for and against each result to reach more balanced conclusions.

Keeping Perspective

It is essential to take measures for your safety (e.g., washing hands regularly, social distancing, and following travel advisories). However, it is also good to look at the big picture of other things that are happening in your life, like school, family, or work. It is difficult not to be overwhelmed by the amount of information on COVID-19 we receive. There is a balance between staying informed while not becoming obsessed with every news story.

Worry Time

An exercise for people with a generalized anxiety disorder or excessive worry is “worry time." The person is allowed a set amount of time each day for worrying. Throughout the rest of the day, they write down their worries for later. When worry hits, there is often a significant amount of emotion behind it. If we delay the worry until later, the feeling has often subsided. Set a time or two a day when you can worry as much as you want about COVID-19 (maybe 15 minutes twice a day). This process compartmentalizes the worry so you can find balance throughout the rest of the day.

Behavioral Activation

One of the most successful treatments for depression is behavioral activation. A simple way to describe it is "acting as if" one is not depressed. The change in behavior leads to a change in thoughts and emotions.

In these challenging times, most people are out of their regular routines and are distanced from social contacts. Trying to change our behaviors (safely) can prevent us from being down or depressed. Taking walks (if one can maintain a safe physical distance from others) or scheduling talks with friends through technological means can be quite helpful in our attempts to act as if we are not depressed.

For a person who is home without social contact, it can be easy to fall in the opposite habit of "acting as if" one is depressed. Try to find alternatives for physical activities, social interactions, and prosocial behaviors. Donating your time can be a powerful way to avoid being stuck inside and stuck inside yourself. Finding ways to exercise and move is excellent for your physical and mental health. Social contact is potent in enhancing our immune systems (Coan, Schaefer, & Davidson, 2006).

Antifragility

We have multiple biological mechanisms that make us more robust when we undergo stress. When we exercise, our strength or endurance adapts to handle more later. Similarly, when we fast (de Cabo & Mattson, 2019) or are exposed to cold (Mulligan, Gonzalez, Stewart, Carey, & Saupe, 2007), our body has adaptive mechanisms that make us stronger or less fragile in the long run.

We can think of this current COVID-19 situation as an opportunity for growth. We might find what is important to us and get rid of less important things. Maybe it makes us realize what we were doing was not as important as it seems. Looking at this stressor as having potential benefits might help us with our worry. Isaac Newton created much of calculus and the law of gravity while having to leave London due to a plague. What can you create out of this stressful situation?

Summary

People have different fears related to COVID-19. Some people might worry about their own or others’ health, while other people have concerns related to ramifications from the outbreak (e.g., stock market, jobs). All of the same above principles are important. There is a lot of uncertainty in what the future holds. Find the right balance of preparing and being OK with the uncertainty.

Reading too much about COVID-19, having an intolerance of uncertainty, and using emotional reasoning are all ways to create anxiety that is not in proportion to the threat. Find your balance between uncertainty and being prepared while also finding a new routine. Finding new physical activities and social support can provide a structure to deal with unpredictability and uncertainty. Being anxious is normal and healthy in this pandemic. Having excessive out of control worry is not helpful. Use the tips described above or if it becomes too bad, seek help from a psychologist.