We are you. We are mothers, daughters, students and teachers. Yet we are also clinical psychologists who spend our days researching and treating pathological anxiety and fear. With the near constant news of the spreading coronavirus and fatalities, our personal and professional identities have dramatically collided, forcing us to consciously live consistent with the scientific principles we know well.
This became very real for one of us on March 1, as two young children developed sudden, unexplained fevers. As they lay uncharacteristically quiet on the couch complaining of sore throats and headaches, fear set in. What followed was 24 hours of worry, internet searching, repeated calls to the pediatrician, and constant self-reassurance — kids are unlikely to develop severe symptoms, coughing and breathing difficulties are primary symptoms — but anxiety persisted. In the end, the two kids were diagnosed with strep infections, and anxiety subsided.
In Seattle’s elevated threat environment, anxiety processes are playing out in our daily lives. A colleague coughing during a faculty meeting captures our attention within seconds and sends our thoughts racing: “Don’t you know there are vulnerable people here?” to “Is this meeting really that important?” This is classic attentional bias to threat, where our brain’s danger system directs attention to any potential threats. Rational and irrational threats are now everywhere, from our well-used office doorknob, a crowded ramen noodle house, to a kindly neighbor shaking an older parent’s hand. Our news media runs constant BREAKING NEWS alerts, promising to provide “facts not fear” or help to “plan not panic.” As experts, we know this coverage amps up anxiety; yet, we watch, too.
Decades of scientific research shows that how we make meaning out of situations can leave us vulnerable to unhelpful, out of proportion anxiety. When our environment is inherently ambiguous — open to interpretation and unknown outcomes — our interpretations matter. They matter a lot. Ambiguity breeds anxiety; more so when the “facts” change hourly. Interpretations matter even more when they lead to prejudice and outright discrimination, as we’ve seen against individuals of Asian descent.
From the neuroscience of fear overgeneralization, we know that our hippocampus is struggling to process ambiguous, contextual information, and that our ventral medial prefrontal cortex is using this information to try to inhibit brain areas associated with fear (e.g., amygdala). We all feel this push/pull process in our brains as we move through our days and struggle to regain control. We feel the need to control uncontrollable situations. Messages about regaining this elusive control are now wearing thin: wash your hands thoroughly; don’t shake hands; don’t touch your face; don’t go to work if you’re sick; use social distancing.
Anxiety and fear have survival value: to prepare and protect. So, what else can we do to not let COVID-19 fears go from helpful to harmful? Or lead us to carelessness or complacency? Tools from evidence-based psychotherapy highlight key principles. Notice unhelpful thoughts and behaviors. Stewing about your co-worker’s cough may lead to positive office changes; however, if it continues, ask yourself, “Is this useful?” Worry that leads to active problem-solving or adaptive coping is helpful. Worry that leads to more worry is not. Build in ways to curb your time engaging in unhelpful worry. Make your news-media consumption intentional; restrict your time and sources each day. Increase activities that bring relaxation and happiness. Use the time you spent commuting to read, exercise, or do some other pleasant activity.
Finally, most important, accept that this is a time fraught with anxiety and fear. It’s OK to acknowledge this; if a loved one comes down with a high fever, you’re going to be scared. It’s good to acknowledge that the risk does not impact us all equally, and there is wide range in our abilities to operate outside our comfort zones. Be kind to yourself and others who may be feeling anxious. A little support goes a long way. Seek it. Provide it. Maybe, just maybe, we can continue these behaviors even after this outbreak is long behind us. After all, they boil down to a more balanced, kinder way of making sense of life’s ambiguities.