If you've had one too many sleepless nights lately, it's all too understandable — there’s a lot to worry about these days! More likely than not, you’re experiencing anxiety. But know that you're not alone.
Anxiety levels are at an all time high with so many unknowns surrounding the COVID-19 pandemic, explains certified holistic health coach Sharla Mandere.
"There don’t seem to be any real answers, the 'solution' changes weekly (and even daily), and we can’t control how other people act in public," says Mandere. "Whether it be not wearing a mask, peaceful protests turning violent, not knowing what the fall will look like with schools and jobs, or feeling isolated from friends and loved ones, anxiety is bound to spike."
In the age of social distancing when everything feels out of our control, taking inventory of our emotional well-being and focusing on mental health is key.
For those experiencing persistent feelings of anxiety, we always encourage you to seek a mental health professional for treatment, but we also spoke to a few experts for their best anxiety-busting tips and self-help advice.
What is anxiety?
Anxiety is the feeling of worry or unease about an imminent event or uncertain outcome. In short, it's the fear of the unknown.
While occasional anxiety is an expected part of daily life (feeling anxious about public speaking or stressing over taking a test) and can sometimes even be a good thing, persistent feelings of anxiety can be cause for concern as they interfere with daily activities or even manifest themselves in physical symptoms.
According to the National Institute of Mental Health (NIMH), an estimated 31% of adults in the United States experience an anxiety disorder at some point in their lives.
7 different types of anxiety disorders
- Generalized anxiety disorder: People with GAD experience excessive worry or anxiety about their personal lives and routine circumstances on most days for a six month period or longer.
- Panic disorder: People with this disorder have recurrent and sudden panic attacks that can be brought on by a trigger or completely unexpectedly.
- Post-traumatic stress disorder: This type of anxiety disorder affects individuals who've experienced some form of traumatic event and continue to feel frightened or stressed by external triggers.
- Obsessive compulsive disorder: OCD is a chronic disorder in which a person has recurring thoughts (obsessions) or behaviors (compulsions) that he or she feels the urge to repeat over and over.
- Social anxiety disorder: People with this disorder have a fear of social situations and worry that their social interactions will be judged by others and lead to embarrassment.
- Separation anxiety disorder: Most common in young children but sometimes also diagnosed in teens and adults, separation anxiety is the fear of being away from home or loved ones. It typically occurs at a developmental age and causes the person to avoid being alone.
- Specific phobias: An intense fear, aversion to, or anxiety about a certain object or situation, such as heights, flying, spiders, snakes, strangers, injections, or blood. Social anxiety disorder is also an example of a specific phobia.
What are the typical symptoms of anxiety?
Have you experienced that familiar knot in your stomach, tension in your shoulders, or weight on your chest lately? Aside from the mental toll that it can take on a person, anxiety can manifest itself in emotional, behavioral and physical symptoms.
Anxiety symptoms can include:
- Emotional symptoms: irritability, crying, overwhelm, anger or general upset, suicidal thoughts
- Physical symptoms: chest pain, rapid heart palpitations, muscle tension, sweating and nausea, fatigue, headaches, teeth grinding, itching and rashes triggered by histamine
- Behavioral symptoms: withdrawal, difficulty sleeping, irrational thinking, domestic violence, drinking alcohol, or upset with others' behavior
How can I tell if I'm having a panic attack?
Panic attacks occur when stress hormones trigger a fight-or-flight response to a stressful situation, often resulting in symptoms such as chest pain, heart palpitations, accelerated heart rate, sweating, trembling, or shortness of breath (which is also a COVID-19 symptom, making things even more scary and confusing).
Panic attacks come on suddenly — typically lasting only 20 to 30 minutes — and can make you feel like you're losing control. While panic attacks are often a response to a specific trigger or fear of an upcoming situation, they can also be brought on unexpectedly for no apparent reason. Those with true panic disorder experience recurring panic attacks, but anyone can have one.
The good news is panic attacks aren't life-threatening, but they are still a frightening experience, so it's best to remind yourself that it's only temporary and focus on calming yourself down.
To de-escalate a panic attack, Dr. Thomas McDonagh, anxiety expert and founder of Good Therapy SF, suggests the following:
- Use a breathing technique. During the buildup of a panic attack, our breathing becomes more rapid and shallow. To change this, breathe in through the nose for four seconds, hold it for one second, and exhale out the mouth for five seconds. Think about breathing into your stomach (this will help prevent the shallow breathing that can trigger panic attacks).
- Focus on relaxing your body. If you are able, some intense exercise for about 10 minutes (such as walking up and downstairs continuously, or doing body squats) exerts the muscles and can help you feel more relaxed.
It's vital not to mistake a heart attack for a panic attack. While the symptoms can be similar, a heart attack is considered an emergency that requires medical attention. Most panic attacks resolve in about 20 minutes, but a heart attack will worsen and is typically brought on by physical exertion.
If there's any question on whether you're experiencing a medical emergency, call your doctor or 911 immediately, especially if you have any family members with a history of heart disease or other serious health issues.
Risk factors for anxiety disorders
Several factors can combine to put someone at risk of developing an anxiety disorder. According to the American Psychiatric Association, anxiety disorders can run in families, suggesting that genetics can be at play, but environmental, psychological and development factors also contribute.
Childhood experiences such as early exposure to a stressful life event or environment, as well as the tendency to display shyness, low self-esteem or withdrawal, are often linked to anxiety later on.
Additionally, health conditions such as thyroid problems and substances such as caffeine can aggravate anxiety symptoms.
Anxiety concerns related to COVID-19
These days, daily activities that involve social situations can feel like a traumatic event. For our own health and safety (and that of others), we know we need to avoid crowds and social gatherings — and have been doing so for the past several months — so now being forced into a social setting and surrounded by people might feel disorienting or anxiety-inducing.
Agoraphobia is a social anxiety disorder that typically involves the fear of standing in line or being in a crowd, using public transportation, or being outside of the home and in enclosed spaces –– all things we've been told aren't currently safe.
On top of this, our self-isolation has given us more time "in our heads" for thinking and reflection, notes life coach Danny Greeves, which can produce intrusive thoughts and heighten anxiety. This could be affecting us physically, emotionally and behaviorally.
Even though we may be engaging in social distancing, now is not the time to engage in emotional distancing, explains clinical psychologist Lauren Cook.
"Share with trusted others how you’re doing. Call people—check in. Don’t worry that you are bothering others by reaching out. Chances are, they will welcome the increased sense of connection," Cook says. "Don’t isolate yourself any more than is necessary."
Anxiety treatment options
Prescriptions for anti-anxiety medication were up 34% from mid-February to mid-March, likely due to the coronavirus pandemic. Beta blockers for high blood pressure are also sometimes used to help reduce physical symptoms such as heart racing and trembling or calm people down during a panic attack.
However, whenever possible, it's recommended to start with holistic approaches to managing anxiety such as psychotherapy, breathing and grounding techniques, and self-compassion.
Cognitive behavioral therapy is a form of "talk therapy" that aims to turn negative thinking patterns into positive ones and limit distorted thinking in order to manage your fears. Dr. McDonagh's best advice is to recognize the pattern of anxiety thinking rather than assuming the worst will happen.
"Try to be inquisitive with yourself and explore what this worst case situation will be, and then focus on how you will adapt and cope with this situation. Reminding yourself how you can adapt and cope to any situation can reduce anxiety overall," he says.
On the other hand, exposure therapy encourages you to safely confront your fears (rather than merely thinking and talking about it) in order to relieve the associated anxiety surrounding that situation.
Grounding techniques are also a quick and easy method for relieving anxiety. You can use a deep breathing exercise to slow your breath if you're feeling short of breath due to anxiety, or you can take a moment to acknowledge the world around you by using your five senses.
There are a number of ways to do this, but one that licensed mental health counselor Kimberly Tucker uses with her clients involves finding five things you can see, four things you can touch, three things you can hear, two you can smell, and one you can taste.
Hanna Milton, mindfulness and well-being teacher, also recommends practicing self-compassion and recognizing the difficulties you're experiencing rather than beating yourself up over them.
"By acknowledging the tough times and offering yourself comfort – much like you would do towards a friend in need – you’re no longer struggling against them. And you might be surprised how quickly they pass when you’re no longer resisting them!" says Milton.
Stress management tips for anxiety prevention
Stress management and mindfulness techniques such as meditation, journaling and exercise are key to building a wellness plan that can help provide a sense of routine and prevent anxiety in your daily life.
Productivity, time management and leadership coach Alexis Haselberger recommends planning out each day, which can alleviate some of the anxiety about what the future holds by putting structure around it. That should include scheduling time to worry!
"Literally put it on your calendar. When your mind knows it has a time and place to worry, your brain can get back to the task at hand. When the time comes on your calendar to worry, you might not even need to," Haselberger says.
Here are are few tips and takeaways on managing stress and anxiety that you can build into your daily routine:
- Meditate: Unwind with an intentional mindfulness meditation. YouTube videos, apps and audio guides are all helpful resources to lead you through your practice.
- Practice gratitude: Thinking about what you're grateful for each day can cultivate positive feelings and benefit your physical and mental health.
- Exercise: Exercise helps release the stress hormone cortisol. Mindful walks or yoga sessions are two simple forms of exercise that can help you feel more centered.
- Journal: Whether you want to reflect on what you accomplished at the end of the day, or work on a to-do list for tomorrow, journaling can be a rewarding mindfulness practice
- Experience nature: Go outside, experience a change of setting, and get yourself moving. Nothing is more eye-opening than surrounding yourself with trees, open skies, or calming waters.
- Get creative: Perhaps you like to draw, dance, sing or write. No matter what art form comes naturally to you, find a way to unleash your creativity and take a break from your day-to-day obligations.
- Limit news intake: With the constant flood of alerts and updates about coronavirus in the news and on social media, it can be helpful to allot a limited amount of time per day to dedicate to news consumption.
- Get good sleep: Wake up at the same time each morning, including on weekends, and allow yourself to de-stress at least an hour before bed by putting away phone screens.