Pandemic Fear and Anxiety

Recognition and management of fear and anxiety are essential to maintain healthy emotions and mood. Cascading anxiety can contribute to emotional collapse and severe depression.

Fear can paralyze a person with a loss of productivity, effectiveness, and quality of life. Unchecked fear with worry can build to loss of confidence, insecurity, and significant emotional states like anxiety, panic, and depression. Today’s unique atmosphere of a viral COVID-19 pandemic is overwhelming for many. Our nation is experiencing a collapsing economy, with the devastating effect of an enormous number of people dying from the viral illness.

During the COVID-19 pandemic, there has been a marked increase in anxiety, depression, and a marked rise in associated illness and death. Emotional distress and mental impairment can likewise cause loss of work-time, disruptions in relationships, drug addictions, deaths from overdoses, and suicidality.

Mental Health America (MHA) reported data from individuals who completed an online mental health screen showed a significant number of moderate to severe depression or anxiety, compared with a similar study before the COVID pandemic. MHA has been conducting online screenings for six years, with over 5.5 million completed, the most extensive such screening program in the United States.

A quarter of participants cited grief, losses, and financial concerns as contributors to anxiety and depression. Current events appeared as a significant factor in the development of mental health problems. Contributors who screened positive for depression reported increased thought of suicide or self-harm on at least half of days to nearly every day

According to a two-month July 2020 survey from the Kaiser Family Foundation, more than half of the U.S. population have experienced adverse effects from COVID-19 related stress. The question asked was: “Has worry or stress caused you to experience any of the following in the past two months.” Frequently reported difficulties included problems with sleep, poor appetite or overeating, mental health issues, headaches, stomachaches, temper difficulties, increased alcohol, and drug use, worsening of chronic illnesses like diabetes and hypertension.

With increasing unemployment, losses of businesses, jobs, and governmental aid, people are terrified about sustaining themselves and their families.

The collapsing economy since the onset of the pandemic has wiped out the five prior years of economic growth, driving fears of a more prolonged recovery than earlier anticipated, as seen in the Great Depression. The current surge in coronavirus cases and deaths in the U.S. and concern that there will be renewed shutdowns has led to decreases in consumer confidence and spending.

Anxiety and fear soar when worried about how to make it through the COVID-times with the many demands like:

• Avoiding close personal contact with social distancing
• Wearing masks
• Doing frequent hand washing and sanitizing of surfaces
• Staying out of closed spaces occupied by potential carriers of the Coronavirus, like places of usual recreation, shopping, working, and entertainment, etc.

Who is more prone to have fear and anxiety?

People that are more apt to have heightened worries: are older individuals, people with medical issues like smoking, chronic airway disease, obesity, diabetes, and individuals living in higher-risk environments like nursing homes or crowded spaces. Essential workers and people that have gone back to work are always aware, or least they should be, of the safety issue to prevent the spread or getting infected by the virus.

Stress and fears can be an overwhelming reality and are frequently higher in disadvantaged, minority communities, and amongst essential workers where higher rates of COVID illnesses and deaths occur. Contributors to a higher spread of the COVID-19 virus are poverty, lack of healthcare resources, living in less healthy environments, where more COVID-vulnerable health conditions exist as obesity, diabetes, and hypertension.

The economic disparity of people in the U.S. living below the poverty line will most likely increase as the current pandemic continues, and unemployment grows.  With the necessary supply of basics as food and shelter threatened, fear, anxiety, and panic will increase among the disadvantaged. Higher demands will be placed on the government and all able citizens to create an increased flow of opportunities and financial assistance to individuals and communities in need. To get past the current crisis will require the best of leadership and personal efforts to address the issues and treats imposed by poverty and disadvantages.

Individuals are more prone to anxiety and mood disturbances that have a prior history of significant trauma. The residual effect of traumatization occurs in individuals who have experienced life-threatening situations, losses, severe illness, victims of or witnesses of violence, near-death experiences, auto accidents, exposure to natural disasters or war, earlier life deprivations, or abuse. Post-Traumatic Stress Syndrome is an example of recurrence of anxiety states and related physical and emotional symptoms from residual prior traumatic experiences – see Article: PTSD, Terror, and Trauma

What are the best strategies or tools to reduce the present heightened anxiety and adverse emotional states to non-harmful levels?

Like the risk of getting a COVID-19 infection when in a closed spaced with other infected people, fear and anxiety can likewise rise dramatically by being “caged-in” or stuck in one’s inner thoughts and emotions. Levels of fear and anxiety get compounded as well when caught in tight quarters with others experiencing fearful states. Avoiding getting help, counseling, or therapy, especially if there is a history of unresolved trauma from the past, will increase the likelihood of developing severe mental health issues or illness. So, seek help or guidance, early on, when you become aware of growing fear, worry, and anxiety.

Early identification of feelings or symptoms of unhealthy emotional or mood states, is an initial step in knowing when to get help or support. Prompt attention and early intervention may prevent the progression of persisting fear and worry to more severe and chronic disruptions in one’s wellbeing and mental health as occurs in continuing anxiety and depression conditions.

Sign of Significant Anxiety May INCLUDE:

• Being frequently nervous, hypersensitive, irritable, moody, or on edge
• Feeling a sense of impending danger or doom
• Increased or rapid pulse/heart rate, palpitations, and dizziness
• Fast or troubled breathing, and sweating
• Increase tiredness, weakness, and wanting to sleep more
• Muscle tension, fatigue, and trembling
• Difficulty concentrating and getting things done
• Having trouble sleeping with more frequent nightmares
• Experiencing digestive problems and changes in appetite
• Panic Attacks which appear suddenly and increase in intensity over several-minute periods, peaks, and then usually goes rapidly away. Panic attack symptoms are more intense over a briefer period. They include symptoms as severe anxiety, muscle tightness, trembling, fast heartbeat, fast or troubled breathing, dizziness, impaired concentration, palpitations, sweating, and sleep disturbances.
• See Article: COVID-19 Anxiety

Signs of Significant Depression may INCLUDE:

• Feeling down, guilt, hopeless, helpless, sad, or irritable (“pushing people away” or not getting along with others)
• Loss of one’s usual interests or pleasure in doing things (anhedonia)
• Changes in sleep patterns as trouble falling asleep, not getting restful sleep, sleeping too much, not wanting to get up, or staying in bed much of the day
• Feeling tired, loss of vitality, or having little energy
• Poor appetite, overeating, weight loss or gain
• Frequently feeling bad about oneself as feeling worthless or as a failure
• Trouble concentrating or remembering things
• Slowing down of speech or movements, having a frequent sad face
• Being fidgety or restless more than usual
• Difficulty functioning at home or work
• Withdrawal and isolating self from others
• Spending more time on T.V., computers, tablets, or cell phones
• Being preoccupied with watching movies or the news
• Thoughts of dying, self-harm (suicidal thoughts), or of harming others (homicidal thoughts)

All the listed symptoms or behaviors may be only slightly present, noticed at times, or be very pervasive in a highly anxious or depressed person’s daily life and activity. If a person is feeling that life has lost its meaning and not worth living and has suicidal thoughts or feelings about hurting oneself or others, it is time to act and seek outside help from a qualified mental healthcare professional or resource.

• In the U.S. for immediate or crisis assistance, call your local suicide hotline or 1-800-273-8255 1-800-273-TALK, 1-800-273-8255 or 1-800-SUICIDE,  1-800-784-2433 for the National Suicide Prevention Lifeline.

See articles: COVID-19 Depression and Grief & Overview of Major Depression

Don’t Forget the Children!

Children are now known to be susceptible to COVID-19 infections. There is also a growing recognition that the younger part of the population, as adults, is at significant risk for difficulties with fear, anxiety, and mood problems during these pandemic times. Signs and symptoms of impending trouble might be different for children than seen in adults. Such behavior or emotional changes might appear like:

• Temper tantrums, acting out behaviors as being destructive, getting into fights or arguments
• Sleep difficulties and nightmare
• Showing decreased interests in things usually enjoyed
• Being more sullen or apathetic, or becoming more hyperactive
• Not wanting to participate in playful or recreational activities with themselves or with others
• Not eating well, gaining or losing weight
• Loss of concentration, attention, and becoming more distractible

Some of these changes observed in children may be a warning sign for the need to seek support or help for the younger at-risk and vulnerable family members.

Early recognition, getting support and help, is a key for the prevention and reduction of the risk for chronic emotional and mental impairments and related physical illnesses.

When severe and recurrent fear and anxiety persist, help and relief can be possible with an effective therapeutic intervention that helps the person to

1. Get unstuck from unhealthy patterns of behavior, rigid beliefs, and fearful or painful memories.
2. Reduce or eliminate anxiety, panic, addictions, and trauma-related symptoms
3. Focus more on the present and the here and now, rather than the past or future
4. Become more present, mindful, and aware
5. Improve energy, focus, concentration, daily functioning, and skills to prevent relapse or recurring symptoms
6. Develop greater acceptance and compassion
7. Regain the wisdom and the balance of personal power, self-needs, and the needs of others
8. Reestablish social support and networks

Therapies for anxiety, mood impairments, and prior trauma, as Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive-Behavioral Therapy (CBT) type of interventions, are often beneficial. These approaches can help an individual to reduce stress and anxiety. See article from “BetterHelp.”

Holistic, humanistic, transpersonal, or holotropic therapies, as EMDR and CBT, may include:

• Education about the body’s physiological reaction to fear and threat
• Use of experiential as well as talk/listening, person to person, or group therapies
• Desensitization to the various physical sensations or triggers of panic through the exposure of a person to the actual object, situation or thought
• Catastrophic thought reducing techniques
• Learning relaxation, breathing, and stress management techniques
• Restructuring dysfunctional thoughts and patterns
• Gaining personal insights and the realization of one’s inner strength and vision to overcome obstacles
• Transforming from being the victim of horrible traumatic experience and memories to a broader perception of life, one’s power, and potentialities
• Acceptance that the mind is continually moving toward the healing of its own emotional and mental health
• Promotes personal commitment to supporting the healing process and therapeutic work needed
• Supports the person’s process and strengths to release frozen past traumatic memories and constricting defenses, to regain energy flow and vitality
• Assistance for regaining flexibility, getting unstuck from rigid core beliefs and attitudes, to experience an expanded vision and perspective about life outside of the narrow constraints of a limiting mind-ego

Underlying medical conditions may also influence fear, anxiety, and feelings of vulnerability.

Healthcare providers are often not familiar with the potentially devastating effect and disability caused by the improper treatment of anxiety-related conditions. Management of anxiety is usually done with a tranquilizer, an anti-depressant, or reassurance by a conventional healthcare practitioner. A thorough evaluation by a qualified and experienced medical and mental health practitioner that has skills and expertise in working with anxiety, panic, and mood difficulties, is often warranted, helpful, and a better route to go when available.  Finding caring and valuable assistance, when possible for you, may get at the deeper issues and the roots of anxiety conditions.

Integrative, holistic, and natural therapies, when combined with more traditional treatment, can be the most effective course of treatment.

Some positive complementary approaches for consideration are:

• Lifestyle modifications and life skill enhancements
• Mind, body and spiritual practice as yoga, chi gong, mindfulness, meditation, creative arts, exercise with mindfulness as running, swimming, biking, or dance
• Stress management and relaxation techniques
• Acupuncture and massage therapies
• Targeted nutritional therapies, botanical medicine, and nutritional education about dietary choices, and micronutrients (as with herbs, vitamins, minerals, essential fatty acids, and amino acids (the smallest units of protein and a precursor of brain neurotransmitters, which can sometimes help relieve anxiety and milder depression in combination with other natural and complementary therapies)

Medication may be of value in resistant or severe emotional or mental health condition, like major depression, if more natural therapies have not worked.

Antidepressants or tranquilizers type of medications are often used by conventional medical practitioners and sometimes bring more immediate relief. However, their long-term use is controversial with the concern for their possible cause of other medical issues. Trying to stop medication can lead to relapse, or, in the case of some of the tranquilizing drugs or alcohol can cause withdrawal seizures. They may not have the same lasting effect and benefits that take place with useful and appropriate therapy programs and the use of natural alternatives.

Ten Intentional ways to reduce anxiety, support yourself, and others through these worrisome pandemic times:

1. Reduce the time watching, checking social media, or listening to news stories on your T.V., computer, or smartphone when home or in the workplace. Check only once or twice per day to keep informed. Pick unbiased, truthful, and authoritative news outlets that do not have partisan political ties. Avoid misinformation or politically motivated reporting about the virus, pandemics, or politics. Hearing about the problems repeatedly during the day can lead to increased worry, anxiety, tension, poor sleep, or worse. 
2. Instead of too much inactivity as passive watching, listening, or obsessing about current worries or events takes frequent time-outs with regular exercise. Active movement includes stretching and eating healthy meals (avoiding sweet binging and over-snacking on high sugar and caloric food or drinks)—do regular relaxation times with deep breathing, meditation, or yoga. Sleep to get adequate restorative rest. Cut down or stop smoking or vaping, which can put you at higher risk for a COVID-19 infection. Use a nicotine patch if necessary. Avoid alcohol and non-prescription drugs. If working from home or in the workplace, take more frequent breaks, stand more, or take outside walks.
3. Keep to a regular exercise schedule as 15 to 30 minutes one to two times per day. Beneficial exercise can take many different forms. Examples would be walking, biking, walking stairs, housework, or an exercise routine. Other choices would be participating in an online group exercise program, or in a circuit exercise routine, including push-ups, lunges, jumping jacks, and running in place. Do relax, enjoy, and allow any worries and fears to the background of your awareness as you fully embrace the physical movement, breathing, and letting go of tension. After doing a good exercise routine, you can treat yourself with a nice hot bath with a couple of cups of Epson salt and a few drops of essential oils as lavender oil to melt away any remaining tension. Get outside and into natural settings. Being in and closer to nature is very calming and healing. Move, breathe, take in the beauty and harmony that abounds in the life around us.
4. Get involved with enjoyable recreational or artistic activities like art, writing, and craftwork. Read a good book. Complete home construction projects or prepare new recipes and meals. It is the time for creative homeschooling if you have children. Enjoy listening to music, dancing, or watching a good movie. Complete a crossword or jigsaw puzzle. Watch a comedy show for some humor and laughs.
5. Stay socially connected with friends, family, and community through video chats, texts, emails, phone calls, or doing socially-distanced, with face mask if needed, meetings. Share your concerns about what you’re experiencing. Value what has made you laugh amidst all the outside turmoil.
6. Learn or do yoga, mindfulness practices, meditation, or beneficial exercise routines to help with destressing and relaxing. Look for some interesting instructional videos that you can watch online with your computer or smartphones. If the time and resources are available, participate in an online virtual certification, continuing education, or a university degree program.
7. Let the current pandemic crisis – a time of significant disruption and travails – be a time to do an in-depth review of what is truly important and meaningful. Meditate and reflect on what is beyond your fears and self-preoccupations. Be aware of our small but significant connection with everything outside of ourselves. Find some inspirational readings or online materials and teachings from the spiritual, mystical, or faith traditions to which we can relate and be inspired.
8. Find some meaning and purpose in the turmoil and tragedy that surrounds us. Being more centered and grounded will bring better preparedness for what may unfold in the coming days, which may call for the strength and the spirit to both do the best for yourself and others, while not giving in to fear or over-focusing on personal issues and losses. Allow the current crisis and stresses to inspire you towards living a simpler, more meaningful life, to serve better the greater good, the community, and the environment. Be encouraged to be socially active to bring change.
9. Take time to do absolutely nothing, be in the moment, breathe, take it all in that is, both the trouble and worry, but also all that is comforting, beautiful, and inspiring for you – all of that for which you can be thankful. Take a respite, a time-out to refill your reserve and regain your resilience and strength, and then move on with purpose, gratitude, and hope. 
10. Find the best path through the fear and anxiety that may come during these stressful times. Be constantly aware and get the help you need at the first signs of distress. Be prepared to offer assistance and support to others having emotional difficulties during the extra-ordinary demands of the present day and events. It is the time for exceptional acceptance and compassion towards oneself and others as ever-changing feelings, emotionality, insecurities, and vulnerabilities challenge us.

Thank you for your interest and review of this article. You are welcome to make comments below and to share this article with others.

Ron Parks MD

To have questions answered or to schedule a consultation with Dr. Parks, fill in the contact form at https://parksmd.com/scheduling/.

**The above is for informational and educational purposes only, not as medical or mental health advice. It is the reader’s responsibility to direct personal medical or mental health questions to their primary care provider and specialty physicians. The information and statements contained in this material are not intended to diagnose, treat, cure, or prevent any disease or to replace the recommendations or advice given to you by your primary or direct care providers.

Your reliance on any information provided by Dr. Parks is solely at your discretion. You are advised not to disregard medical advice from your primary or direct care providers, or delay seeking medical advice or treatment because of information contained in this article. Management of severe mental or physical health problems should remain under the care and guidance of your primary care physicians, specialist, or psychiatrists.

Lead-in photo for the article: ©Graham Oliver/123rf.com

References and Information

REFERENCES & LINKS

The U.S. Surpasses 5 Million Coronavirus Cases – At least 161,000 people have died since the pandemic began – The New York Times, August 9, 2020, https://www.nytimes.com/2020/08/08/world/coronavirus-updates.html?campaign_id=9&emc=edit_nn_20200809&instance_id=21118&nl=the-morning&regi_id=125736997&segment_id=35643&te=1&user_id=b0b1bc916ed96aa57abcc5aa00f927e0#link-697eb3e1

Medscape, Psychiatry, Depression, Updated: October 7, 2019, Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD    https://emedicine.medscape.com/article/286759-overview

Staggering’ Increase in COVID-Linked Depression, Anxiety – Medscape Psychiatry, Batya Swift Yasgur, MA, LSW July 30, 2020, https://www.medscape.com/viewarticle/934882?nlid=136640_329&src=WNL_mdplsnews_200731_mscpedit_psyc&uac=372718HX&spon=12&impID=2485367&faf=1

COVID-19 and Mental Health: What We Are Learning from www.mhascreening.org July 1, 2020, https://mhanational.org/sites/default/files/Coronavirus%20Mental%20Health%20Presentation%207-1-2020.pdf

Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center. https://www.medscape.com/resource/coronavirus

Pandemic-related stress causing health issues in many Americans

– MDedge, Medscape Health News – Richard Franki July 29, 2020, https://www.mdedge.com/psychiatry/article/226193/coronavirus-updates/pandemic-related-stress-causing-health-issues-many

A Collapse That Wiped Out 5 Years of Growth, With No-Bounce in Sight The New York Times –  Ben Casselman July 30, 2020

A Gloomy Prediction on How Much Poverty Could Rise – Jason DeParle July 28, 2020, https://www.nytimes.com/2020/04/16/upshot/coronavirus-prediction-rise-poverty.html

What Is Trauma Therapy And How Does It Work? Betterhelp article by Sarah Fader March 09, 2020, https://www.betterhelp.com/advice/trauma/what-is-trauma-therapy-and-how-does-it-work/

How to Overcome Trauma with EMDR – Functional Medicine Research with Dr. Nikolas Hedberg, Podcast with therapist Martina Barnes about how EMDR can help people overcome trauma https://drhedberg.com/overcome-trauma-emdr/

Supplement Plus Probiotic May Improve Depressive Symptoms, Medscape Medical News, Batya Swift Yasgur, MA, LSW, August 12, 2020, https://www.medscape.com/viewarticle/935603?nlid=136908_421&src=WNL_mdplsfeat_200818_mscpedit_psyc&uac=372718HX&spon=12&impID=2513527&faf=1#vp_2

Depression, Anxiety in COVID-19 Indicators of CNS Attack? Medscape Medical News, Megan Brooks, August 03, 2020, https://www.medscape.com/viewarticle/935019?src=WNL_infoc_200819_MSCPEDIT_Alzheimer&uac=372718HX&impID=2512171&faf=1#vp_2

SEE Dr. Parks’ PRIOR COVID-19, TRAUMA, PTSD, GRIEF, MOURNING, LOSS, AND AWARENESS RELATED ARTICLES:

COVID-19’S REVELATION

COVID-19 DEPRESSION & GRIEF

COVID-19 & Polio Past

COVID-19 Wake Up Call

Coronavirus Anxiety

Coronavirus Natural Approaches

Coronavirus Holistic Health Steps

Remembering the Holocaust

Mourning Pet Loss

Hurricanes, Trauma, and Recovery

Meditation – Mental Health Essential

Hurricanes, Depression, and Recovery

Awareness the Core of Healing

PTSD, Terror, and Trauma

Holistic and Humanistic Programs is Asheville, NC area:

The Center for Spiritual Emergence is a concierge-level service, transpersonally-based, systems-oriented, body-centered, and trauma-integrated approach to healing spiritual emergence, spiritual emergencies, and addictions that holistically addresses the physical, emotional, mental, social, and spiritual dimensions. http://www.centerforspiritualemergence.com/

Great Global Life offers nutritional, lifestyle, and macrobiotic programs and teaching for individuals and groups. http://greatlifeglobal.com/