Anxiety in this Covid-time (or any time)

Those of us who have learned to manage our anxiety disorders may have useful lessons in this day of Covid. This is my contribution.

Have you ever tried to stop a feeling? Or a thought? What about a thought-feeling combination? For example, for me the thought ‘I will get the Covid – 19 virus if I go the store today’ is followed almost instantaneously with a feeling of anxiety, a tightening of my stomach.

Sometimes its the other way around. An anxious feeling leads my mind to search for reasons. These reasons or thoughts worsen the anxiety leading the mind to continue its search for reasons or what often happens to me, to latch onto a thought, what then becomes an obsession. To rid myself of this uncomfortable feeling I decide not to go the store and almost immediately my stomach loosens, as my anxiety retreats. Unfortunately, I have also retreated from life, even if only just a bit.

In my circle of family, friends and acquaintances I know too many people whose lives are in some way lessened by anxiety, just as mine is. What do I mean by lessened? There are things we do not do because our anxious feelings shout out there is danger ahead. This feeling – for me it is a tightened stomach, for you it might be some other physical sensation – stops us in our tracks. Something must be wrong, otherwise why would I feel this way?

About 15 years ago I was diagnosed with OCD, an anxiety disorder. What Freud once considered an untreatable mental disease is now, along with other anxiety illnesses, very responsive to treatment. You and I are fortunate to be living during a time when a variety of cognitive, behavioral and pharmaceutical treatments with proven track records are available, even as we all deal with yet another anxiety-inducing phenomenon the world has thrown at us.

Below are insights from my journey of recovery that may help you in this anxious time. I am not a mental health professional and so at the end of this post I list the books by professionals that were most helpful to me.

1. Our thoughts and feelings are frequently outside our conscious control. I grew up thinking I could control what I thought and what I felt. This is a cognitive mistake. All of us have thousands of thoughts every day, most unbidden. Feelings come and go, often without rhyme or reason. Or with a kind of reason, upon reflection. The sun breaks through the clouds and my mood improves. Nothing else has changed. It dips behind the clouds again and…

2. Our minds, hearts, and guts are unruly and we ought not take them literally. For much of my adult life, I let my thoughts and feelings bully me. While walking along a cliff I have the thought, ‘why don’t you jump off.’ Immediately, my stomach tightens as anxiety sets in. What could such a thought mean? Do I really want to jump off this cliff? I take the thought and the feeling literally, as danger signals, and not only do I back away from the cliff but stop walking along cliffs. I lessen my life, just a bit. Worse, I begin to doubt myself.

Although I have no genuine suicidal symptoms, I wonder whether there might be something wrong with me, something deep inside me I am afraid to face. This directs me away from the world and others and toward myself and too easily results in unhelpful rumination.

3. What we resist persists. What happens when I give in to the thought and feeling and stop walking along cliffs? I am training my mind to warn me about this danger. Something similar happens when I ruminate about the thought and/or the anxiety that comes from the thought. I take the substance of the thought and the accompanying feeling of anxiety as a danger signal and so whenever I come upon a cliff, my brain and gut work in tandem to warn me of this danger.

While on the cliff, I might try to argue with the thought, as in ‘I am not really suicidal,’ but that does not work because the source of the problem, the amygdala, has no reasoning capability. Neither of my solutions, not walking on cliffs or arguing with my cliff-thoughts, work because both are forms of resistance to the thought and the feeling. Anything we resists persists unless we…

4. We can train our brains to ignore the noise of our thoughts and feelings. A lot of the thoughts our brains throw at us and the feelings that follow are better thought of as noise and not as signals (see below Reid Wilson’s Stopping the Noise in Your Head). Noise because they seem to contradict our basic values or lived experience, as in my fear that I really wanted to jump off the cliff, or seem irrational.

For example, when I was diagnosed with OCD one of my symptoms was a compulsion to check whether the stove top burners were turned off. I would often check 20 to 30 times – meaning I would walk out the back door, to the garage and back again – before my anxiety would go down enough to allow me to leave the house. I treated the thought, ‘the burner might be on,’ and the accompanying anxiety, literally or as signals of danger. The checking compulsion was a form of resistance, a way of me telling my brain I might have left the burner on. Thus the thought and anxiety would persist until I retrained my brain.

How did I retrain my brain? Describing the protocol I followed is simple although doing it was difficult and took a long time. The gold standard treatment for OCD is exposure, response prevention. I would expose myself to an obsession, for example, that a stove burner might be on as I go to leave the house, and instead of returning to the stove to check, a compulsion and my usual response, I would accept and tolerate the anxiety while I walked to the car. Eventually my brain learned that I no longer considered the thought ‘the stove top burner is on’ a danger and so it quit sending a danger signal to my stomach. This process took many months and even today, more than a decade later, I still occasionally get a little dose of anxiety as a leave the house and wonder whether the burner is turned off.

5. Living with our fears. Too many of us in too many ways limit our lives because we think we fear some thing, like a crowd or Covid – 19 or a cliff. What we really fear are the thoughts and feelings about that crowd or Covid – 19 or that damn cliff. Two years ago when I hiked in the Alps, I knew my brain would send me thoughts and my amygdala would send a danger signal to my stomach. I almost said no to Rebecca and our host-hikers and to be honest for much of the hike I wish I had. But the decade-long work I had done learning to manage my OCD somehow kicked in and I hiked the Alps with my fears alongside me, as companions. Of course, they were always between me and the ledge.

Books by experts that helped me. Each includes material on all anxiety-related disorders, including OCD.

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