Alan Frischer, MD, MPH
Guess what the #1 concern of my patients has been lately…now guess again. Anxiety. The world has changed so dramatically in such a short period of time that it makes our heads spin. It isn’t only our health that is threatened today; it’s the economy, our jobs, and our savings. Add to that the physical isolation from our friends and loved ones, and yes, anxiety is running rampant.
Anxiety manifests in a number of ways. Many people develop persistent worrying; overthinking plans and solutions and dwelling on worst-case outcomes. They have difficulty handling uncertainty, and show indecisiveness and fear of making the wrong decision. They have an inability to relax, feeling restless; keyed up; on edge. They have difficulty concentrating. Physical signs include fatigue, trouble sleeping, muscle tension or muscle aches, trembling, nervousness or being easily startled, sweating, nausea, diarrhea, flare-ups of irritable bowel syndrome, and irritability.
Clearly, anxiety is not merely a mental disorder. It affects both our minds and our bodies, so we need to pay attention to both our physical and our mental health. Let’s look at some coping mechanisms to help manage our lives during this unprecedented and challenging time:
Take care of your body with exercise, hydration, nutrition, and sleep. Your body will handle stress far more easily when it is fit and healthy.
Limit your alcohol, caffeine, tobacco, and sugar consumption.
Take a multivitamin if you are unable to consume a healthy, balanced diet.
Take time for yourself every day. Just 20 minutes of relaxation or doing something pleasurable can be restorative and decrease your overall anxiety level.
Practice relaxation techniques including meditation, yoga, tai chi, breathing exercises, massage, music, and walks.
Don’t neglect hobbies and personal interests.
Keep a positive attitude as best you can.
Be assertive rather than aggressive. State your feelings, opinions, or beliefs instead of becoming angry, defensive, or passive.
Work on managing your time. Where possible, avoid activities that you find stressful. Set personal limits.
Keep an anxiety journal. Rank your anxiety on a 1 to 10 scale. Note the events that make you feel anxious (such as watching TV news), and the thoughts going through your mind before and during the anxiety. Note the things that make you feel less anxious.
Be aware of hyperventilation. If you begin to breathe rapidly, exhale into a paper bag and inhale the air within the bag. This increases the amount of carbon dioxide inhaled, which can reduce the urge to hyperventilate. It also helps to reduce dizziness or tingling.
Seek out social support from your community of family, friends, religious organization, etc. Spend time with those you love, over the phone or online.
We can all use a reminder to reconsider our lifestyle; incorporating relaxation techniques, physical activity, nutrition, better control of alcohol, caffeine and drug use, and more effective time management. If these measures don’t seem to help, seek treatment with your personal physician, therapist, or other mental health professional. It is very likely that they will be able to “see” you via your computer or phone. Remember that while we don’t know how long this crisis will last, we do know that it is temporary.