COVID-19: You're not alone in your anxiety

If you're feeling on edge, you're not alone. The World Health Organization (WHO) has declared COVID-19 a pandemic. That designation and the spread of the virus across the globe and throughout the United States is causing concern. Schools are closing, events are being canceled, and the news media releases update upon update, all adding to a building sense of anxiety.

Though these are serious matters, it's important to try to maintain perspective, say Yale Medicine experts.

"While our daily lives are going to be interrupted for weeks or months, this isn't our first pandemic," says Yale Medicine infectious disease specialist Joseph Vinetz, MD, "We have dealt with worse. Just because this has been labeled a pandemic does not mean anything about lethality. Many people may be infected, but the vast majority of people will be fine."

Still, if you find yourself worrying about COVID-19 and potential quarantine, remember that "it is normal to feel anxious," says Yale Medicine's Eli Lebowitz, Ph.D., a clinical psychologist, who is the director of the Anxiety Disorders Program at Yale Child Study Center.

"The rapid spread of the current virus, the potential for large numbers of people exposed, and the impact it is already having on daily life in many parts of the world are contributing to a particularly high anxiety level," Lebowitz says. "On the other hand, it's important to keep in mind that some other outbreaks had much higher mortality rates for those who became ill."

The key is to try to stay calm. "During this legitimately anxious-making time, it is important to develop a strategy for managing anxiety that works for you such as practicing meditation or yoga," suggests Carolyn Mazure, Ph.D., a Yale Medicine psychologist. She says it's also useful to regularly remind yourself what is important to you—what helps you to find value in life and to be of value to others. Exploring these ideas can help you be more psychologically resilient and guide you in times of high anxiety, she says.

As information about this outbreak continues to evolve, Lebowitz provides tips on how to manage any stress and anxiety you may feel about your own health, as well as the well-being of your family, friends, co-workers, and the community.

Why do people feel anxious when a disease outbreak occurs?

Our brains evolved to monitor our environment for signs of danger. During an outbreak like this we are flooded with frightening messages about the risks to us, to the ones we care about, and to our daily routines. This can push our anxiety system into 'overdrive' making it hard to focus on anything but the disease.

How can people stay calm during this COVID-19 outbreak?

When you feel anxious, here are steps you can take to put those feelings in perspective:

1. Information is useful—but too much information can be unhelpful. Limit news intake to what is actually providing new information, and stick to reliable news sources. There's no benefit to watching the same news over and over.
2. Take the necessary and recommended precautions, but don't try to "innovate" new ones. As with all dangers, the trick is to be 'careful enough." When we try to ensure 100% safety, we get caught up in unhelpful behaviors.
3. Keep up daily routines, and make changes only when necessary. Maintaining regular schedules and routines is a good way to keep anxiety at bay and feel normal. Even if some changes need to be made, maintaining the overall routine is helpful.
4. Don't completely isolate yourself from other people. Fear of contagion can cause some people to withdraw socially, but maintaining relationships and social support are good ways to combat anxiety. Even if you are in self-quarantine or mandatory quarantine, keep up social interaction using FaceTime/Skype, phone calls, or text messages.
5. Stay physically active—be outdoors if you can. Maintaining physical activity and spending time in fresh air can help to keep anxiety down.
6. Limit screen time. Too much time on the phone or computer, on social media or websites, can lead to less activity and more anxiety.

Any specific advice for people living in communities with confirmed cases?

Follow the advice and guidelines of local authorities. Find ways to keep your routines as much as possible. For example, if you cannot go to work or if you must stay home, don't simply do nothing all day. Make a schedule. Think about what you can accomplish and check things off your "To Do' list. Stay in touch with colleagues from home and work on things together. Be physically active. For example, if you cannot go to your local gym for now, work out at home, or go for a run.

What would you say to someone who is feeling very anxious about the disease outbreak?

It's normal to feel concern. Talk with friends, be physically active, breathe and relax, and focus on the things you need to get done. If the anxiety is really getting in your way, consider talking with a professional. For example, if you can't sleep, or you can't eat (or can't stop eating), or you can't concentrate on anything else because of fears of illness, you may want to get help from a knowledgeable provider. In some cases, telehealth services may be available, if you're unable to see a mental health provider in person.

"Also, know what sensible actions you can take to address legitimate concerns," says Mazure. Wash your hands, stay away from crowds, if possible, and stay home if you aren't feeling well, adds Dr. Vinetz. "We want to bend the curve to reduce the number of people infected and make sure that those who are sick are well taken care of," he says.