Q & A with a Psychiatrist #6: COVID-19 Part 2

(Read Part One of Dr. Wang's COVID-19 Mental Health Blog Here)

Navigating mental healthcare can be a difficult and confusing process. In our semi-monthly column, we take your questions for a psychiatrist and ask the professionals on your behalf.

Please note that this article is for educational purposes only. The following does not constitute official medical advice, and no treatment relationship has been established. You should consult your own doctors to best understand the needs of your unique situation. If you or someone you know is in crisis, please visit the nearest emergency room or call the National Suicide Prevention Hotline at 1-800-273-TALK(8255), which is a 24/7 toll-free number. For non-crisis situations and non-U.S. resources, check out the resources on our Find Support page.

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PART TWO:

How do I manage my anxiety with all the COVID-19 news around?​

Dr. Wang says:

Adversity can bring out both the good and the bad in people. We’ve seen the bad – racist attacks directed towards minority groups, selfish hoarding of medical supplies, price gouging by greedy vendors, flagrant disregard for social responsibility by those who insist on traveling and ignoring calls for social distancing. But we’ve also seen the good – brave and dedicated healthcare workers who risk their own wellbeing to care for the ill, everyday people donating medical supplies to make up for the unconscionable shortage we face, neighbors checking on each other, organizations coming together to make sure kids who depend on school lunches are fed when schools are closed. As a psychiatrist, I can vouch for the mental health benefit of altruism. When we step out of the narrow focus of our own day-to-day existence and start to contribute to something greater, we feel better about ourselves. We become more resilient. We experience less depression and anxiety. So take a moment and think about how you can make a difference in someone else’s life. Give yourself the opportunity to do something kind and thoughtful for someone else, without expecting anything in return. Teach your children, younger siblings, and peers about empathy and about giving.

"Social distancing does not have to lead to social isolation."

In fact, one could argue that mankind has never before been more connected as the whole world now fights against a common enemy. If you feel isolated at home, reach out to friends and relatives with a heartfelt message. Write a letter. Facetime your aunt.

Many of my patients with baseline anxiety are experiencing heightened anxiety and even recurrent panic attacks these days because of the pandemic. They can’t stop worrying about terrible things happening to them or their loved one and live in constant fear and agony.

Indeed, when our lives have been so profoundly changed and the devastation caused by COVID19 is so painfully visible, our brains can take us to dark places. Perhaps we imagine ourselves or our loved ones getting sick, even dying from the virus. Perhaps a slowing economy has us worrying about personal bankruptcy and possible social unrest from people becoming destitute. When we are anxiety stricken and faced with an uncertain future, these dark images can flood our minds and fill us with dread. What can we do to not get overwhelmed and fixated on these morbid thoughts? First, take a deep breath and try not to judge or suppress our own feelings. The more we deny feelings, the more powerful they become. Acknowledge the fear calmly. You can say – “Yes, this is a possibility. BUT this is only one of the many possible outcomes, and not the most probable one.” Then, take another deep breath and think calmly about the other possible outcomes. For example: it is possible that my family and I will not get sick at all. It is possible that some of us get sick but also recover – as statistically is the case with most people who contract COVID19. It is possible that I will encounter some financial difficulty in the short-run, but it is also possible that I will get back on my feet. The point is, anxiety propels us to focus exclusively on the worst possible outcome. We then go into limbic overdrive and lose our ability to reason and think logically. Our job, then, is to reverse that downward spiral. We do that by acknowledging our fears in a nonjudgmental way, and then identifying the many alternative outcomes that exist in addition to the worst possible outcome. In doing so, we take away the VIP status that was unwittingly given to our worst fear.

What if your anxiety is so great that you are in a state of panic and can’t tap into the logical part of your brain and think of alternative outcomes? You could start by focusing on your breath. Take slow and deep breaths through your nose and then exhale slowly through your mouth. Pay attention to your body and the sensations that flow through your body as you breathe. As you take slow and deliberate breaths, your heart rate will come down and you will feel calmer. You could also try to do a guided progressive relaxation exercise that helps you let go of tension in different muscle groups. For beginners who have a hard time getting into a meditative state, you could also try a set of jumping jacks, take a hot shower, or splash some cold water on your face. What you are trying to accomplish here is to bring awareness to your senses and bring focus back to the present.

Anxiety is often associated with a lack of control and an uncertain future. When it comes to COVID19, many of us feel a lack of control. But it helps to remind ourselves of the things that we do have control over: hand washing, social distancing, mask wearing when we absolutely have to go out, and taking good care of ourselves so that our immune system is in good working order. These are all proven methods that can reduce rates of infection and lead to positive outcomes.

If you find that your anxiety is so great that you are unable to manage your day-to-day, and / or you are experiencing recurrent panic attacks, you will likely benefit from therapy and medication treatment offered by a mental health professional. You can search for a psychiatrist / therapist on psychologytoday.com or talk to your primary care physician and ask for a referral. Please do not delay treatment if you are suffering.

Some Resources

• Guided breathing exercise

• https://soundcloud.com/rfmw/breath-guided-meditation-music

• Progressive relaxation narrated in Chinese

• https://soundcloud.com/ying-wang-781468883

• https://www.mghstudentwellness.org/covid-19-general

Helpful Apps

• Headspace

• UCLA mindfulness Aoo

• Shine app

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Got questions you want to ask Dr. Wang? Submit them to our social media @L2Smentalhealth or email them to us by the 15th of each month for a chance to see your question answered!

ABOUT DR. WANG

Dr. Ying Wang is a psychiatrist in Pennsylvania, USA. She received her medical degree from Yale University School of Medicine and completed her residency at Harvard Medical School’s Massachusetts General Hospital/McLean Hospital adult psychiatry program.