Joel Minden is a lecturer in the Department of Psychology and director of the Chico Center for Cognitive Behavior Therapy, and he specializes in cognitive behavioral therapy for anxiety. A frequent contributor to Psychology Today, he’s also been quoted in The Washington Post and recently authored his first book, “Show Your Anxiety Who’s Boss.” As anxiety stemming from the COVID-19 pandemic becomes more widespread, Minden encourages us to exercise patience with others and ourselves—a critical step to pushing through so much uncertainty.
What is anxiety?
The simplest way to think about it is anxiety is a future-oriented emotional response to a perceived threat. We make these predictions, and we anticipate that something bad will happen—and that it won’t just be bad, but it’ll be catastrophic and we won’t be able to cope. And when we think that way, when we anticipate these experiences, we have that emotional response. Anxiety is a lot like fear. The difference is that with fear, there’s an actual threat. Maybe it’s something that we encounter in the moment and we have that reaction. With anxiety, it’s a perceived threat and something that we think might happen. But the physical responses and the way we understand the reactions might be very similar.
How is the COVID-19 pandemic affecting people emotionally?
Anxiety is a normal emotional response, it’s something we all deal with. But when we think about anxiety disorders, where people experience significant distress or dysfunction, the common thread we see is an intolerance of uncertainty. Right now, everyone’s dealing with uncertainty that perhaps they hadn’t encountered before. Some people are unsure how long they’ll have to stay at home, and that’s anxiety-provoking. Other people are questioning whether they’ll be able to go back to work or if they’ll have to look for a new job, whether they’re going to be able to take care of all of their financial responsibilities, whether their relationships are going to be disrupted or affected in some way that they won’t be able to repair—not to mention the possibility of getting sick. When we’re faced with so much uncertainty, especially uncertainty related to outcomes or experiences that are really important, meaningful, and foundational, it’s understandable that most of us are going to feel anxious, because there are just so many questions about what’s going to happen. And it’s really difficult to answer those questions and to find some sort of satisfying resolution, because we just can’t get the information we want and that’s really overwhelming for a lot of people.
When should people become concerned about their anxiety?
I think the two things that we always want to keep in mind are distress and dysfunction. When anxiety gets to be so intense that you get to a point where you don’t think you can tolerate the emotional distress, then it might be important to seek professional help. Or, if anxiety creates problems of dysfunction, for example, avoidance is really central to all anxiety disorders, but patterns of avoidance, where a lot of effort is put into, “how can I distance myself from something that’s going to make me more uncomfortable?” Dysfunction can also involve things like safety behaviors. What we understand to be healthy safety behaviors would be things like working out, yoga, or going for a walk, things that are truly health-promoting. But when these activities become time consuming, when we start to develop the idea that the only way one can cope is to do these things, then instead of being a healthy pattern of behavior, it becomes more of an anxiety-coping mechanism. And with more destructive things like drugs and alcohol, that’s where it’s important to consider how anxiety is creating problems in life, how it’s taking you away from other things that might be important.
How can we support someone in our lives experiencing anxiety, especially as we’re socially distancing?
It’s so variable. People have different social needs and expectations. But I think social support can be really helpful. As a starting point, it’s really important to take steps to address a practical problem. For example, if someone’s finding that because of anxiety they’re not comfortable reaching out to friends or family members for help or emotional support, a practical solution would be trying to provide some sort of tangible, practical, instrumental support. It could be something as simple as, “Do you need me to get groceries for you? Are you just missing social contact? We could talk on the phone or chat online in a video.” Something that might give that person an opportunity to get some of their needs met, especially if they’re having trouble asking for what they want or clarifying what they need. I think it’s also good to recognize that some people get overwhelmed by too much social contact, too many people expressing concern or offering to assist. Maybe they do like a little more time for themselves to sort out a problem or to figure out what’s really going to be helpful for them to address anxiety. We want to tread lightly, because sometimes people will get defensive and say, “there’s nothing wrong and let’s not make this a bigger deal than it is.”
What can we do to practice self-care?
If you’re not able to change your situation or take action to address a practical problem, then it’s really important to be patient with yourself, to be more accepting of the emotional struggle with anxiety. It’s an awareness that “uncertainty is hard and I really would like to get the answers to these questions, but I can’t get them and that’s tough for me.” Instead of spending all of this time and energy on trying to eliminate the emotion of anxiety and resolve uncertainty of the different elements of the emotion and uncertainty itself can be really useful for people. Acceptance does not mean that “well, I just have to deal with something I have no control over and I have to suffer.” Acceptance is more, “I’m willing to acknowledge the emotional experience that I’m dealing with or that I’m facing. I don’t have to like it, and it doesn’t have to be comfortable. But I’m willing to allow that to be there, because this is just a difficult time. And probably the best thing I can do is be kind to myself, be patient with myself, and really give myself a break for struggling with these difficult thoughts and feelings, and then redirect my attention and behavior to something that might be more meaningful in the moment.”
Additional Resources: For fact sheets, self-help book recommendations, therapist finders, and other resources, visit the websites of Anxiety and Depression Association of America or the Association for Behavioral and Cognitive Therapies.