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by Ken Goodman, LCSW
Ken Goodman LCSW

We invite you to read Ken's latest ADAA COVID-19 blog post: Flatten the Fear with Facts: What is an Appropriate Level of COVID-19 Worry and the Steps You Can Take to Reduce Anxiety

During this time of national crisis, we must manage two things simultaneously: 1) Protect ourselves from the Coronavirus, and 2) Protect ourselves from anxiety. If your anxiety, fear, and worry has been overwhelming, put these ten strategies into practice.

1.      Media Distancing: To stop the spread of COVID-19, we’ve had to practice social distancing. But to stop the spread of anxiety, we must distance ourselves from the media. All anxiety stems from uncertainty and an active imagination which produces catastrophic thoughts. The media, which is 24/7 Coronavirus and virtually all negative, is the driver of those thoughts. My patients who are the most anxious about the Coronavirus are those who are consuming the most news from social media, online, and traditional outlets. The more anxious you feel, the more you should distance from the media. And if you are extremely fearful, stop altogether. Do no Google or research. Stop checking the latest news about the virus. Any vital information you need to know, you will find out.

2.      Do Not Engage with Worry. Take Action: Whether you are worried about contracting the virus, your struggling business, or being unemployed, the more your mind focuses on worst-case scenarios, the more anxious you feel. You can’t stop thoughts from entering your mind, but you can choose to stop dwelling and you can choose to take action to solve problems. There is a huge difference between worrying and problem solving. When your mind tries to bait you into worry, don’t take the bait. If you do, like a fish in a lake, you will be caught. Anxiety will try to bait you with many “what if” questions. Don’t answer them. Respond, “Not taking the bait,” turn your attention away, and focus elsewhere. Spinning your wheels with questions that don’t have answers will take you down the rabbit hole of fear. Instead, find creative measures to get you through this storm until you can get back on your feet. None of these measures will be comfortable. Like an umbrella and a raincoat, we use them to get through the storm, not to stop it. Much of anxiety stems from a lack of confidence in our ability to handle challenges. Push yourself to take one uncomfortable step at a time. The goal is to stay afloat until the storm passes, and now with a vaccine, the forecast looks brighter.

3.      Focus on Present Odds: All deaths are tragic and the coronavirus can be deadly but maintaining proper perspective can reduce your anxiety. No doubt the symptoms of COVID-19 can be horrible but the vast majority of people infected with COVID-19 have mild to moderate symptoms or no symptoms at all. The Infection Fatality Rate (IFR) is the total number of deaths divided by the total number of people that carry the infection, regardless of them having clinical symptoms or not. The IFR is the chance of death once you have the virus. This number is difficult to calculate accurately because of the high number of asymptomatic individuals. As of November 2020, the estimated Infection Fatality Rate of Covid-19 for various age groups is as follows: 

      For purpose of comparison only, the World Health Organization has stated that influenza has an overall Infection Fatality Rate of 0.1% or lower. With increased testing over the last several months as well as people spending more time inside because of the cold weather, the number of cases has risen, yet, the chance of you or a loved-one dying is still remote. But death is possible and COVID-19 is a serious illness, and that is why anxious people take the bait and dwell. Possibility becomes probability.

Remind yourself of the present odds, which are very good. If you take care of yourself properly, even if you are in a higher risk category, your risk of death is still low. And if you’re under the age of 59 your risk is incredibly low. There are roughly 74 million children in the United States.  Between February 1 and August 1, approximately 13,000 children died from all causes, 105 died of the flu and 45 died of coronavirus and almost all of them had a pre-existing medical condition. I am not minimizing the seriousness of COVID-19 but children, teens, and people in their 20s and 30s, should not worry about dying from coronavirus.

4.      Do Not React to Physical Symptoms: If you cough, it does not mean you have the COVID-19. The same is true for others who cough.  Allergies, bronchitis, post-nasal drip, and the cold are more common and a more likely explanation. Accept uncertainty as you do in other areas of life and assume what is most likely. Do not scan your body looking for symptoms. This behavior reinforces your worries and will increase anxiety.

5.      Focus on Being Productive and New Ways of Enjoying Life: Although we have no control over the national crisis, we must focus on where we do have control – our response to the crisis. This is an opportunity to try something new and do things we haven’t had time for. Organize a messy room, paint a fence, clean the garage, edit the photos on your phone, clean a rusty bike and take it for a ride, and play a board game ­— remember those? You can also learn a new skill or start a new hobby from videos on You Tube or various apps and websites. My son, who hasn’t played piano in six years, downloaded a free piano course and is practicing once a day. Creating and accomplishing puts your attention on what is satisfying. Consider starting something new: genealogy, gardening, photography, knitting, drawing, cooking, woodworking, video editing, ballroom dancing, or chess, just to name a few. You can start and learn all of these online. Put your attention on creating and accomplishing, not on the virus.

6.      Engage in Stress Reduction Activities: Focusing on what you are grateful for, exercising your body, and relaxing your mind will help give you the peace you desire. Guided meditation, yoga, exercise, and a gratitude journal are all practices that lower stress. Select one or two, learn about them so you do them correctly, and practice each day. If you and your loved ones are not severely sick or experiencing dire financial hardship, be grateful. Once this crisis has passed, perhaps we will all appreciate what we take for granted: a healthy society, freedom to gather, dinner with friends, a night at the movies, and a simple haircut.

 

7.      Do Not Go Beyond CDC Guidelines: Compulsive hand washing until your hands are dry and red, taking off all of your clothes before entering the house, and isolating indoors are anxiety’s guidelines, not the CDCs. People who spray everything in sight with bleach and other harsh cleaners should know that disinfectants can irritate the lungs and is not necessary based on what science knows about transmission of the virus. Emanuel Goldman, PhD, a professor of microbiology, biochemistry, and molecular genetics at the New Jersey Medical School of Rutgers University wrote in The Lancet Infectious Diseases, "In my opinion, the chance of transmission through inanimate surfaces is very small, and only in instances where an infected person coughs or sneezes on a surface and someone else touches that surface soon within 1-2 hours."                

Dean Blumberg, MD, chief of pediatric infectious diseases at UC Davis Children's Hospital talked about the likelihood of catching Covid-19 from inanimate surfaces: "You'd need a unique sequence of events. First, someone would need to get a large enough amount of the virus on a surface to cause infection. Then, the virus would need to survive long enough for you to touch that surface and get some on your hands. Then, without washing your hands, you'd have to touch your eyes, nose, or mouth.” Our skin is a protective barrier. As long as you wash your hands and don’t touch your face, there is no reason to clean packages brought to your home. Anxious behaviors maintain worry. To reduce worry, slowly reduce unnecessary behaviors that are not recommended.

8.      Preserve Some Sense of Normalcy:

During World War II, second-tier baseball players filled in for the professionals who were entering the army. Baseball, during a time of war, was important for the morale of the country. To the extent you can, maintaining a structure to your day with some semblance of normalcy will help reduce anxiety. Much has been learned about the virus since last spring and doctors are treating it more effectively now. Unless you are in a high-risk category you do not need to lock yourself in your home. According to the New England Journal of Medicine,Public health authorities define a significant exposure to COVID-19 as face-to-face contact within 6 feet with a patient with symptomatic COVID-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching COVID-19 from a passing interaction in a public space is therefore minimal.” They Journal article and subsequent articles stress the importance of wearing a mask but maintain that the risk of contracting COVID-19 comes from “sustained contact within six feet” not from “a passing interaction.” Therefore, wearing a mask when driving a car, exercising outside, or walking in a quiet neighborhood alone is not necessary. You might believe wearing masks outside is socially responsible and in some cities, it is required by law, but if you happen to cross paths with an unmasked person, there is no reason to worry. 

9.      Be Kind to Yourself and Others and Have Faith: It’s normal to feel anxious and worried during a national crisis. Don’t be hard on yourself. Reaching out to relatives and friends who are isolated or in need will boost their spirits and yours. If you are in good financial standing, be grateful and continue to pay others for the services they cannot provide. Venmo or mail checks to your housekeeper, hairdresser, or others who are unable to work. If you are unemployed or your business is suffering, this is tragic and may lead to depression or other mental health issues. Your new job is to manage through the crisis as best as you can until it passes. Have faith that it will, despite not having all the answers. Having faith or imagining the worst is a choice. Which one will you choose?

10.  Seek Out Professional Help: You don’t need to do this alone. If you are experiencing an escalation of anxiety, talk to a professional who can help you through this difficult time. Almost all therapists are using telehealth, so you are not limited to professionals in your area. Medication for anxiety, depression, and insomnia might also be needed and can be prescribed by a psychiatrist or your primary care physician. You can find a therapist and psychiatrist at the Anxiety and Depression Association of America (ADAA.org).

This list is a recipe to reduce anxiety. Review it again and put it into practice. Otherwise, it’s like reading a cooking recipe in bed – in the end you have nothing to show for it. 

This blog was originally written in March, 2020 and updated by the author on December 30, 2020

We invite you to read Ken's latest ADAA COVID-19 blog postFlatten the Fear with Facts: What is an Appropriate Level of COVID-19 Worry and the Steps You Can Take to Reduce Anxiety


About the Author

Ken Goodman, LCSW, treats anxiety and OCD in Los Angeles. He is the author of The Anxiety Solution Series: Your Guide to Overcoming Panic, Worry, Compulsions and Fear, A Step-by-Step Self-help Audio Program, Break Free from Anxiety, a coloring, self-help book for anxiety sufferers, and the Emetophobia Manual, for those who suffer with the fear of vomit.  Ken Goodman is an ADAA board member and Clinical Fellow. Visit Ken's website.

Sir your words is exactly what I was looking for and needed. Thank you for this article and God bless you and your fam.

Orlando El Paso TX

Yes thank you. My anxiety us killing me lately. Im a nurse and can't deal with this anymore!

I contracted the virus weeks ago. Now I'm back to work, I noticed I can't think properly, I'm absent minded and feels my mind is away somewhere. I worry that I might make a serious error sometime at work.

Thank you for your article. I really need to stop reading and watching videos on the pandemic. I cant sleep well at night. I just need to take precautions and live as normal a life as possible. I am recovering from anxiety.

Ive had GAD for many years. This is such helpful advice! So glad I stumbled upon it today! I am certainly going to try your wonderful suggestions. Thank you!

I can’t tell you how helpful this was to read. I have really succumbed to reading numbers and panic inducing articles and have been feeling sick from anxiety. Printing this list out!

Thank you for your blog post with all sorts of sound advice. However, please stop comparing this to "the flu." I practice in NYC. While most of us can avoid infection with sensible precautions, NYC ER's and hospital staff are seeing a tidal wave of patients needing intubation. Not enough ICU beds are available. A shortage of ventilators. Even in the worst flu season, these dire conditions never occur. It is not simply a case of anxiety being triggered by COVID-19 because it is "unfamiliar." Sound advice can be given about managing Coronavirus anxiety without the inaccurate comparison of the disease to the more manageable influenza viruses for which we have vaccines and known treatments. One can accept the facts about the pandemic and still manage anxiety in all the ways you wisely advise.

Thank you for responding to my article and I’m glad you brought up this point. You are correct. COVID-19 and the flu are completely different. I was comparing the way the media covers these deadly diseases and how the 24/7 coverage over COVID -19 has contributed to an escalation of anxiety. If the media had provided similar coverage of the 2017 flu when 80,000 people died in the United States, there would have been high anxiety as well. Most likely not as much, but there would have been fear and hysteria. The same is true for car accidents. More than 100 people die every day in this country in car collisions. If they media provided non-stop coverage of car accidents on a daily basis there would be an increase in the fear of driving and more people would be afraid to drive.

This COVID-19 pandemic is on top of the flu, car accidents, etc. This is something completely new and highly disruptive, and worthy of being treated as such in the media. We don't see worldwide lockdowns for flu or car accidents. This is different. It makes 100% sense that this is in the media 24/7. It feels a bit like gaslighting every time someone makes these comparisons. I understand the advice to limit consumption, which is wise in general, but the comparisons are very unhelpful.

Even so, I do appreciate the rest of the article.

You and the above mentioned MD, of course you need to tell us your vast knowledge of the current situation being an MD. The point of this article is to provide an outlet for people to cope and manage their mental capacity at this time. The comparison was made to ease people’s anxiety. The vast majority of the general public needs something less negative to hear. As an md your bedside manner sucks.
T

Sorry, but if you feel that it's somehow promotive of national mental health for the media to report this 24/7 in completely negative terms, I worry for your mental health. I've met few people with less innate understanding of mental health than infectious disease experts. It is not pollyanna behavior to give oneself a break, a long break from all this terrible news, just as we do with all other disasters. There is nothing to be gained in terms of knowledge about how to stay healthy from reading and listening to more and more of the bad Covid-19 news, just a reinforcement of one's anxiety, dislike of certain politicians, etc.
People need to live their lives based around what and whom they love, not around a vast crisis of indefinite duration.

Mr. Goodman, you have been irresponsible for minimizing the seriousness of this illness, as well as citing inaccurate information about how it spreads. While I have had to work extra hard on supporting my clients with OCD and GAD and their significant increase in anxiety, the fact remains that just because the death rate is relatively low, they (medical providers/CDC) still don't know about the LONGTERM life altering effects of this virus, with approx. 15-20% ending up with "long haul" Covid symptoms. The risk of serious disability from this illness is MUCH much higher than from the flu. And for the millions of us with compromised immune systems or autoimmune illnesses, we are actually at higher risk of getting the "long haul" symptoms. In addition, the CDC has revised the facts regarding what is considered "close contact". There is enough misinformation STILL out here, please don't add to the "myths"....to post such inaccurate information that could potentially have deadly effects for so many requires correction to your original article...it is in your NASW Code of Ethics!! As a leader in the field of Clinical Social Work, you are morally (and possibly legally) obligated to correct the inaccurate information in your article.

this state of events makes me feel like i should make things quicker for myself then letting the corona virus get me. I'm an obese 22 year old with severe anxiety. Upon tonight reading factual cases on obesity and its complications with covid, I am in a mental wreck

José Luann Oli…

April 12, 2020

Hello everyone from ADAA, first of all I want to thank you for this wonderful article, it helps me a lot! Can you give me the permission to translate it to portuguese? I'm from Brazil, COVID-19 is increasing very fast here and the population is very scared. I whould like to share these informations with people in my social media. Is it possible? Obviasly I'll give the total credit to the author Ken Goodman.

Thank you for reaching out to ADAA Jose.  I have spoken with Ken Goodman and he would fine with you translating this blog post into Portugese as long as you clearly state credit along with Mr. Goodman's bio and cite the Anxiety and Depression Association of America (www.adaa.org) as the source. If you could also site QuietMindSolutions.com that would be much appreciated. Once the blog post is translated could you send a link to information@adaa.org.? Thank you!

 

I see a lot of stress reducing activities - I was doing fine until I had to drop my adult daughter at the hospital. No information was given to me. No forms were filled out, so I'm not on the contact list should something go terribly wrong. We didn't think to grab her phone charger, so she may run the battery down sooner than we'd like, so she is powering down and only using it to give me an update first thing in the morning. I'm a bit overwhelmed, to say the least. No visitors is making this even more stressful. I have yet to tell other family members because I have no idea what I would say.

Respected sir, I am from India. Read your article. Sir, thanks for the wonderful and very helpful tips to fight anxiety and depression caused by corona. God bless you!

I've read a lot of strategies for reducing anxiety and these have been the most helpful to me. Thank you!

Wonderful to read such an understanding human being.

Any advice for those of us who have covid and the symptoms are lingering for months? Besides having little energy I don't have much of an appetite. Have lost weight. Now my anxiety is going through the roof about never recovering, never having a normal quality life, etc.

Thank you for publishing this. We all know the things to do, but we need people to remind us so we actually do them. Thank you.

Thank you so much for your page. I have an anxiety disorder and every little symptom I get, I worry about. Then it is a viscious cycle of what if's. Which in turns makes my physical symptoms of anxiety worse. I have your page in my favorite places and will reread often. Just knowing someone understands is a precious gift. Thank you very much!!

I’ve also been very dizzy since my release to work and it’s been going on for a month have gone to the doctor they’ve checked me with ekg X-ray and say there is nothing wrong with me and have prescribed anxiety pills they help a lot but I still get dizzy...

Fantastic Article, I have been stressed and dealing with this for 8 months like the rest of us. Your suggestions are RIGHT ON TARGET. Don't watch the news who is 'sensationalizing', spend as much time as you can excercising and getting out into nature. Parctice mindfullness, it works!! Support your friends and neighbors and be extra nice to everyone as there are a lot of stressed out people!

Mr. Goodman,
I am a retired Us Army Military Police Veteran with diagnosed PTSD. I, like so may others, am struggling through this Pandemic. It has triggered so many buried feelings that I have managed to deal with through years of different therapy programs provided by the VA. Now I have almost nothing but a few Tele visits here and there. I just started my first Semester with Troy University online #5) and navigating the online system is nerve wrecking as I am not a "Techy". My Abnormal Psychology Professor( Kitty Smothers) posted your video for us to view. l have managed a few of the suggestions on the list and plan to work on #'s 2, 3 (only bothers me when I have to be around Strangers, like Grocery store, Voting.) #4 is my #1 priority,7 (The CDC has managed to loose all Credibility thus far), 8 (I really would like to go to the Movies) and #9 (I really need to give myself more Grace) I returned to school during the 2nd wave of the Pandemic at 57 years old.

Thank you for the check list,
Stay well, Safe and live long and prosper!
Michele Dawson

Hello! Great advice. I wish newspapers, TV-channels and the liking reported on things like this for a change.

I’m struggling with anxiety over this pandemic and on and off with other things before this. Sometimes it gets too much and it’s hard to keep your nose above the surface.

Regards

Markus from Sweden

hello there sir i am a student here in the Philippines studying Bachelor science in Midwifery we are having a research about anxiety, our tittle is 'Impact of Covid 19 awareness on the maternal anxiety of pregnant women", Hope that you could give us a answer regarding how to reduce anxiety to pregnant women. thank you in advance to your reply .keep safe

I’m a social worker and find myself forgetting about my skills and letting my panic take over. Thank you for putting this pandemic into perspective.

Than you sir you really changed my way of dealing with my COVID anxiety just in 15 min compared to many sessions with a group therapy. Thank you.

Thank you I got Covid July 06 and just last week got an anxiety attack. I have never suffer from anything like this. I already look for professional help and medicine to feel under control. Great article

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