Anxiety Or COVID-19?

Updated April 1, 2020.

When medical students are in school, they often spend so much time studying chronic diseases and obscure medical conditions that they start thinking they are developing symptoms. It’s so common, in fact, that it’s jokingly referred to as “medical student syndrome.”

With so much information swirling around COVID-19, many are finding themselves consumed reading about the virus and its symptoms. Between a 24-hour news cycle, a heightened awareness of the virus and social distancing, it’s easy to begin questioning your own health. Amid a pandemic like COVID-19, a simple sneeze or cough is enough to trigger feelings of anxiety and fear.

In particular, many people are worried about the symptom “shortness of breath.” Maybe you are reading an article talking about the latest outbreak and you start thinking, “hmm, am I breathing normally?” You might notice that you are breathing a little shallowly and worry this could be a sign of illness. As you get worried, your heart might speed up, maybe your face flushes, or you get hot, causing you to further worry about a potential fever. The sense of impending doom builds and builds, leaving you lightheaded, nauseous, or even numb. All the worst case scenarios start popping into your head: Are you having a heart attack? Do you have COVID-19?

It is incredibly scary to feel this way, but if you are generally a healthy adult with no major other issues (i.e. diabetes or high blood pressure), this might be anxiety. If you are very concerned, please contact your healthcare provider by phone or video visit. Depending on your medical history, there could be a medical issue that needs to be treated, or your provider may be able to further help with anxiety.

Our bodies have a built-in mechanism to keep us safe when we perceive something as an immediate threat. When we feel as if our safety is threatened in some way, our sympathetic nervous system (the “fight or flight” system) releases adrenaline. Your heart rate and your breathing speed up, and your muscles tense up. And when the danger passes, your parasympathetic nervous system (the “rest and digest” system), which regulates your sense of calm, kicks in and brings you back to normal.

With elevated anxiety, your body often kicks into high gear even though the threat isn’t real. There is no immediate threat, so that feeling of hyperarousal doesn’t go away. That is, your parasympathetic nervous system doesn’t have a cue to kick in and restore your sense of calm again.

While elevated anxiety and panic attacks have overlapping symptoms of a worrisome medical issue, it’s important to remember, they go away. They are so scary, though, that you might go out of your way to avoid whatever triggered it in the first place. And if what triggered it is constantly thinking about, talking about and reading about COVID…well, they might come more often.

If you are generally a healthy adult without other risk factors, there are a few ways to manage elevated anxiety. If you sense symptoms coming on, try the following;

Slowing down your breathing
Oftentimes people get the symptoms of anxiety because they are taking shallow, rapid breaths -- in effect, hyperventilating. Controlling and slowing down your breathing can allow you to breathe a little deeper. Either try practicing 4-7-8 breathing — inhale through your nose for 4 counts, hold for 7, and exhale through your mouth for 8, or a square breath (in for the count of 4, hold for the count of 4, out for the count of 4, hold for the count of 4). Try either of these at least 5 times to get that parasympathetic nervous system to kick in. Sometimes hyper-focusing on the breath can create more anxiety, so be aware of how it is affecting you.

Countdown to mindfulness
With elevated anxiety, you are so in your head that you might lose sense of the world around you. This countdown can help you feel grounded:

• 5: Find and name FIVE things you see around you: a pen, a rubber band on the floor, your keyboard, whatever is around.
• 4: Find and name FOUR things you can touch around you: the chair you are sitting in, the floor beneath your feet, your desk, your knee, etc.
• 3: Find and name THREE things you hear: the refrigerator humming, birds chirping, car driving outside.
• 2: Find and name TWO things you can smell: you can walk around for this -- smell the hand soap at your sink, the shampoo in your shower, etc
• 1: Find and name ONE thing you can taste. What does your mouth taste like? What did you last eat?
  

Scan your body
A great mindfulness exercise is a body scan. Start at the top of your head and slowly check in with how each part of your body is feeling. Is your face scrunched? Jaw set? Shoulders near your ears? Posture hunched? Clenched stomach? Slowly check in with your body parts, gently relaxing them if you notice some tension. Follow the scan through the muscles in your legs all the way to the bottom of your feet. Here is a good guided mindfulness body scan to help you reset.

Try progressive muscle relaxation
Flex the muscles in your feet and toes, then release. Flex the muscles in your calves, then release. Flex the muscles in your thighs, then release. Continue doing this with each muscle group, moving up your body until you get to your head.

Repeat after me
If anxiety is not new to you, you have one advantage: you know they go away. Have a mantra that you can tell yourself to remind yourself that you have gotten through this before like “this will be over soon,” “this too will pass”, or even “this feels really scary right now, but I know this is anxiety and that it goes away.”

Go on a Digital Detox
While it’s important to stay updated on the latest from local health authorities, too much news consumption can increase feelings of stress and anxiety. Find a regular time in the morning or the afternoon to check your news feed or the CDC website. You can also try setting a time limit for all reading related to COVID-19. This might be hard -- it could be all over social media where you usually go for a distraction. Distracting yourself might require some creativity. This is a great time to pick up an e-book, podcast or other non-news related source of media.

Reduce other stressors in your life through exercise, good nutrition, and things like yoga, and meditation. For more tips on how to relieve stress and anxiety during COVID-19, see here.

If you do all these things and are still experiencing significant symptoms, please schedule a visit with a provider.