Saturday, March 14, 2020

Ways to cope with worry during a pandemic


Image result for covid 19 worry

The topic of this week's post is physical and mental health. 

Each day the news about COVID-19 becomes more worrisome. The spread, risks, and ripple effects  are alarming, and certainly cause for worry. And some worry is a good thing--it can drive us to make the hard changes that prevents/slows the spread of this new virus. But there is such a thing as too much worry---and too much worry can take a toll on both our mental and physical health. 

A lot of my time right now is focused on learning and implementing cognitive behavioral therapy techniques with my patients. In this week's post I want to share some cognitive behavioral strategies that can help people who might be worrying a little too much. The information is adapted from the American Academy of Family Physicians. 

On the left side of the chart below are some problematic thoughts/beliefs that people can have about worry. In the middle of the chart are some facts that counter that thought. In the third column are some strategies/behaviors you can turn to if you catch yourself falling into one of the problematic thoughts. 



PROBLEMATIC THOUGHT/BELIEF 
ABOUT WORRY
COUNTERING FACTS
SUGGESTED COPING STRATEGIES
If I'm worried it is a warning. 
Worry rarely saves us from anything. Most things we worry about are unlikely events. The bad things that happen to us are rarely anticipated through worry and rarely allow us any control. A compelling worry is still just a thought that will pass.
Challenge your distorted risk assessments: “Am I overestimating the risk?” “Yes, it feels likely, but how likely is it really?”

Remind yourself about the transient nature of worries: “What will this situation be like in year,  or even next month?”
I need to seek re-assurance for my worries. 
Frequently seeking reassurance (e.g., searching the Internet, checking your body/temperature constantly, repeated consultations with health care professionals) often stimulates more worry and doubt. The brief relief provided by reassurance only perpetuates the worry cycle.
If you repeatedly seek reassurance from others, encourage them to gradually withhold the reassurance that only perpetuates the problem. Stop “investigating” on line.  Getting the facts from trusted sources is fine, but spending hours reading information on questionable web sites is less than helpful. Checking your temperature if you feel feverish is important, but doing so incessantly should be avoided. 
I have to avoid thinking about my worries.
Trying not to think about a particular thing is the problem, not the solution.

What we resist persists. We think about what we are striving not to think about. Do not try to eliminate your worries. Worried thoughts can be accepted as background noise without being actively engaged.

Learn mindfulness meditation. It is simple, but not easy. Learning to be in the moment, focusing on your breathing and accepting the contents of your thoughts, can gradually ameliorate worry as you become more skilled.
I need to give my worries immediate attention
This only perpetuates the worry cycle. Strive to experience your worries “on the clock” rather than whenever they intrude and upset you. You can learn to have worries on your schedule rather than having them intrude on you all day.
This only perpetuates the worry cycle. Strive to experience your worries “on the clock” rather than whenever they intrude and upset you. You can learn to have worries at your bidding rather than having them “chase” you all day. 

Some people find it helpful to keep a small box handy to "put their worries in" until they want to give them their attention. 
If I worry I can  control what worries me and the future will be certain
More worrying will not yield control or certainty. If a worried thought is truly a signal, it should dictate certain actions. If a worry does not call for action (other than reassurance seeking), it is likely to be merely noise, not a signal.
More worrying will not yield control or certainty. If a worried thought is truly a signal, it should dictate certain actions. If a worry does not call for action (other than reassurance seeking), it is likely to be merely noise, not a signal.
My worries are leading my body to feel tense and anxious.
When you give credence to your worried thoughts, your body will respond with tension, anxiety, and somatic symptoms. When you accept worries as “just thinking,” your body will respond accordingly.
Relaxation and diaphragmatic breathing skills can help decrease body tension.  Discover what calms you, (examples include massage, yoga, exercise, music, a hot bath, journaling, prayer, giving your time to someone or something).
If I worry it is a sign of weakness or lack of faith
Worries are not the litmus test of strength or religious faith. All people are prone to worry. However, unhealthy habits perpetuate worry, and healthy habits can diminish worry.
Give a worried thought your full attention for five minutes, but then do something physical or interpersonal instead. Exercise and social contact (while not seeking reassurance) usually make worry much less compelling.



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