The following is the first chapter of a book about the psychological impact of the Coronavirus that I am ghost writing.
The uncertainty around Coronavirus has created widespread anxiety, anger, fear and exhaustion. It is an unusual situation since the pandemic has truly impacted every part of our lives from the most mundane tasks and activities to the family and community events we cherish. School is different. Shopping is different. Weddings and funerals are different. It is not an exaggeration to say that everything is different. The virus has forced all of us to reconsider our lives, our goals and the things that are important. It has transformed our definition of what is “normal” as our daily routines have been completely upended. This book was inspired by the discussions with my patients, friends and family as I’ve seen all of them struggle to cope with our new world.
Over the past 30 years, I’ve treated thousands of patients. They come to me for a variety of reasons – depression, grief, anxiety, fear, substance abuse, suicidal thoughts, eating disorders, anger, PTSD and on and on. Ordinarily, we meet once or twice a week for a few months or longer and my patients begin to understand what’s driving their emotions, how to recognize when trouble is brewing and how to deal with the feelings that result. In many ways, it is textbook therapy like you see in the movies or read about in books like this one.
The issues I’m seeing with Coronavirus are often the same but the circumstances and scale are completely different. This is universal. Everyone and every place is affected. Unlike a natural disaster, there is no predictable timeline for recovery and there is no escape -- you can’t just go away for a few days to a safe place to recharge since no matter where you are, so too is the virus. So how do you deal with this? What can you do to manage the uncertainty and calm the anxiety? How can you build a strong foundation for yourself that can also support and comfort others? What’s really important to you? I’ll address all of these things with the goal of helping you understand why you may be feeling like you do so you can create a new normal and find solace and stability.
Not only is the news cycle relentless, it comes at us from so many different angles – Coronavirus, politics, social justice, the economy, climate change and the resultant natural disasters. Occasionally, there is some good news sprinkled in but for the most part, the stories are not upbeat or positive. It is overwhelming and frequently depressing. No wonder we’re all feeling anxious, especially as it gets harder to discern what is true, what’s fake, what’s overblown and what really needs our immediate attention. Ultimately, we have to decide what deserves our attention and how or if we respond.
Before Covid, many of us would turn to our friends, families or communities for support. Now, we turn to social media, which often drives anxiety more than it comforts. If there was a way to join together and support one another, it would make it a whole lot easier than having to do this by ourselves. These are strange times unlike anything we’re experienced in our lives. We can look to the past for lessons, of course. Maybe read about the outbreak of the Spanish flu in 1918 or the bubonic plague in the 14th century. Sure, those were real events that reshaped the world but even in the context of the Coronavirus, they are just stories from the pages of history before science, medicine and technology came along to protect us. Of course, those were terrible times, we think, but we’ve come so far since then that nothing as horrible as those distant outbreaks could ever befall us.
Not so! Coronavirus has reminded us that we are fragile and the lives we’ve built can be upended instantly by a microscopic bug that spreads though the same breath that sustains life. A vaccine will likely emerge, and science will triumph but not without a great human and economic cost. It's scary.
There's a reason that people are anxious. Anxiety functions adaptively so just because you’re feeling anxious doesn't mean that there is anything wrong with you. Think of anxiety as a warning signal that is there to protect us. Picture yourself having a peaceful walk through the through the woods when you hear something rustle some leaves or break a stick ahead of you. You’d probably stop and look around to see if you can identify the source of the sound. That heightened awareness can quickly send thoughts racing in your mind leaving you worried that you’re on the brink of encountering a bear, a rattlesnake or something else that will surely attack you. And if it actually is a real threat, you’ll need to do something.
Anxiety exists to protect us from our environment and keep us aware of what's going on around us. And there's a lot to be aware of at this point. While we need to pay attention to what's happening, we also have to realize that we're not just a victim of the anxiety and the path it sets for us. There are all sorts of physical symptoms that go with anxiety: our heartbeat accelerates, we get sweaty and fatigued, and some people might feel their stomachs begin to rebel. These are real physical manifestations that occur when our bodies get flooded with a perception of danger or unease. When we get anxious, we tend to also begin to think over and over and over again about the same things.
This becomes sort of a rabbit hole, a downward spiral, and it feels like we can't control anything. When we feel out of control, we don't know what to do. It makes it hard to get a handle that lets us get an edge on what's happening in our life. Think about this: If you were trying to peel a sticker off of your car, you’d start by trying to lift the edge of one corner. It might not come easy but once you’ve got it and are able to get it started, the sticker peels off pretty easily from there. Getting the edge allowed you to accomplish your goal and that’s a positive thing. The same thing applies with anxiety. One little edge helps us get control back. It allows us to stop the spiral, not feel as overwhelmed and extinguish the feeling that we can’t control any of the things that seem to be happening to us.
Now it's important to recognize up front that this is all very real. We do need to take this seriously. It is dangerous. It's huge. It's all of those things. We need to be wearing masks, washing our hands, practicing social distancing and doing what the CDC tells us to do. Our actions impact others and despite the urge to return to “normal,” we need to realize that doing the wrong things may prolong the pain we are all feeling. And in the process of doing that, we find that our whole life has been turned upside down: the structure that we know, the things that we've done, the people with whom we interact, everything that has defined who we are, has now been removed, or at least it seems so. On top of that, we’re physically isolated. We can't congregate in places that we normally go, and we can't shake hands, hug or, in most cases, even be around other people. What happens? We get more scared and anxious. How do we deal with it?
One way is anger. We start trying to find people to blame and we figure that this must be somebody else's fault. This must be happening to us because somebody screwed up, did something they shouldn’t have done or maybe didn’t do something that was necessary. We get upset and when our blood begins to boil, we find it easier to focus on that rather than the source of the anger. We can externalize our sense of upset, our sense of being displaced. And when we do that, the search for a solution becomes someone else’s problem. We hope that they’ll realize the error of their ways and begin doing the right thing so we we can return back to normal.
But when we externalize that responsibility, we cede our power to control our own destiny. Picture yourself watching repetitive news loops about what's going on here or in Europe, China or somewhere else. It is easy to start feeling overwhelmed to the point where we can't think about anything else. And as we're doing that, as we're thinking about nothing else, then it becomes bigger and bigger and bigger in our daily life. And eventually, nothing else seems to matter. There isn't anything else that demands our attention, or that we even feel like we should be paying attention to. It reinforces the sense that we really can't do anything to make our lives better and just makes us feel more helpless.
When that happens, we're back to feeling anxious and hopeless. We start to feel depressed since we don't have any control over anything that makes a difference so why bother even trying? Down the rabbit hole we go, but now, anxiety gives way to depression. New symptoms appear -- sleeping too much or not enough, loss of appetite or uncontrollable hunger, difficulty concentrating, the absence of pleasure or joy and a gloomy feeling that nothing in life matters. We find ourselves withdrawing from things that might have at some point made us happy and content. It is not the end, though, as we have an opportunity to fight against those feelings, to fight against the irrational thoughts, because even in the face of something that's as big as the Coronavirus, it starts individually with each of us. The first step is deciding how we choose to view what's happening to us.